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

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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.

Early predictors of brain damage in full-term newborns with hypoxic ischemic encephalopathy

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Alkholy UM

2017-08-01

Full Text Available Usama M Alkholy,1 Nermin Abdalmonem,1 Ahmed Zaki,2 Yasser F Ali,1 Soma Abdalla Mohamed,3 Nasser I Abdelsalam,1 Mustafa Ismail Abu Hashim,1 Mohamed Abou Sekkien,3 Yasser Makram Elsherbiny4 1Pediatric Department, Zagazig University, Egypt; 2Pediatric Department, Mansoura University, Egypt; 3Pediatric Department, Al Azhar University, Egypt; 4Clinical Pathology Department, Menoufia University, Egypt Objective of the study: To evaluate the value of serum creatine phosphokinase-brain specific (CK-BB and urinary lactate/creatinine (L/C ratio as early indicators of brain damage in full-term newborns with hypoxic ischemic encephalopathy (HIE.Patients and methods: A case–control study including 25 full-term new-born infants with perinatal asphyxia who were admitted to neonatal intensive care unit (NICU with a proven diagnosis of HIE, compared to 20 healthy age- and sex-matched full-term newborns. All newborn infants were subjected to full history taking, clinical examination, routine investigations (cord blood gases and complete blood picture, and assessment of serum CK-BB (cord blood, 6 and 24 hours after birth and urinary L/C ratio (collected within the first 6 hours, on the 2nd and 3rd day after birth.Results: The serum CK-BB and urinary L/C ratio in infants with HIE were significantly higher in samples collected throughout the monitoring period when compared with the control group (all P<0.001. The cord CK-BB and urinary L/C ratio within the first 6 hours were significantly higher in infants with severe HIE than in infants with mild and moderate HIE (P<0.001. Cord CK-BB level at 12.5 U/L had 100% sensitivity and 84% specificity in the detection of severe HIE infants. Urinary L/C ratio of more than 10.5 collected within the first 6 hours after birth had 100% sensitivity and 78% specificity for the detection of severe HIE infants.Conclusion: The serum CK-BB and urinary L/C ratio in HIE infants were significantly increased early in the course of the

Infant and Newborn Development - Multiple Languages

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... List of All Topics All Infant and Newborn Development - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) Chinese, Simplified (Mandarin dialect) (简体中文) Chinese, Traditional (Cantonese dialect) ( ...

Physiological responses of preterm newborn infants submitted to classical music therapy.

Science.gov (United States)

da Silva, Camila Mendes; Cação, Jessica Marcelle R; Silva, Karin Cristina dos S; Marques, Cassia Fernandes; Merey, Leila Simone F

2013-01-01

To evaluate the physiological effects of music therapy on hospitalized preterm newborns. A noncontrolled clinical trial including 12 newborn infants with gestational age classical music therapy twice a day (morning and afternoon) for three consecutive days. The variables: heart and respiratory rates, oxygen saturation, diastolic and systolic arterial pressures, and body temperature were analyzed before and immediately after each music therapy session. There was a decrease in the heart rate after the second session of music therapy (paired t-test; p=0.002), and an increase at the end of the third session (paired t-test; p=0.005). Respiratory rate decreased during the fourth and fifth sessions (paired t-test; p=0.01 and 0.03, respectively). Regarding oxygen saturation, there was an increase after the fifth session (p=0.008). Comparison of physiological parameters among sessions, for the six studied sessions, showed only that the gain in oxygen saturation during the fifth session was significantly higher than during the sixth one (Tukey's test after variance analysis; p=0.04). Music therapy may modify short-term physiological responses of hospitalized preterm newborn infants.

FATAL UREAPLASMAL PNEUMONIA AND SEPSIS IN A NEWBORN-INFANT

NARCIS (Netherlands)

BRUS, F; VANWAARDE, WM; SCHOOTS, C; OETOMO, SB

Ureaplasma urealyticum was isolated in pure culture from blood tracheal aspirate and lung tissue in a newborn infant, who died of a severe pneumonia within 48 h after birth. The clinical course was characterized by persistent pulmonary hypertension of the newborn (PPHN). Post-mortem examination

Infant Directed Speech Enhances Statistical Learning in Newborn Infants: An ERP Study.

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Alexis N Bosseler

Full Text Available Statistical learning and the social contexts of language addressed to infants are hypothesized to play important roles in early language development. Previous behavioral work has found that the exaggerated prosodic contours of infant-directed speech (IDS facilitate statistical learning in 8-month-old infants. Here we examined the neural processes involved in on-line statistical learning and investigated whether the use of IDS facilitates statistical learning in sleeping newborns. Event-related potentials (ERPs were recorded while newborns were exposed to12 pseudo-words, six spoken with exaggerated pitch contours of IDS and six spoken without exaggerated pitch contours (ADS in ten alternating blocks. We examined whether ERP amplitudes for syllable position within a pseudo-word (word-initial vs. word-medial vs. word-final, indicating statistical word learning and speech register (ADS vs. IDS would interact. The ADS and IDS registers elicited similar ERP patterns for syllable position in an early 0-100 ms component but elicited different ERP effects in both the polarity and topographical distribution at 200-400 ms and 450-650 ms. These results provide the first evidence that the exaggerated pitch contours of IDS result in differences in brain activity linked to on-line statistical learning in sleeping newborns.

Xe enhanced CT in the human newborn infant

International Nuclear Information System (INIS)

Fuse, Yozen; Nemoto, Yuko; Shimizu, Mitsumasa; Uga, Naoki; Tada, Hiroshi; Fujii, Toshi; Machida, Keiichi; Kikuchi, Hideo; Izumi, Shigemitsu.

1990-01-01

With a cranial computed tomography (CT) using stable xenon gas as a diffusible tracer, we measured regional cerebral blood flow (rCBF) in 6 newborn infants with a variety of neurological abnormalities. Gestational ages and birthweights were 35 to 43 weeks and 2436 to 3540 g, respectively. Four infants exhibited hypoxic-ischemic encephalopathy (HIE), one infant had subdural hemorrhage and the other one was the infant with hyponatremia. A baseline CT was done during denitrogenation by 100% oxygen breathing and then a mixture of 35% xenon and 65% oxygen was breathed for 6 minutes. Six scans were obtained during the inhalation period then the infant was returned to breathing 100% oxygen and additional 7 scans were taken. Four samples of arterial blood were collected every 2 minutes before and during inhalation of the xenon gas. A rCBF was calculated with the changes of Hounsfield units in brain tissue and arterial blood. Relatively high blood flows in the region of the basal nuclei as well as decreased flows in the occipital white matter were observed in the infants with HIE. In an infant with subdural hemorrhage, the blood flows were markedly reduced in the areas adjacent to the lesion, including the basal nuclei, and frontal white matter in the opposite hemisphere. Xenon-enhanced CT by inhaling low concentration of the xenon gas enables to measure rCBF in the human newborn infants without no obvious side effect. (author)

Intrapartum fever and chorioamnionitis as risks for encephalopathy in term newborns: a case-control study.

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Blume, Heidi K; Li, Christopher I; Loch, Christian M; Koepsell, Thomas D

2008-01-01

In this study we examined the relationship between diagnoses of isolated intrapartum fever or chorioamnionitis and the risk of encephalopathy in term newborns. We conducted a population-based, case-control study in Washington State using 1994 to 2002 linked data from the Washington State Birth Registry and the Comprehensive Hospital Abstract Reporting System (CHARS). We identified 1060 singleton, term newborns (602 males, 458 females) with International Classification of Diseases (ICD-9) diagnoses consistent with encephalopathy, and 5330 unaffected control newborns (2756 males, 2574 females). Intrapartum fever was defined by a diagnosis of intrapartum temperature of >38 degrees C in the birth registry or CHARS databases. Chorioamnionitis was defined using ICD-9 diagnoses recorded in CHARS. We identified 2.2 cases of encephalopathy per 1000 births. Isolated intrapartum fever was associated with a 3.1-fold (95% confidence interval [CI] 2.3-4.2) increased risk of newborn encephalopathy. Chorioamnionitis was associated with a 5.4-fold (95% CI 3.6-7.8) increased risk of encephalopathy. We found that isolated intrapartum fever and chorioamnionitis were independently associated with an increased risk of encephalopathy in term infants. Our data also indicate that there is a spectrum of risk for encephalopathy in term infants exposed to intrapartum fever. Infants born to women with signs of chorioamnionitis other than isolated intrapartum fever may be at higher risk of encephalopathy than those exposed only to isolated intrapartum fever.

[Prognostication of immunological reactivity and the choice of the variant of reflexotherapy for a newborn infant].

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Filonenko, A V; Sergeeva, A I; Filonenko, V A

2014-01-01

The objective of the present study was to determine the classification differences in immunological reactivity and to identify its predictors in the newborn infants. The study involved 115 full-term newborn infants presenting with grade 3 prenatal hypoxic ischemic encephalopathy in the late neonatal period. The features of immunological reactivity under the influence of acupuncture were examined. Statistical processing was carried out by means of discriminant analysis. The assessment and prediction of the effectiveness of acupuncture in the neonates suffering from cerebral ischemia are based on the index of immunological reactivity and the leukocyte index of intoxication, as well as on the ratio of monocytes to band neutrophils content. For generation of the group classifier of immunological predictors in a newborn infant and development of indications for reflex therapy, nine parameters of interest were measured. The group specificity of the child was determined by three variables, viz. leukocyte index of intoxication, monocyte and band neutrophil counts with values of the Fisher's exact test (F) and reliability (Wilks Lambda 0.90894; approximation F (3.144) = 4.809; p newborn infants and the choice of the treatment modality on an individual basis (parent, child, or both) in the "mother-newborn" system. The variant of treatment was determined by comparing the values of the results of the formulas. The newborns were referred to the subgroup with the highest value of the classification function. The predictors made it possible to reliably distinguished the second (p = 0.032) and the third (p = 0.022) subgroups from the first one, with some degree of overlapping between the edge zones of centroids of the second and third subgroups (p = 0.073). Therefore, the sensitivity of classification in the individual subgroups was lower than in the group model and was estimated at 34.4, 71.9, and 65.6% for the first, second and third groups, respectively. The mathematical models

Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers

DEFF Research Database (Denmark)

Lee, C; Gong, Yanzhang; Brok, J

2006-01-01

Hepatitis B vaccine and hepatitis B immunoglobulin are considered for newborn infants of HBsAg-positive mothers to prevent hepatitis B infection.......Hepatitis B vaccine and hepatitis B immunoglobulin are considered for newborn infants of HBsAg-positive mothers to prevent hepatitis B infection....

90Sr in the skeleton of new-born children and infants

International Nuclear Information System (INIS)

Borisov, B.K.

1980-01-01

The correlation between 90 Sr content in the skeleton of new-born children and infants and 90 Sr content in the vertebrae spongy tissue of mother, is studied in different countries from 1965 to 1973. The highest indexes of 90 Sr concentration in the bone tissue of new-born children are found to be characteristic of Canada and Norway. The minimum 90 Sr content is observed in Japan. The dynamics of indexes which characterize 90 Sr content in the bone tissue of infants is presented. The peculiarities are conditioned by particular nutrition of an infant nursing and cow milk used as additional food

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.

Management of hyperbilirubinemia in near ... term newborns according to American Academy of Pediatrics Guidelines: Report of three cases

OpenAIRE

Naomi Esthemita Dewanto; Rinawati Rohsiswatmo

2009-01-01

All neonates have a transient rise in bilirubin levels, and about 30-50% of infants become visibly jaundiced.1,2 Most jaundice is benign; however, because of the potential brain toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. Ten percent of term infants and 25% of near-term infants have significant hyperbilirubinemia and requir...

Ventilatory response of the newborn infant to mild hypoxia.

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Cohen, G; Malcolm, G; Henderson-Smart, D

1997-09-01

The transition from an immature (biphasic) to a mature (sustained hyperpneic) response to a brief period of sustained hypoxia is believed to be well advanced by postnatal day 10 for newborn infants. However, a review of the supporting evidence convinced us that this issue warranted further, more systematic investigation. Seven healthy term infants aged 2 days to 8 weeks were studied. The ventilatory response (VR) elicited by 5 min breathing of 15% O2 was measured during quiet sleep. Arterial SaO2 (pulse oximeter) and minute ventilation (expressed as a change from control, delta V'i) were measured continuously. Infants were wrapped in their usual bedding and slept in open cots at room temperature (23 degrees-25 degrees). Infants aged 2-3 days exhibited predominantely a sustained hypopnea during the period of hypoxia (delta V'i = -2% at 1 min, -13% at 5 min). At 8 weeks of age, the mean response was typically biphasic (delta V'i = +9% at 1 min, -4% at 5 min). This age-related difference between responses was statistically significant (two-way ANOVA by time and age-group; interaction P < 0.05). These data reveal that term infants studied under ambient conditions during defined quiet sleep may exhibit an immature VR to mild, sustained hypoxia for at least 2 months after birth. This suggests that postnatal development of the O2 chemoreflex is slower than previously thought.

Pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension.

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Tourneux, Pierre; Rakza, Thameur; Bouissou, Antoine; Krim, Gérard; Storme, Laurent

2008-09-01

To evaluate the respiratory and the pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension (PPHN)-induced cardiac dysfunction. Inclusion criteria were: 1) Newborn infants >35 weeks gestational age; 2) PPHN treated with inhaled nitric oxide; and 3) symptoms of circulatory failure despite adequate fluid resuscitation. Lung function and pulmonary hemodynamic variables assessed with Doppler echocardiography were recorded prospectively before and after starting norepinephrine. Eighteen newborns were included (gestational age: 37 +/- 3 weeks; birth weight: 2800 +/- 700 g). After starting norepinephrine, systemic pressure and left ventricular output increased respectively from 33 +/- 4 mm Hg to 49 +/- 4 mm Hg and from 172 +/- 79 mL/kg/min to 209+/-90 mL/kg/min (P ventilatory variables have not been changed, the post-ductal transcutaneous arterial oxygen saturation increased from 89% +/- 1% to 95% +/- 4%, whereas the oxygen need decreased from 51% +/- 24% to 41% +/- 20% (P newborn infants with PPHN through a decrease in pulmonary/systemic artery pressure ratio and improved cardiac performance.

[Palliative care for newborn infants with congenital malformations or genetic abnormalities].

Science.gov (United States)

Viallard, M-L; Moriette, G

2017-02-01

The choice of palliative care can be made today in the perinatal period, as it can be made in children and adults. Palliative care, rather than curative treatment, may be considered in three clinical situations: babies born at the limits of viability, withholding/withdrawing treatments in the NICU, and babies with severe malformations of genetic abnormalities identified during pregnancy. Only the last situation is addressed hereafter. In newborn infants as in older patients, palliative care aims at taking care of the baby and at providing comfort and well-being. The presence of human beings by the newborn infant, most importantly the parents and family, is of utmost importance. The available time should not be used only for care and medical treatments. Sufficient time should be kept for the parents to interact with the baby and for human presence and warmth. The best interests of the newborn infant are the main element for guiding appropriate care. Before birth, the choice of palliative care for newborn infants requires successive steps: (1) establishing a diagnosis of malformation(s) or genetic abnormalities; (2) making a prognosis and ruling out intensive treatments at birth and thereafter; (3) giving the parents appropriate information; (4) assisting the pregnant woman in deciding to continue pregnancy while excluding intensive treatment of the newborn baby; (5) dialoguing with parents about the expected duration of the baby's life and the related uncertainty; (6) planning of palliative care to be implemented at birth; (7) preparing a plan with the parents for discharging the infant from the hospital and for taking care of him over a long time, when it is deemed possible that the baby may live for more than a few days. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Results of ultrasound screening of the hips in newborns and infants

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Džoleva-Tolevska Roza

2012-01-01

Full Text Available The aim of this study is to analyze the results of ultrasound screening of the hips in newborns and infants and to establish the importance of ultrasonography in early diagnosis and treatment of developmental dysplasia of the hips (DDH. Material and Methods: In 2010, at the Clinic for orthopedic surgery in Skopje, 6333 newborns and infants were examined. They were classified in 2 groups: first group consisted of patients with normal ultrasound findings and second group consisted of patients with DDH on ultrasound finding. Patients underwent clinical examination and ultrasonography of the hips. Results: We examined 6333 newborns and infants up to 6 months of age. 3213 were female and 3120 were male. In the first group there were 5932 (93.67% patients with normal ultrasound of the hip-Graf Type 1. In the second group there were 401 (6.33% patients with DDH on ultrasound. The patients of the second group were divided in 3 types according to Graf method. Graf Type 2-Patients with dysplasia 378 (5.97% subdivided in 2a- 260 (4.11% patients, 2b 85 (1.34% patients and 2c 33 (0.52% patients. Graf Type 3 - Patients with subluxation of the hip 9 (0.1%, subdivided in 3a 3 (0.05% patients and 3b 3 (0.5% patients. Graf Type 4 -Patients with luxation of the hip 17 (0.27% patients. 124 patients (30.5% with DDH had an associated risk factors (65 patients with positive family history, 48 patients with breech delivery and 11 patients with clubfoot deformity. 387 patients with dysplasia and subluxation of the hips were treated with abduction brace and Pavlik harness. 17 patients with luxation of the hips were treated with exercises and overhead traction of the muscles, close reduction of the hip placed in spica cast or open reduction. Conclusion: Ultrasound screening of hips in newborns and infants is important for early diagnosis of DDH. This is necessary for adequate treatments. If this disease is not treated properly it gives long term morbidity such as gait

Newborn infants' sensitivity to perceptual cues to lexical and grammatical words.

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Shi, R; Werker, J F; Morgan, J L

1999-09-30

In our study newborn infants were presented with lists of lexical and grammatical words prepared from natural maternal speech. The results show that newborns are able to categorically discriminate these sets of words based on a constellation of perceptual cues that distinguish them. This general ability to detect and categorically discriminate sets of words on the basis of multiple acoustic and phonological cues may provide a perceptual base that can help older infants bootstrap into the acquisition of grammatical categories and syntactic structure.

Weight loss and low age are associated with intensity of rooting behaviours in newborn infants.

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Takahashi, Yuki; Jonas, Wibke; Ransjö-Arvidson, Anna-Berit; Lidfors, Lena; Uvnäs Moberg, Kerstin; Nissen, Eva

2015-10-01

Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants' prebreastfeeding behaviour during the second day of life and explores possible associations with infant characteristics. We studied 13 mothers and healthy full-term infants after normal births. At 24-48 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video-filmed. The order, frequency and duration of predefined infant prefeeding behaviours and suckling were coded and analysed using computer-based video software. Prefeeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p ≤ 0.001) and positively related to neonatal weight loss (p = 0.02) after birth. Infants exhibited a distinct sequence of prefeeding behaviours during the second day of life, and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Jaundice in the full-term newborn.

Science.gov (United States)

Cohen, Shannon Munro

2006-01-01

Jaundice is a common problem affecting over half of all full-term and most preterm infants. Jaundice describes the yellow orange hue of the skin caused by excessive circulating levels of bilirubin that accumulate in the skin. In most healthy full-term newborns, jaundice is noticed during the first week of life. Shortened hospital stays and inconsistent follow up, especially for first-time breastfeeding mothers, prompted the American Academy of Pediatrics (AAP) to update management guidelines. Health care providers need to be familiar with the diagnosis and management of jaundice to prevent brain, vision, and hearing damage. Treatment of choice for jaundice remains close observation and frequent feeding followed by phototherapy, and finally exchange transfusion for severe or refractory cases.

Magnetic resonance and cranial ultrasound characteristics of periventricular white matter abnormalities in newborn infants

International Nuclear Information System (INIS)

Childs, Anne-Marie; Cornette, Luc; Ramenghi, Luca A.; Tanner, Steven F.; Arthur, Rosemary J.; Martinez, Delia; Levene, Malcolm I.

2001-01-01

OBJECTIVE: To characterize the range of abnormalities within the periventricular white matter (PVWM) in a cohort of newborns using magnetic resonance (MR) brain imaging and to compare the focal MR abnormalities with the cranial ultrasound (CUS) findings. METHODS: Retrospective study of MR brain and CUS findings of infants born in the 18-month period 1998-1999. PVWM abnormalities were identified by MR and focal lesions were characterized by size, number and distribution using a grading scale. Correspondence with CUS findings was assessed. RESULTS: 175 MR examinations corresponding to n = 105 preterm infants, (median GA 28, range 23-36 weeks) and n = 25 term infants (median GA 39, range 37-42 weeks) were analysed for PVWM abnormalities. In the preterm group, MR demonstrated a normal PVWM in n = 76, focal areas of altered signal intensity (SI) in PVWM in n = 26 and venous infarction inn 3. In the term group, MR demonstrated a normal PVWM in n = 15, focal areas of altered SI in PVWM in n = 4, oedematous PVWM in n = 2 and a middle cerebral artery infarction in n = 4. All infants with normal MR had normal CUS findings. A focal PVWM SI abnormality detectable on MR corresponded with an abnormality on CUS in only n = 10/30. CONCLUSIONS: MR appears considerably more sensitive than CUS in demonstrating the existence and extent of focal PVWM lesions in newborn infants. Satisfactory correspondence between the two imaging investigations is obtained only for cystic PVWM lesions. Childs, A.-M. et al. (2001)

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.

Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-Year Results of the Newborn Eye Screen Test Study.

Science.gov (United States)

Callaway, Natalia F; Ludwig, Cassie A; Blumenkranz, Mark S; Jones, Jennifer Michelle; Fredrick, Douglas R; Moshfeghi, Darius M

2016-05-01

To report the birth prevalence, risk factors, characteristics, and location of fundus hemorrhages (FHs) of the retina and optic nerve present in newborns at birth. Prospective cohort study at Stanford University School of Medicine. All infants who were 37 weeks postmenstrual age or older and stable were eligible for screening. Infants with known or suspected infectious conjunctivitis were excluded. Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013, through July 25, 2014, were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test study. Maternal, obstetric, and neonatal factors were obtained from hospital records. The location, retinal layer, and laterality of FH were recorded by 1 pediatric vitreoretinal specialist. Birth prevalence of FH. Secondary outcomes included rate of adverse events, risk factors for FH, hemorrhage characteristics, and adverse events. The birth prevalence of FH in this study was 20.3% (41/202 infants). Ninety-five percent of FHs involved the periphery, 83% involved the macula, and 71% involved multiple layers of the retina. The fovea was involved in 15% of FH cases (birth prevalence, 3.0%). No cases of bilateral foveal hemorrhage were found. Fundus hemorrhages were more common in the left eye than the right. Fundus hemorrhages were most commonly optic nerve flame hemorrhages (48%) and white-centered retinal hemorrhages (30%). Retinal hemorrhages were found most frequently in all 4 quadrants (35%) and more often were multiple than solitary. Macular hemorrhages most often were intraretinal (40%). Among the risk factors examined in this study, vaginal delivery compared with cesarean section (odds ratio [OR], 9.34; 95% confidence interval [CI], 2.57-33.97) showed the greatest level of association with FH. Self-identified ethnicity as Hispanic or Latino showed a protective effect (OR, 0.43; 95% CI, 0.20-0.94). Other study factors were not significant. Fundus

Burst-suppression pattern in the electroencephalogram of newborns and infants. Its clinical expression

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Cervantes Blanco Jorge Mauricio

2014-07-01

Full Text Available Burst-suppression pattern in the electroencephalogram (EEG is associated with severe brain damage and has a bad prognosis in 85% of the cases. Objectives. To identify the prevalence of the EEG burst-suppression pattern (BSP in fullterm newborns and infants, determine its etiol- ogy, clinical features and course. Methods. A retrospective study was conducted. Between January 2008 and December 2012, 4,891 EEGs were reviewed. The EEGs of newborns and infants (< 3 months of age with BSP were selected. Results. 11 cases identified with burst suppression pattern. The overall prevalence of which was 3.5%; 8.1% among the newborns and 1.2% among infants. Seizures were the main reason for doing an EEG in the newborn period in 7 patients and after day 28 in three. The clinical manifestations were abnormal level of consciousness (n=8, hypotonia (n=2, and spasticity (n=6. The main causes were hypoxic ischemic injury, stroke and kernicterus. There were two cases of early infantile epileptic encephalopathy. Two patients died before the third month of age; 8 survived an average of 13 months. All had epilepsy, neurologic retardation and disability. Two patients had persistent EEG burst-suppression pattern; 1 and 3 months after the neonatal period respectively; 7 had focal spikes and an asymmetric pattern. Conclusions. Electroencephalographic burst-suppression pat- tern predicts a severe neurologic injury in fullterm newborns and infants.

Present practice of diagnostic imaging in the newborn infants

International Nuclear Information System (INIS)

Akamatsu, Hiroshi

1994-01-01

The present practice of diagnostic imaging in our NICU (which includes premature unit) was studied, surveying the total 637 admitted newborn infants during the year of 1992. The total number of diagnostic imaging performed other than scout radiography was 939. The number of ultrasonography of the heart and the brain, and brain CT was 752 or 80.0% of the total. These were done more frequently in the cases of very low birth weight infants. In our NICU, ultrasonography including pulse-doppler method, is performed for diagnosis of structural and functional abnormality of the cardiopulmonary systems and also for finding intracranial lesion, on the basis of finding in plain chest films. In spite of various limitation, we are performing, as the necessity commands, fluoroscopic contrast study, angiography, scintigraphy and MRI for the low birth weight (≥1,500g) and mature infants. Some of the actual cases in which diagnostic imaging was helpful were presented. Recently, upon admittance to the NICU for the specific abnormality of the newborn and premature infants, orginally, asymptomatic diseases are often found and diagnosed. This should be the results of progress in diagnostic imaging in recent years. (author)

Music processing in preterm and full-term newborns: A psychophysiological interaction (PPI) approach in neonatal fMRI.

Science.gov (United States)

Lordier, Lara; Loukas, Serafeim; Grouiller, Frédéric; Vollenweider, Andreas; Vasung, Lana; Meskaldij, Djalel-Eddine; Lejeune, Fleur; Pittet, Marie Pascale; Borradori-Tolsa, Cristina; Lazeyras, François; Grandjean, Didier; Van De Ville, Dimitri; Hüppi, Petra S

2018-04-06

Neonatal Intensive Care Units (NICU) provide special equipment designed to give life support for the increasing number of prematurely born infants and assure their survival. More recently NICU's strive to include developmentally oriented care and modulate sensory input for preterm infants. Music, among other sensory stimuli, has been introduced into NICUs, but without knowledge on the basic music processing in the brain of preterm infants. In this study, we explored the cortico-subcortical music processing of different types of conditions (Original music, Tempo modification, Key transposition) in newborns shortly after birth to assess the effective connectivity of the primary auditory cortex with the entire newborn brain. Additionally, we investigated if early exposure during NICU stay modulates brain processing of music in preterm infants at term equivalent age. We approached these two questions using Psychophysiological Interaction (PPI) analyses. A group of preterm infants listened to music (Original music) starting from 33 weeks postconceptional age until term equivalent age and were compared to two additional groups without music intervention; preterm infants and full-term newborns. Auditory cortex functional connectivity with cerebral regions known to be implicated in tempo and familiarity processing were identified only for preterm infants with music training in the NICU. Increased connectivity between auditory cortices and thalamus and dorsal striatum may not only reflect their sensitivity to the known music and the processing of its tempo as familiar, but these results are also compatible with the hypothesis that the previously listened music induces a more arousing and pleasant state. Our results suggest that music exposure in NICU's environment can induce brain functional connectivity changes that are associated with music processing. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Eye disorders in newborn infants (excluding retinopathy of prematurity).

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Wan, Michael J; VanderVeen, Deborah K

2015-05-01

A screening eye examination is an essential part of the newborn assessment. The detection of many ocular disorders in newborn infants can be achieved through careful observation of the infant's visual behaviour and the use of a direct ophthalmoscope to assess the ocular structures and check the red reflex. Early diagnosis and subspecialty referral can have a critical impact on the prognosis for many ocular conditions, including potentially blinding but treatable conditions such as congenital cataracts, life-threatening malignancies such as retinoblastoma and harbingers of disease elsewhere such as sporadic aniridia and its association with the development of Wilms tumour. 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.

Climate change is associated with male:female ratios of fetal deaths and newborn infants in Japan

DEFF Research Database (Denmark)

Fukuda, Misao; Fukuda, Kiyomi; Shimizu, Takashi

2014-01-01

. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Yearly sex ratios of fetal deaths and newborn infants and monthly fetal death rates and sex ratios of newborn infants. RESULT(S): A statistically significant positive association was found between yearly temperature differences and sex ratios of fetal deaths......; a statistically significant negative association was found between temperature differences and sex ratios of newborn infants from 1968 to 2012, and between sex ratios of births and of fetal deaths. The sex ratios of fetal deaths have been increasing steadily along with temperature differences, whereas the sex......OBJECTIVE: To evaluate whether climate change is associated with male:female ratios (sex ratios) of fetal deaths and births in Japan. DESIGN: A population-based cohort study. SETTING: Not applicable. PATIENT(S): Newborn infants and fetuses spontaneously aborted after 12 weeks of gestation...

Diabetic mothers and their newborn infants - rooming-in and neonatal morbidity

DEFF Research Database (Denmark)

Stage, E; Mathiesen, E R; Emmersen, P B

2010-01-01

As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity....

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

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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.

Excessive weight loss in exclusively breastfed full-term newborns in a Baby-Friendly Hospital

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Maria Aparecida Mezzacappa

Full Text Available Abstract Objective: To determine the risk factors for weight loss over 8% in full-term newborns at postpartum discharge from a Baby Friendly Hospital. Methods: The cases were selected from a cohort of infants belonging to a previous study. Healthy full-term newborns with birth weight ≥2.000g, who were exclusively breastfed were included and excluded twins and those undergoing phototherapy as well as those discharged after 96h of life. The analyzed maternal and neonatal variables were maternal age, parity, ethnicity, type of delivery, maternal diabetes, gender, gestational age and appropriate weight for age. Adjusted multiple and univariate Cox regression analyses were used, considering as significant p8% were cesarean delivery and older maternal age. At the adjusted multiple regression analysis, the model to explain the weight loss was cesarean delivery (Relative risk 2.27, 95% of Confidence Interval 1.54–3.35. Conclusions: The independent predictor for weight loss>8% in exclusively breastfed full-term newborns in a Baby-Friendly Hospital was the cesarean delivery. It is possible to reduce the number of cesarean sections to minimize neonatal excessive weight loss and the resulting use of infant formula during the first week of life.

Neutropenia in infants with hemolytic disease of the newborn.

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Blanco, Esther; Johnston, Donna L

2012-06-01

This study examined the incidence, outcome and risk factors of neutropenia in infants with hemolytic disease of the newborn (HDN). A retrospective chart review was performed on infants with HDN. Of 69 evaluable infants, 45% developed neutropenia. Only one infectious complication was recorded. In most instances the neutropenia resolved spontaneously, but in seven infants it persisted for a median of 397 days. Males were at higher risk for developing neutropenia, but severity of HDN, antibody specificity, or therapy were not significant risk factors. Neutropenia is a common feature of HDN, regardless of severity of disease, treatment received, or antibody specificity. Copyright © 2011 Wiley Periodicals, Inc.

Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury

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Paulina A. Toso

2014-04-01

Full Text Available OBJECTIVE: to test the clinical utility of an early amplitude-integrated electroencephalography (aEEG to predict short-term neurological outcome in term newborns at risk of neurology injury. METHODS: this was a prospective, descriptive study. The inclusion criteria were neonatal encephalopathy, neurologic disturbances, and severe respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values, and likelihood ratio (LR were calculated. Clinical and demographic data were analyzed. Neurological outcome was defined as the sum of clinical, electroimaging, and neuroimaging findings. RESULTS: ten of the 21 monitored infants (48% presented altered short-term neurologic outcome. The aEEG had 90% sensitivity, 82% specificity, 82% positive predictive value, and 90% negative predictive value. The positive LR was 4.95, and the negative LR was 0.12. In three of 12 (25% encephalopathic infants, the aEEG allowed for a better definition of the severity of their condition. Seizures were detected in eight infants (38%, all subclinical at baseline, and none had a normal aEEG background pattern. The status of three infants (43% evolved and required two or more drugs for treatment. CONCLUSIONS: in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detected early subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurological outcomes for all sick newborn.

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.

Effect of massage stimulation on weight gain in full term infants

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Nyoman Nursari Dewi

2011-08-01

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

Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

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Evgeny Viktorovich Mikhalev

2015-03-01

Full Text Available The article reviews the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes; possible mechanisms of their development are also highlighted. The review describes changes in blood glucose concentration in term newborns from women with gestational diabetes, and their impact on the child's condition. In addition to already known factors causing macrosomia and other metabolic disorders in term neonates, the role of leptin (peptide hormone that regulates energy metabolism is quite discussable. Low leptin levels lead to the development of obesity. It is also confirmed, that leptin influences brain development of the newborn, leading to later cognitive deficits in children from women with GDM. The aim of the review is to summarize the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes.

Prediction of hyperbilirubinemia by noninvasive methods in full-term newborns

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Danijela Furlan

2013-02-01

Full Text Available Introduction: The noninvasive screening methods for bilirubin determination were studied prospectively in a group of full-term healthy newborns with the aim of early prediction of pathological neonatal hyperbilirubinemia. Laboratory determination of bilirubin (Jendrassik-Grof (JG was compared to the noninvasive transcutaneous bilirubin (TcBIL together with the determination of bilirubin in cord blood.Methods: The study group consisted of 284 full-term healthy consecutively born infants in the period from March to June 2011. The whole group was divided into a group of physiological (n=199, and a group of pathological hyperbilirubinemia (n=85 according to the level of total bilirubin (220 μmol/L. Bilirubin in cord blood (CbBIL and from capillary blood at the age of three days was determined according to the JG, on the 3rd day TcBIL was also detected by Bilicheck bilirubinometer. The Kolmogorov-Smirnov and Mann-Whitney tests were used for the statistical analysis.Results: Bilirubin concentrations were statisti cally significantly different (CbBIL (p<0,001 on the 3rd day control sample (p<0,001, TcBil (p<0,001 between the groups of newborns with physiological (n=199 and pathological (n=85 hyperbilirubinemia. Using the cut-off value of cord blood bilirubin 28 μmol/L, we could predict the development of pathological hyperbiliru binemia with 98.8% prognostic specificity, and with 100% sensitivity that newborns will not require a phototherapy (all irradiated newborns were taken into account. We confirmed an excellent agreement between bilirubin concentrations determined by the TcBIL and JG methods for both groups of healthy full-term newborns.Conclusion: Based on our results, we could recommend that determination of the cord blood bilirubin in combination with the measurement of TcBIL should be implemented into practice for early prediction of pathological hyperbilirubinemia in full-term healthy newborns. The advantages of both methods in the routine

Higher versus lower amino acid intake in parenteral nutrition for newborn infants.

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Osborn, David A; Schindler, Tim; Jones, Lisa J; Sinn, John Kh; Bolisetty, Srinivas

2018-03-05

intake were performed. Two review authors independently selected trials, assessed trial quality, and extracted data from included studies. We performed fixed-effect analyses and expressed treatment effects as mean difference (MD), risk ratio (RR), and risk difference (RD) with 95% confidence intervals (CIs) and assessed the quality of evidence using the GRADE approach. Thirty-two studies were eligible for inclusion. Six were short-term biochemical tolerance studies, one was in infants at > 35 weeks' gestation, one in term surgical newborns, and three yielding no usable data. The 21 remaining studies reported clinical outcomes in very preterm or low birth weight infants for inclusion in meta-analysis for this review.Higher AA intake had no effect on mortality before hospital discharge (typical RR 0.90, 95% CI 0.69 to 1.17; participants = 1407; studies = 14; I 2 = 0%; quality of evidence: low). Evidence was insufficient to show an effect on neurodevelopment and suggest no reported benefit (quality of evidence: very low). Higher AA intake was associated with a reduction in postnatal growth failure ( 2 to ≤ 3 g/kg/day); that occurred with increased amino acid and non-protein caloric intake; that commenced on intake at parenteral nutrition was associated with a reduction in hyperglycaemia (> 8.3 mmol/L) (typical RR 0.69, 95% CI 0.49 to 0.96; participants = 505; studies = 5; I 2 = 68%), although the incidence of hyperglycaemia treated with insulin was not different. Low-quality evidence suggests that higher AA intake in parenteral nutrition does not affect mortality. Very low-quality evidence suggests that higher AA intake reduces the incidence of postnatal growth failure. Evidence was insufficient to show an effect on neurodevelopment. Very low-quality evidence suggests that higher AA intake reduces retinopathy of prematurity but not severe retinopathy of prematurity. Higher AA intake was associated with potentially adverse biochemical effects resulting from excess amino

Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants.

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Woodgate, P G; Davies, M W

2001-01-01

Experimental animal data and uncontrolled, observational studies in human infants have suggested that hyperventilation and hypocapnia may be associated with increased pulmonary and neurodevelopmental morbidity. Protective ventilatory strategies allowing higher levels of arterial CO2 (permissive hypercapnia) are now widely used in adult critical care. The aggressive pursuit of normocapnia in ventilated newborn infants may contribute to the already present burden of lung disease. However, the safe or ideal range for PCO2 in this vulnerable population has not been established. To assess whether, in mechanically ventilated neonates, a strategy of permissive hypercapnia improves short and long term outcomes (esp. mortality, duration of respiratory support, incidence of chronic lung disease and neurodevelopmental outcome). Standard strategies of the Cochrane Neonatal Review Group were used. Searches were made of the Oxford Database of Perinatal Trials, MEDLINE, CINAHL, and Current Contents. Searches were also made of previous reviews including cross-referencing, abstracts, and conference and symposia proceedings published in Pediatric Research. All randomised controlled trials in which a strategy of permissive hypercapnia was compared with conventional strategies aimed at achieving normocapnia (or lower levels of hypercapnia) in newborn infants who are mechanically ventilated were eligible. Standard methods of the Cochrane Neonatal Review Group were used. Trials identified by the search strategy were independently reviewed by each author and assessed for eligibility and trial quality. Data were extracted separately. Differences were compared and resolved. Additional information was requested from trial authors. Only published data were available for review. Results are expressed as relative risk and risk difference for dichotomous outcomes, and weighted mean difference for continuous variables. Two trials involving 269 newborn infants were included. Meta-analysis of

Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-year Results of the Newborn Eye Screen Test (NEST) Study

Science.gov (United States)

Callaway, Natalia F.; Ludwig, Cassie A.; Blumenkranz, Mark S.; Jones, Jennifer Michelle; Fredrick, Douglas R.; Moshfeghi, Darius M.

2016-01-01

Purpose To report the birth prevalence, risk factors, characteristics and location of fundus hemorrhages (FH) of the retina and optic nerve present in newborns at birth. Design Prospective cohort study at Stanford University School of Medicine. Participants All infants who were 37 weeks postmenstrual age or older and were deemed stable by their pediatrician were eligible for screening. Infants who were anophthalmic or had known or suspected infectious conjunctivitis were excluded. Methods Infants born at Lucile Packard Children's Hospital (LPCH) from July 25, 2013 through July 25, 2014 were offered universal newborn screening via wide-angle digital retinal photography in the Newborn Eye Screen Test (NEST) study. Maternal, obstetric, and neonatal factors were obtained by reviewing hospital records prior to discharge. The location, retinal layer, and laterality of FH were recorded by one pediatric vitreoretinal specialist. Main Outcome Measures Birth prevalence of FH. Secondary outcomes included rate of adverse events, risk factors for FH, hemorrhage characteristics and adverse events. Results The birth prevalence of FH in this study was 20.3% (41/202 infants). Ninety-five percent of FHs involved the periphery, 83% involved the macula, and 71% involved multiple layers of the retina. The fovea was involved in 15% of FH cases (birth prevalence, 3.0%). No cases of bilateral foveal hemorrhage were found. Fundus hemorrhages were more common in the left eye than the right. Fundus hemorrhages were most commonly optic nerve flame hemorrhages (48%) and white-centered retinal hemorrhages (30%). Retinal hemorrhages were found most frequently in all 4 quadrants (35%) and more often were multiple than solitary. Macular hemorrhages most often were intraretinal (40%). Among the risk factors examined in this study, vaginal delivery compared with cesarean section (odds ratio [OR], 9.34; 95% confidence interval [CI], 2.57-33.97) showed the greatest level of association with FH. Self

Weaning newborn infants from mechanical ventilation

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Paolo Biban

2013-06-01

Full Text Available Invasive mechanical ventilation is a life-saving procedure which is largely used in neonatal intensive care units, particularly in very premature newborn infants. However, this essential treatment may increase mortality and cause substantial morbidity, including lung or airway injuries, unplanned extubations, adverse hemodynamic effects, analgosedative dependency and severe infectious complications, such as ventilator-associated pneumonia. Therefore, limiting the duration of airway intubation and mechanical ventilator support is crucial for the neonatologist, who should aim to a shorter process of discontinuing mechanical ventilation as well as an earlier appreciation of readiness for spontaneous breathing trials. Unfortunately, there is scarce information about the best ways to perform an effective weaning process in infants undergoing mechanical ventilation, thus in most cases the weaning course is still based upon the individual judgment of the attending clinician. Nonetheless, some evidence indicate that volume targeted ventilation modes are more effective in reducing the duration of mechanical ventilation than traditional pressure limited ventilation modes, particularly in very preterm babies. Weaning and extubation directly from high frequency ventilation could be another option, even though its effectiveness, when compared to switching and subsequent weaning and extubating from conventional ventilation, is yet to be adequately investigated. Some data suggest the use of weaning protocols could reduce the weaning time and duration of mechanical ventilation, but better designed prospective studies are still needed to confirm these preliminary observations. Finally, the implementation of short spontaneous breathing tests in preterm infants has been shown to be beneficial in some centres, favoring an earlier extubation at higher ventilatory settings compared with historical controls, without worsening the extubation failure rate. Further

Birth defects in children with newborn encephalopathy

NARCIS (Netherlands)

Felix, JF; Badawi, N; Kurinczuk, JJ; Bower, C; Keogh, JM; Pemberton, PJ

2000-01-01

This study was designed to investigate birth defects found in association with newborn encephalopathy. All possible birth defects were ascertained in a population-based study of 276 term infants with moderate or severe encephalopathy and 564 unmatched term control infants. A strong association

3-D cardiac MRI in free-breathing newborns and infants: when is respiratory gating necessary?

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Seeger, Achim [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); University Hospital of Tuebingen, Department of Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Krumm, Patrick; Schaefer, Juergen F.; Kramer, Ulrich [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Hornung, Andreas; Sieverding, Ludger [University Hospital of Tuebingen, Department of Pediatric Cardiology, Tuebingen (Germany)

2015-09-15

Newborns and small infants have shallow breathing. To suggest criteria for when respiratory gating is necessary during cardiac MRI in newborns and infants. One-hundred ten data sets of newborns and infants with (n = 92, mean age: 1.9 ± 1.7 [SD] years) and without (n = 18, mean age: 1.6 ± 1.8 [SD] years) navigator gating were analysed retrospectively. The respiratory motion of the right hemidiaphragm was recorded and correlated to age, weight, body surface area and qualitative image quality on a 4-point score. Quantitative image quality assessment was performed (sharpness of the delineation of the ventricular septal wall) as well as a matched-pair comparison between navigator-gated and non-gated data sets. No significant differences were found in overall image quality or in the sharpness of the ventricular septal wall between gated and non-gated scans. A navigator acceptance of >80% was frequently found in patients ages <12 months, body surface area <0.40 m{sup 2}, body weight <10 kg and a size of <80 cm. Sequences without respiratory gating may be used in newborns and small infants, in particular if age <12 months, body surface area <0.40 m{sup 2}, body weight <10 kg and height <80 cm. (orig.)

The Profile Of Congenital Malformation Among Newborn Infants In ...

African Journals Online (AJOL)

Objective: The study pattern of congenital malformations (CM) among newborn infants in Calabar, South-south Nigeria. Patients and Methods: Medical records of all inborn and out-born neonates who were admitted and treated for CM in University of Calabar teaching Hospital (UCTH) from 1997 to 2006 (10 years) were ...

Development of emotional sweating in the newborn infant.

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Harpin, V A; Rutter, N

1982-09-01

Sweating from the palm and sole occurs independently of ambient temperature but is influenced by emotional factors. It thus provides a useful objective measure of emotional state. The development of this emotional sweating in the newborn was investigated by measuring palmar water loss and relating it to the infant's state of arousal. Although 433 individual measurements were made on 124 babies of gestational age 25 to 41 weeks and postnatal age 15 hours to 9 weeks. Palmar water loss was also recorded continuously in 22 infants undergoing heel prick for routine blood sampling. In babies of 37 weeks' gestation or more, there was a clear relationship between palmar water loss and arousal from the day of birth, and by the third week levels on vigorous crying were comparable with those of an anxious adult. Less mature babies did not show emotional sweating at birth; it was first seen at the equivalent of 36 to 37 weeks' gestation regardless of maturity. Continuous recordings confirmed the cross-sectional data and illustrated the abrupt nature of the response. Emotional sweating could be a useful tool for the assessment of emotional state of the newborn.

Newborn hearing screening program: association between hearing loss and risk factors

OpenAIRE

Pereira, Priscila Karla Santana; Martins, Adriana de Souza; Vieira, Márcia Ribeiro; Azevedo, Marisa Frasson de

2007-01-01

BACKGROUND: hearing loss in newborns. Aim: to verify the prevalence of auditory alterations in newborns of Hospital São Paulo (hospital), observing if there are any correlations with the following variables: birth weight, gestational age, relation weight/gestational age and risk factors for hearing loss. METHOD: A retrospective analysis of the hospital records of 1696 newborns; 648 records of preterm infants and 1048 records of infants born at term. All of the infants had been submitted to an...

Diagnostic Criteria for Transient Myocardial Ischemia in Newborn Infants with Intrauterine Growth Retardation

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Umida F. Nasirova, PhD

2012-06-01

Full Text Available Metabolic and hemodynamic disturbances in newborns with intrauterine growth retardation resulting from the transferred intrauterine hypoxia, lead to the development of transient myocardial ischemia. Study included 158 newborn infants with intrauterine growth retardation, 83% of which have the asymmetric and 17% - the symmetric form of IUGR, revealed differences in heart rate due to higher dispersion parameters of cardiac rhythm. It was determined that in infants with intrauterine growth retardation heart rate, respiratory rate accelerated and blood pressure increased in compare with the newborns in the control group. According to the ECG examination results, were revealed the signs of focal changes of ST-T, accompanied by inversion of the ST-T segment below the isoline, which accompanied with the positive and peaked T waves, considered as myocardial ischemia. In infants with intrauterine growth retardation, survived after perinatal damage of the central nervous system, the prolongation of the QRST interval was noted in compare with the control group newborns, which could be an indicator of conjunction of hypoxic and ischemic changes in the myocardium. Clinical manifestations of transient myocardial ischemia followed by pale skin, acrocyanosis, and perioral cyanosis against dullness of heart sounds. Obtained results deepened an understanding of posthypoxic myocardial dysfunction, which is characterized by cardiac rhythm and conductivity disturbances, as well as changes in ventricular complex, and causing the need for electrocardiographic screening in the neonatal period

Neurological outcomes in symptomatic congenital cytomegalovirus-infected infants after introduction of newborn urine screening and antiviral treatment.

Science.gov (United States)

Nishida, Kosuke; Morioka, Ichiro; Nakamachi, Yuji; Kobayashi, Yoko; Imanishi, Takamitsu; Kawano, Seiji; Iwatani, Sota; Koda, Tsubasa; Deguchi, Masashi; Tanimura, Kenji; Yamashita, Daisuke; Nibu, Ken-Ichi; Funakoshi, Toru; Ohashi, Masanobu; Inoue, Naoki; Iijima, Kazumoto; Yamada, Hideto

2016-02-01

Newborn screening for urinary cytomegalovirus (CMV) and early introduction of antiviral treatment are expected to improve neurological outcomes in symptomatic congenital CMV-infected infants. This cohort study prospectively evaluated neurological outcomes in symptomatic congenital CMV-infected infants following the introduction of hospital-based newborn urinary CMV screening and antiviral treatment. Following institutional review board approval and written informed consent from their parents, newborns were prospectively screened from 2009 to 2014 for urinary CMV-DNA by PCR within 1 week after birth at Kobe University Hospital and affiliated hospitals. CMV-positive newborns were further examined at Kobe University Hospital, and those diagnosed as symptomatic were treated with valganciclovir for 6 weeks plus immunoglobulin. Clinical neurological outcomes were evaluated at age ⩾12 months and categorized by the presence and severity of neurologic sequelae. Urine samples of 6348 newborns were screened, with 32 (0.50%) positive for CMV. Of these, 16 were diagnosed with symptomatic infection and 12 received antiviral treatment. Four infants developed severe impairment (33%), three developed mild impairment (25%), and five developed normally (42%). This is the first Japanese report of neurological assessments in infants with symptomatic congenital CMV infection who received early diagnosis and antiviral treatment. Urinary screening, resulting in early diagnosis and treatment, may yield better neurological outcomes in symptomatic congenital CMV-infected infants. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

The status of newborn infants born to women with hypertensive disorders

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N. A. Shakhbazova

2014-01-01

Full Text Available The status of 239 newborn infants born to mothers with hypertensive syndrome (a study group and that of 51 neonates from healthy mothers (a control group were analyzed. Neonatal mortality and morbidity rates were studied in relation to gestational age and the type and severity of hypertensive disorders. Hypertensive disorders in pregnancy were found to lead to still birth in 2,1% of cases, late miscarriage in 12,1%, prematurity in 47,7%, and intrauterine growth retardation in 27,6%. The incidence of diseases in the infants born to hypertensive mothers was 6,6 times higher than that in those from healthy mothers. The most common nosological entities among the newborn infants were intracranial hemorrhage (29,3%, respiratory distress syndrome (20,1%, hypoxic-ischemic brain damage (22,6%, polycythemia (8,4%, and hyperbihrubinemia (8,8%. Reproductive losses in hypertensive disorders accounted for 17,2% and occurred in 70,7% of cases in the early postnatal period. Severe pathology and prematurity are responsible for high neonatal morbidity and mortality rates.

Evaluation by computed tomography in premature and newborn infants

International Nuclear Information System (INIS)

Kuckein, D.

1981-01-01

By means of cranio-cerebral computed tomography hypoxic brain damage of varying degrees and different types may be demonstrated in premature infants and high-risk newborns. Paraventricular leucomalacia of varying extent up to porencephalic defects are found, as well as cortical infarctions, hemorrhage into brain tissue or ventricles, cerebral atrophy, developing hydrocephalus and congenital anomalies. (orig.) [de

INTESTINAL COLIC IN NEWBORNS AND INFANTS: FROM DIAGNOSTICS TO THE DIFFERENTIATED CORRECTION

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I.A. Belyaeva

2011-01-01

Full Text Available Functional disorders of digestion are the most widespread disturbances of adaptation in infants. The article presents classification of colic in newborns and infants, characterizes their etiology and pathogenesis depending on maturity of a child, presence of perinatal pathology, defects of nursing and nutrition. Authors describe main principles of intestinal colic correction including diet and medicamental treatment in infants. «Mild» drugs (herbal therapy have some advantages in treatment of colic. The results of an observation of 47 mature and premature infants treated with Plantex are presented.Key words: infants, intestinal colics, dietotherapy, herbal therapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2: 137–140

Effects of antiretroviral agents during pregnancy on liver enzymes and amylase in HIV-exposed, uninfected newborn infants

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Patrícia El Beitune

Full Text Available This study assessed the effect of antiretroviral drugs administered to pregnant women on amylase and liver enzymes of the neonate. A prospective study was conducted on 52 neonates divided into three groups: infants born to HIV-infected mothers taking zidovudine (ZDV group, n = 18, infants born to mothers taking zidovudine + lamivudine + nelfinavir (TT group, n = 22 and infants born to normal women (control group, n = 12. Umbilical cord blood from the newborn infant was used to determine liver transaminases and amylase. Data were analyzed statistically by nonparametric tests, with the level of significance set at p<0.05. The median levels for TT group newborns were 33.3 U/L for oxaloacetic transaminase, 21.5 U/L for pyruvic transaminase, 1.9 mg/dL for total bilirubin, 153 mg/dL for alkaline phosphatase, and 9.6 U/L for amylase. These results did not differ from those obtained for Control newborns or newborns exposed to ZDV alone. No association was observed between the use of antiretroviral drugs during pregnancy and adverse effects on neonatal amylase and hepatic parameters at birth.

The effect of surgery on lung volume and conventional monitoring parameters in ventilated newborn infants.

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Proquitté, H; Freiberger, O; Yilmaz, S; Bamberg, C; Degenhardt, P; Roehr, C C; Wauer, R R; Schmalisch, G

2010-05-01

In newborn infants, thoraco-abdominal surgery is a serious intervention with respect to gas exchange and lung mechanics. This prospective clinical study compared surgery-induced changes in functional residual capacity (FRC) and ventilation inhomogeneity (VI) indices with changes in conventional monitoring parameters. Of 29 ventilated newborns (mean weight 2,770+/-864 g at surgery), 13, nine and seven underwent thoracic, abdominal or congenital diaphragmatic hernia (CDH) surgery, respectively. The multiple breath washout (MBWO) technique using heptafluoropropane as tracer gas (Babylog 8000; Dräger, Lübeck, Germany) was performed ventilatory monitoring parameters. FRC decreased in non-CDH infants, while FRC increased and VI indices decreased in CDH infants. Despite improvements, the differences in FRC and VI between CDH and non-CDH infants indicated persistent impaired lung function in CHD infants. MBWO can be advantageously used to measure the effect of surgery on the lung. While FRC and VI indices changed following surgery, conventional monitoring parameters did not.

Diagnostic accuracy of S100B urinary testing at birth in full-term asphyxiated newborns to predict neonatal death.

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Diego Gazzolo

Full Text Available BACKGROUND: Neonatal death in full-term infants who suffer from perinatal asphyxia (PA is a major subject of investigation, since few tools exist to predict patients at risk of ominous outcome. We studied the possibility that urine S100B measurement may identify which PA-affected infants are at risk of early postnatal death. METHODOLOGY/PRINCIPAL FINDINGS: In a cross-sectional study between January 1, 2001 and December 1, 2006 we measured S100B protein in urine collected from term infants (n = 132, 60 of whom suffered PA. According to their outcome at 7 days, infants with PA were subsequently classified either as asphyxiated infants complicated by hypoxic ischemic encephalopathy with no ominous outcome (HIE Group; n = 48, or as newborns who died within the first post-natal week (Ominous Outcome Group; n = 12. Routine laboratory variables, cerebral ultrasound, neurological patterns and urine concentrations of S100B protein were determined at first urination and after 24, 48 and 96 hours. The severity of illness in the first 24 hours after birth was measured using the Score for Neonatal Acute Physiology-Perinatal Extension (SNAP-PE. Urine S100B levels were higher from the first urination in the ominous outcome group than in healthy or HIE Groups (p1.0 microg/L S100B had a sensitivity/specificity of 100% for predicting neonatal death. CONCLUSIONS/SIGNIFICANCE: Increased S100B protein urine levels in term newborns suffering PA seem to suggest a higher risk of neonatal death for these infants.

Outbreak of Late-onset Group B Streptococcal Infections in Healthy Newborn Infants after Discharge from a Maternity Hospital: A Case Report

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Kim, Hyung Jin; Kim, Soo Young; Seo, Won Hee; Choi, Byung Min; Yoo, Young; Lee, Kee Hyoung; Eun, Baik Lin; Kim, Hai Joong

2006-01-01

During a four-week period, four healthy term newborn infants born at a regional maternity hospital in Korea developed late-onset neonatal group B Streptococcus (GBS) infections, after being discharged from the same nursery. More than 10 days after their discharge, all of the infants developed fever, lethargy, and poor feeding behavior, and were subsequently admitted to the Korea University Medical Center, Ansan Hospital. GBS was isolated from the blood cultures of three babies; furthermore, G...

[The regulation of microecological disorders of the intestines in newborn infants with perinatal pathology using the new probiotic bifidumbacterin-forte].

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Iakushenko, M N; Tkhagapsoeva, Zh M; Bondarenko, V M

1997-01-01

The study was made on 93 newborn infants with perinatal pathology, among them infants with the perinatal lesion of the central nervous system (52), hemolytic disease of newborns (19) and conjugation jaundice (12). All newborn infants were examined for the presence of intestinal microflora in its dynamics and for the state microbiocenosis, evaluated by the rapid method based on the determination of the caseinolytic activity of fecal supernatants after the correction of normal flora with bifidumbacterin in 55 infants and with bifidumbacterin-forte in 38 infants. The comparative study of these two preparations revealed that the use of probiotics containing Bifidobacterium bifidum was mainly substitutional, promoting the colonization of the intestine by lactobacteria, which later determined the suppression opportunistic microflora. The effectiveness of bifidumbacterin-forte containing live B. bifidum, immobilized on sorbent, proved to be most pronounced.

Seroprevalence of Bordetella pertussis among vaccinated and unvaccinated pregnant women and newborn infants in a university hospital of Buenos Aires.

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Bosch, Juan J; Fernández, Hilaria; Polak, Fernando P; Musante, Gabriel; Libster, Romina; Rocca Rivarola, Manuel

2017-08-01

Pertussis is a highly contagious disease caused by Bordetella pertussis. It poses a high morbidity and mortality rate, especially among infants younger than 6 months old. In Argentina, pertussis incidence and mortality have increased over the past three decades. To establish Bordetella pertussisantibody titers among pregnant women in their third trimester and among newborn infants, as measured in cord blood. This was an observational, cross-sectional study. The study started in 2011; at that time, pertussis vaccination was not mandatory for pregnant women as per the national immunization schedule, only optional. Maternal antibodies were measured in the last trimester of pregnancy for women and in cord blood for newborn infants. Antibody titers were determined using Abcam's anti-Bordetella pertussis toxin (PT) IgG in vitro ELISA kit. The χ² test was used to compare prevalence rates. The study included 111 mother-newborn infant dyads; 35 infants from unvaccinated mothers (before the introduction of the vaccine) and 76 from vaccinated mothers. Positive IgG antibodies were found in 92% (70/76) of infants born from vaccinated mothers whereas 100% (35/35) of infants born from unvaccinated mothers had negative results for antibodies; p < 0.001. In the vaccinated population of this study, 92% of infants had positive IgG antibodies. This study supports the need for maternal immunization against Bordetella pertussis to provide protection to newborn infants. Sociedad Argentina de Pediatría

Detection of cytomegalovirus DNA in dried blood spots of Minnesota infants who do not pass newborn hearing screening.

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Choi, K Yeon; Schimmenti, Lisa A; Jurek, Anne M; Sharon, Bazak; Daly, Kathy; Khan, Cindy; McCann, Mark; Schleiss, Mark R

2009-12-01

Up to 15% of infants with asymptomatic congenital cytomegalovirus (CMV) infection will experience some degree of sensorineural hearing loss. Many infants who fail newborn hearing screening (NHS) are likely to have congenital CMV infection, but may escape definitive virologic identification because diagnostic evaluation may not commence until several weeks or months of age, making differentiation between congenital and postnatal CMV infection difficult. Early diagnosis linking virologic identification of congenital CMV infection to infants failing NHS may improve diagnostic precision and enhance opportunities for therapeutic intervention. The goal of this study was to compare newborn dried blood spots from Minnesota infants who had failed NHS, and were designated for referral, with control infants who passed NHS, for the presence of CMV DNA by real-time PCR, using hybridization probes for the CMV gene UL54. Of 479 infants with a failed NHS (bilateral failure), 13 had CMV DNA present in the blood spot (2.7%). This compared with only 2/479 positive results from a control group of infants who passed the NHS (0.4%; P = 0.007, Fisher exact test). Comparisons of the glycoprotein B (gB) genotype as well as direct DNA sequencing of selected positives revealed that PCR positive samples represented unique clinical isolates. The mean viral load among the 15 positive samples was 1.6 x 10(3) genomes/microgram of total DNA. Newborn bloodspot CMV screening by real-time PCR may be a useful and rapid adjunct to functional NHS and may enable more rapid etiologic diagnosis of sensorineural hearing loss in newborns.

Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition in 88 newborn infants

DEFF Research Database (Denmark)

Colding, H; Møller, S; Andersen, G E

1982-01-01

Ampicillin and gentamicin were dissolved once a day in an L-amino acid solution especially prepared for parenteral nutrition of newborn infants and infused continuously to 88 infants in whom septicaemia was suspected or had been proved. The mean dosages were 162 and 5.3 mg/kg per 24 hours...

Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

DEFF Research Database (Denmark)

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

1978-01-01

In the course of our studies on cerebral blood flow in newborn infants, we have observed a striking depressing effect of sodium bicarbonate infusion on cerebral blood flow which in some cases may severely aggravate cerebral ischemia. We measured cerebral blood flow before and after the treatment...... with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior...... to the bicarbonate infusion. In one case an extreme reduction occurred: cerebral blood flow was reduced to 3 ml/100 g/min, well below the level compatible with tissue survival. The results are discussed with regard to the optimal treatment of the acidotic newborn....

Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury

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Paulina A. Toso

2014-03-01

Conclusions: in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detectedearly subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurologicaloutcomes for all sick newborn.

Hypothermia therapy for newborns with hypoxic ischemic encephalopathy.

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Silveira, Rita C; Procianoy, Renato S

2015-01-01

Therapeutic hypothermia reduces cerebral injury and improves the neurological outcome secondary to hypoxic ischemic encephalopathy in newborns. It has been indicated for asphyxiated full-term or near-term newborn infants with clinical signs of hypoxic-ischemic encephalopathy (HIE). A search was performed for articles on therapeutic hypothermia in newborns with perinatal asphyxia in PubMed; the authors chose those considered most significant. There are two therapeutic hypothermia methods: selective head cooling and total body cooling. The target body temperature is 34.5 °C for selective head cooling and 33.5 °C for total body cooling. Temperatures lower than 32 °C are less neuroprotective, and temperatures below 30 °C are very dangerous, with severe complications. Therapeutic hypothermia must start within the first 6h after birth, as studies have shown that this represents the therapeutic window for the hypoxic-ischemic event. Therapy must be maintained for 72 h, with very strict control of the newborn's body temperature. It has been shown that therapeutic hypothermia is effective in reducing neurologic impairment, especially in full-term or near-term newborns with moderate hypoxic-ischemic encephalopathy. Therapeutic hypothermia is a neuroprotective technique indicated for newborn infants with perinatal asphyxia and hypoxic-ischemic encephalopathy. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

[Developmental parameters and vitality of newborn infants in the period 1991-2002 in the health centre in Subotica].

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Durković, Jasmina; Pavlović, Mirjana

2005-01-01

Infants having a birth weight of 2500 g or less are known as low birth weight infants. There are multiple factors which affect the nutritional status of newborn children: genetic potential, maternal age, parity, maternal health and maternal nutrition, drugs, alcohol, smoking, geographical situation and socioeconomic living conditions. Developmental parameters were analyzed in 15,455 live newborn infants in Subotica, from 1991 to 2002. The following parameters were registred: body mass in the first hour of life, body length, head and thorax circumference. These parameters were examined and correlated with other indicators of maturity and vitality, such as gestational age and Apgar score values. Parameter mean values are presented for each year from 1991 to 2002. Mean body mass values ranged from 3335.74 g in 1991 to 3418.01 g in 1998. Compared with the estimates provided by World Health Organization, the percentage of newborn infants with birth weight under 2500 g has increased (5.64%) in 1991, which was the first year of war and sanctions in our country. From 1994 to 1997, there was a war in neighbouring republics and a huge number of refugees from war regions arrived. The percentage of newborn infants with low birth weight has increased (the gratest percentage 5.08% has been found in 1996). During 1999, our country was bombed and since then, we have an increased number of newborn infants with low birth weight (4.46% were registred in 1999 to 5.22% in 2002). The number of children born before 37th week of gestation is greatest in 2000 (3.17%). Average Apgar score in 1992 was (9.20), showing graduate decrease since 1999, with lowest value during 2001 (8.85). Harmful environmental factors can strongly affect fetal growth. Continual follow-up of developmental parameters and vitality of infants on populatin level is an index of interactions between genetic potential and environmental factors, pointing to quality of health care and preventive services.

Evidence on Adrenaline Use in Resuscitation and Its Relevance to Newborn Infants: A Non-Systematic Review.

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Pinto, Merlin; Solevåg, Anne Lee; OʼReilly, Megan; Aziz, Khalid; Cheung, Po-Yin; Schmölzer, Georg M

2017-01-01

Guidelines for newborn resuscitation state that if the heart rate does not increase despite adequate ventilation and chest compressions, adrenaline administration should be considered. However, controversy exists around the safety and effectiveness of adrenaline in newborn resuscitation. The aim of this review was to summarise a selection of the current knowledge about adrenaline during resuscitation and evaluate its relevance to newborn infants. A search in PubMed, Embase, and Google Scholar until September 1, 2015, using search terms including adrenaline/epinephrine, cardiopulmonary resuscitation, death, severe brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and adrenaline versus vasopressin/placebo. Adult data indicate that adrenaline improves the return of spontaneous circulation (ROSC) but not survival to hospital discharge. Newborn animal studies reported that adrenaline might be needed to achieve ROSC. Intravenous administration (10-30 μg/kg) is recommended; however, if there is no intravenous access, a higher endotracheal dose (50-100 μg/kg) is needed. The safety and effectiveness of intraosseous adrenaline remain undetermined. Early and frequent dosing does not seem to be beneficial. In fact, negative hemodynamic effects have been observed, especially with doses ≥30 μg/kg intravenously. Little is known about adrenaline in birth asphyxia and in preterm infants, but observations indicate that hemodynamics and neurological outcomes may be impaired by adrenaline administration in these conditions. However, a causal relationship between adrenaline administration and outcomes cannot be established from the few available retrospective studies. Alternative vasoconstrictors have been investigated, but the evidence is scarce. More research is needed on the benefits and risks of adrenaline in asphyxia-induced bradycardia or cardiac arrest during perinatal transition. © 2016 S. Karger AG, Basel.

White matter injury in newborns with congenital heart disease: a diffusion tensor imaging study.

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Mulkey, Sarah B; Ou, Xiawei; Ramakrishnaiah, Raghu H; Glasier, Charles M; Swearingen, Christopher J; Melguizo, Maria S; Yap, Vivien L; Schmitz, Michael L; Bhutta, Adnan T

2014-09-01

Brain injury is observed on cranial magnetic resonance imaging preoperatively in up to 50% of newborns with congenital heart disease. Newer imaging techniques such as diffusion tensor imaging provide sensitive measures of the white matter integrity. The objective of this study was to evaluate the diffusion tensor imaging analysis technique of tract-based spatial statistics in newborns with congenital heart disease. Term newborns with congenital heart disease who would require surgery at less than 1 month of age were prospectively enrolled (n = 19). Infants underwent preoperative and postoperative brain magnetic resonance imaging with diffusion tensor imaging. Tract-based spatial statistics, an objective whole-brain diffusion tensor imaging analysis technique, was used to determine differences in white matter fractional anisotropy between infant groups. Term control infants were also compared with congenital heart disease infants. Postmenstrual age was equivalent between congenital heart disease infant groups and between congenital heart disease and control infants. Ten infants had preoperative brain injury, either infarct or white matter injury, by conventional brain magnetic resonance imaging. The technique of tract-based spatial statistics showed significantly lower fractional anisotropy (P tensor imaging analysis technique that may have better sensitivity in detecting white matter injury compared with conventional brain magnetic resonance imaging in term newborns with congenital heart disease. Copyright © 2014 Elsevier Inc. All rights reserved.

Newborn jaundice

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Jaundice of the newborn; Neonatal hyperbilirubinemia; Bili lights - jaundice; Infant - yellow skin; Newborn - yellow skin ... newborns have some yellowing of the skin, or jaundice. This is called physiological jaundice. It is often ...

The effect of the pre-pregnancy weight of the mother and the gestational weight gain on the bilirubin level of term newborn.

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Özdek, Suat; Kul, Mustafa; Barış Akcan, Abdullah; Çekmez, Ferhat; Aydemir, Gökhan; Aydınöz, Seçil; Karademir, Ferhan; Süleymanoğlu, Selami

2016-01-01

Jaundice is a problem in newborns. There are many maternal and infant-related factors affecting neonatal jaundice. The maternal pre-pregnancy weight, maternal body mass index (BMI) and gestational weight gain may have an effect on the newborn bilirubin levels. We research the effect of the maternal pre-pregnancy weight and gestational weight gain on the bilirubin levels of the newborn infants in the first 2 weeks prospectively. Term and healthy infants who were born between 38 and 42 weeks in our clinic were included in the study. Maternal pre-pregnancy BMIs were calculated. Babies were divided into three groups according to their mothers' advised amount of gestational weight gain. Total serum bilirubin (TSB) values of the newborns were measured in the 2nd, 5th and 15th postnatal days. In our study, the 5th and 15th day capillary bilirubin level of the babies with mothers who gained more weight than the advised amount during pregnancy were found statistically significant higher compared to the other two groups (p mothers who gained more weight than the advised amount were found statistically significant higher compared to the other two groups (p mothers who gained more weight than the advised amount were under risk for newborn jaundice. Therefore, these babies should be monitored more closely for neonatal jaundice and prolonged jaundice.

Resuscitation of the Newborn

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Kilduff, C. J.

1975-01-01

All infants have some degree of hypoxia and respiratory acidosis at birth, but these conditions are more profound in the asphyxiated newborn. The newborn infant is very susceptible to cooling and may require warming. Skin temperature should be maintained between 36-36.5°.2 Resuscitation of the asphyxiated newborn must include both ventilatory and metabolic correction. Newborn infants may have cardiorespiratory problems due to asphyxia, drugs given to the mother, intrathoracic disease, anemia, hypovolemia (due to antepartum hemorrhage), hypotension, etc. There is no substitute for oxygen which is the drug of choice in respiratory depression of the newborn. The use of stimulating drugs like Coramine, picrotoxin, alphalobectine, and Megamide has no place in the resuscitation of the asphyxiated newborn. Imagesp74-ap74-bp74-cp74-d PMID:20469196

Screening for congenital hypothyroidism (CH) among Filipino newborn infants. Philippine Newborn Screening Study Group.

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Fagela-Domingo, C; Padilla, C D; Cutiongco, E M

1999-01-01

From June 1996 to June 1998 a total of 62.841 newborn infants were screened for congenital hypothyroidism with thyroid stimulating hormone assay as a primary test. The method used was an immunofluorescent assay using the DELFIA TSH Kit on dried blood specimens collected by heelprick on filter paper. All infants with TSH values greater than 20 microU/ml were retested. If the results remained abnormally high, confirmatory testing was done by radioimmunoassay. All infants who were confirmed to be hypothyroid were referred to pediatric endocrinologists for initial management. The overall weighted incidence of congenital hypothyroidism obtained in this study was 0.000277 (95% CI; 0.000122 - 0.000432) or 1:3,610 which may be higher than that reported by most screening programs worldwide. The recall rate was 0.16%. The higher recall rate may be explained by early testing in a number of cases and by the possibility of iodine deficiency in some of the mothers. On the basis of the results of this study, we would recommend (1) screening on a greater number of infants to verify the incidence of CH and (2) establishing normal TSH values at different hours of life to improve our recall rate.

Evaluation of TSH Levels in the Program of Congenital Hypothyroidism Newborn Screening in a Pilot Study of Preterm Newborns in Bogotá, Colombia

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Gustavo Adolfo Giraldo

2015-07-01

Full Text Available Introduction: Preterm infants (<37 weeks of gestation have low levels of thyroid hormones due to multiple factors. Objective: To evaluate levels of thyroid-stimulation hormone (TSH in the program congenital hypothyroidism (CH newborn screening in a sample of preterm infants in the city of Bogotá, Colombia. Methods: The Secretaría de Salud Distrital screening protocol for CH (blood sample is collected from the umbilical cord in all the newborns remeasured the serum TSH and heel TSH when preterm infants completed 37 weeks of gestation. Results: A total of 59 preterm neonates were rescreened, of which 2 neonates had elevated levels of TSH and 1 neonate had transient hypothyroxinemia. The Kolmogorov-Smirnov 2-sample/bilateral statistical test was used to compare the neonatal TSH levels of preterm and full-term newborns, which do not follow the same distribution. Conclusion: In our pilot study, 2 of the rescreened infants presented high levels of TSH and 1 had transient hyperthyrotropinemia, suggesting the need for rescreening of preterm infants. Additionally, a larger study should be performed to determine the screening cutoff values for preterm newborns.

Aortic mass in a newborn infant with respiratory distress

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Michelle J. Vaz

2017-10-01

Full Text Available Thrombotic disease is rare in neonates. Many of the cases reported in literature are attributed to the placement of central catheters. We report on a case of aortic thrombosis in a newborn infant with significant respiratory distress due to meconium aspiration, necessitating intubation and placement of central catheters. Due to the location and size of the thrombus in our case, various subspecialties were involved, which ultimately guided therapy to anti-coagulate the patient.

Positive pressure ventilation and cranial volume in newborn infants.

OpenAIRE

Milligan, D W

1981-01-01

The relationship between changes in airways pressure, pleural pressure, and cranial volume was studied in a group of sick newborn infants requiring ventilatory assistance. Cranial volume increased appreciably only when lung compliance was such that more than 20% of the applied airways pressure was transmitted to the pleural space, or if the absolute pleural pressure was greater than 4 cmH2O above atmospheric pressure. The findings stress the need for more-critical monitoring during periods of...

Newborn hearing screening and strategy for early detection of hearing loss in infants.

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Jakubíková, Janka; Kabátová, Zuzana; Pavlovcinová, Gabriela; Profant, Milan

2009-04-01

More than 80% of permanent hearing losses (HL) in children are congenital. Newborn hearing screening (NHS) is the best method for early detection of suspected hearing loss. If the NHS is not universal more than 30% permanent hearing losses are not identified. There are various methods of NHS: otoacoustic emissions (TEOAE, DPOAE) and automatic auditory brainstem response (AABR). After hearing screening, and when hearing loss is suspected, tympanometry and audiological methods then used for determination of hearing threshold; these include ABR, ASSR or/and behavioral methods. The goal of this study is to evaluate the influence of UNHS on the early detection of hearing loss in children before and after the implementation of obligatory universal newborn hearing screening in Slovakia, and also on the etiologic evaluation of hearing impaired infants identified by screening. In Slovakia NHS started in 1998 and was provided in ENT departments. From May 1, 2006 UNHS has been mandatory in Slovakia, using two stages TEOAE in all newborn departments in Slovakia (64 newborn departments). In year 2005--42% of newborns in Slovakia were screened, in 2006--66% newborns and in 2007--94, 99% (three small newborn departments do not yet have equipment for OAE screening). For determination of hearing thresholds ASSR are used in two ENT departments and ABR in the other four ENT departments. Comparing the number of identified cases with bilateral severe permanent HL or deafness before and after UNHS, 22.8% more cases of PHL were identified in the first year of UNHS. Also the average age of diagnosis of PHL was lower. In the year 2007, 94% of newborns were screened. We found 0.947/1000 newborns with bilateral severe PHL (35.9%) more than before UNHS). After audiologic and etiologic assessment of the 76 infants who failed screening, 5 (6.58%) were found to have normal hearing, 16 (22.54%) had unilateral and 55 (77.46%) had bilateral SNHL. A non-syndromic genetic cause was present in 25

Dosimetry of iodine-123 for newborn and infant

International Nuclear Information System (INIS)

Guilhem, M.T.; Therain, F.

1987-01-01

Iodine-123 ( 123 I) is a radionuclide of choice of neonatal hypothyroidism diagnosis. It is important to know infant main organs adsorbed doses during a thyroid scan with 123 I. Absorbed doses are already available for adults: for infants, they must be transformed taking account of organs sizes and inter-organs distances. Calculations are done for commercially available 123 I(p,2n) and 123 I(p,5n). Important contamination of 124 I in 123 I(p,2n) increases considerably the absorbed-dose during thyroid scan of a newborn (the ratio 124 I/ 123 I doubles every 15h). For routinely used activities, thyroid absorbed dose, 24 h after end of production, is fifteen times higher with 123 I(p,5n) than with 99m Tc: for one month old child; total body absorbed dose is of the same order of magnitude [fr

Imitation in Newborn Infants: Exploring the Range of Gestures Imitated and the Underlying Mechanisms.

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Meltzoff, Andrew N.; Moore, M. Keith

1989-01-01

Evaluated psychological mechanisms underlying imitation of facial actions in 40 newborn infants. Results showed imitation of head movement and a tongue-protrusion gesture. Subjects imitated from memory after displays had stopped. (RJC)

PHENYLKETONURIA, DETECTION IN THE NEWBORN INFANT AS A ROUTINE HOSPITAL PROCEDURE.

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GUTHRIE, ROBERT; WHITNEY, STEWART

A FIELD TRIAL OF AN INHIBITION ASSAY METHOD FOR SCREENING FOR PHENYLKETONURIA (PKU) TESTED MORE THAN 400,000 NEWBORN INFANTS PRIOR TO DISCHARGE FROM THE HOSPTIAL. IN ALL, 39 CASES WERE FOUND, A HIGHER INCIDENCE THAN HAD PREVIOUSLY BEEN EXPECTED. THE PRACTICALITY OF THE INHIBITION ASSAY METHOD WAS ALSO DEMONSTRATED. THE REPORT DETAILS THE TRIAL'S…

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.

Avaliação neurológica pelo método Dubowitz em recém-nascidos prematuros com idade corrigida de termo comparada a de nascidos a termo Neonatal neurological assessment by the Dubowitz method in preterm infants at term corrected age compared with term infants

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Marina Ortega Golin

2009-12-01

Full Text Available OBJETIVO: Comparar a avaliação neurológica de recém-nascidos pré-termo em idade de termo com a de recém-nascidos a termo e verificar a presença de associação entre alterações na avaliação neurológica e características e intercorrências clínicas nos prematuros. MÉTODO: Estudo transversal de 60 nascidos a termo e 30 prematuros do Hospital Estadual Mário Covas, em Santo André (SP, avaliados pelo método Dubowitz. Os pontos de corte da pontuação total foram 30,5 e 26 para comparar recém-nascidos pré-termo e a termo, respectivamente. Os prematuros foram avaliados com idade correspondente ao termo, na 37ª semana, e os do grupo controle, 48 horas após o nascimento. Todos os neonatos foram avaliados pela mesma examinadora, entre as mamadas, nos estágios 4 e 5 de sono e vigília. Para análise estatística, utilizaram-se testes de associação. RESULTADOS: 90% dos nascidos pré-termo não atingiram a pontuação esperada para a idade de termo (pOBJECTIVE: To compare neonatal neurological assessment of preterm newborn infants at term corrected age with term infants, and to identify the presence of association between neurologic abnormalities in preterm infants and demographic characteristics and neonatal clinical conditions. METHODS: This cross-sectional study enrolled 60 term and 30 preterm infants born at the Mario Covas State Hospital in Santo André, São Paulo, Brazil. The Dubowitz method was applied to assess neurobehavior. The total score cut-offs of 30.5 and 26 were used to compare respectively preterm and term infants and to analyze the variables related to performance in the preterm group. Preterm newborns were evaluated at 37 post-conceptual weeks and the control group was evaluated 48 hours after birth. All newborns were evaluated by the same neurologist, between feedings and at sleep-awake stages 4 or 5. Statistical analysis was performed by association tests. RESULTS: 90% of the preterm infants did not reach the

Cooling for newborns with hypoxic ischaemic encephalopathy.

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Jacobs, Susan E; Berg, Marie; Hunt, Rod; Tarnow-Mordi, William O; Inder, Terrie E; Davis, Peter G

2013-01-31

Newborn animal studies and pilot studies in humans suggest that mild hypothermia following peripartum hypoxia-ischaemia in newborn infants may reduce neurological sequelae without adverse effects. To determine the effect of therapeutic hypothermia in encephalopathic asphyxiated newborn infants on mortality, long-term neurodevelopmental disability and clinically important side effects. We used the standard search strategy of the Cochrane Neonatal Review Group as outlined in The Cochrane Library (Issue 2, 2007). Randomised controlled trials evaluating therapeutic hypothermia in term and late preterm newborns with hypoxic ischaemic encephalopathy were identified by searching the Oxford Database of Perinatal Trials, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2007, Issue 2), MEDLINE (1966 to June 2007), previous reviews including cross-references, abstracts, conferences, symposia proceedings, expert informants and journal handsearching. We updated this search in May 2012. We included randomised controlled trials comparing the use of therapeutic hypothermia with standard care in encephalopathic term or late preterm infants with evidence of peripartum asphyxia and without recognisable major congenital anomalies. The primary outcome measure was death or long-term major neurodevelopmental disability. Other outcomes included adverse effects of cooling and 'early' indicators of neurodevelopmental outcome. Four review authors independently selected, assessed the quality of and extracted data from the included studies. Study authors were contacted for further information. Meta-analyses were performed using risk ratios (RR) and risk differences (RD) for dichotomous data, and weighted mean difference for continuous data with 95% confidence intervals (CI). We included 11 randomised controlled trials in this updated review, comprising 1505 term and late preterm infants with moderate/severe encephalopathy and evidence of intrapartum asphyxia

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

Science.gov (United States)

Cassidy

1999-01-01

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

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

Science.gov (United States)

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

2016-08-30

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

White matter injury in term newborns with neonatal encephalopathy.

Science.gov (United States)

Li, Amanda M; Chau, Vann; Poskitt, Kenneth J; Sargent, Michael A; Lupton, Brian A; Hill, Alan; Roland, Elke; Miller, Steven P

2009-01-01

White matter injury (WMI) is the characteristic pattern of brain injury detected on magnetic resonance imaging in the premature newborn. Focal noncystic WMI is increasingly recognized in populations of term newborns. The aim of this study was to describe the occurrence of focal noncystic WMI in a cohort of 48 term newborns with encephalopathy studied with magnetic resonance imaging at 72 +/- 12 h of life, and to identify clinical risk factors for this pattern of injury. Eleven newborns (23%; 95% CI 11-35) were found to have WMI (four minimal, three moderate, and four severe). In 10 of the 11 newborns, the WMI was associated with restricted diffusion on apparent diffusion coefficient maps. An increasing severity of WMI was associated with lower gestational age at birth (p = 0.05), but not lower birth weight. Newborns with WMI had milder encephalopathy and fewer clinical seizures relative to other newborns in the cohort. Other brain injuries were seen in three of the 11 newborns: basal nuclei predominant pattern of injury in one and cortical strokes in two. These findings suggest that WMI in the term newborn is acquired near birth and that the state of brain maturation is an important determinant of this pattern of brain injury.

Diuretics for transient tachypnoea of the newborn.

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Kassab, Manal; Khriesat, Wadah M; Anabrees, Jasim

2015-11-21

Transient tachypnoea of the newborn (TTN) results from delayed clearance of lung liquid and is a common cause of admission of full-term infants to neonatal intensive care units. The condition is particularly common after elective caesarean section. Conventional treatment involves appropriate oxygen administration and continuous positive airway pressure in some cases. Most infants receive antibiotic therapy. Hastening the clearance of lung liquid may shorten the duration of the symptoms and reduce complications. To determine whether diuretic administration reduces the duration of oxygen therapy and respiratory symptoms and shortens hospital stay in term infants presenting with transient tachypnoea of the newborn. An updated search was carried out in September 2015 of the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 9, 2015), MEDLINE via Ovid, EMBASE, PubMed, and CINAHL via OVID. We included randomised and quasi-randomised controlled trials that compared the effect of diuretics administration versus placebo or no treatment in infants of less than seven days of age, born at 37 or more weeks of gestation with the clinical picture of transient tachypnoea of the newborn. We extracted and analysed data according to the methods outlined in the latest Cochrane Handbook for Systematic Reviews of Interventions. Two review authors assessed trial quality in each potentially eligible manuscript and two review authors extracted data. Our previous systematic review included two trials enrolling a total of 100 infants with transient tachypnoea of the newborn (Wiswell 1985; Karabayir 2006). The updated search revealed no new trials. Wiswell 1985 randomised 50 infants to receive either oral furosemide (2 mg/kg body weight at time of diagnosis followed by a 1 mg/kg dose 12 hours later if the tachypnoea persisted) or placebo. Karabayir 2006 randomised 50 infants to receive either intravenous furosemide (2 mg/kg body

Neurological features of newborns associated with late preterm and early term birth.

Directory of Open Access Journals (Sweden)

T. K. Mavropulo

2018-05-01

Full Text Available Infants delivered at 37 and 38 weeks’ gestation are at increased risk for morbidity as compared to infants delivered at 39-40 weeks. Our objectives were to study the frequency of transient neurologic dysfunction in the first months in newborns and infants, depending on the gestational age. We found a higher incidence of risk factors of pregnancy, more frequent need in oxytherapy after birth, and differences of hemo lyquordynamics at the age of 2-3 months.

Intracranial hemorrhage of the mature newborn infant

International Nuclear Information System (INIS)

Takemine, Hisao

1983-01-01

Concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT, the labour course, treatment, and prognoses were discussed. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by severeness of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal. (Ueda, J.)

Neural breathing pattern in newborn infants pre- and postextubation.

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Iyer, Narayan P; Dickson, John; Ruiz, Michelle E; Chatburn, Robert; Beck, Jennifer; Sinderby, Chister; Rodriguez, Ricardo J

2017-12-01

To describe the neural breathing pattern before and after extubation in newborn infants. Prospective, observational study. In infants deemed ready for extubation, the diaphragm electrical activity (EAdi) was continuously recorded from 30 minute before to two hours after extubation. Total of 25 neonates underwent 29 extubations; 10 extubations resulted in re-intubation within 72 hours. Postextubation, there was an increase in peak EAdi (EAdi-max) and EAdi-delta (peak minus minimum EAdi) in both groups. The pre- to postextubation change in EAdi-max (8.9-11.1 μv) and EAdi-delta (6-8 μv) was less in the failure group in comparison with the change in EAdi-max (10.2-13.4 μv) and EAdi-delta (6.3-10.6 μv) in the success group, (p = 0.02 and 0.01, respectively). In our neonatal cohort, extubation failure was associated with a smaller increase in peak and delta EAdi after extubation. If confirmed, these findings indicate an important cause of extubation failure in preterm infants. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Radiation dose estimates for adults and newborns from tungsten-178: based on distribution data in adult and infant animals

International Nuclear Information System (INIS)

Wiles, H.; Lacy, J.; LeBlanc, A.; Bricker, J.; Watson, E.; Stabin, M.

1987-01-01

Biodistribution and retention of tungsten-178 ( 178 W) were studied in adult and infant animals in order to extrapolate radiation dose estimates to human newborns and adults. Whole body retention and organ distribution of 178 W were determined at 0.5, 2, 8, 24 and 48 hours after blood-pool injection in infant and adult rats. Percent whole body retention and percent organ uptake per gram of tissue were higher in infant than adult rats at each time interval. When extrapolated to humans on the basis of percent injected activity kilogram per gram, most organs, except bone and kidney, showed higher uptake in newborns than adults. Total body radiation dose estimates for humans from 178 w based on these data were: 0.93 mGy/MBq (3.4 rad/mCi) for newborns and 0.024 mGy/MBq (0.089 rad/mCi) for adults. 13 refs.; 5 tabs

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:

High-dose phenobarbital or erythropoietin for the treatment of perinatal asphyxia in term newborns.

Science.gov (United States)

Avasiloaiei, Andreea; Dimitriu, Cristina; Moscalu, Mihaela; Paduraru, Luminita; Stamatin, Maria

2013-10-01

The aim of this study was to compare two neuroprotective strategies to supportive care in the treatment of perinatal asphyxia. A total of 67 term newborns with perinatal asphyxia were included and randomized into three groups: one group received supportive treatment; another group received a single dose of 40 mg/kg phenobarbital; and the third received three daily doses of 1000 IU/kg erythropoietin. The following parameters were analyzed: gestational age, birthweight, Apgar scores, cord blood pH, total serum antioxidant status (TAS), superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA). The newborns were included in the follow-up program and examined up to 18 months of age. TAS was higher in the erythropoietin group than in the other groups. SOD and GPx were lower for infants treated with phenobarbital or erythropoietin compared to control infants. MDA was lower in the erythropoietin group compared to the other groups, although the difference was not statistically significant (P > 0.05). The mortality rate was lower in the phenobarbital and erythropoietin groups (both 4.6%) than in the control group (17.4%). Long-term neurologic follow up showed a high incidence of sequelae in the control group compared to the phenobarbital and erythropoietin groups. Follow-up results were better in the phenobarbital group than in the erythropoietin group for motor and cognitive function at 3 and 6 months and worse for expressive language. At 18 months, however, the differences between these two groups were not significant. High-dose phenobarbital or erythropoietin along with supportive treatment has a positive influence on the outcome of newborns with perinatal asphyxia. Phenobarbital has the advantage of low cost and simplicity. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Exogenous surfactant therapy in 2013: what is next? who, when and how should we treat newborn infants in the future?

Science.gov (United States)

2013-01-01

Background Surfactant therapy is one of the few treatments that have dramatically changed clinical practice in neonatology. In addition to respiratory distress syndrome (RDS), surfactant deficiency is observed in many other clinical situations in term and preterm infants, raising several questions regarding the use of surfactant therapy. Objectives This review focuses on several points of interest, including some controversial or confusing topics being faced by clinicians together with emerging or innovative concepts and techniques, according to the state of the art and the published literature as of 2013. Surfactant therapy has primarily focused on RDS in the preterm newborn. However, whether this treatment would be of benefit to a more heterogeneous population of infants with lung diseases other than RDS needs to be determined. Early trials have highlighted the benefits of prophylactic surfactant administration to newborns judged to be at risk of developing RDS. In preterm newborns that have undergone prenatal lung maturation with steroids and early treatment with continuous positive airway pressure (CPAP), the criteria for surfactant administration, including the optimal time and the severity of RDS, are still under discussion. Tracheal intubation is no longer systematically done for surfactant administration to newborns. Alternative modes of surfactant administration, including minimally-invasive and aerosolized delivery, could thus allow this treatment to be used in cases of RDS in unstable preterm newborns, in whom the tracheal intubation procedure still poses an ethical and medical challenge. Conclusion The optimization of the uses and methods of surfactant administration will be one of the most important challenges in neonatal intensive care in the years to come. PMID:24112693

[Ganciclovir therapy for congenital cytomegalovirus infection in newborn infants: a meta analysis].

Science.gov (United States)

Hu, Jin-Tao; Chen, Ping-Yang; Xie, Zong-De; Dang, Xi-Qiang; Wang, Tao; He, Xiao-Ri; Li, Wen; Bo, Tao

2010-01-01

To evaluate the efficacy and safety of ganciclovir therapy for congenital cytomegalovirus (CMV) infection in newborn infants. The randomized controlled trials (RCTs) and quasi-RCTs on ganciclovir therapy for congenital CMV were reviewed in the following electronic databases: PubMed (January 1988 to January 2009), EMbase (January 1988 to January 2009), the Cochrane library (Issue 3, 2003 and Issue 1, 2009), the Chinese Journals Full-text Database (January 1994 to January 2009), the Chinese Biological Medical Disc (January 1994 to January 2009) and the Chinese Medical Current Contents (January 1994 to January 2009). Quality assessment, data extraction, and meta analysis were performed. Ten papers were included. Meta analysis showed that the ganciclovir therapy increased the improvement rate (91.4% vs 34.0%; pCMV infection indexes to become negative in more patients (87.6% vs 15.3%; pCMV infection indexes becoming negative, and decrease incidence of hearing disturbance, with few side effects, in newborn infants with CMV infection. However the supporting evidence is not strong due to few trials and more high-quality research is needed.

[Dermohypodermitis and gut translocation Escherichia coli septicemia in a newborn infant].

Science.gov (United States)

Gouache, E; Chantier, E; Hubert, N; Rivière, M-F

2013-01-01

The burden of neonatal bacterial infections continues. They remain a significant cause of death and morbidity, despite recommendations for prevention. The epidemiology of these infections has changed. Currently the two most causative pathogens for early-onset neonatal sepsis and for late-onset sepsis in term infants are Group B streptococci (GBS) and Escherichia coli. E. coli's role is increasingly important since the widespread use of intrapartum antibiotic prophylaxis. In late-onset infections, one of the suggested pathophysiological mechanisms is microbial translocation in the gut secondary to digestive colonization, particularly when E. coli is isolated in blood cultures. This can occur either before or after birth. Bacterial sepsis can be associated with various non-specific peripheral manifestations involving skin and soft tissues. We report the case of a full-term, 26-day-old newborn admitted to the hospital for fever. She presented with dermohypodermitis of the left trunk and was diagnosed with E. coli septicemia. She was discharged in good condition after appropriate intravenous antibiotic therapy. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Obstetric Antecedents to Body Cooling Treatment of the Newborn Infant

Science.gov (United States)

Nelson, David B.; Lucke, Ashley M.; McIntire, Donald D.; Sánchez, Pablo J.; Leveno, Kenneth J.; Chalak, Lina F.

2014-01-01

Objective Obstetric antecedents were analyzed in births where the infant received whole-body cooling for neonatal encephalopathy. Methods This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared to a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. Results A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1/1,000 livebirths). Of these 98 infants, 80 (88%) newborns had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age less than or equal to 15 years, low parity, maternal body habitus (BMI ≥ 40 kg/m2), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during univariable analysis. Catastrophic events to include umbilical cord prolapse (OR 14; 95%CI, 3–72), placental abruption (OR 17; 95%CI, 7–44), uterine rupture (OR 130; 95%CI, 11–1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. Conclusion A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. PMID:24530976

White matter tract integrity and developmental outcome in newborn infants with hypoxic-ischemic encephalopathy treated with hypothermia.

Science.gov (United States)

Massaro, An N; Evangelou, Iordanis; Fatemi, Ali; Vezina, Gilbert; Mccarter, Robert; Glass, Penny; Limperopoulos, Catherine

2015-05-01

To determine whether corpus callosum (CC) and corticospinal tract (CST) diffusion tensor imaging (DTI) measures relate to developmental outcome in encephalopathic newborn infants after therapeutic hypothermia. Encephalopathic newborn infants enrolled in a longitudinal study underwent DTI after hypothermia. Parametric maps were generated for fractional anisotropy, mean, radial, and axial diffusivity. CC and CST were segmented by DTI-based tractography. Multiple regression models were used to examine the association of DTI measures with Bayley-II Mental (MDI) and Psychomotor Developmental Index (PDI) at 15 months and 21 months of age. Fifty-two infants (males n=32, females n=20) underwent DTI at median age of 8 days. Two were excluded because of poor magnetic resonance imaging quality. Outcomes were assessed in 42/50 (84%) children at 15 months and 35/50 (70%) at 21 months. Lower CC and CST fractional anisotropy were associated with lower MDI and PDI respectively, even after controlling for gestational age, birth weight, sex, and socio-economic status. There was also a direct relationship between CC axial diffusivity and MDI, while CST radial diffusivity was inversely related to PDI. In encephalopathic newborn infants, impaired microstructural organization of the CC and CST predicts poorer cognitive and motor performance respectively. Tractography provides a reliable method for early assessment of perinatal brain injury. © 2014 Mac Keith Press.

[Measurement of the passive compliance of the total respiratory system in newborn after respiratory insufficiency for risk assessment of respiratory disorders during the first 6 month of life].

Science.gov (United States)

Olechowski, Wiesław; Majorek-Olechowska, Bernadetta

2010-01-01

To evaluate the relationships between postnatal passive respiratory compliance (Crs) and development of respiratory disorders during the first 6 month of life in preterm and full-term infants after respiratory insufficiency. The purpose of this study was to investigate whether other relevant neonatal factors, like degree of prematurity, birth weigh, ventilatory conditions, sepsis, and respiratory disease severity affected this relationship. The passive respiratory compliance was measured by the single occlusion technique in 73 preterm infants after respiratory distress syndrome (RDS), 19 full-term infants after congenital pneumonia and 33 healthy full-term infants. Respiratory function measurements were performed by single occlusion technique, during natural sleep, after acute phase of illness, before discharge from neonatal department. Crs was significantly lower in premature newborns newborns who have suffered from a congenital pneumonia (p = 0.0411), than in healthy full-term newborn infants. Premature infants who have undergone sepsis have significantly decreased Crs in relationship with those who did not have this complication (p = 0.0334). Preterm newborns who have suffered pneumonia during treatment of RDS have significantly frequent respiratory problems during the first 6 month of age (p = 0.043). Full-term infants after congenital pneumonia have more but not significantly frequent respiratory problems than healthy term newborns (p = 0.055) in this period. Decreased neonatal Crs wasn't significantly related to respiratory disorders in age of 6 month of life. Prematurity under 36 week of gestational age, low birth weight and suffering from sepsis in premature infants significantly decreased Crs in newborn. Decreased neonatal Crs in premature and full term infants after respiratory insufficiency wasn't significantly related to respiratory disorders during first 6 month of life. This study has showed significantly increase of respiratory problems in this

Newborn jaundice - discharge

Science.gov (United States)

... Biliary atresia Bili lights Bilirubin blood test Bilirubin encephalopathy Exchange transfusion Jaundice and breastfeeding Newborn jaundice Premature infant Rh incompatibility Patient Instructions Newborn ...

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

Science.gov (United States)

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.

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.

Multiple arterial anomalies in the newborn infant. Echocardiographic and angiographic diagnosis

Directory of Open Access Journals (Sweden)

Ivan Romero Rivera

2000-08-01

Full Text Available Multiple arterial anomalies characterized by tortuosity and rolling of the pulmonary arteries and aorta were diagnosed on echocardiography in an asymptomatic newborn infant with a phenotype suggesting Ehlers-Danlos syndrome. These changes were later confirmed on angiography, which also showed peripheral vascular abnormalities. The electrocardiogram showed a probable hemiblock of the left anterosuperior branch, and the chest x-ray showed an excavated pulmonary trunk with normal pulmonary flow.

ABO incompatibility hemolytic disease following exchange transfusion 96 newborn

Directory of Open Access Journals (Sweden)

Khatami S.F

2007-09-01

Full Text Available Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newborn blood type A or B, rising indirect hyperbilirubinemia in the first two days of life, positive immunohematologic test for newborns and exchange transfusion. Exclusion criteria were: incomplete information, other accompanying diseases that induce hyperbilirubinemia. All newborn infants received phototherapy before and after exchange transfusion. We did not use intravenous immunoglobulin, hemoxygenase inhibitor drugs and blood products before exchange transfusion.Results: Double-volume exchange transfusion via umbilical cord catheter was performed in 96 patients, 19 (20% of whom suffered from ABO incompatibility. Of these 19 newborns, two-thirds (13 were preterm infants. The minimum level of serum bilirubin was 10 mg/dl and the maximum serum bilirubin level was 35 mg/dl. In six patients (32% serum bilirubin levels were >25mg/dl. The most common blood group was type A for newborns. Immunohematologic tests were positive in 84% of the mothers. ABO incompatibility hemolytic disease was the fourth and second most common reasons for blood exchange transfusion in preterm and term infants, respectively. Laboratory complications were more common than clinical complications. The etiology of 48% of the alloimmunization and 42% of the hemolytic disease in these newborns was ABO incompatibility.Conclusions: Mothers with blood group O and newborns with blood group A or B with positive immunohematologic tests in first hours of life are at high risk for hemolytic disease

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.

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.

Continuous intravenous infusion of ampicillin and gentamicin during parenteral nutrition to 36 newborn infants using a dosage schedule

DEFF Research Database (Denmark)

Colding, H; Møller, S; Andersen, G E

1984-01-01

Ampicillin and gentamicin were given continuously i.v. to 36 newborn infants using a dosage schedule and the results were compared with those obtained in an earlier study including 88 infants who received individually calculated dosages. With the dosage schedule the variation in the serum concent...

Severe hemolytic disease of the newborn in a group B African-American infant delivered by a group O mother.

Science.gov (United States)

Drabik-Clary, Kathryn; Reddy, Vishnu V B; Benjamin, William H; Boctor, Fouad N

2006-01-01

Maternal-fetal ABO incompatibility is a common hematological problem affecting the newborn. In general, hemolysis is minimal and the clinical course is relatively benign, rarely causing the escalating levels of hyperbilirubinemia and significant anemia commonly associated with Rh hemolytic disease of the newborn (HDN). The incidence of HDN ranges from one in 150 births to 1:3000 births, depending on the degree of anemia and level of serum bilirubin. The etiology of ABO hemolytic disease of the newborn (ABO-HDN) is complex because anti-A and anti-B antibodies are composed mainly of IgM. Since only IgG antibodies cross the placenta, those pregnant women with high levels of IgG anti-A,B, anti-A, or anti-B with an ABO incompatible fetus will be the ones to give birth to an infant with ABO-HDN. We describe a case of a B/Rh positive term newborn born to an O/Rh negative African-American mother demonstrating aggressive hemolysis and a robust response of the bone marrow. This case was successfully managed with phototherapy and simple RBC transfusion without the need for exchange transfusion.

NAA, GC(EC) and SRXRF study of Hg species in head hair of mothers and their newborn infants

International Nuclear Information System (INIS)

Feng Weiyue; Qian Qinfang; Zhang Peiqun; Chai Zhifang

1997-01-01

Twenty-seven pairs of head from mothers and their new-born infants were collected at the time of delivery in a hospital in Beijing. The total mercury content in the hair samples was determined by INAA. The correlation between mercury content in hair of mothers and their new-born infants has been investigated. In addition, the change of Hg content in pregnant women's hair during their pregnancy was also studied by INAA and SRXRF. The results indicate a significant positive correlation between the mercury content in maternal and infant head hairs (r = +0.862, p < 0.001). The average content of Hg in infant and maternal hairs was (0.66 +- 0.31) μg/g and (0.59 +- 0.25) μg/g, respectively. The infant level exceeded the maternal by 12%. The Hg content in maternal head hair gradually reduced during pregnancy. Further, the methylmercury (Me-Hg) content in 3 maternal hair samples was analyzed by GC(EC). The Me-Hg was in accordance with the total mercury content. Thus a conclusion can be drawn that damage to the infant from Hg occurred in the early stages of pregnancy

L-citrulline provides a novel strategy for treating chronic pulmonary hypertension in newborn infants

Science.gov (United States)

Fike, Candice D.; Summar, Marshall; Aschner, Judy L.

2014-01-01

Effective therapies are urgently needed for infants with forms of pulmonary hypertension that develop or persist beyond the first week of life. The L-arginine nitric oxide (NO) precursor, L-citrulline, improves NO signalling and ameliorates pulmonary hypertension in newborn animal models. In vitro studies demonstrate that manipulating L-citrulline transport alters NO production. Conclusion Strategies that increase the supply and transport of L-citrulline merit pursuit as novel approaches to managing infants with chronic, progressive pulmonary hypertension. PMID:24862864

Obstetric antecedents to body-cooling treatment of the newborn infant.

Science.gov (United States)

Nelson, David B; Lucke, Ashley M; McIntire, Donald D; Sánchez, Pablo J; Leveno, Kenneth J; Chalak, Lina F

2014-08-01

Obstetric antecedents were analyzed in births in which the infant received whole-body cooling for neonatal encephalopathy. This retrospective cohort study included all live-born singleton infants delivered at or beyond 36 weeks' gestation from October 2005 through December 2011. Infants who had received whole-body cooling identified by review of a prospective neonatal registry were compared with a control group comprising the remaining obstetric population delivered at greater than 36 weeks but not cooled. Univariable analysis was followed up by a staged, stepwise selection of variables with the intent to rank significant risk factors for cooling. A total of 86,371 women delivered during the study period and 98 infants received whole-body cooling (1.1 per 1000 live births). Of these 98 infants, 80 newborns (88%) had moderate encephalopathy and 10 (12%) had severe encephalopathy prior to cooling. Maternal age of 15 years or younger, low parity, maternal body habitus (body mass index of ≥40 kg/m(2)), diabetes, preeclampsia, induction, epidural analgesia, chorioamnionitis, length of labor, and mode of delivery were associated with significantly increased risk of infant cooling during a univariable analysis. Catastrophic events to include umbilical cord prolapse (odds ratio [OR], 14; 95% confidence interval [CI], 3-72), placental abruption (OR, 17; 95% CI, 7-44), uterine rupture (OR, 130; 95% CI, 11-1477) were the strongest factors associated with infant cooling after staged-stepwise logistic analysis. A variety of intrapartum characteristics were associated with infant cooling for neonatal encephalopathy, with the most powerful antecedents being umbilical cord prolapse, placental abruption, and uterine rupture. Copyright © 2014 Mosby, Inc. All rights reserved.

Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

Science.gov (United States)

Aithal, Sreedevi; Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie

2012-10-01

Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known. This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology. Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted. Chart review of 234 infants referred for one or both ears from a newborn hearing screening program in north Queensland was conducted. A total of 211 infants attended the diagnostic appointment. Review appointments to monitor hearing status were completed for 46 infants with middle ear pathology or conductive hearing loss. Diagnosis of hearing impairment was made using an age-appropriate battery of audiological tests. Results were analyzed for both initial and review appointments. Mean age at initial diagnostic assessment was 47.5 days (SD = 31.3). Of the 69 infants with middle ear pathology during initial diagnostic assessment, 18 had middle ear pathology with normal hearing, 47 had conductive hearing loss, and 4 had mixed hearing loss. Prevalence of conductive hearing loss in the newborns was 2.97 per 1,000 while prevalence of middle ear pathology (with or without conductive hearing loss) was 4.36 per 1,000. Indigenous Australians or Aboriginal and Torres Strait Islander (ATSI) infants had a significantly higher prevalence of conductive hearing loss and middle ear pathology than non-ATSI infants (35.19 and 44.45% vs 17.83 and 28.66%, respectively). ATSI infants also showed poor resolution of conductive hearing loss

Noninvasive monitoring of gas in the lungs and intestines of newborn infants using diode lasers: feasibility study.

Science.gov (United States)

Lundin, Patrik; Svanberg, Emilie Krite; Cocola, Lorenzo; Lewander Xu, Märta; Somesfalean, Gabriel; Andersson-Engels, Stefan; Jahr, John; Fellman, Vineta; Svanberg, Katarina; Svanberg, Sune

2013-12-01

Preterm newborn infants have a high morbidity rate. The most frequently affected organs where free gas is involved are the lungs and intestines. In respiratory distress syndrome, both hyperexpanded and atelectatic (collapsed) areas occur, and in necrotizing enterocolitis, intramural gas may appear in the intestine. Today, these conditions are diagnosed with x-ray radiography. A bed-side, rapid, nonintrusive, and gas-specific technique for in vivo gas sensing would improve diagnosis. We report the use of noninvasive laser spectroscopy, for the first time, to assess gas content in the lungs and intestines of three full-term infants. Water vapor and oxygen were studied with two low-power diode lasers, illuminating the skin and detecting light a few centimeters away. Water vapor was easily detected in the intestines and was also observed in the lungs. The relatively thick chest walls of the infants prevented detection of the weaker oxygen signal in this study. However, results from a previous phantom study, together with scaling of the results presented here to the typical chest-wall thickness of preterm infants, suggest that oxygen also should be detectable in their lungs.

Neonatal facial coding system scores and spectral characteristics of infant crying during newborn circumcision.

Science.gov (United States)

Lehr, Victoria Tutag; Zeskind, Philip Sanford; Ofenstein, John P; Cepeda, Eugene; Warrier, Indulekha; Aranda, J V

2007-06-01

To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision. Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (analgesia before circumcision. NFCS scores were determined by blinded assistant from video recordings of facial activity. Measures of infant crying were determined via spectrum analysis of audio recordings by a blinded, independent researcher. Pearson product-moment correlations were used to examine relationship between NFCS scores and measures of crying. Principal component factor analysis detected dimensions underlying related measures of crying. Factor scores from a factor analysis were used in stepwise linear regression to predict NFCS scores. Higher NFCS scores correlated with lower peak fundamental frequency of crying (P<0.01) and with higher amplitudes of crying at peak fundamental frequency and dominant frequency and in overall cry sample (P<0.01). The factor analysis showed 3 significant orthogonal dimensions underlying measures of crying: Power and Velocity (amplitude and rapidity), Pitch of Crying (frequency characteristics), and Infant Arousal (turbulence and intensity) accounting for 42.3%, 17.8%, and 14.6% of variance, respectively. A regression analysis showed all 3 factor scores accounted for significant and separate portions of variance (P<0.001). The best predictor of NFCS score was Power and Velocity (P<0.002), followed by Infant Arousal (P<0.002), and Pitch of Crying (P<0.007). These data provide some of the first known evidence linking specific measures of infant crying with an independent, validated measure of pain.

The added value of simultaneous EEG and amplitude-integrated EEG recordings in three newborn infants

NARCIS (Netherlands)

de Vries, Nathalie K. S.; ter Horst, Hendrik J.; Bos, Arend F.

2007-01-01

Amplitude-integrated electroencephalograms (aEEGs) recorded by cerebral function monitors (CFMs) are used increasingly to monitor the cerebral activity of newborn infants with encephalopathy. Recently, new CFM devices became available which also reveal the original EEG signals from the same leads.

Newborn Irritability Moderates the Association between Infant Attachment Security and Toddler Exploration and Sociability

Science.gov (United States)

Stupica, Brandi; Sherman, Laura J.; Cassidy, Jude

2011-01-01

This longitudinal investigation of 84 infants examined whether the effect of 12-month attachment on 18- and 24-month exploration and sociability with unfamiliar adults varied as a function of newborn irritability. As expected, results revealed an interaction between attachment (secure vs. insecure) and irritability (highly irritable vs. moderately…

Reliability of the echoMRI infant system for water and fat measurements in newborns

Science.gov (United States)

The precision and accuracy of a quantitative magnetic resonance (EchoMRI Infants) system in newborns were determined. Canola oil and drinking water phantoms (increments of 10 g to 1.9 kg) were scanned four times. Instrument reproducibility was assessed from three scans (within 10 minutes) in 42 heal...

[A new method of investigation of "child's" behavior (infant-mother attachment) of newborn rats].

Science.gov (United States)

Stovolosov, I S; Dubynin, V A; Kamenskiĭ, A A

2010-01-01

A new method of studying "child's" (maternal bonding) behavior of newborn rats was developed. The efficiency of the method was proved in estimation of dopaminergic control of the infant-mother attachment. Selective D2-antagonist clebopride applied in subthreshold for motor activity doses caused a decrease in aspiration of pups to be in contact with a dam. On the basis of features analyzed (latent periods and expression of various behavioral components), the integrated criterion for the estimation of "child's" reactions was suggested. Application of this criterion made it possible to neutralize high individual variability of the behavior typical of newborns.

NAA, GC(EC) and SRXRF study of Hg species in head hair of mothers and their newborn infants

International Nuclear Information System (INIS)

Feng, W.Y.; Qian, Q.F.; Zhang, P.Q.; Chai, C.F.

1995-01-01

Twenty-seven pairs of head hair from mothers and their new-born infants were collected at the time of delivery in a hospital in Beijing. The total mercury content in the hair samples was determined by INAA. The correlation between mercury content in hair of mothers and their new-born infants has been investigated. In addition, the change of Hg content in pregnant women's hair during their pregnancy was also studied by INAA and SRXRF. The results indicate a significant positive correlation between the mercury content in maternal and infant head hairs (r = +0.862, p< 0.001). The average content of Hg in infant and maternal hairs was 0.66 ± 0.31 μg/g and 0.59 ± 0.25 μg/g, respectively. The infant level exceeded the maternal by 12%. The Hg content in maternal head hair gradually reduced during pregnancy. Further, the methylmercury (Me-Hg) content in 3 maternal hair samples was analyzed by GC(EC). The Me-Hg was in accordance with the total mercury content. Thus a conclusion can be drawn that damage to the infant from Hg occurred in the early stages of pregnancy. (author). 9 refs., 5 figs., 2 tabs

Medical practice and legal background of decisions for severely ill newborn infants: viewpoints from seven European countries.

Science.gov (United States)

Sauer, P J J; Dorscheidt, J H H M; Verhagen, A A E; Hubben, J H

2013-02-01

To comparing attitudes towards end-of-life (EOL) decisions in newborn infants between seven European countries. One paediatrician and one lawyer from seven European countries were invited to attend a conference to discuss the practice of EOL decisions in newborn infants and the legal aspects involved. All paediatricians/neonatologists indicated that the best interest of the child should be the leading principle in all decisions. However, especially when discussing cases, important differences in attitude became apparent, although there are no significant differences between the involved countries with regard to national legal frameworks. Important differences in attitude towards neonatal EOL decisions between European countries exist, but they cannot be explained solely by medical or legal reasons. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population.

Science.gov (United States)

Berngard, Samuel Clark; Berngard, Jennifer Bishop; Krebs, Nancy F; Garcés, Ana; Miller, Leland V; Westcott, Jamie; Wright, Linda L; Kindem, Mark; Hambidge, K Michael

2013-12-01

Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala. The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy. One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained. Mean ± SD length-for-age Z-score (LAZ) declined from newborn -1.0 ± 1.01 to -2.20 ± 1.05 and -2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R(2) = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education∗maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from -0.44 to +1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ. The primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions. © 2013.

Why do premature newborn infants display elevated blood adenosine levels?

Science.gov (United States)

Panfoli, Isabella; Cassanello, Michela; Bruschettini, Matteo; Colella, Marina; Cerone, Roberto; Ravera, Silvia; Calzia, Daniela; Candiano, Giovanni; Ramenghi, Luca

2016-05-01

Our preliminary data show high levels of adenosine in the blood of very low birth weight (VLBW) infants, positively correlating to their prematurity (i.e. body weight class). This prompted us to look for a mechanism promoting such impressive adenosine increase. We hypothesized a correlation with oxygen challenge. In fact, it is recognized that either oxygen lack or its excess contribute to the pathogenesis of the injuries of prematurity, such as retinopathy (ROP) and periventricular white matter lesions (PWMI). The optimal concentration of oxygen for resuscitation of VLBW infants is currently under revision. We propose that the elevated adenosine blood concentrations of VLBW infants recognizes two sources. The first could be its activity-dependent release from unmyelinated brain axons. Adenosine in this respect would be an end-product of the hypometabolic VLBW newborn unmyelinated axon intensely firing in response to the environmental stimuli consequent to premature birth. Adenosine would be eventually found in the blood due to blood-brain barrier immaturity. In fact, adenosine is the primary activity-dependent signal promoting differentiation of premyelinating oligodendrocyte progenitor cells (OPC) into myelinating cells in the Central Nervous System, while inhibiting their proliferation and inhibiting synaptic function. The second, would be the ecto-cellular ATP synthesized by the endothelial cell plasmalemma exposed to ambient oxygen concentrations due to premature breathing, especially in lung. ATP would be rapidly transformed into adenosine by the ectonucleotidase activities such as NTPDase I (CD39), and NT5E (CD73). An ectopic extra-mitochondrial aerobic ATP synthetic ability was reported in many cell plasma-membranes, among which endothelial cells. The potential implications of the cited hypotheses for the neonatology area would be great. The amount of oxygen administration for reviving of newborns would find a molecular basis for its assessment. VLBW

Administration of gentamicin and ampicillin by continuous intravenous infusion to newborn infants during parenteral nutrition

DEFF Research Database (Denmark)

Colding, H; Andersen, G E

1982-01-01

Gentamicin and ampicillin were dissolved in an L-amino acid solution especially prepared for newborn infants and infused intravenously over 24 h in 7 babies with serious neonatal surgical problems. Serum concentrations of the antibiotics were maintained rather constant and well above the minimal ...

Kinetics and dose calculations of ampicillin and gentamicin given as continuous intravenous infusion during parenteral nutrition in 88 newborn infants

DEFF Research Database (Denmark)

Colding, H; Møller, S; Bentzon, M W

1983-01-01

Ampicillin and gentamicin were administered continuously intravenously to 88 newborn infants using individually calculated dosages. For infants with a mean value of plasma clearance of the antibiotics, it was calculated that the serum ampicillin and gentamicin concentrations would be between 35-5...

Impact of physiotherapy on neuromotor development of premature newborns

OpenAIRE

Coutinho, Giselle Athayde Xavier; Lemos, Daniela de Mattos; Caldeira, Antônio Prates

2014-01-01

Introduction The population of children born prematurely has increased in line with improving the quality of perinatal care. It is essential to ensure to these children a healthy development. Objective We evaluate the neuromotor development of a group of preterm infants regularly assisted by a physiotherapy service in comparison to full-term newborns, checking, so the impact of the service. Materials and methods We randomly assigned preterm and full-term infants that formed two distinct group...

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

Newborn Body Indices in Housewives and Working Mothers

Directory of Open Access Journals (Sweden)

Alieh Torabizadeh

2008-06-01

Full Text Available Objective: This study aimed to compare newborns anthropometric indices of housewives and employed women.Materials and Methods: This case control study compared newborns’ anthropometric indices (weight, length, head circumference and first minute APGAR between working women and housewives. Two hundred consecutive term pregnant women during active phase of labor without any pregnancy complications were evaluated. For each participant a questionnaire was filled by the researcher. Employed women according to their standing position during work time were divided into three groups: heavy, light and moderate jobs.   Results: The mean weight, length and head circumference of the newborns were higher in employed women (p=0.018, p<0.001, p=0.010, respectively. After eliminating effect of the interfering variables by using a general linear model, it was observed that the mother’s job has a direct influence on newborn's length and head circumference. But infant's weight was similar in two groups (p=0.340. The newborn's anthropometric indices and first minute APGAR had not significant difference in subgroups of job difficulty.Conclusion: Maternal job has a direct positive influence on newborn's length and head circumference. But infant's weight is not related to maternal job.

Gastric emptying patterns of a liquid meal in newborn infants, measured by epigastric impedance

DEFF Research Database (Denmark)

Lange, Aksel; Funch-Jensen, Peter; Thommesen, Peter

1997-01-01

time (T50) was calculated. For mature infants it was found to be 6.9 mins. For a second meal given within an hour after the first meal the half emptying time was 5.5 mins (p times were not significant different from mature infants, but the number examined was small......  Epigastric impedance was used to measure patterns of the gastric emptying of a liquid non-caloric meal (5 ml water/kg) in newborn infants. The emptying patterns consisted of two components, theemptying signal - the DC component - and a phasic 3 cycle per minutes (CPM) signal - the AC component.......A periodic change of the impedance signal, the phasic 3 CPM signal, was observed after a meal in 24 of the infants. The median frequency was 3.03 CPM in 20 mature and 2.93 CPM in 4 preterminfants. In 9 infants a phasic 3 CPM signal was observed during fasting state. The median frequency was 2.9 CPM...

Referential values of certain roentgenometric indices of the humerus diaphysis in newborn infants

International Nuclear Information System (INIS)

Georgieva, P.G.; Georgiev, I.G.

1985-01-01

A roentgenometric study was made on two indicies of the humerus diaphysis in the corpses of newborn infants: 1) the transverse diameter of the medullar canal in the centre of the diaphysis after Svadkovski; 2) the transverse diameter of the diaphysis at the level of the same bone after Spencer. The statistical processing of the data established had to take into consideration the fact that Gauss's distribution is not often found in biological indices. This complicates the determination of referntial values. That is why a combined method was applied which was worked out by the authors and ensures orderliness and precision. A similar mathematical-statistical apparatus has not been used by other authors. The studies made and the processing of the data obtained contribute to the following inferences on the transverse diameter of the medullar canal in the centre of the humerus diaphysis and the transverse diameter of the diaphysis at the same level of the same bone in newborn infants: 1) their referential values have Gauss's distribution; 2) sex dimorphism does not exist as an objective law; 3) their referential intervals have been determined

Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

DEFF Research Database (Denmark)

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

1978-01-01

with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior...

Uvula Abscess in a Newborn Infant.

Science.gov (United States)

Tuncer, Erkun; Ors, Rahmi

2018-05-01

Abscesses can be found in several places in the oral cavity, most commonly occurring in peritonsillar and periodontal regions. In this report, the authors described a uvula abscess in a 1-month-old term newborn who was brought to the pediatric outpatient clinic with the complaints of difficulty in sucking-swallowing and refusal to suck at the breast. To the best of the authors' knowledge this is the first report of a uvula abscess in the literature.

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...

Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress.

Science.gov (United States)

Carvalho, Clarissa Gutierrez; Silveira, Rita de Cassia; Neto, Eurico Camargo; Procianoy, Renato Soibelmann

2015-01-01

Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet. To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants. Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP. 23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks) were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP. Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.

Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress.

Directory of Open Access Journals (Sweden)

Clarissa Gutierrez Carvalho

Full Text Available Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet.To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants.Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP.23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP.Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.

Development and evaluation of a newborn care education programme in primiparous mothers in Nepal.

Science.gov (United States)

Shrestha, Sharmila; Adachi, Kumiko; Petrini, Marcia A; Shrestha, Sarita; Rana Khagi, Bina

2016-11-01

the health and survival of newborns depend on high levels of attention and care from caregivers. The growth and development of some infants are unhealthy because of their mother's or caregiver's lack of knowledge or the use of inappropriate or traditional child-rearing practices that may be harmful. to develop a newborn care educational programme and evaluate its impact on infant and maternal health in Nepal. a randomised controlled trial. one hundred and forty-three mothers were randomly assigned to the intervention (n=69) and control (n=74) groups. Eligible participants were primiparous mothers who had given birth to a single, full-term, healthy infant, and were without a history of obstetric, medical, or psychological problems. prior to being discharged from the postnatal unit, the intervention group received our structured newborn care education programme, which consisted of one-on-one educational sessions lasting 10-15minutes each and one postpartum follow-up telephone support within two weeks after discharge, in addition to the hospital's routine general newborn care education. The control group received only the regular general newborn care education. Outcomes were measured by using Newborn care Knowledge Questionnaires, Karitane Parenting Confidence Scale, State-Trait Anxiety Inventory for Adults and infant health and care status. the number of mothers attending the health centre due to the sickness of their babies was significantly decreased in the intervention group compared to the control group. Moreover, the intervention group had significant increases in newborn care knowledge and confidence, and decreases in anxiety, compared with the control group. the structured newborn care education programme enhanced the infant and mother health. Moreover, it increased maternal knowledge of newborn care and maternal confidence; and reduced anxiety in primiparous mothers. Thus, this educational programme could be integrated into routine educational programs to

Vertically transmitted cytomegalovirus infection in newborn preterm infants.

Science.gov (United States)

Balcells, Carla; Botet, Francesc; Gayete, Sònia; Marcos, M Ángeles; Dorronsoro, Izaskun; de Alba, Concepción; Figueras-Aloy, Josep

2016-07-01

To determine the epidemiology of congenital and acquired cytomegalovirus (CMV) infections in preterm infants and to analyze the efficacy of breast milk freezing in decreasing the vertical transmission rate of CMV. During 2013 and 2014, preterm newborns who weighed ≤1500 g and were admitted to 22 Spanish neonatal units were included and screened for CMV infection according to the Spanish Neonatology Society recommendations. Each hospital treated the breast milk according to its own protocols. Among the 1236 preterm neonates included, 10 had a congenital infection (0.8%) and 49 had an acquired infection (4.0%) (82% demonstrated positive PCR-CMV in breast milk). The neonates who received only frozen milk presented less frequently with acquired infection (1.2%) than those fed fresh milk (5.5%) (RR=0.22; 95% CI 0.05-0.90; P=0.017). The newborns who received bank milk followed by frozen or fresh breast milk more frequently had an acquired infection (2.1% or 2.2%, respectively) than those fed only frozen breast milk. The incidence of congenital CMV infection in our sample is low, as described in the literature. To reduce acquired CMV infection, freezing breast milk might be an advisable procedure for preterm neonates born from seropositive mothers, either from the beginning of lactation or after a period of bank milk administration.

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

Discordant expression of pro-B-type and pro-C-type natriuretic peptide in newborn infants of mothers with type 1 diabetes

DEFF Research Database (Denmark)

Nybo, Mads; Nielsen, Lars Bo; Nielsen, Søren Junge

2007-01-01

CNP-derived peptides in newborn infants. METHODS: Plasma concentrations of proCNP-derived peptides were measured in umbilical cord plasma and human placental tissue extracts using sequence-specific radioimmunoassays raised against N-terminal and C-terminal proCNP regions, respectively. RESULTS: The median pro...... in umbilical cord plasma compared to adult plasma (4.6 vs. 1.1), which parallels our earlier findings for proBNP and BNP peptides. CONCLUSIONS: There is a discordant expression of CNP and BNP peptides in newborn infants of mothers with diabetes. Moreover, fetal metabolism of proCNP and CNP appears to differ...

Preterm newborns show slower repair of oxidative damage and paternal smoking associated DNA damage.

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Vande Loock, Kim; Ciardelli, Roberta; Decordier, Ilse; Plas, Gina; Haumont, Dominique; Kirsch-Volders, Micheline

2012-09-01

Newborns have to cope with hypoxia during delivery and a sudden increase in oxygen at birth. Oxygen will partly be released as reactive oxygen species having the potential to cause damage to DNA and proteins. In utero, increase of most (non)-enzymatic antioxidants occurs during last weeks of gestation, making preterm neonates probably more sensitive to oxidative stress. Moreover, it has been hypothesized that oxidative stress might be the common etiological factor for certain neonatal diseases in preterm infants. The aim of this study was to assess background DNA damage; in vitro H(2)O(2) induced oxidative DNA damage and repair capacity (residual DNA damage) in peripheral blood mononucleated cells from 25 preterm newborns and their mothers. In addition, demographic data were taken into account and repair capacity of preterm was compared with full-term newborns. Multivariate linear regression analysis revealed that preterm infants from smoking fathers have higher background DNA damage levels than those from non-smoking fathers, emphasizing the risk of paternal smoking behaviour for the progeny. Significantly higher residual DNA damage found after 15-min repair in preterm children compared to their mothers and higher residual DNA damage after 2 h compared to full-term newborns suggest a slower DNA repair capacity in preterm children. In comparison with preterm infants born by caesarean delivery, preterm infants born by vaginal delivery do repair more slowly the in vitro induced oxidative DNA damage. Final impact of passive smoking and of the slower DNA repair activity of preterm infants need to be confirmed in a larger study population combining transgenerational genetic and/or epigenetic effects, antioxidant levels, genotypes, repair enzyme efficiency/levels and infant morbidity.

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.

A Study Of Fungal Colonization In Newborn

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S Rashid Husain

1997-04-01

Full Text Available Research Problem: What are the factors responsible for fungal colonization in newborns? Objective: To study the pattern of and predisposing fac­tors for the development of superficial candidiasis and fungal colonization in the newborns. Study Design: Prospective study. Setting: Neonatology unitof the Paediatrics department of a teaching hospital. Participants: Randomly selected pregnant mothers admit­ted to the maternity ward and the newborns delivered to them. Sample Size: 120 pregnant mothers and the newborns delivered. Study Variables: Candida, Site of colonization. Statistical Analysis: By tests of significance Results: Candida was isolated from 23 (19.16% infants on the first day increasing to 52 (43.33% infants on the sixth day. The most common site of colonization was oral cavity. Candida colonization was more common in prema­ture infants (p<0.05. Oral thrush was seen in 29 (24.17% infants during the study and a significant number of these infants showed colonization from the first day of life. Conclusions: Fungal colonization of the newborns due to Candida species is quite common, and in the first week of life predominantly occurred in the ora I cavity. Superficial clinical candidiasis, especially oral thrush is more common in those colonized on the first day of life.

Analysis of risk factors for hydrocephalus development in newborn infants with germinal matrix hemorrhage.

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Romero, L; Ros, B; Arráez, M A; Ríus, F; González, L; Martín, A; Carrasco, A; Segura, M

2015-10-01

The aim of this study was to analyze risk factors for the development of hydrocephalus in newborn infants with germinal matrix (GM) hemorrhage. The study comprised 271 patients admitted to Carlos Haya University Hospital in Malaga with GM hemorrhage. The following data were recorded: gestational age, gender, twin birth, head circumference at birth, weight at birth, and Papile grade. Severe obstetrical (abruption, chorioamnionitis, pregnancy-induced hypertension, tocolytic treatment) and neonatal disorders (respiratory distress syndrome, neonatal infection, coagulation disorder, patent ductus arteriosus, necrotizing enterocolitis) were also recorded. Symptomatic hydrocephalus was diagnosed in the event of a progressive increase in head circumference and ventricular indices requiring shunting. Of the 271 patients, 139 (51%) developed posthemorrhagic ventriculomegaly; 47 patients (17%) developed symptomatic hydrocephalus and needed shunt implantation. We found a significant relationship between the development of symptomatic hydrocephalus and Papile grade, lower gestational age, lower birth weight, twin birth, and neonatal infection. Awareness of risk factors for the development of hydrocephalus in newborn infants with GM hemorrhage should be emphasized in order to enable an early diagnosis of ventriculomegaly and symptomatic hydrocephalus and thus make a correct therapeutic decision.

The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: the Swedish Hygiene Intervention and Transmission of S aureus study.

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Mernelius, Sara; Löfgren, Sture; Lindgren, Per-Eric; Blomberg, Marie; Olhager, Elisabeth; Gunnervik, Christina; Lenrick, Raymond; Thrane, Malena Tiefenthal; Isaksson, Barbro; Matussek, Andreas

2013-07-01

Newborn infants are often colonized with Staphylococcus aureus originating from health care workers (HCWs). We therefore use colonization with S aureus of newborn infants to determine the effect of an improved compliance with hygiene guidelines on bacterial transmission. Compliance with hygiene guidelines was monitored prior to (baseline) and after (follow-up) a multimodal hygiene intervention in 4 departments of obstetrics and gynecology. spa typing was used to elucidate transmission routes of S aureus collected from newborn infants, mothers, fathers, staff members, and environment. The compliance with hygiene guidelines increased significantly from baseline to follow-up. The transmission of S aureus from HCWs to infants was however not affected. Fathers had the highest colonization rates. Persistent carriage was indicated in 18% of the HCWs. The most commonly isolated spa type was t084, which was not detected in a previous study from the same geographic area. It is possible to substantially improve the compliance with hygiene guidelines, by using multimodal hygiene intervention. The improved compliance did not decrease the transmission of S aureus from sources outside the own family to newborn infants. Furthermore, we show the establishment of a new spa type (t084), which now is very common in our region. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Comparison of the effect of topical application of human milk and dry cord care on the bacterial colonization of umbilical cord in newborn infants

OpenAIRE

Fatemeh Abbaszadeh; zanab Hajizadeh; Mahboobeh Kafaei Atrian; Azam Bagheri; Nahid Sarafraz

2014-01-01

Background: Breast milk contains significant amounts of compounds that act as natural antimicrobial agents. This study was conducted to compare the effect of topical application of human milk and dry cord care on bacterial colonization in the umbilical cord of newborn infants. Methods: This clinical trial study was carried out on 174 infants in Kashan. The newborns were randomized to mother's milk group and dry cord care group from the birth. In group 1, the mother rubbed her own milk on ...

Urinary paraben concentrations among pregnant women and their matching newborn infants of Korea, and the association with oxidative stress biomarkers

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Kang, Sungeun; Kim, Sunmi [School of Public Health, Seoul National University (Korea, Republic of); Park, Jeongim [College of Natural Sciences, Soonchunhyang University (Korea, Republic of); Kim, Hae-Joong [College of Medicine, Korea University (Korea, Republic of); Lee, Jeongjae; Choi, Gyuyeon [College of Medicine, Soonchunhyang University (Korea, Republic of); Choi, Sooran; Kim, Sungjoo [College of Medicine, Hallym University (Korea, Republic of); Kim, Su Young [College of Medicine, Jeju National University (Korea, Republic of); Moon, Hyo-Bang [College of Science and Technology, Hanyang University (Korea, Republic of); Kim, Sungkyoon [School of Public Health, Seoul National University (Korea, Republic of); Kho, Young Lim [Department of Health, Environment and Safety, Eulji University (Korea, Republic of); Choi, Kyungho, E-mail: kyungho@snu.ac.kr [School of Public Health, Seoul National University (Korea, Republic of)

2013-09-01

Parabens have been used in multiple products including personal care products, pharmaceuticals, and foods for more than 50 years but increasing numbers of studies have raised concerns on their safety. The present study was designed to determine urinary paraben levels among pregnant women and their matching newborn infants (< 48 h after delivery), and the association between paraben levels and stress markers. Pregnant women (n = 46) and their matching newborn infants were recruited from four university hospitals located in Seoul, Ansan and Jeju of Korea, 2011. Parabens including methyl paraben (MP), ethyl paraben (EP), n-propyl paraben (PP), and n-butyl paraben (BP) were measured in the urine using an automatic, high throughput online SPE–LC–MS/MS method. Urinary concentrations were normalized with specific gravity (SG). Free cortisol, malondealdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured in the urine as stress marker. Urinary MP was detected as the highest, and BP was detected as the lowest paraben in the urine samples of both pregnant women and their infants. Significant correlations between paraben concentrations of maternal and their newborn infant's urine were observed. The levels of urinary parabens among Korean pregnant women are comparable to those reported elsewhere, except for EP which were 4–9 folds higher than pregnant women of other countries. The ratios of infant to maternal urinary paraben concentrations varied between 0.5 and 0.6 for MP and PP, but approximately 10 fold lower for EP. Urinary MP or EP levels were associated with several oxidative stress related biomarkers such as urinary 8-OHdG and MDA, even after the adjustment of relevant covariates such as maternal age, mode of delivery, pre-pregnancy BMI, gestational age and parity. This is the first study that reported the levels of major parabens in the first urine of newborn infants. Further studies are warranted to understand the implications of paraben exposure

Measurements and monitoring of phototherapy in newborn jaundice

International Nuclear Information System (INIS)

Sisson, T.R.

1982-01-01

Hyperbilirubinemia in the newborn (neonatal jaundice) may cause irreversible brain damage if plasma concentrations of bilirubin exceed the number of binding sites on albumin and other blood components. Phototherapy or exchange transfusions to prevent the excessive rise in concentration of the pigment should be instituted in appropriate clinical situations. In phototherapy, the jaundiced infant is exposed to visible light containing the wavelength (about 450 nm) bilirubin will absorb. Because bilirubin is quite photolabile and will readily isomerize in vivo, it is rapidly converted to excretable forms. The effectiveness of this therapy, however, depends upon the maintenance of adequate radiant flux in the required wavelength. Energy output and spectral distributions of phototherapy lamps must be measured. The long-term effects of irradiation of newborn infants over several days are not yet known

Angiogenesis Dysregulation in Term Asphyxiated Newborns Treated with Hypothermia

Science.gov (United States)

Shaikh, Henna; Boudes, Elodie; Khoja, Zehra; Shevell, Michael; Wintermark, Pia

2015-01-01

Background Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesis-related markers following birth asphyxia in human newborns. Objective This study aimed to evaluate the expression of angiogenesis-related protein markers in asphyxiated newborns developing and not developing brain injury compared to healthy control newborns. Design/Methods Twelve asphyxiated newborns treated with hypothermia were prospectively enrolled; six developed eventual brain injury and six did not. Four healthy control newborns were also included. We used Rules-Based Medicine multi-analyte profiling and protein array technologies to study the plasma concentration of 49 angiogenesis-related proteins. Mean protein concentrations were compared between each group of newborns. Results Compared to healthy newborns, asphyxiated newborns not developing brain injury showed up-regulation of pro-angiogenic proteins, including fatty acid binding protein-4, glucose-6-phosphate isomerase, neuropilin-1, and receptor tyrosine-protein kinase erbB-3; this up-regulation was not evident in asphyxiated newborns eventually developing brain injury. Also, asphyxiated newborns developing brain injury showed a decreased expression of anti-angiogenic proteins, including insulin-growth factor binding proteins -1, -4, and -6, compared to healthy newborns. Conclusions These findings suggest that angiogenesis pathways are dysregulated following birth asphyxia and are putatively involved in brain injury pathology and recovery. PMID:25996847

Angiogenesis dysregulation in term asphyxiated newborns treated with hypothermia.

Directory of Open Access Journals (Sweden)

Henna Shaikh

Full Text Available Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesis-related markers following birth asphyxia in human newborns.This study aimed to evaluate the expression of angiogenesis-related protein markers in asphyxiated newborns developing and not developing brain injury compared to healthy control newborns.Twelve asphyxiated newborns treated with hypothermia were prospectively enrolled; six developed eventual brain injury and six did not. Four healthy control newborns were also included. We used Rules-Based Medicine multi-analyte profiling and protein array technologies to study the plasma concentration of 49 angiogenesis-related proteins. Mean protein concentrations were compared between each group of newborns.Compared to healthy newborns, asphyxiated newborns not developing brain injury showed up-regulation of pro-angiogenic proteins, including fatty acid binding protein-4, glucose-6-phosphate isomerase, neuropilin-1, and receptor tyrosine-protein kinase erbB-3; this up-regulation was not evident in asphyxiated newborns eventually developing brain injury. Also, asphyxiated newborns developing brain injury showed a decreased expression of anti-angiogenic proteins, including insulin-growth factor binding proteins -1, -4, and -6, compared to healthy newborns.These findings suggest that angiogenesis pathways are dysregulated following birth asphyxia and are putatively involved in brain injury pathology and recovery.

Black lung persistent pulmonary hypertension of the newborn

Science.gov (United States)

Alnemri, AbdulRahman M.

2017-01-01

Objectives: To determine the clinical presentation, risk factors, diagnosis, and treatment outcome of Saudi infants with black lung persistent pulmonary hypertension of the newborn (PPHN). Methods: This is a retrospective review of all neonates with PPHN presented to the Armed Force Hospital Southern Region, Kingdom of Saudi Arabia from January 2012 to December 2014. Results: Ten term and near term infants presented with PPHN were included. Maternal diabetes and Down syndrome were the most common identified risk factors for PPHN in the study group. Nine infants were treated with oral sildenafil and did not require mechanical ventilation. Only one infant required mechanical ventilation and inhaled nitric oxide in addition to oral sildenafil. Conclusion: Most of the patients in this cohort with PPHN had risk factors, they did not require mechanical ventilation and responded well to oral sildenafil. PMID:28042638

Sucrose and warmth for analgesia in healthy newborns: an RCT.

Science.gov (United States)

Gray, Larry; Garza, Elizabeth; Zageris, Danielle; Heilman, Keri J; Porges, Stephen W

2015-03-01

Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns. A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups. The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination. The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain. Copyright © 2015 by the American Academy of Pediatrics.

Tc-99m-labeled red blood cells for the measurement of red cell mass in newborn infants: concise communication

International Nuclear Information System (INIS)

Linderkamp, O.; Betke, K.; Fendel, H.; Klemm, J.; Lorenzen, K.; Riegel, K.P.

1980-01-01

In vitro and in vivo investigations were performed to examine the binding of Tc-99m to neonatal red blood cells (RBC). Labeling efficiency was about 90%, and unbound Tc-99m less than 3% after one washing, in premature and full-term newborns and in children. Thus presence of high percentages of fetal hemoglobin (Hb F) did not influence the labeling of RBCs with Tc-99m. RBCs of 11 newborns were hemolysed and the distribution of Tc-99m on RBC components was analyzed. Although Hb F percentage averaged (60.0 +- 8.10)% (s.d.), only (11.9 +- 3.7)% of Tc-99m was bound by Hb F, whereas (45.0 +- 6.1)% was associated with Hb A. RBC membranes bound (13.7 +- 4.3)% and (29.3 +- 4.0)% were found unbound in hemolysates. These results indicate that Tc-99m preferentially binds to beta chains. In vivo equilibration of Tc-99m RBCs and of albumin labeled with Evans blue was investigated in five newborn infants. Tc-99m RBCs were stable in each case during the first hour after injection. Elution of Tc-99m from RBCs was (3.4 +- 1.5)% per h. Body-to-venous hematocrit ratio averaged 0.86 +- 0.03

[Sensitivity and specificity of the cerebral blood flow reactions to acupuncture in the newborn infants presenting with hypoxic ischemic encephalopathy].

Science.gov (United States)

Filonenko, A V; Vasilenko, A M; Khan, M A

2015-01-01

To evaluate the effects of acupuncture integrated into the standard therapy, the condition of cerebral blood flow, and other syndromes associated with cerebral ischemia in the newborn infants. MATERIAL AND METHODS. A total of 131 pairs of puerperae and newborns with hypoxic ischemic encephalopathy were divided into four treatment groups. 34 children of the first group were given standard therapy (control), in the second group comprised of 33 mothers and children the standard treatment was supplemented by acupuncture, the third group included only 32 mothers given the acupuncture treatment alone, and the fourth group contained only 32 newborn infants treated by acupuncture. Each course of acupuncture treatment consisted of five sessions. Sensitivity and specificity of cerebral blood flow reactions were determined based on the results of the ROC-analysis and the area under the curve before and after the treatment. The treatment with the use of acupuncture greatly improved the cerebrospinal hemodynamics (p newborn babies. The high level of sensitivity (84.4-94.8%) associated with good specificity makes it possible to distinguish between the true positive and true negative cases. Acupuncture integrated into the treatment of "mother-baby" pairs presenting with hypoxic ischemic encephalopathy can be used to improve the initially low level of cerebral blood flow in neonates presenting with this condition.

Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: a prospective multicenter study.

Science.gov (United States)

Alan, Serdar; Erdeve, Omer; Cakir, Ufuk; Akduman, Hasan; Zenciroglu, Aysegul; Akcakus, Mustafa; Tunc, Turan; Gokmen, Zeynel; Ates, Can; Atasay, Begum; Arsan, Saadet

2016-01-01

To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs). A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions. The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU. RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU.

Risk Factors Affecting the Severity of Full-Term Neonatal Retinal Hemorrhage

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Zhang Yanli

2017-01-01

Full Text Available Objective. The purpose of this study was to explore the underlying clinical factors associated with the degree of retinal hemorrhage (RH in full-term newborns. Methods. A total of 3054 full-term infants were included in this study. Eye examinations were performed with RetCamIII within one week of birth for all infants. Maternal, obstetric, and neonatal parameters were compared between newborns with RH and controls. The RH group was divided into three sections (I, II, and III based on the degree of RH. Results. RH was observed in 1202 of 3054 infants (39.36% in this study. The quantity and proportion of newborns in groups I, II, and III were 408 (13.36%, 610 (19.97%, and 184 (6.03%, respectively. Spontaneous vaginal delivery (SVD, prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage positively correlated with aggravation of the degree of RH in newborns. Conversely, cesarean section was protective against the incidence of RH. Conclusions. SVD, prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage were potential risk factors for aggravation of the degree of RH in full-term infants. Accordingly, infants with these risk factors may require greater attention with respect to RH development.

Heart Failure Treated with Low-dose Milrinone in a Full-term Newborn

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S. Šebková

2012-01-01

Full Text Available A term newborn with a hypocontractile myocardium complicating persistent pulmonary hypertension of the newborn was successfully treated with a low-dose phosphodiesterase III inhibitor milrinone. Echocardiography diagnosed heart failure with a left ventricular ejection fraction of 35% and a left ventricular shortening fraction of 18% and severe persistent pulmonary hypertension of the newborn with oxygenation index of 28. Milrinone was started at an initial dose of 50 mcg/kg, followed by continuous infusion of 0.20 mcg/kg/min. With lowdose milrinone oxygenation index decreased to 3 within 6 hours, left ventricular ejection fraction and left ventricular shortening fraction increased to 57%, and 30%, respectively. Low doses of milrinone might be promising in the treatment of heart failure and persistent pulmonary hypertension of the newborn in term newborns.

Heart failure treated with low-dose milrinone in a full-term newborn.

Science.gov (United States)

Sebková, S; Tomek, V; Zemanová, P; Janota, J

2012-01-01

A term newborn with a hypocontractile myocardium complicating persistent pulmonary hypertension of the newborn was successfully treated with a low-dose phosphodiesterase III inhibitor milrinone. Echocardiography diagnosed heart failure with a left ventricular ejection fraction of 35% and a left ventricular shortening fraction of 18% and severe persistent pulmonary hypertension of the newborn with oxygenation index of 28. Milrinone was started at an initial dose of 50 mcg/kg, followed by continuous infusion of 0.20 mcg/kg/min. With lowdose milrinone oxygenation index decreased to 3 within 6 hours, left ventricular ejection fraction and left ventricular shortening fraction increased to 57%, and 30%, respectively. Low doses of milrinone might be promising in the treatment of heart failure and persistent pulmonary hypertension of the newborn in term newborns.

Learning, Play, and Your Newborn

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Learning, Play, and Your Newborn KidsHealth / For Parents / Learning, ... Some Other Ideas Print What Is My Newborn Learning? Play is the chief way that infants learn ...

Estimation of gluconeogenesis in newborn infants

NARCIS (Netherlands)

Kalhan, SC; Parimi, P; Van Beek, R; Gilfillan, C; Saker, F; Gruca, L; Sauer, P.J.J.

2001-01-01

The rate of glucose turnover (R-a) and gluconeogenesis (GNG) via pyruvate were quantified in seven full-term healthy babies between 24 and 48 h after birth and in twelve low-birth-weight infants on days 3 and 4 by use of [C-13(6)]glucose and (H2O)-H-2. The preterm babies were receiving parenteral

Evaluation of correlation between nucleated red blood cell count in term newborns and meconium-stained amniotic fluid

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Esmaeilian L

2001-09-01

Full Text Available Considering the incidence of meconium-stained amniotic fluid (MSAF in newborns and its complications, and also based on indirect reports pointing out relationship between nucleated red blood cell (nRBC, as a marker of chronic hypoxia, and MSAF in term newborns, and in order to determine this relationship more accurately, this study was done on women with uncomplicated singleton term pregnancy that admitted for delivery at Shariati hospital in year 2000. After excluding confounding factors on nRBC, case group who includes infants with MSAF, and control group who have clear amniotic fluid were determined. Maternal age and parity, gestational age, birth weight, apgar score, neonatal out come, and FHR pattern as well as newborn hemoglobin values were evaluated. Venous cord blood was analyzed for nRBC counts per 100 WBC. Case and control groups were divided according to nRBC counts with cutoff point of 10 and then compared statistically. From the samples, 117 cases and 67 controls were evaluated. Maternal and neonatal factors were similar in two situations. Number of nRBC was 3.75±4.8 in control group and 12.04±11.7 in case group (P<0.01 and it was abnormal (>10 in 9 percent of newborns with clear fluid and 32 percent of MSAF (P<0.01. Cord blood nRBC count increased when meconium is passed intrauterine. This suggests that cases with MSAF may be at risk of chronic hypoxia. Cohort research is recommended to study the affect of delivery mode on the neonatal outcome in cases with MSAF and to evaluate the cause of fetal hypoxia in uncomplicated pregnancy with MSAF.

Dietary transition difficulties in preterm infants: critical literature review

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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.

A newborn infant chimpanzee snatched and cannibalized immediately after birth: Implications for "maternity leave" in wild chimpanzee.

Science.gov (United States)

Nishie, Hitonaru; Nakamura, Michio

2018-01-01

This study reports on the first observed case of a wild chimpanzee infant being snatched immediately after delivery and consequently cannibalized by an adult male in the Mahale Mountains, Tanzania. We demonstrate "maternity leave" from long-term data from the Mahale M group and suggest that it functions as a possible counterstrategy of mother chimpanzees against the risk of infanticide soon after delivery. The subjects of this study were the M group chimpanzees at Mahale Mountains, Tanzania. The case of cannibalism was observed on December 2, 2014. We used the long-term daily attendance record of the M group chimpanzees between 1990 and 2010 to calculate the lengths of "maternity leave," a perinatal period during which a mother chimpanzee tends to hide herself and gives birth alone. We observed a very rare case of delivery in a wild chimpanzee group. A female chimpanzee gave birth in front of other members, and an adult male snatched and cannibalized the newborn infant immediately after birth. Using the long-term data, we demonstrate that the length of "maternity leave" is longer than that of nonmaternity leave among adult and adolescent female chimpanzees. We argue that this cannibalism event immediately after birth occurred due to the complete lack of "maternity leave" of the mother chimpanzee of the victim, who might lack enough experience of delivery. We suggest that "maternity leave" taken by expecting mothers may function as a possible counterstrategy against infanticide soon after delivery. © 2017 Wiley Periodicals, Inc.

Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Infants Who Fail Newborn Hearing Screening.

Science.gov (United States)

Vancor, Emily; Shapiro, Eugene D; Loyal, Jaspreet

2018-01-24

Congenital cytomegalovirus (CMV) infection is a major cause of sensorineural hearing loss. By law, newborns in Connecticut who fail newborn hearing screening are tested for infection with CMV. This targeted screening is controversial, because most children with congenital CMV infection are asymptomatic, and CMV-related hearing loss can have a delayed onset. Our hospital uses a saliva polymerase chain reaction (PCR) assay (confirmed by a urine PCR assay) to detect CMV. Here, we report the results of the first year of our screening program. We reviewed the medical records of newborns in the Yale New Haven Health System who failed the newborn hearing screening test between January 1 and December 31, 2016. Of 10964 newborns, 171 failed newborn hearing screening, and 3 of these newborns had positive saliva CMV PCR test results. Of these 3 newborns, 2 had positive results on the confirmatory test (for 1 of them the confirmatory test was not performed until the infant was 10 weeks old), and 1 had a negative result on the confirmatory test. Three additional newborns with congenital CMV infection were tested because of clinical indications (1 for ventriculomegaly on prenatal ultrasound and 2 for CMV infection of the mother). Results of audiology follow-up were available for 149 (87.1%) of the 171 newborns who failed newborn hearing screening; 127 (85.2%) had normal results. Our targeted screening program for congenital CMV infection had a low yield. Consideration should be given to other strategies for identifying children at risk of hearing loss as a result of congenital CMV infection. © The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

Objective assessment of induced acute pain in neonatology with the Newborn Infant Parasympathetic Evaluation index.

Science.gov (United States)

Cremillieux, C; Makhlouf, A; Pichot, V; Trombert, B; Patural, H

2018-01-25

Objective tools are needed to improve pain assessment in newborns. The aim of this study was to assess the correlation between the Newborn Infant Parasympathetic Evaluation (NIPE) index and two pain scales during a painful procedure in premature infants. Each baby born at least at 26 weeks of gestational age (GA) undergoing a planned painful procedure in the Neonatal Intensive Care Unit (NICU) was eligible. NIPE index, heart rate variability (HRV) indices and Neonatal Acute Pain scale (DAN) were recorded across three periods: the first at rest 5 min before the painful procedure (T1), the second during it (T2) and the third 3 min after the end of it (T3). The Premature Infant Pain Profile-Revised (PIPP-R) pain scale was recorded at T2. Sixty-four recordings were performed in 29 preterm infants (mean GA = 29.9 ± 4.2 weeks). Twenty-eight tachograms were coupled to NIPE for analysis. We did not find a correlation between the NIPE index and DAN and PIPP-R at the pain time T2. Between T1 and T2, heart rate was higher (159 ± 16 vs. 169 ± 12, p < 0.001). Considering the linear HRV indices, we did not observe a modification in parasympathetic or sympathetic activity, while for the nonlinear HRV indices (H exponent, Approximate and conditional Entropy), a significant change towards a loss of physiological chaotic cardiac behaviour was detected. The NIPE index seems to be not reliable to assess acute pain in the preterm infant, but other HRV indices could be explored as additional tools next to pain scales in NICUs. The NIPE monitor was developed for objective pain assessment in neonates based on HFnu variations, but it does not seem reliable enough for assessing acute pain in real time in preterm neonates. Pain assessment in preterm babies still relies on pain scales. © 2018 European Pain Federation - EFIC®.

Prevention of Vitamin K Deficiency Bleeding in Newborn Infants: A Position Paper by the ESPGHAN Committee on Nutrition

NARCIS (Netherlands)

Mihatsch, Walter A.; Braegger, Christian; Bronsky, Jiri; Campoy, Cristina; Domellöf, Magnus; Fewtrell, Mary; Mis, Nataša F.; Hojsak, Iva; Hulst, Jessie; Indrio, Flavia; Lapillonne, Alexandre; Mlgaard, Christian; Embleton, Nicholas; van Goudoever, Johannes

2016-01-01

Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for newborn and young infants and can be largely prevented by adequate vitamin K supplementation. The aim of this position paper is to define the condition, describe the prevalence,

Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities.

Science.gov (United States)

Nasiell, Josefine; Papadogiannakis, Nikos; Löf, Erika; Elofsson, Fanny; Hallberg, Boubou

2016-03-01

Birth asphyxia and hypoxic ischemic encephalopathy (HIE) of the newborn remain serious complications. We present a study investigating if placental or umbilical cord abnormalities in newborns at term are associated with HIE. A prospective cohort study of the placenta and umbilical cord of infants treated with hypothermia (HT) due to hypoxic brain injury and follow-up at 12 months of age has been carried out. The study population included 41 infants treated for HT whose placentas were submitted for histopathological analysis. Main outcome measures were infant development at 12 months, classified as normal, cerebral palsy, or death. A healthy group of 100 infants without HIE and normal follow-up at 12 months of age were used as controls. A velamentous or marginal umbilical cord insertion and histological abruption was associated with the risk of severe HIE, OR = 5.63, p = 0.006, respectively, OR = 20.3, p = 0.01 (multiple-logistic regression). Velamentous or marginal umbilical cord insertion was found in 39% among HIE cases compared to 7% in controls. Placental and umbilical cord abnormalities have a profound association with HIE. A prompt examination of the placentas of newborns suffering from asphyxia can provide important information on the pathogenesis behind the incident and contribute to make a better early prognosis.

Outbreak of late-onset group B streptococcal infections in healthy newborn infants after discharge from a maternity hospital: a case report.

Science.gov (United States)

Kim, Hyung Jin; Kim, Soo Young; Seo, Won Hee; Choi, Byung Min; Yoo, Young; Lee, Kee Hyoung; Eun, Baik Lin; Kim, Hai Joong

2006-04-01

During a four-week period, four healthy term newborn infants born at a regional maternity hospital in Korea developed late-onset neonatal group B Streptococcus (GBS) infections, after being discharged from the same nursery. More than 10 days after their discharge, all of the infants developed fever, lethargy, and poor feeding behavior, and were subsequently admitted to the Korea University Medical Center, Ansan Hospital. GBS was isolated from the blood cultures of three babies; furthermore, GBS was isolated from 2 cerebral spinal fluid cultures. Three babies had meningitis, and GBS was isolated from their cerebral spinal fluid cultures. This outbreak was believed to reflect delayed infection after early colonization, originating from nosocomial sources within the hospital environment. This report underlines the necessity for Korean obstetricians and pediatricians to be aware of the risk of nosocomial transmissions of GBS infection in the delivery room and/or the nursery.

Early skin-to-skin contact for mothers and their healthy newborn infants.

Science.gov (United States)

Moore, E R; Anderson, G C; Bergman, N

2007-07-18

Mother-infant separation postbirth is common in Western culture. Early skin-to-skin contact (SSC) begins ideally at birth and involves placing the naked baby, covered across the back with a warm blanket, prone on the mother's bare chest. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neurobehaviors ensuring fulfillment of basic biological needs. This time may represent a psychophysiologically 'sensitive period' for programming future behavior. To assess the effects of early SSC on breastfeeding, behavior, and physiological adaptation in healthy mother-newborn dyads. Cochrane Pregnancy and Childbirth Group's and Neonatal Group's Trials Registers (August 2006), Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 2), MEDLINE (1976 to 2006). Randomized and quasi-randomized clinical trials comparing early SSC with usual hospital care. We independently assessed trial quality and extracted data. Study authors were contacted for additional information. Thirty studies involving 1925 participants (mother-infant dyads), were included. Data from more than two trials were available for only 8-of-64 outcome measures. We found statistically significant and positive effects of early SSC on breastfeeding at one to four months postbirth (10 trials; 552 participants) (odds ratio (OR) 1.82, 95% confidence interval (CI) 1.08 to 3.07), and breastfeeding duration (seven trials; 324 participants) (weighted mean difference (WMD) 42.55, 95% CI -1.69 to 86.79). Trends were found for improved summary scores for maternal affectionate love/touch during observed breastfeeding (four trials; 314 participants) (standardized mean difference (SMD) 0.52, 95% CI 0.07 to 0.98) and maternal attachment behavior (six trials; 396 participants) (SMD 0.52, 95% CI 0.31 to 0.72) with early SSC. SSC infants cried for a shorter length of time (one trial; 44 participants) (WMD -8.01, 95% CI -8.98 to -7.04). Late preterm infants had

Permanent Childhood Hearing Impairment: Aetiological Evaluation of Infants identified through the Irish Newborn Hearing Screening Programme

LENUS (Irish Health Repository)

Smith, A

2017-11-01

The Newborn Hearing Screening Programme (NHSP) was established in Cork University Maternity Hospital (CUMH) in April 2011. Between April 2011 and July 2014, 42 infants were identified with a Permanent Childhood Hearing Impairment (PCHI). Following this diagnosis, infants underwent a paediatric assessment according to recognised guidelines with the intention of identifying the underlying aetiology of the PCHI. The aim of this study was to assess the findings of this aetiological workup via retrospective chart review. PCHI data was obtained from the eSP database. This is a web based information system (eSP) used to track each baby through the screening and referral process A retrospective chart review of these patients was performed. Sixteen (38%) infants were diagnosed with a bilateral sensorineural hearing loss. Two infants had congenital CMV infection. A Connexin 26 gene mutation was detected in one infant. Two infants were diagnosed with Waardenburg syndrome, One with Pendred syndrome and one with Pfeiffer syndrome. Five babies underwent cochlear implantation. Through adherence to the recommended protocol a possible cause of PCHI may be determined. This study has identified areas of future improvement for this service in Ireland.

Problems of the decrease in periventricular density due to hypoxia in computer tomograms of new-born infants

Energy Technology Data Exchange (ETDEWEB)

Kotlarek, F.; Bruell, D.; Sturm, K.W.; Zeumer, H.

200 premature and mature neonates with clinical evidence of hypoxia or traumatic encephalopathy were examined by cranial computerized tomography (CT) during the first two weeks postnatally. The findings were compared with those in a control-group consisting of 14 neonates with extraneural malformations. Cerebral hemorrhages were easily identified by their high density, in CT images. Bilateral areas of lowered density within the periventricular white matter, however, could not always be attributed to irreversible tissue damage prior to about 14 days after the hypoxic event in term newborns, and in preterm infants even later. During this early period of life an apparent decrease of periventricular density was regularily observed that must not be mistaken for a pathological change. In two cases persistent periventricular areas of decreased density were caused by neuropathologically verified foci of incomplete leucomalacia.

Conservation of the fourth gene among rotaviruses recovered from asymptomatic newborn infants and its possible role in attenuation

International Nuclear Information System (INIS)

Flores, J.; Midthun, K.; Hoshino, Y.; Green, K.; Gorziglia, M.; Kapikian, A.Z.; Chanock, R.M.

1986-01-01

RNA-RNA hybridization was performed to assess the extent of genetic relatedness among human rotaviruses isolated from children with gastroenteritis and from asymptomatic newborn infants. 32 P-labeled single-stranded RNAs produced by in vitro transcription from viral cores of the different strains tested were used as probes in two different hybridization assays: (1) undenatured genomic RNAs were resolved by polyacrylamide gel electrophoresis, denatured in situ, electrophoretically transferred to diazobenzyloxymethyl-paper (Northern blots), and then hybridized to the probes under two different conditions of stringency; and (ii) denatured genomic double-stranded RNAs were hybridized to the probes in solution and the hybrids which formed were identified by polyacrylamide gel electrophoresis. When analyzed by Northern blot hybridization at a low level of stringency, all genes from the strains tested cross-hybridized, providing evidence for some sequence homology in each of the corresponding genes. However, when hybridization stringency was increased, a difference in gene 4 sequence was detected between strains recovered from asymptomatic newborn infants (nursery strains) and strains recovered from infants and young children with diarrhea. Although the nursery strains exhibited serotypic diversity, the fourth gene appeared to be highly conversed. These results were confirmed and extended during experiments in which the RNA-RNA hybridization was carried out in solution and the resulting hybrids were analyzed by polyacrylamide gel electrophoresis. Full-length hybrids did not form between the fourth genes from the nursery strains and the corresponding genes from the strains recovered from symptomatic infants and young children

Maternal Affective-Cognitive Processes in the Perception of Newborn Difficultness.

Science.gov (United States)

Wolke, Dieter; St. James-Roberts, Ian

A short-term longitudinal study investigated the way parents come to perceive their infant's temperament as difficult, and to identify factors influencing parents' impression formation. Subjects were 40 middle and lower middle class breastfeeding mothers and their singleton newborns of 38 weeks gestation and 2500 grams birth weight. All mothers…

Antepartum risk factors for newborn encephalopathy: the Western Australian case-control study

Science.gov (United States)

Badawi, Nadia; Kurinczuk, Jennifer J; Keogh, John M; Alessandri, Louisa M; O’Sullivan, Fiona; Burton, Paul R; Pemberton, Patrick J; Stanley, Fiona J

1998-01-01

Objective To ascertain antepartum predictors of newborn encephalopathy in term infants. Design Population based, unmatched case-control study. Setting Metropolitan area of Western Australia, June 1993 to September 1995. Subjects All 164 term infants with moderate or severe newborn encephalopathy; 400 randomly selected controls. Main outcome measures Adjusted odds ratio estimates. Results The birth prevalence of moderate or severe newborn encephalopathy was 3.8/1000 term live births. The neonatal fatality was 9.1%. The risk of newborn encephalopathy increased with increasing maternal age and decreased with increasing parity. There was an increased risk associated with having a mother who was unemployed (odds ratio 3.60), an unskilled manual worker (3.84), or a housewife (2.48). Other risk factors from before conception were not having private health insurance (3.46), a family history of seizures (2.55), a family history of neurological disease (2.73), and infertility treatment (4.43). Risk factors during pregnancy were maternal thyroid disease (9.7), severe pre-eclampsia (6.30), moderate or severe bleeding (3.57), a clinically diagnosed viral illness (2.97), not having drunk alcohol (2.91); and placenta described at delivery as abnormal (2.07). Factors related to the baby were birth weight adjusted for gestational age between the third and ninth centile (4.37) or below the third centile (38.23). The risk relation with gestational age was J shaped with 38 and 39 weeks having the lowest risk. Conclusions The causes of newborn encephalopathy are heterogeneous and many of the causal pathways start before birth. Key messagesThe birth prevalence of moderate or severe newborn encephalopathy was 3.8 per 1000 term live births and the neonatal case fatality was 9.1%Independent risk factors before conception and in the antepartum period for newborn encephalopathy include socioeconomic status, family history of seizures or other neurological disease, conception after

Noninvasive measurements of regional cerebral perfusion in preterm and term neonates by magnetic resonance arterial spin labeling

DEFF Research Database (Denmark)

Miranda Gimenez-Ricco, Maria Jo; Olofsson, K; Sidaros, Karam

2006-01-01

Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term-born neon......Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term...

Different methods for assessment of nutritional status in newborn infants based on physical and anthropometric indexes: a short review article

Directory of Open Access Journals (Sweden)

Ali Asghar Rashidi

2017-01-01

Full Text Available Several complications during childhood is associated with nutritional status of infants at birth. Therefore, nutritional status of newborns must be evaluated properly after birth. Assessment of the nutritional status of neonates based on anthropometric and physical indices is simple and inexpensive without the need for advanced medical equipment. However, no previous studies have focused on the assessment methods of the nutritional status of infants via anthropometric and physical indices. This study aimed to review some of the key methods used to determine the nutritional status of neonates using anthropometric and physical indices. To date, most studies have focused on the diagnosis of fetal malnutrition (FM and growth monitoring. In order to diagnose FM, researchers have used growth charts and Ponderal index (PI based on anthropometric indices, as well as Clinical Assessment of Nutritional (CAN Score based on physical features. Moreover, in order to assess the growth status of infants, growth charts were used. According to the findings of this study, standard intrauterine growth curves and the PI are common measurement tools in the diagnosis of FM. Furthermore, CAN score is widely used in the evaluation of the nutritional status of neonates. Given the differences in the physical features of term and preterm infants, this index should be adjusted for preterm neonates. Longitudinal growth charts are one of the most prominent methods used for monitoring of the growth patterns of infants.

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

Directory of Open Access Journals (Sweden)

Katharina Zinke

2018-01-01

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

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.

Proceedings: regional lung function in the newborn infant assessed by means of 133Xe

Energy Technology Data Exchange (ETDEWEB)

Koch, G.

1975-01-01

Regional distribution of ventilation and perfusion was assessed in 14 normal newborn infants and in some with respiratory distress (RDS) using a gamma camera computer system and /sup 133/Xe as tracer. The normal infants were at ages when R-L shunting through fetal channels is mainly abolished but minor L-R shunting through the ductes arteriosus still may occur. In the normal infant, distribution of ventilation and perfusion is nearly identical to that in the adult. The disappearance constants after inhalation (ventilated areas) and injection (perfused areas) are high indicating great efficiency of ventilation. This finding of high ventilatory efficiency is in accordance with direct measurements of alveolar ventilation. Despite the high efficiency, however, its distribution even in the normal infant is suprisingly uneven. The most important data is the ventilation/perfusion ratio which shows, as in the adult, relative hyperperfusion basically, while relative hyperventilation in the upper parts is less pronounced than in the adult. During RDS, uneven ventilation and perfusion distribution is much more pronounced. Another striking feature is the low ventilatory efficiency, a finding in agreement with PaCO/sub 2/ data indicating alveolar hypoventilation. Repeated studies in the same infant have demonstrated striking differences in corresponding distribution data between different studies despite similar clinical conditions suggesting that the degree of regional contribution to the overall function disturbance may vary considerably in the course of the disease.

Bacterial meningitis in newborn and infant: correlation between organism, CT findings and clinical outcome

International Nuclear Information System (INIS)

Choi, Hye Young; Park, Young Seo; Yoo, Shi Joon; Suh, Dae Chul; Chung, Young Kyo

1993-01-01

Acute bacterial meningitis often results in significant neurologic complications regardless of the antibiotics treatment Computed tomographic (CT) finding of tuberculous meningitis is fairly well known but not the findings of bacterial meningitis. This study was performed to determine the incidence of causative organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bacterial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates without no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outcomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cisternal obliteration and enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis

School-age effects of the newborn individualized developmental care and assessment program for preterm infants with intrauterine growth restriction: preliminary findings.

Science.gov (United States)

McAnulty, Gloria; Duffy, Frank H; Kosta, Sandra; Weisenfeld, Neil I; Warfield, Simon K; Butler, Samantha C; Alidoost, Moona; Bernstein, Jane Holmes; Robertson, Richard; Zurakowski, David; Als, Heidelise

2013-02-19

The experience in the newborn intensive care nursery results in premature infants' neurobehavioral and neurophysiological dysfunction and poorer brain structure. Preterms with severe intrauterine growth restriction are doubly jeopardized given their compromised brains. The Newborn Individualized Developmental Care and Assessment Program improved outcome at early school-age for preterms with appropriate intrauterine growth. It also showed effectiveness to nine months for preterms with intrauterine growth restriction. The current study tested effectiveness into school-age for preterms with intrauterine growth restriction regarding executive function (EF), electrophysiology (EEG) and neurostructure (MRI). Twenty-three 9-year-old former growth-restricted preterms, randomized at birth to standard care (14 controls) or to the Newborn Individualized Developmental Care and Assessment Program (9 experimentals) were assessed with standardized measures of cognition, achievement, executive function, electroencephalography, and magnetic resonance imaging. The participating children were comparable to those lost to follow-up, and the controls to the experimentals, in terms of newborn background health and demographics. All outcome measures were corrected for mother's intelligence. Analysis techniques included two-group analysis of variance and stepwise discriminate analysis for the outcome measures, Wilks' lambda and jackknifed classification to ascertain two-group classification success per and across domains; canonical correlation analysis to explore relationships among neuropsychological, electrophysiological and neurostructural domains at school-age, and from the newborn period to school-age. Controls and experimentals were comparable in age at testing, anthropometric and health parameters, and in cognitive and achievement scores. Experimentals scored better in executive function, spectral coherence, and cerebellar volumes. Furthermore, executive function, spectral coherence

Congenital Heart Diseases in the Newborns of Diabetic Mothers: an Echocardiographic Study

Directory of Open Access Journals (Sweden)

S Rahimpour

2011-10-01

Full Text Available Introduction: Despite the discovery of insulin and current improvement in diabetics care, congenital malformations in diabetics are still more frequent than in the general population. The aim of this study was to identify congenital heart dieases (CHD in the newborns of diabetic mothers (IDMS. Methods: In our prospective study, color doppler echocardiography was performed in 75 consecutive full- term newborns of diabetic mothers by GE Vivid3 echocardiographic device. Newborns were classified into two subgroups according to the type of the mothers’ diabetes: pre-gestational and gestational. They were also those were classified into three subgroups according to their birth weight: appropriate, large and small for gestational age. Data analysis was made by Fisher exact test and Chi-Square test. Results: Forty nine (65% and thirty six (35% of subjects were infants of gestational (IGDM and pre-gestational diabetic mothers (IPDM, respectively. Fifty five Newborns (73% were apropriate, fourteen (19% were large and six (8% were small for gestational age. The most common echocardiographic findings included: patent ductus arteriosus (PDA: 54.7%, hypertrophic cardiomyopathy (HCMP: 24%, ventricular septal defect (VSD: 4%, atrial septal defect (ASD: 2.7%, transposition of great arteries (TGA: 1.3% and coarctation of the Aorta (COA: 1.3%. Overall incidence of congenital heart diseases was 9.3 after exclusion of PDA and HCMP cases. The incidence of congenital heart diseases was higher in macrosomic than nonmacrosomic infants of diabetic mothers (P<0.001. Congenital heart diseases were more common in infants of pre-gestational than gestational diabetic mothers (P=0.004. Conclusion: Our results showed that diabetic mothers are at increased risk of giving birth to a newborn with congenital heart disease, and transthoracic echocardiography is recommended for all infants of diabetic mothers.

The role of carboxyhemoglobin measured with CO-oximetry in the detection of hemolysis in newborns with ABO alloimmunization.

Science.gov (United States)

Lozar-Krivec, Jana; Bratanic, Borut; Paro-Panjan, Darja

2016-01-01

To evaluate carboxyhemoglobin (COHb) values measured with a CO-oximeter (Roche-cobas b 221) in jaundiced newborns with or without hemolysis and healthy controls in order to assess whether COHb measurement determined with a CO-oximeter could be used as an indicator of hemolysis in newborns with ABO alloimmunization. A total of 86 term newborn infants were prospectively studied. The study cohort consisted of three subgroups: 18 infants with ABO HDN, 21 infants with hyperbilirubinemia without hemolytic disease who required phototherapy, and 47 healthy controls. The COHb, bilirubin, and Hb levels were measured. The three subgroups did not differ significantly with respect to birth weight, gestational age, gender, Apgar score, or mode of delivery. The ABO HDN infants had significantly higher COHb values than the healthy controls (median 2.4% versus 1.3%, p < 0.0005) and the group with hyperbilirubinemia without hemolytic disease (median 2.4% versus 1.3%, p < 0.0005), although the infants with hyperbilirubinemia without hemolytic disease did not have significantly higher COHb values compared with the healthy controls. The cut-off value of 1.7% COHb had 72% sensitivity and 97% specificity for confirming hemolysis in ABO alloimmunization. Our data show that COHb values determined with CO-oximeters are higher in newborns with hemolysis than in those without hemolysis. COHb measured with CO-oximeters could be used to confirm hemolysis in infants with ABO alloimmunization.

[Endoscopic treatment of intestinal malrotation in newborns and infants].

Science.gov (United States)

Kozlov, Yu A; Novozhilov, V A; Rasputin, A A; Us, G P; Kuznetsova, N N; Pakelchuk, A

To compare treatment of intestinal malrotation in newborns and infants using laparoscopy and laparotomy. For the period from January 2004 to December 2013 34 Ladd's procedures were performed. Children were divided into 2 groups by 17 patients: laparoscopic (group I) and open treatment (group II). Both groups had similar demographic and other preoperative parameters. There were significant differences in duration of operation between both groups (61 vs. 70 minutes). Nutrition was initiated earlier after mini-invasive treatment (1.5 days vs. 3 days) and the time need for full enteral nutrition was also less (4.2 days vs. 6.9 days). Hospital-stay was shorter in group I (7.7 vs. 10.2 days). Number of early postoperative complications was similar in groups. Incidence of remote complications was higher in laparotomy group but the differences were not significant. Our results showed that endoscopic correction of congenital anomalies of intestinal rotation provides better postoperative results than open surgery and can be widely used in young children.

Intrauterine growth restriction and prematurity influence regulatory T cell development in newborns.

Science.gov (United States)

Mukhopadhyay, Dhriti; Weaver, Laura; Tobin, Richard; Henderson, Stephanie; Beeram, Madhava; Newell-Rogers, M Karen; Perger, Lena

2014-05-01

The aim of this study was to determine the relationship of birth weight and gestational age with regulatory T cells (Tregs) in cord blood of human newborns. Cord blood mononuclear cells (CBMCs) of 210 newborns were analyzed using flow cytometry to identify Tregs (CD3(+), CD4(+), CD25(high), FoxP3(high)) and measure FoxP3 mean fluorescence intensity (MFI). Suppressive index (SI) was calculated as FoxP3 MFI per Treg. Mode of delivery had no significant effect on Tregs at birth. Term babies with growth restriction had fewer Tregs than their appropriate weight counterparts but equivalent SI. Preterm babies had higher percentages of Tregs, but lower SI than term controls. SI steadily increased through gestation. Intrauterine growth restriction is correlated with fewer circulating Tregs and prematurity with decreased functionality of Tregs compared to term appropriate weight infants. This may have implications in diseases such as necrotizing enterocolitis that disproportionately affect premature and lower birth weight infants. Copyright © 2014 Elsevier Inc. All rights reserved.

A Targeted Approach for Congenital Cytomegalovirus Screening Within Newborn Hearing Screening.

Science.gov (United States)

Fowler, Karen B; McCollister, Faye P; Sabo, Diane L; Shoup, Angela G; Owen, Kris E; Woodruff, Julie L; Cox, Edith; Mohamed, Lisa S; Choo, Daniel I; Boppana, Suresh B

2017-02-01

Congenital cytomegalovirus (cCMV) infection remains a leading cause of childhood hearing loss. Currently universal CMV screening at birth does not exist in the United States. An alternative approach could be testing infants who do not pass their newborn hearing screening (NHS) for cCMV. This study was undertaken to evaluate whether a targeted approach will identify infants with CMV-related sensorineural hearing loss (SNHL). Infants born at 7 US medical centers received NHS and were also screened for cCMV while in the newborn nursery. Infants who tested positive for CMV received further diagnostic audiologic evaluations to identify or confirm hearing loss. Between 2007 and 2012, 99 945 newborns were screened for both hearing impairment and cCMV. Overall, 7.0% of CMV-positive infants did not pass NHS compared with 0.9% of CMV-negative infants (P CMV-infected infants who passed their NHS had SNHL confirmed by further evaluation during early infancy. NHS in this cohort identified 57% of all CMV-related SNHL that occurred in the neonatal period. A targeted CMV approach that tests newborns who fail their NHS identified the majority of infants with CMV-related SNHL at birth. However, 43% of the infants with CMV-related SNHL in the neonatal period and cCMV infants who are at risk for late onset SNHL were not identified by NHS. Copyright © 2017 by the American Academy of Pediatrics.

Mechanisms of Sucrose and Non-Nutritive Sucking in Procedural Pain Management in Infants

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Sharyn Gibbins

2001-01-01

Full Text Available The administration of sucrose with and without non-nutritive sucking (NNS has been examined for relieving procedural pain in newborn infants. The calming and pain-relieving effects of sucrose are thought to be mediated by endogenous opioid pathways activated by sweet taste. The orogustatory effects of sucrose have been demonstrated in animal newborns, and in preterm and full term human infants during painful procedures. In contrast to sucrose, the analgesic effects of NNS are hypothesized to be activated through nonopioid pathways by stimulation of orotactile and mechanoreceptor mechanisms. Although there is uncertainty as to whether the effects of sucrose and NNS are synergistic or additive, there is sufficient evidence to support the efficacy of combining the two interventions for procedural pain relief in infants. In this review article, the underlying mechanisms of sucrose and NNS, separately and in combination for relieving procedural pain in preterm and full term infants, are examined. Clinical and research implications are addressed.

Late haemorrhagic disease of the newborn.

Science.gov (United States)

Zengin, Emine; Sarper, Nazan; Türker, Gülcan; Corapçioğlu, Funda; Etuş, Volkan

2006-09-01

Late haemorrhagic disease of the newborn (HDN) can occur owing to a lack of vitamin K prophylaxis, as a manifestation of an underlying disorder or idiopatically from the 8th day to 12 weeks after birth. Eight infants admitted to Kocaeli University Hospital with nine episodes of late HDN between January 2002 and April 2005 were evaluated retrospectively from hospital records. The median age at presentation was 46 (26-111) days. All the infants were born at full-term to healthy mothers and were exclusively breast-fed. All had an uneventful perinatal history, except one who had meconium aspiration. Four patients had received no vitamin K prophylaxis and another three had uncertain histories. At presentation, six had intracranial bleeding and the remainder had bleeding either from the venepuncture site or the gastro-intestinal tract. The presenting signs and symptoms were irritability, vomiting, bulging or full fontanelle, convulsions and diminished or absent neonatal reflexes. Galactosaemia was detected in a 2-month-old infant with prolonged jaundice. There was no surgery-related mortality or complications but one survived for only 2 days on ventilatory support following surgery. Only one of the six survivors had severe neurological sequelae. Late HDN frequently presents with intracranial haemorrhage, leading to high morbidity and mortality. HDN can be the manifestation of an underlying metabolic disorder. Vitamin K prophylaxis of the newborn should be routine in developing countries.

There is an association between disease location and gestational age at birth in newborns submitted to surgery due to necrotizing enterocolitis.

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Feldens, Letícia; Souza, João C K de; Fraga, José C

2017-08-30

To evaluate if there are differences regarding disease location and mortality of necrotizing enterocolitis, according to the gestational age at birth, in newborns submitted to surgery due to enterocolite. A historical cohort study of 198 newborns submitted to surgery due to necrotizing enterecolitis in a tertiary hospital, from November 1991 to December 2012. The newborns were divided into different categories according to gestational age (<30 weeks, 30-33 weeks and 6 days, 34-36 weeks and 6 days, and ≥37 weeks), and were followed for 60 days after surgery. The inclusion criterion was the presence of histological findings of necrotizing enterocolitis in the pathology. Patients with single intestinal perforation were excluded. The jejunum was the most commonly affected site in extremely premature infants (p=0.01), whereas the ileum was the most commonly affected site in premature infants (p=0.002), and the colon in infants born at term (p<0.001). With the increasing gestational age, it was observed that intestinal involvement decreased for the ileum and the jejunum (decreasing from 45% to 0% and from 5% to 0%, respectively), with a progressive increase in colon involvement (0% to 84%). Total mortality rate was 45.5%, and no statistical difference was observed in the mortality at different gestational ages (p=0.287). In newborns submitted to surgery due to necrotizing enterocolitis, the disease in extremely preterm infants was more common in the jejunum, whereas in preterm infants, the most affected site was the ileum, and in newborns born close to term, it was the colon. No difference in mortality was observed according to the gestational age at birth. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Effects of Familiarity and Feeding on Newborn Speech-Voice Recognition

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Valiante, A. Grace; Barr, Ronald G.; Zelazo, Philip R.; Brant, Rollin; Young, Simon N.

2013-01-01

Newborn infants preferentially orient to familiar over unfamiliar speech sounds. They are also better at remembering unfamiliar speech sounds for short periods of time if learning and retention occur after a feed than before. It is unknown whether short-term memory for speech is enhanced when the sound is familiar (versus unfamiliar) and, if so,…

Impact of Prophylactic Continuous Positive Airway Pressure on Transient Tachypnea of the Newborn and Neonatal Intensive Care Admission in Newborns Delivered by Elective Cesarean Section.

Science.gov (United States)

Celebi, Miray Yilmaz; Alan, Serdar; Kahvecioglu, Dilek; Cakir, Ufuk; Yildiz, Duran; Erdeve, Omer; Arsan, Saadet; Atasay, Begum

2016-01-01

This study aims to evaluate the effect of the prophylactic continuous positive airway pressure (CPAP) administration in the delivery room to newborns who were delivered by elective cesarean section (CS). Inborn infants with gestational age between 34(0/7) to 38(6/7) and born by elective CS were prospectively randomized to receive either prophylactic CPAP for 20 minutes via face mask or standardized care without CPAP in the delivery room. Primary outcomes were the incidence of transient tachypnea of the newborn (TTN) and neonatal intensive care unit (NICU) admission due to respiratory distress. A total of 259 infants with a mean gestational age of 37.7 ± 0.8 weeks and birth weight of 3,244 ± 477 g were included. A total of 134 infants received prophylactic CPAP and 125 received control standard care. The rate of NICU admission was significantly lower in prophylactic CPAP group (p = 0.045). Although the rate of TTN was lower in the prophylactic CPAP group, the difference was not statistically significant (p = 0.059). The rate of NICU admission due to respiratory distress was significantly higher in late-preterm cohort than early-term cohort (p CPAP administration decreases the rate of NICU admission without any side effect in late-preterm and early-term infants delivered by elective CS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Colestasis del recién nacido y del lactante Cholestasis of newborn and infant

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Norma Hondal Álvarez

2010-09-01

Full Text Available Los recién nacidos y lactantes pequeños tienen una inmadurez funcional y anatómica que justifica que las enfermedades hepáticas que se manifiestan en estas edades tengan la ictericia como signo principal y que otros procesos extrahepáticos o sistémicos puedan condicionar colestasis. La colestasis del lactante es un síndrome clínico caracterizado por ictericia, acolia o hipocolia, y coluria, que evoluciona con elevación de la bilirrubina directa y de los ácidos biliares séricos. La evaluación diagnóstica del lactante con colestasis, realizada por un equipo multidisciplinario, debe minimizar la realización de pruebas innecesarias para lograr un diagnóstico correcto en el menor tiempo posible, diferenciar entre colestasis intrahepática o extrahepática y lograr un diagnóstico etiológico, que incluya aquellos procesos que ponen en peligro la vida o requieren un tratamiento específico médico o quirúrgico. El presente trabajo pretende revisar las principales causas, procedimientos diagnósticos y el enfoque terapéutico de la colestasis del recién nacido y del lactante en aras de contribuir a su diagnóstico temprano y su tratamiento adecuado.The small newborns and infants have a functional anatomical immaturity justifying that liver diseases present at these ages have the jaundice as leading sign and that other extra-hepatic or systemic processes may conditioning the Cholestasis. Infant Cholestasis is a clinical syndrome characterized by jaundice, acholia or hypoacholia and choluria evolving with a rise of direct bilirubin and of serum biliary acids. The diagnostic assessment of infant presenting with Cholestasis made by a multidisciplinary staff must to minimize the carrying out of unnecessary tests to obtain an appropriate diagnosis in less time, to differentiate among the intrahepatic or extrahepatic cholestasis and to achieve an etiologic diagnosis including the processes threatening the life or that requiring a medical or

Measurement of penile size in healthy Nigerian newborns using ...

African Journals Online (AJOL)

newborn male infants. J Pediatr 1975; 86:395–398. 6 Flatau E, Josefsberg Z, Reisner SH, Bialik O, Iaron Z. Letter: penile size in the newborn infant. J Pediatr 1975; 87:663–664. 7 Boas M, Boisen KA, Virtanen HE, Kaleva M, Suomi AM, Schmidt IM, et al. Postnatal penile length and growth rate correlate to serum testosterone.

Impact of physiotherapy on neuromotor development of premature newborns

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Giselle Athayde Xavier Coutinho

Full Text Available Introduction The population of children born prematurely has increased in line with improving the quality of perinatal care. It is essential to ensure to these children a healthy development. Objective We evaluate the neuromotor development of a group of preterm infants regularly assisted by a physiotherapy service in comparison to full-term newborns, checking, so the impact of the service. Materials and methods We randomly assigned preterm and full-term infants that formed two distinct groups. The group of preterm infants was inserted into a monitoring program of physiotherapy while the other infants were taken as a control group not receiving any assistance in physiotherapy. The groups were compared using the Alberta Infant Motor Scale (AIMS at forty-week, four and six months of corrected gestational age and the scores were compared using Student's t-test, assuming a significance level of 5% (p < 0.05. Results The preterm group had significantly lower scores at 40th week compared to the control group, but subsequent scores showed no significant differences between the two groups. Conclusion The timely and adequate stimulation was efficient to promote the motor development of premature infants included in a follow up clinic.

Indicadores en adolescentes con ingresos de recién nacidos en cuidados especiales neonatales Indicators of adolescent mothers having newborn infants admitted to Neonatal Intensive Care Unit

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Nuvia Suárez Garcia

2013-02-01

Full Text Available Introducción: el embarazo en adolescentes constituye un indicador negativo de salud ocasionando serias consecuencias materno- infantiles. Objetivo: evaluar indicadores materno-perinatales y neonatales en adolescentes atendidos en el Hospital "Abel Santamaría Cuadrado" durante el 2010. Métodos: se realizó una investigación aplicada, observacional, analítica, retrospectiva tipo caso-control, cuyo universo englobó 5363 nacimientos vivos en el período, asignándose como casos(n=59: aquellos neonatos que ingresaron en cuidados especiales neonatales (CEN hijos de madres adolescentes (Introduction: pregnancy in adolescence constitutes a negative health indicator that provokes serious maternal-child consequences. Objective: to evaluate maternal-perinatal and neonatal indicators in adolescent mothers admitted at "Abel Santamaria Cuadrado" University General Hospital during 2010. Material and method: an applied, observational, analytical, retrospective, case-control type study which target group comprised 5363 live-born babies during the period, assigning as cases (n=59: newborn infants who were admitted to Neonatal Intensive Care Unit (NICU, newborn infants of adolescent mothers ( Results: the majority of the adolescents whose newborn infants were admitted to NICU were primigravida (69.49% (OR=5.63; CI 95%: 2.7-11.8; 45, 6% suffered from some affection (OR=2.27; CI 95%: 1.12-4.59, prevailing Premature Rupture of Membranes (18.64% and pregnancy-induced hypertension (11.86%, 49,15% of newborn infants were premature (OR=3.11; CI 95 %: 1.53-6.38, 52.54% were low-birth-weight infants (OR=3.4; CI 95%: 1.67-3.95 and 59,32% got the Apgar score of Conclusions: adolescence had a negative influence on perinatal and neonatal indicators increasing the risks of diseases associated with pregnancy: prematurity, low-weight and depression at birth.

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.

ACUTE RENAL FAILURE IN THE NEWBORNS HOSPITALIZED AT THE INTENSIVE CARE UNIT, UNIVERSITY CLINICAL CENTRE TUZLA

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Zulić Evlijana

2015-03-01

Full Text Available Introduction: Reasons for acute renal failure in hospitalized infants were sepsis, hypovolemia, asphyxia, respiratory distress syndrome, surgical interventions and congenital heart defects. The aim of this study was to determine the frequency and and main etiologies, and early outcome of neonatal acute renal failure. Materials and Methods: At Intensive Care Unit, Clinical Center Tuzla, from 15. 01. 2013 to 15. 01. 2015 in 21 newborn was diagnosed renal failure, based on the amount of excreted urine and serum creatinine. Results: The prevalence of renal failure was 6.84%, with a higher incidence of female. 33.3% of infants were term neonates. Oliguria was diagnosed in 71.4% of newborns. Sepsis was the most common predisposing factor for the development of renal failure, associated with high mortality. Other causes of renal failure were perinatal hypoxia, RDS, surgical interventions and congenital heart defects. There was a positive correlation between the gestational age of the newborn and serum creatinine. Discussion: Early prevention of risk factors with rapid diagnosis and effective treatment, can affect further outcome of acute renal failure in infants.

Body composition of term healthy Indian newborns.

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Jain, V; Kurpad, A V; Kumar, B; Devi, S; Sreenivas, V; Paul, V K

2016-04-01

Previous anthropometry-based studies have suggested that in Indian newborns fat mass is conserved at the expense of lean tissue. This study was undertaken to assess the body composition of Indian newborns and to evaluate its relation with parents' anthropometry, birth weight and early postnatal weight gain. Body composition of healthy term singleton newborns was assessed by the deuterium dilution method in the second week of life. Anthropometry was carried out at birth and on the day of study. Data from 127 babies were analyzed. Birth weight was 2969±383 g. Body composition was assessed at a mean age of 12.7±3.1 days. Fat and fat-free mass were 354±246 and 2764±402 g, respectively, and fat mass percentage (FM%) was 11.3±7.3%. Birth weight and fat-free mass were higher among boys, but no gender difference was noted in FM%. Birth weight was positively correlated with fat as well as fat-free mass but not FM%. FM% showed positive correlation with gain in weight from birth to the day of assessment. This is the first study from India to report body composition in newborns using deuterium dilution. FM% was comparable to that reported for Western populations for babies of similar age. Our results suggest that the percentage of fat and fat-free mass is relatively constant over the range of birth weights included in this study, and greater weight gain during early postnatal period results in greater increase in FM%.

[A temporal bone CT study of the infants with hearing loss referred from universal newborn hearing screening].

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Tao, Zheng; Li, Yun; Hou, Zheng; Cheng, Lan

2007-02-01

To explore the high resolution CT image of temporal bone in infants with hearing loss, and its value in evaluating the cause of hearing loss. In 2005, 0.12 million newborns have been included in the hearing screening system in Shanghai, and 1077 infants have failed to pass the hearing screening. One hundred and eight four infants were diagnosed as congenital hearing loss from mild to profound. A temporal bone HRCT scanning was performed to these infants. Among the 184 patients with congenital hearing loss, HRCT showed that 26 cases (14.1%) were associated with external ear malformation, and 21 cases (11.4%) were associated with middle ear malformation, 31 cases (16.8%) associated with inner ear malformation. The patients with inner ear malformation included 12 cases with Mondini malformation, 1 case with common cavity malformation, 6 cases with large vestibule malformation, 5 cases with internal auditory canal abnormalities, and 10 cases with vestibule, semicircular canals abnormalities. In addition, there were 20 cases (10.8%) with fluid in middle ear. HRCT image play an important role in the differential diagnosis and treatment of infants with congenital hearing loss.

The problems of the decrease in periventricular density due to hypoxia in computer tomograms of new-born infants

International Nuclear Information System (INIS)

Kotlarek, F.; Bruell, D.; Sturm, K.W.; Zeumer, H.

1982-01-01

200 premature and mature neonates with clinical evidence of hypoxia or traumatic encephalopathy were examined by cranial computerized tomography (CT) during the first two weeks postnatally. The findings were compared with those in a ''control-group'' consisting of 14 neonates with extraneural malformations. Cerebral hemorrhages were easily identified by their high density, in CT images. Bilateral areas of lowered density within the periventricular white matter, however, could not always be attributed to irreversible tissue damage prior to about 14 days after the hypoxic event in term newborns, and in preterm infants even later. During this early period of life an apparent decrease of periventricular density was regularily observed that must not be mistaken for a pathological change. In two cases persistent periventricular areas of decreased density were caused by neuropathologically verified foci of incomplete leucomalacia. (orig.) [de

Heart rate variability in newborns.

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Javorka, K; Lehotska, Z; Kozar, M; Uhrikova, Z; Kolarovszki, B; Javorka, M; Zibolen, M

2017-09-22

Heart rate (HR) and heart rate variability (HRV) in newborns is influenced by genetic determinants, gestational and postnatal age, and other variables. Premature infants have a reduced HRV. In neonatal HRV evaluated by spectral analysis, a dominant activity can be found in low frequency (LF) band (combined parasympathetic and sympathetic component). During the first postnatal days the activity in the high frequency (HF) band (parasympathetic component) rises, together with an increase in LF band and total HRV. Hypotrophy in newborn can cause less mature autonomic cardiac control with a higher contribution of sympathetic activity to HRV as demonstrated by sequence plot analysis. During quiet sleep (QS) in newborns HF oscillations increase - a phenomenon less expressed or missing in premature infants. In active sleep (AS), HRV is enhanced in contrast to reduced activity in HF band due to the rise of spectral activity in LF band. Comparison of the HR and HRV in newborns born by physiological vaginal delivery, without (VD) and with epidural anesthesia (EDA) and via sectio cesarea (SC) showed no significant differences in HR and in HRV time domain parameters. Analysis in the frequency domain revealed, that the lowest sympathetic activity in chronotropic cardiac chronotropic regulation is in the VD group. Different neonatal pathological states can be associated with a reduction of HRV and an improvement in the health conditions is followed by changes in HRV what can be use as a possible prognostic marker. Examination of heart rate variability in neonatology can provide information on the maturity of the cardiac chronotropic regulation in early postnatal life, on postnatal adaptation and in pathological conditions about the potential dysregulation of cardiac function in newborns, especially in preterm infants.

Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss.

Science.gov (United States)

Ross, Shannon A; Ahmed, Amina; Palmer, April L; Michaels, Marian G; Sánchez, Pablo J; Stewart, Audra; Bernstein, David I; Feja, Kristina; Fowler, Karen B; Boppana, Suresh B

2017-05-01

To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life. Copyright © 2017 Elsevier Inc. All rights reserved.

[Universal cytomegalovirus infection screening in premature newborns less than 1500 g].

Science.gov (United States)

Botet, F; Figueras Aloy, J; Álvarez, E; de Alba, C; Dorronsolo, I; Echaniz Urcelay, I; Rite, S; Moreno, J; Fernández Lorenzo, J R; Herranz Carrillo, G; Salguero, E; Sánchez Luna, M

2014-10-01

Cytomegalovirus (CMV) infection is endemic, and children who attend day care are the most important source of infection. To establish recommendations based on the medical evidence on the vertical transmission of cytomegalovirus in preterm infants weighing less than 1500g at birth. Infection in pregnant women may be primary or secondary. Although there is fetal infection, 85% of newborn infants are asymptomatic. Symptoms of infection include low birth weight, hepatosplenomegaly, thrombocytopenia, microcephaly and neurological disorders. The prognosis of symptomatic children is very poor, with high mortality and neurological disorders. The virus can be reactivated during breast feeding, and early infection is possible through breast milk, probably with little impact in term infants, although the long-term neurological outcome worsens in preterm infants. The diagnostic method of choice is the identification of CMV in urine; the determination in the first two weeks of life suggests congenital infection; later it can be acquired at birth or through breast milk or contaminated blood transfusion. Determine viral DNA at 4-6 weeks of life by protease chain reaction. If it is positive, monitoring of samples from the first days of life and breast milk are mandatory. This should allow the newborn to be classified into three states: "Without CMV infection", "Congenital CMV infection", "Acquired CMV infection". Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Growth hormone in intra-uterine growth retarded newborns.

Science.gov (United States)

Setia, Sajita; Sridhar, M G; Bhat, Vishnu; Chaturvedula, Latha

2007-11-01

To study growth hormone levels in IUGR and healthy controls and its association with birth weight and ponderal index. We studied 50 Intra uterine growth retarded (IUGR) and 50 healthy newborns born at term by vaginal delivery in JIPMER, Pondicherry, India. Cord blood was collected at the time of delivery for measurement of growth hormone. When compared with healthy newborns, IUGR newborns had higher growth hormone levels (mean +/- SD, 23.5 +/- 15.6 vs 16.2 +/- 7.61 ngm/ml, P = 0.019). A negative correlation was identified between growth hormone levels and birth weight (r2 = - 0.22, P = 0.03) and ponderal index (r2 = - 0.36, P = 0.008). Correlation of growth hormone levels was much more confident with ponderal index than with birth weight. At birth IUGR infants display increased growth hormone levels which correlate with ponderal index much more confidently than with birth weight.

Factors relating to readmission of term and near-term neonates in the first two weeks of life. Early Discharge Survey Group of the Health Professional Advisory Board of the Greater New York Chapter of the March of Dimes.

Science.gov (United States)

Brown, A K; Damus, K; Kim, M H; King, K; Harper, R; Campbell, D; Crowley, K A; Lakhani, M; Cohen-Addad, N; Kim, R; Harin, A

1999-01-01

A multisite study of term and near term infants readmitted in the first two weeks of life to 9 New York City area hospitals in 1995 was conducted to evaluate factors related to readmission, including length of newborn stay. Of the 30,884 infants born at the 9 study hospitals 391 newborns were readmitted. The major admission diagnoses were infection, 40.7%, hyperbilirubinemia, 39.1%, and feeding and/or gastrointestinal problems, 10.5%. In the first week, 65.1% of readmissions were for hyperbilirubinemia and 19.1% were for infection or suspected sepsis. In the second week, 67.8% of readmissions were for infection and 7.6% were for hyperbilirubinemia. Hyperbilirubinemia was the most frequent diagnosis for White and Asian infants, while infection was most frequent for African-American and Hispanic infants. Age at readmission was younger and the interval from discharge was shorter for infants with hyperbilirubinemia. Abnormalities which should have precluded early discharge included feeding difficulties, cyanotic congenital heart defects, hemolytic disease of the newborn, early jaundice or early high bilirubin levels. Attention to identification of infants at risk and programs such as lactation counseling and universal screening for bilirubin (with appropriate interpretation) prior to discharge could have reduced the necessity for readmission regardless of the newborn length of stay.

Maternal pre- and postnatal mental health and infant development in war conditions: The Gaza Infant Study.

Science.gov (United States)

Punamäki, Raija-Leena; Diab, Safwat Y; Isosävi, Sanna; Kuittinen, Saija; Qouta, Samir R

2018-03-01

Women and their infants need special protection in war context, as traumatic events can risk maternal mental and obstetric health and compromise infant development. This prospective study examined, first, how exposure to war trauma is associated with maternal mental health in pregnancy and postpartum, obstetric and newborn health, and infant development. Second, it tested the role of maternal mental health and obstetric risks in mediating between war trauma and infant development. Palestinian women (N = 511) from the Gaza strip participated during pregnancy (T1) and at 4 (T2) and 12 (T3) months postpartum. They reported PTSD, depressive, anxiety, and dissociative symptoms, as well as pregnancy complications, newborn health risks such as prematurity, and infant sensorimotor and language development. First, exposure to war trauma was associated with high levels of maternal mental health and complications at pregnancy, and with increased postpartum mental health symptoms, but exposure was not directly associated with newborn health risks or problems in infant development. Second, maternal mental health both in pregnancy and postpartum, but not pregnancy complications or newborn health, mediated the negative impact of war trauma on infant sensorimotor and language development at 12 months. Interventions to protect early child development in war conditions should be tailored to support maternal mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Hiperecogenicidade dos vasos talâmicos no recém-nascido prematuro Hyperechogenicity of thalamic vessels in preterm newborn infants

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Natália Paczko

2002-09-01

(HCPA from July 1998 to May 1999. All of them were submitted to BUS in the first week of life. Preterm children who needed hospital admission and had a term of informed consent signed up by their guardians were included in this study. Preterm newborn children with BUS showing intracranial hemorrhage and/or associated congenital malformation were excluded from this study. Results: through BUS it was possible to identify 65 preterm newborn children with HETV and 141 preterm newborn children without HETV. Conclusions: we identified the following risk factors for HETV: pelvic presentation, longer gestational period, increased birthweight and big for gestational age classification. On the other hand, mother's hypertension during the gestational period tended to protect infants from HETV. The newborn infants that presented convulsive crises during hospitalization had a 3.2-fold higher risk of having HETV when compared to the ones who did not go through any convulsive crises.

Vitamin D Deficiency among Newborns in Amman, Jordan

Science.gov (United States)

Khuri-Bulos, Najwa; Lang, Ryan D.; Blevins, Meridith; Kudyba, Katherine; Lawrence, Lindsey; Davidson, Mario; Faouri, Samir; Halasa, Natasha B.

2014-01-01

Objective: Vitamin D deficiency is well recognized in selected Middle Eastern countries, but neonatal vitamin D status is not well studied in Jordan and other nearby countries. The aim of this study is to determine the prevalence of vitamin D deficiency in Jordanian newborns and risk factors associated with low levels. Methods: This is a prospective cohort study of newborn infants who were delivered at the Al Bashir Government Hospital in Amman, Jordan, from January 31, 2010, to January 27, 2011. Heel stick blood samples for 25-hydroxyvitamin D [25(OH)D] levels were obtained within 96 hours of birth. Maternal dress pattern, vitamin supplementation, smoke exposure during pregnancy, mode of delivery, gestational age, and birth weight were documented. Results: Samples were obtained from 3,731 newborns. Median gestational age was 39 weeks, median birth weight was 3.1 kilograms, median maternal age was 27 years, and median newborn 25(OH)D level was 8.6nmol/L. A total of 3,512 newborns (94.1%) in this study were vitamin D deficient (< 50 nmol/L). Lower gestational age, maternal smoke exposure, and birth during winter months were associated with lower infant vitamin D levels, while vitamin D supplementation and time spent outside during pregnancy were associated with higher vitamin D levels. Conclusions: The prevalence of severely low vitamin D levels in newborn infants in Amman, Jordan, is substantial, even in newborns born during the spring and summer months. Vitamin D supplementation is needed in this population. PMID:24373276

Diabetes mellitus in newborns and infants.

Science.gov (United States)

Menon, P S; Khatwa, U A

2000-06-01

Diabetes mellitus is uncommon in infancy and newborn period. The two common forms seen are the transient and permanent forms of diabetes mellitus of the newborn. They have to be differentiated from the transient hyperglycemic states (Blood sugar > 125 mg/dl) seen in newborns who receive parenteral glucose infusions and in those with septicemia and CNS disorders. Transient diabetes mellitus of the newborn (TDNB) is defined as hyperglycemia occurring within the first month of life lasting at least 2 weeks and requiring insulin therapy. Most of these cases resolve spontaneously by 4 months. It has a reported incidence of 1 in 45,000 to 60,000 live births. The most likely etiology is a maturational delay of cAMP mediated insulin release. The clinical features include small for datedness, proneness for birth asphyxia, open-eye alert facies, dehydration, emaciation, polyuria and poydipsia. These children are prone to septicemia and urinary tract infections. They have hyperglycemia, glucosuria, absent or mild ketonuria, low basal insulin, C-peptide and IGF-1 levels. Treatment consists of hydration and judicious administration of insulin with close monitoring. Thirty percent of these children are likely to develop permanent neonatal diabetes. Compared to transient form, permanent diabetes mellitus is uncommon. It is usually due to pancreatic dysgenesis often associated with other malformations and rarely due to type 1 diabetes mellitus. The diagnosis is based on the demonstration of both exocrine and endocrine pancreatic dysfunction. These children are managed as type 1 diabetes mellitus. They are prone to develop the vascular complications of diabetes at an earlier date.

Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths.

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Abouk, Rahi; Grosse, Scott D; Ailes, Elizabeth C; Oster, Matthew E

2017-12-05

In 2011, critical congenital heart disease was added to the US Recommended Uniform Screening Panel for newborns, but whether state implementation of screening policies has been associated with infant death rates is unknown. To assess whether there was an association between implementation of state newborn screening policies for critical congenital heart disease and infant death rates. Observational study with group-level analyses. A difference-in-differences analysis was conducted using the National Center for Health Statistics' period linked birth/infant death data set files for 2007-2013 for 26 546 503 US births through June 30, 2013, aggregated by month and state of birth. State policies were classified as mandatory or nonmandatory (including voluntary policies and mandates that were not yet implemented). As of June 1, 2013, 8 states had implemented mandatory screening policies, 5 states had voluntary screening policies, and 9 states had adopted but not yet implemented mandates. Numbers of early infant deaths (between 24 hours and 6 months of age) coded for critical congenital heart disease or other/unspecified congenital cardiac causes for each state-month birth cohort. Between 2007 and 2013, there were 2734 deaths due to critical congenital heart disease and 3967 deaths due to other/unspecified causes. Critical congenital heart disease death rates in states with mandatory screening policies were 8.0 (95% CI, 5.4-10.6) per 100 000 births (n = 37) in 2007 and 6.4 (95% CI, 2.9-9.9) per 100 000 births (n = 13) in 2013 (for births by the end of July); for other/unspecified cardiac causes, death rates were 11.7 (95% CI, 8.6-14.8) per 100 000 births in 2007 (n = 54) and 10.3 (95% CI, 5.9-14.8) per 100 000 births (n = 21) in 2013. Early infant deaths from critical congenital heart disease through December 31, 2013, decreased by 33.4% (95% CI, 10.6%-50.3%), with an absolute decline of 3.9 (95% CI, 3.6-4.1) deaths per 100 000 births after

Seizure and electroencephalographic changes in the newborn period induced by opiates and corrected by naloxone infusion.

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da Silva, O; Alexandrou, D; Knoppert, D; Young, G B

1999-03-01

To describe the association between opioid administration in the newborn period and neurologic abnormalities. Case reports of two infants who presented with seizure activity and abnormal electroencephalograms associated with opiate administration, and reversed by naloxone. The first was a preterm infant who developed a burst-suppression pattern on the electroencephalogram while receiving a continuous infusion of morphine and muscle paralysis. Naloxone injection during the electroencephalogram recording reversed the burst-suppression pattern. The second was a term infant receiving fentanyl infusion for pain control following surgery, who presented with motor seizure that was only partially controlled with barbiturates. An abnormal electroencephalogram recording during the opiate infusion improved with naloxone administration. Our observations indicate a potential for neurologic abnormalities, including induction of seizure activity and electroencephalogram abnormalities, suggesting caution when opiates are used for sedation and/or pain control in the newborn period.

Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury

Directory of Open Access Journals (Sweden)

Paulina A. Toso

2014-03-01

Full Text Available Objective: to test the clinical utility of an early amplitude-integrated electroencephalography (aEEG to predict short-term neurological outcome in term newborns at risk of neurology injury. Methods: this was a prospective, descriptive study. The inclusion criteria were neonatal encephalopathy, neurologic disturbances, and severe respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values, and likelihood ratio (LR were calculated. Clinical and demographic data were analyzed. Neurological outcome was defined as the sum of clinical, electroimaging, and neuroimaging findings. Results: ten of the 21 monitored infants (48% presented altered short-term neurologic outcome. The aEEG had 90% sensitivity, 82% specificity, 82% positive predictive value, and 90% negative predictive value. The positive LR was 4.95, and the negative LR was 0.12. In three of 12 (25% encephalopathic infants, the aEEG allowed for a better definition of the severity of their condition. Seizures were detected in eight infants (38%, all subclinical at baseline, and none had a normal aEEG background pattern. The status of three infants (43% evolved and required two or more drugs for treatment. Conclusions: in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detected early subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurological outcomes for all sick newborn. Resumo: Objetivo: testar a utilidade clínica do aEEG precoce em recém-nascidos a termo com risco de lesão neurológica, para prever resultados neurológicos de curto prazo. Métodos: estudo prospectivo e descritivo. Os critérios de inclusão foram encefalopatia neonatal, distúrbios neurológicos e bebês com SARA grave. Sensibilidade, especificidade

Infants long-term memory for complex music

Science.gov (United States)

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

2002-05-01

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

Health Literacy Among Parents of Newborn Infants

Science.gov (United States)

Mackley, Amy; Winter, Michael; Guillen, Ursula; Paul, David A.; Locke, Robert

2016-01-01

BACKGROUND Health Literacy is the ability to obtain, process, and understand health information to make knowledgeable health decisions. PURPOSE To determine baseline health literacy of NICU parents at a tertiary care hospital during periods of crucial information exchange. METHODS Health Literacy of English speaking NICU parents was assessed using the Newest vital Sign (NVS) on admission (n=121) and discharge (n=59). A quasi-control group of well newborn (WBN) parents (n=24) and prenatal obstetric clinic (PRE) parents (n=18) were included. A single, Likert-style question measured nurse’s assessment of parental comprehension with discharge teaching. Suspected limited health literacy (SLHL) was defined as NVS score of ≤3. FINDINGS / RESULTS Forty-three percent of parents on NICU admission and 32% at NICU discharge had SLHL (pNICU parents and 25% of WBN parents with SLHL at time of admission/infant birth had a college education. Nurse subjective measurement of parental comprehension of discharge instructions was not correlated to the objective measurement of health literacy (p=0.26). IMPLICATIONS FOR PRACTICE SLHL is common during peak time periods of complex health discussion in the NICU, WBN, and PRE settings. NICU providers may not accurately gauge parent’s literacy status. IMPLICATIONS FOR RESEARCH Methods for improving health communication are needed. Studies should evaluate SLHL in a larger NICU population and across different languages and cultures. PMID:27391562

Bone densitometry by dual-energy X-ray absorptiometry (DXA in preterm newborns compared with full-term peers in the first six months of life

Directory of Open Access Journals (Sweden)

Virginia S. Quintal

2014-12-01

Full Text Available OBJECTIVES: To longitudinally assess bone mineral content (BMC, bone mineral density (BMD, and whole-body lean mass obtained through bone densitometry by dual-energy X-ray absorptiometry (DXA in preterm newborns (PTNs and compare them with full-term newborns (FTNs from birth to 6 months of corrected postnatal age. METHODS: A total of 28 adequate for gestational age (AGA newborns were studied: 14 preterm and 14 full-term newborns. DXA was used to determine BMC, BMD, and lean mass in three moments: 40 weeks corrected post-conceptual age, as well as 3 and 6 months of corrected postnatal age. PTNs had gestational age ≤ 32 weeks at birth and were fed their mother's own milk or milk from the human milk bank. RESULTS: All infants had an increase in BMC, BMD, and lean body mass values during the study. PTNs had lower BMC, BMD, and lean mass at 40 weeks of corrected post-conceptual age in relation to FTNs (p < 0.001, p < 0.001, p = 0.047, respectively. However, there was an acceleration in the mineralization process of PTNs, which was sufficient to achieve the normal values of FTNs at 6 months of corrected age. CONCLUSIONS: This study suggests that bone densitometry by dual-energy X-ray absorptiometry is a good method for the assessment of body composition parameters at baseline, and at the follow-up of these PTNs.

Infant - newborn development

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... is on the changing table. Consider the following important safety tips: Be aware of poisons (household cleaners, cosmetics, ... middle of the back seat. It is very important for the driver to pay attention to driving, not playing with the infant. If you need ...

Volvulus in term and preterm infants - clinical presentation and outcome.

Science.gov (United States)

Horsch, Sandra; Albayrak, Bilge; Tröbs, Ralf-Bodo; Roll, Claudia

2016-06-01

Our aim was to assess if term and preterm infants with volvulus showed different patterns with regard to pathogenesis, clinical presentation and outcome. We reviewed the medical records and imaging data of infants aged less than six months with volvulus treated in a single surgical referral centre from 2006-2013. Volvulus was diagnosed in 19 infants, with no anatomical anomaly in three of the 12 preterm infants and one of the seven term infants. Most cases (74%) presented during the first eight days of life. Later presentations occurred exclusively in preterm infants, with only one of the five having no anatomic anomalies. Bilious vomiting was the leading symptom in six of the seven term infants, while the symptoms in preterm infants were rather nonspecific. Intestinal necrosis, with the need for bowel resection, occurred in one term (14%) infant and nine (75%) preterm infants. The clinical presentation and outcome of volvulus differed between preterm and term infants, but the rate and distribution of underlying anomalies did not differ. Symptoms in preterm infants were often nonspecific and led to a delay in diagnosis. This might have contributed to the higher rate of intestinal necrosis in preterm infants. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

[A case of severe hemolytic disease of the newborn due to anti-Dia antibody].

Science.gov (United States)

Lee, Sun Min; Im, Sun Ju; Park, Su Eun; Lee, Eun Yup; Kim, Hyung Hoi

2007-10-01

Here we report a severe case of hemolytic anemia of the newborn with kernicterus caused by anti-Di(a) antibody. A full term male infant was transferred due to hyperbilirubinemia on the third day of life. Despite single phototherapy, the baby's total bilirubin had elevated to 30.1 mg/dL. After exchange transfusion, total bilirubin decreased to 11.45 mg/dL. The direct antiglobulin test on the infant's red cells was positive. The maternal and infant's sera showed a negative reaction in routine antibody detection tests, but were positive in Di(a) panel cells. The frequency of the Di(a) antigen among the Korean population is estimated to be 6.4-14.5%. Anti-Di(a) antibody could cause a hemolytic reaction against transfusion or hemolytic disease of the newborn. We suggest the need for reagent red blood cell panels to include Di(a) antigen positive cells in antibody identification test for Korean.

Changes in plasma and urinary nitrite after birth in premature infants at risk for necrotizing enterocolitis

Science.gov (United States)

Pun, Priti; Jones, Jesica; Wolfe, Craig; Deming, Douglas D.; Power, Gordon G.; Blood, Arlin B.

2016-01-01

Background Plasma nitrite serves as a reservoir of nitric oxide (NO) bioactivity. Because nitrite ingestion is markedly lower in newborns than adults, we hypothesized plasma nitrite levels would be lower in newborns than in adults, and that infants diagnosed with necrotizing enterocolitis (NEC), a disease characterized by ischemia and bacterial invasion of intestinal walls, would have lower levels of circulating nitrite in the days prior to diagnosis. Methods Single blood and urine samples were collected from 9 term infants and 12 adults, 72 preterm infants every 5 d for 3 wk, and from 13 lambs before and after cord occlusion. Results Nitrite fell 50% relative to cord levels in the first day after birth; and within 15 min after cord occlusion in lambs. Urinary nitrite was higher in infants than adults. Plasma and urinary nitrite levels in infants who developed NEC were similar to those of preterm control infants on days 1 and 5, but significantly elevated at 15 and 20 d after birth. Conclusion Plasma nitrite falls dramatically at birth while newborn urinary nitrite levels are significantly greater than adults. Acute NEC is associated with elevated plasma and urinary nitrite levels. PMID:26539663

Hip sonography in the newborn

International Nuclear Information System (INIS)

Riboni, G.; Serantoni, S.; De Simoni, M.; Bascape', P.; Facchini, R.; Pirovano, G.

1991-01-01

The authors report the data relative to 1507 cases studied with clinical and US examinations, in the neonatal period, in order to exclude hip dysplasia dislocation. US examination was carried out according to Graf's technique and the newborns were classified according to US hip type, to clinical examination and to possible risk factors. The patients were included in a protocol including orthopedic and US controls. Seventeen treated infants were considered as pathologic. Ten of them had IIc or D hips ar birth; the other 7, with IIa hips at birth, presented a X-ray pathologic hip after the 4th months of life. At about one year of age all infants could normally walk, excpet for one who was being treated with herness. No statistically significant differences were observed between the number of pathologic infants in the risk group (1.7%) and that in the no-risk group (0.8%). Clinical examination of the newborn has low sensitivity in detecting pathologic hips. On the basis of their results, thw authors belive US examination of the newborn to be a valuable screening method to diagnose hip dysplasia/dislocation. Moreover, Graf's morphologic method is the best one for US screening of the hip in the neonatal period

Effects of white noise and holding on pain perception in newborns.

Science.gov (United States)

Karakoç, Ayse; Türker, Funda

2014-12-01

This experimental study on newborns was conducted to compare the effects of various atraumatic care procedures during an infant's crying response to pain. Included in this study were 120 newborns chosen from among healthy infants admitted to the Obstetrics Department of Çanakkale State Hospital between April 2010 and June 2010. The patients were divided into three physically homogeneous groups. Infants in group 1 were held on the mothers' laps, infants in group 2 were held on the mother's laps and listened to white noise, and infants in group 3 lay in their cribs and listened to white noise while undergoing a painful procedure. Data collection included the Neonatal Infant Pain Scale, which was used to evaluate the behavioral responses to pain during a heel prick blood draw and a newborn information sheet developed by the researcher. Changes in cardiac and respiratory rates recorded during the invasive procedure were statistically significant among the three groups (p white noise. This group was then followed by the infants who listened to white noise while being held by their mothers. The highest behavioral reaction was reported by those infants who were held by their mothers but did not listen to white noise. According to the results, white noise is an effective nonpharmacologic method to control pain, reduce crying time, and positively effect vital signs. Therefore, it is recommended that the use of white noise be practiced on newborns when they undergo painful procedures. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Mugambi, Mary N; Musekiwa, Alfred; Lombard, Martani; Young, Taryn; Blaauw, Reneé

2012-10-04

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

The Effect of Perinatal Hypoxia on Red Blood Cell Morphology in Newborns

OpenAIRE

S. A. Perepelitsa; V. A. Sergunova; O. E. Gudkova

2017-01-01

Aim. To study the red blood cell (RBC) morphology in newborn infants with a history of perinatal hypoxia using the atomic-force microscopy. Material and methods. The state of RBC membranes of 10 newborns with a history of perinatal hypoxia was studied. All infants were born with low Apgar scoring; the following resuscitative measures were carried out at birth: tracheal intubation, mechanical ventilation (MV). The study group newborns were transferred from the delivery room to the ICU, where M...

Quality maternal and newborn care to ensure a healthy start for every newborn in the World Health Organization Western Pacific Region.

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Obara, H; Sobel, H

2014-09-01

In the World Health Organization Western Pacific Region, the high rates of births attended by skilled health personnel (SHP) do not equal access to quality maternal or newborn care. 'A healthy start for every newborn' for 23 million annual births in the region means that SHP and newborn care providers give quality intrapartum, postpartum and newborn care. WHO and the UNICEF Regional Action Plan for Healthy Newborn Infants provide a platform for countries to scale-up Early Essential Newborn Care (EENC). The plan emphasises the creation of an enabling environment for the practice of EENC; thereby, preventing 50,000 newborn deaths annually. © 2014 Royal College of Obstetricians and Gynaecologists.

Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer.

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Dominguez-Bello, Maria G; De Jesus-Laboy, Kassandra M; Shen, Nan; Cox, Laura M; Amir, Amnon; Gonzalez, Antonio; Bokulich, Nicholas A; Song, Se Jin; Hoashi, Marina; Rivera-Vinas, Juana I; Mendez, Keimari; Knight, Rob; Clemente, Jose C

2016-03-01

Exposure of newborns to the maternal vaginal microbiota is interrupted with cesarean birthing. Babies delivered by cesarean section (C-section) acquire a microbiota that differs from that of vaginally delivered infants, and C-section delivery has been associated with increased risk for immune and metabolic disorders. Here we conducted a pilot study in which infants delivered by C-section were exposed to maternal vaginal fluids at birth. Similarly to vaginally delivered babies, the gut, oral and skin bacterial communities of these newborns during the first 30 d of life was enriched in vaginal bacteria--which were underrepresented in unexposed C-section-delivered infants--and the microbiome similarity to those of vaginally delivered infants was greater in oral and skin samples than in anal samples. Although the long-term health consequences of restoring the microbiota of C-section-delivered infants remain unclear, our results demonstrate that vaginal microbes can be partially restored at birth in C-section-delivered babies.

[Follow-up of newborns with hypoxic-ischaemic encephalopathy].

Science.gov (United States)

Martínez-Biarge, M; Blanco, D; García-Alix, A; Salas, S

2014-07-01

Hypothermia treatment for newborn infants with hypoxic-ischemic encephalopathy reduces the number of neonates who die or have permanent neurological deficits. Although this therapy is now standard of care, neonatal hypoxic-ischaemic encephalopathy still has a significant impact on the child's neurodevelopment and quality of life. Infants with hypoxic-ischaemic encephalopathy should be enrolled in multidisciplinary follow-up programs in order to detect impairments, to initiate early intervention, and to provide counselling and support for families. This article describes the main neurodevelopmental outcomes after term neonatal hypoxic-ischaemic encephalopathy. We offer recommendations for follow-up based on the infant's clinical condition and other prognostic indicators, mainly neonatal neuroimaging. Other aspects, such as palliative care and medico-legal issues, are also briefly discussed. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Stability of ampicillin, piperacillin, cefotaxime, netilmicin and amikacin in an L-amino acid solution prepared for total parenteral nutrition of newborn infants

DEFF Research Database (Denmark)

Goldstein, K; Colding, H; Andersen, G E

1988-01-01

The stability of ampicillin, piperacillin and cefotaxime, alone or in combination with either netilmicin or amikacin, was tested by microbiological methods at 29 degrees C (ampicillin, also at 22 degrees C) in an L-amino acid solution specially prepared for newborn infants. In the case of ampicil...

ABO incompatibility hemolytic disease following exchange transfusion 96 newborn

OpenAIRE

Khatami S.F; Behjati SH.

2007-01-01

Background: ABO incompatibility hemolytic disease of the newborn is a common cause of clinical jaundice and causes two-thirds of the hemolytic disease in newborns. This study was undertaken to determine the frequency of ABO incompatibility hemolytic disease and its complications in newborns undergoing exchange transfusion.Methods: This prospective and descriptive study was performed in jaundiced newborn infants during a three-year period. Inclusion criteria were: maternal blood type O, newbor...

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.

Mother-to-infant emotional involvement at birth.

Science.gov (United States)

Figueiredo, Bárbara; Costa, Raquel; Pacheco, Alexandra; Pais, Alvaro

2009-07-01

To study mother-to-infant emotional involvement at birth, namely factors (socio-demographics, previous life events, type of delivery, pain at childbirth, support from partner, infant characteristics, early experiences with the newborn, and mother's mood) that interfere with the mother's positive, negative and not clear emotions toward the newborn. The Bonding Scale (an extended Portuguese version of the 'New Mother-to-Infant Bonding Scale') and the Edinburgh Postnatal Depression Scale were administrated during the first after delivery days to 315 mothers recruited at Júlio Dinis Maternity Hospital (MJD, Porto, Portugal). A worse emotional involvement with the newborn was observed when the mother was unemployed, unmarried, had less than grade 9, previous obstetrical/psychological problems or was depressed, as well as when the infant was female, had neonatal problems or was admitted in the intensive care unit. Lower total bonding results were significantly predicted when the mother was depressed and had a lower educational level; being depressed, unemployed and single predicted more negative emotions toward the infant as well. No significant differences in the mother-to-infant emotional involvement were obtained for events related to childbirth, such as type of delivery, pain and partner support, or early experiences with the newborn; these events do not predict mother's bonding results either. The study results support the need for screening and supporting depressed, unemployed and single mothers, in order to prevent bonding difficulties with the newborn at birth.

Comparison of the effect of topical application of human milk and dry cord care on the bacterial colonization of umbilical cord in newborn infants

Directory of Open Access Journals (Sweden)

Fatemeh Abbaszadeh

2014-04-01

Full Text Available Background: Breast milk contains significant amounts of compounds that act as natural antimicrobial agents. This study was conducted to compare the effect of topical application of human milk and dry cord care on bacterial colonization in the umbilical cord of newborn infants. Methods: This clinical trial study was carried out on 174 infants in Kashan. The newborns were randomized to mother's milk group and dry cord care group from the birth. In group 1, the mother rubbed her own milk on the cord stump every 12 hours from 3 hours after birth to 2 days after the umbilical cord separation. In group 2, the mother was recommended not to use any material on the cord. Then, the cord samples were taken four times; 3hours after birth, at days 3 and 7, and 2 days after the umbilical cord separation. Results: The findings of the culture two days after umbilical cord separation indicated that low percentage of neonates in the breast milk (23.1% and dry cord care (28.8% groups had bacterial colonization. Moreover, no significant difference was found between the two groups in terms of growth of pathogenic organisms and normal flora of the skin (P>0.05. Conclusion: Given the low prevalence of pathogenic microorganisms in the two groups, it seems using breast milk and dry cord care are equally effective methods of taking care of umbilical cord.

The Methodology of Doppler-Derived Central Blood Flow Measurements in Newborn Infants

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Koert A. de Waal

2012-01-01

Full Text Available Central blood flow (CBF measurements are measurements in and around the heart. It incorporates cardiac output, but also measurements of cardiac input and assessment of intra- and extracardiac shunts. CBF can be measured in the central circulation as right or left ventricular output (RVO or LVO and/or as cardiac input measured at the superior vena cava (SVC flow. Assessment of shunts incorporates evaluation of the ductus arteriosus and the foramen ovale. This paper describes the methodology of CBF measurements in newborn infants. It provides a brief overview of the evolution of Doppler ultrasound blood flow measurements, basic principles of Doppler ultrasound, and an overview of all used methodology in the literature. A general guide for interpretation and normal values with suggested cutoffs of CBFs are provided for clinical use.

Continuous Glucose Monitoring in Newborn Infants

Science.gov (United States)

Thomas, Felicity; Signal, Mathew; Harris, Deborah L.; Weston, Philip J.; Harding, Jane E.; Shaw, Geoffrey M.

2014-01-01

Neonatal hypoglycemia is common and can cause serious brain injury. Continuous glucose monitoring (CGM) could improve hypoglycemia detection, while reducing blood glucose (BG) measurements. Calibration algorithms use BG measurements to convert sensor signals into CGM data. Thus, inaccuracies in calibration BG measurements directly affect CGM values and any metrics calculated from them. The aim was to quantify the effect of timing delays and calibration BG measurement errors on hypoglycemia metrics in newborn infants. Data from 155 babies were used. Two timing and 3 BG meter error models (Abbott Optium Xceed, Roche Accu-Chek Inform II, Nova Statstrip) were created using empirical data. Monte-Carlo methods were employed, and each simulation was run 1000 times. Each set of patient data in each simulation had randomly selected timing and/or measurement error added to BG measurements before CGM data were calibrated. The number of hypoglycemic events, duration of hypoglycemia, and hypoglycemic index were then calculated using the CGM data and compared to baseline values. Timing error alone had little effect on hypoglycemia metrics, but measurement error caused substantial variation. Abbott results underreported the number of hypoglycemic events by up to 8 and Roche overreported by up to 4 where the original number reported was 2. Nova results were closest to baseline. Similar trends were observed in the other hypoglycemia metrics. Errors in blood glucose concentration measurements used for calibration of CGM devices can have a clinically important impact on detection of hypoglycemia. If CGM devices are going to be used for assessing hypoglycemia it is important to understand of the impact of these errors on CGM data. PMID:24876618

Congenital varicella-zoster virus infection. A rare case of severe brain and ocular malformations without limb or cutaneous involvement in a newborn after maternal subclinical infection

International Nuclear Information System (INIS)

Al-Katawee, Yousef A.; Al-Hasoun, Yousef A.; Taha, Mohamed N.; Al-Moslem, Khaled

2005-01-01

Although congenital varicella-zoster virus VZV infection is rare, it carries serious morbidity and mortality to the fetus and newborn infant. We report a full term female newborn infant, born to a multipara unbooked mother who had VZV subclinical infection during the first trimester of pregnancy. Routine newborn examination showed cystic malformation of the left eye, and absence of the right eye globe. Radiological work up revealed severe brain and eye malformations, serological studies of both mother and baby were positive for VZV. The baby underwent palliative surgery to the eyes, upon discharge, a plan of multidisciplinary team was made for follow up including neurologist, ophthalmologist, pediatrician and social worker. Congenital VZV infection can be severe enough to cause catastrophic fetal anomalies and damage to the vital organs as many of those infants die in infancy. (author)

Passive cooling during transport of asphyxiated term newborns

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O’Reilly, Deirdre; Labrecque, Michelle; O’Melia, Michael; Bacic, Janine; Hansen, Anne; Soul, Janet S

2014-01-01

Objective To evaluate the efficacy and safety of passive cooling during transport of asphyxiated newborns. Study Design Retrospective medical record review of newborns with perinatal asphyxia transported for hypothermia between July 2007 and June 2010. Results Forty-three newborns were transported, 27 of whom were passively cooled. Twenty (74%) passively cooled newborns arrived with axillary temperature between 32.5 and 34.5 °C. One newborn (4%) arrived with a subtherapeutic temperature, and 6 (22%) had temperatures >34.5 °C. Time from birth to hypothermia was significantly shorter among passively cooled newborns compared with newborns not cooled (215 vs. 327 minutes, pencephalopathy results in significantly earlier achievement of effective therapeutic hypothermia without significant adverse events. PMID:23154670

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

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Mugambi Mary N

2012-10-01

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

Congenital CMV infection: prevalence in newborns and the impact on hearing deficit.

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Engman, Mona-Lisa; Malm, Gunilla; Engstrom, Lotta; Petersson, Karin; Karltorp, Eva; Tear Fahnehjelm, Kristina; Uhlen, Inger; Guthenberg, Claes; Lewensohn-Fuchs, Ilona

2008-01-01

Congenital cytomegalovirus (CMV) infection is asymptomatic in 90% of infected newborns but approximately 10-20% of these infants are at risk of developing sequelae later, mostly hearing deficit. The aims of the study were to investigate the prevalence of congenital CMV infection in a Swedish population of newborns and investigate the relative risk of hearing deficit in newborns with congenital CMV infection. The dried blood spot (DBS) samples of 6060 newborns in southern Stockholm during 12 months (October 2003-June 2004; August 2004-October 2004) were analysed for CMV DNA by TaqMan based real-time PCR. Hearing deficit was assessed by otoacoustic emission (OAE) within a newborn screening programme. 12 infants out of 6060 or 0.2% (95% CI 0.1-0.3%) had congenital CMV infection. One boy among the 12 infected infants had unilateral hearing loss, indicating that the risk of hearing loss is greatly increased (about 20 times) in CMV infected infants. No child developed ocular complications such as chorioretinopathy during 3 y of follow-up. Congenital CMV has an impact on child health but can easily be overlooked due to lack of signs in the neonatal period. Surveillance for congenital CMV is important in addition to programmes for prevention and treatment.

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

Full Text Available OBJETIVO: Relatar os resultados de um projeto de acompanhamento de recém-nascidos de termo e próximos ao termo ictéricos no período neonatal. MÉTODOS: Foram encaminhados a ambulatório especializado neonatos com peso > 2.000 g e/ou idade gestacional > 35 semanas, cuja icterícia na alta foi avaliada inicialmente com o icterômetro de Ingram, Bilicheck® e, se indicado, com bilirrubinômetro Unistat (Leica. A bilirrubinemia destes recém-nascidos situava-se no ou acima do percentil 40 do nomograma elaborado por Bhutani. Todos recém-nascidos tratados com fototerapia durante internação foram reavaliados laboratorialmente 24 horas após suspensão do tratamento. A indicação de reinternação para tratamento fototerápico intensivo foi para paciente com nível > 20 mg/dL. RESULTADOS: De um total de 11.259 neonatos, 2.452 (21,8% foram encaminhados para acompanhamento, dos quais 87,2% (2.140 retornaram. Oitenta neonatos retornados foram reinternados. Dos 2.452 encaminhados para retorno, 180 (7,3% tinham bilirrubinemia > 15 mg/dL na alta. Destes, 151 retornaram para acompanhamento. Vinte (13,2% foram reinternados para tratamento. Do total de reinternados, dois recém-nascidos apresentaram nível > 25 mg/dL e nenhum > 30 mg/dL. Todos responderam rapidamente à fototerapia intensiva, e não houve necessidade de utilizar exsangüinotransfusões. CONCLUSÕES: Nossos resultados sugerem que o esquema adotado é eficiente na detecção e prevenção de hiperbilirrubinemias de risco para produzir encefalopatia bilirrubínica em recém-nascidos de termo e próximos ao termo.OBJECTIVE: To report on the results of a project following term and near term newborn infants who were jaundiced during the neonatal period. METHODS: Neonates were referred to the follow-up clinic with weight > 2,000 g and/or gestational age > 35 weeks, and jaundice at discharge was initially assessed with an Ingram icterometer or Bilicheck and, if indicated, with a Unistat

Heart rate variability during sleep in healthy term newborns in the early postnatal period

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Doyle, O M; Korotchikova, I; Boylan, G B; Lightbody, G; Marnane, W; Kerins, D

2009-01-01

Normative time- and frequency-domain heart rate variability (HRV) measures were extracted during quiet sleep (QS) and active sleep (AS) periods in 30 healthy babies. All newborn infants studied were less than 12 h old and the sleep state was classified using multi-channel video EEG. Three bands were extracted from the heart rate (HR) spectrum: very low frequency (VLF), 0.01–0.04 Hz; low frequency (LF), 0.04–0.2 Hz, and high frequency (HF), >0.2 Hz. All metrics were averaged across all patients and per sleep state to produce a table of normative values. A noticeable peak corresponding to activity in the RSA band was found in 80% patients during QS and 0% of patients during AS, although some broadband activity was observed. The majority of HRV metrics showed a statistically significant separation between QS and AS. It can be concluded that (i) activity in the RSA band is present during QS in the healthy newborn, in the first 12 h of life, (ii) HRV measures are affected by sleep state and (iii) the averaged HRV metrics reported here could assist the interpretation of HRV data from newborns with neonatal illnesses

Phenobarbital and Phototherapy Combination Enhances Decline of Total Serum Bilirubin and May Decrease the Need for Blood Exchange Transfusion in Newborns with Isoimmune Hemolytic Disease

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Kaabneh, Mahmoud AF; Salama, Ghassan SA; Shakkoury, Ayoub GA; Al-abdallah, Ibrahim MH; Alshamari, Afrah; Halaseh, Ruba AA

2015-01-01

OBJECTIVE The objective of this study was to evaluate the effect of phenobarbital and phototherapy combination on the total serum bilirubin of the newborn infants with isoimmune hemolytic disease (IHD) and its impact on blood exchange transfusion rates. PATIENTS AND METHOD This single-blinded, prospective, randomized, controlled trial was conducted between March 2013 and December 2014 at the pediatric ward of two Military Hospitals in Jordan. A total of 200 full-term neonates with IHD were divided randomly into two groups: (1) the phenobarbital plus phototherapy group (n = 103), and (2) the phototherapy-only group (n = 97). Infants in group 1 received an oral dose of 2.5 mg/kg phenobarbital every 12 hours for 3 days in addition to phototherapy. The total serum bilirubin was observed. RESULTS Of the total 200 included newborn infants, 186 infants completed the study: 97 infants were included in group 1 and 89 infants in group 2. The difference between the mean total serum bilirubin levels at 24, 48, and 72 hours after starting the trial was clinically and statistically significant at P newborn infants with IHD, as it results in a faster decline in total serum bilirubin, thus decreasing the need for blood exchange transfusion than phototherapy alone. PMID:26309423

Trend of head circumference as a predictor of microcephaly among term infants born at a regional center in Malaysia between 2011-2015

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Sutan R

2018-01-01

Full Text Available Rosnah Sutan,1 May Luu Yeong,1 Zaleha Abdullah Mahdy,2 Ahmad Shuhaila,2 Jaafar Rohana,3 Shareena Ishak,3 Khadijah Shamsuddin,1 Aniza Ismail,1 Idayu Badillah Idris,1 Saperi Sulong4 1Department of Community Health, 2Department of Obstetrics and Gynecology, 3Department of Pediatrics, 4Department of Medical Records, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia Introduction: The aim of this study was to determine the trend of head circumference as predictor of microcephaly among term infants born in a teaching hospital in Malaysia from 2011 to 2015. Methodology: This was a cross-sectional study using data from the electronic birth census. The independent variables were mothers’ age and height, parity, birth weight and birth length. All term newborns, both alive and stillbirth, with 37–41 completed gestational weeks, and a birth weight of at least 500 g was extracted from the census. Results: A total of 26,503 newborns fulfilled the inclusion criteria (13,655 males, 12,840 females. The mean head circumferences for male and female newborns were 32.93 cm (± SD 1.32 and 32.56 cm (± SD 1.31. The average head circumference for Malaysian newborns was found to be smaller than the World Health Organization Standard Growth Chart for Term Infant. A total of 17.6% (n=4,669 of the total samples were observed to have microcephaly. Among them, 73.2% (n=3,419 were non-proportionate microcephaly with normal birth weight of 2.5kg and above. Bivariate analyses showed that all independent variables were significant predictors of microcephaly. Both simple and multiple logistic regressions demonstrated that low birth weight was the most significant predictors for microcephaly (adjusted OR 12.14, 95% CI 10.80, 13.65. Conclusion: There is an increasing trend of microcephaly across the years and the low birth weight was noted as the main predictor of microcephaly. Future studies are needed to determine the possible cause of increasing

A new approach to define acute kidney injury in term newborns with hypoxic ischemic encephalopathy.

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Gupta, Charu; Massaro, An N; Ray, Patricio E

2016-07-01

Current definitions of acute kidney injury (AKI) are not sufficiently sensitive to identify all newborns with AKI during the first week of life. To determine whether the rate of decline of serum creatinine (SCr) during the first week of life can be used to identify newborns with AKI, we reviewed the medical records of 106 term neonates at risk of AKI who were treated with hypothermia for hypoxic ischemic encephalopathy (HIE). Of the newborns enrolled in the study, 69 % showed a normal rate of decline of SCr to ≥50 % and/or reached SCr levels of ≤0.6 mg/dl before the 7th day of life, and therefore had an excellent clinical outcome (control group). Thirteen newborns with HIE (12 %) developed AKI according to an established neonatal definition (AKI-KIDGO group), and an additional 20 newborns (19 %) showed a rate of decline of SCr of newborns in the other two groups required more days of mechanical ventilation and vasopressor drugs and had higher gentamicin levels, more fluid overload, lower urinary epidermal growth factor levels, and a prolonged length of stay. The rate of decline of SCr provides a sensitive approach to identify term newborns with AKI during the first week of life.

Parental experiences of providing skin-to-skin care to their newborn infant--part 2: a qualitative meta-synthesis.

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Anderzén-Carlsson, Agneta; Lamy, Zeni C; Tingvall, Maria; Eriksson, Mats

2014-01-01

To synthesize and interpret qualitative research findings focusing on parental experiences of skin-to-skin care (SSC) for newborn infants. SSC induces many benefits for newborn infants and their parents. Three meta-analyses have been conducted on physiological outcomes, but no previous qualitative meta-synthesis on parental experiences of SSC has been identified. The present meta-synthesis was guided by the methodology described by Paterson and co-workers. Four databases were searched, without year or language limitations, up until December 2013. Manual searches were also performed. The searches and subsequent quality appraisal resulted in the inclusion of 29 original qualitative papers from 9 countries, reporting experiences from 401 mothers and 94 fathers. The meta-synthesis entails a meta-data analysis, analysis of meta-method, and meta-theory in the included primary studies. Based on the three analyses, the meta-synthesis represents a new interpretation of a phenomenon. The results of the meta-data analysis have been presented as a qualitative systematic review in a separate paper. When synthesizing and interpreting the findings from the included analyses, a theoretical model of Becoming a parent under unfamiliar circumstances emerged. Providing SSC seems to be a restorative as well as an energy-draining experience. A supportive environment has been described as facilitating the restorative experience, whereas obstacles in the environment seem to make the provision of SSC energy-draining for parents. When the process is experienced as positive, it facilitates the growth of parental self-esteem and makes the parents ready to assume full responsibility for their child. The results show that SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent. The process of becoming a parent in this specific situation is influenced by external factors in three different levels; family and

Amino acid composition of parturient plasma, the intervillous space of the placenta and the umbilical vein of term newborn infants

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J.S. Camelo Jr.

2004-05-01

Full Text Available The objective of the present study was to determine the levels of amino acids in maternal plasma, placental intervillous space and fetal umbilical vein in order to identify the similarities and differences in amino acid levels in these compartments of 15 term newborns from normal pregnancies and deliveries. All amino acids, except tryptophan, were present in at least 186% higher concentrations in the intervillous space than in maternal venous blood, with the difference being statistically significant. This result contradicted the initial hypothesis of the study that the plasma amino acid levels in the placental intervillous space should be similar to those of maternal plasma. When the maternal venous compartment was compared with the umbilical vein, we observed values 103% higher on the fetal side which is compatible with currently accepted mechanisms of active amino acid transport. Amino acid levels of the placental intervillous space were similar to the values of the umbilical vein except for proline, glycine and aspartic acid, whose levels were significantly higher than fetal umbilical vein levels (average 107% higher. The elevated levels of the intervillous space are compatible with syncytiotrophoblast activity, which maintain high concentrations of free amino acids inside syncytiotrophoblast cells, permitting asymmetric efflux or active transport from the trophoblast cells to the blood in the intervillous space. The plasma amino acid levels in the umbilical vein of term newborns probably may be used as a standard of local normality for clinical studies of amino acid profiles.

The usefulness of plasma asymmetric dimethylarginine (ADMA) levels and tissue doppler echocardiography for heart function in term infants born to mothers with gestational diabetes mellitus.

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Arslan, Derya; Oran, Bulent; Vatansev, Husamettin; Cimen, Derya; Guvenc, Osman

2013-11-01

The aim of this study was to examine whether asymmetric dimethylarginine (ADMA) concentrations are associated with ventricular function in the infants of mothers with gestational diabetes. Twenty-five term newborns of mothers with gestational diabetes and term newborns as the control group (n = 25) with normal general health status were evaluated at two time points, on the 3rd postnatal day, at the 3th months. Echocardiographic evaluations of all participants were performed and ADMA level was measured. In the first analysis, 10 patients (40%) had a septal thickness of 6 mm or more, indicating septal hypertrophy. In the first and second analysis, interventricular septum end-diastolic thickness (IVSTd) and the left ventricular posterior wall end-diastolic thickness (LVPWTd) in the patient group were higher than the control group. ADMA level measurement was not significantly different between the groups the first and second analysis. There was no difference in ADMA levels of the group with septal thickness ≥6 mm and the group with Gestational diabetes mellitus (GDM), and the increase was independent of glycemic control. Diastolic newborn cardiac function was impaired in GDM, and this effect was independent of septal thickness. We found no association between ADMA levels and cardiac systolic, diastolic functions or septum thickness in the GDM newborn.

Hemoglobin and hematocrit values of Saudi newborns in the high altitude of Abha, Saudi Arabia

International Nuclear Information System (INIS)

Bassuni, W.; Asindi, A.A.; Mustafa, F.S.; Hassan, B.; Din, Z.S.; Kumar, R.K.

1996-01-01

A study was designed to determine the red cell values (hemoglobin and hematocrit) of neonates born in the high altitude of Abha and to compare these values with known values of other lowland areas of Saudi Arabia. From the cord blood of 587 normal, appropriate for gestational age and term infants born in 1993 in Abha Maternity Hospital, the ranges of Hb and Hct were 130 to 240 g/L and 0.24 to 0.79 L/L respectively. The mean Hb was 187 g/L. There was no significant difference between the male and female values. Also, 17% of the infants in this study were polycythemic, while no polycythemia was recorded in these lowland areas and only 2% to 4% in the general global newborn population. It was therefore revealed that Abha newborns had higher red cell values at the birth when compared to other newborns in the low altitude areas of Riyadh and Jeddah (P<0.001). We postulate that high altitude (2700 meters above sea level) of Abha, and therefore its relative hypoxia, has induced high red cell values in infants born in the city. The phenomenon therefore warrants the adoption of higher red cell reference values and not necessarily those already documented in other Saudi new born populations. (author)

Black lung persistent pulmonary hypertension of the newborn. Saudi experience with sildenafil and nitric oxide

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AbdulRahman M. Alnemri

2017-01-01

Full Text Available Objectives: To determine the clinical presentation, risk factors, diagnosis, and treatment outcome of Saudi infants with black lung persistent pulmonary hypertension of the newborn (PPHN. Methods: This is a retrospective review of all neonates with PPHN presented to the Armed Force Hospital Southern Region, Kingdom of Saudi Arabia from January 2012 to December 2014. Results: Ten term and near term infants presented with PPHN were included. Maternal diabetes and Down syndrome were the most common identified risk factors for PPHN in the study group. Nine infants were treated with oral sildenafil and did not require mechanical ventilation. Only one infant required mechanical ventilation and inhaled nitric oxide in addition to oral sildenafil. Conclusion: Most of the patients in this cohort with PPHN had risk factors, they did not require mechanical ventilation and responded well to oral sildenafil.

Black lung persistent pulmonary hypertension of the newborn. Saudi experience with sildenafil and nitric oxide.

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Alnemri, AbdulRahman M

2017-01-01

To determine the clinical presentation, risk factors, diagnosis, and treatment outcome of Saudi infants with black lung persistent pulmonary hypertension of the newborn (PPHN). Methods: This is a retrospective review of all neonates with PPHN presented to the Armed Force Hospital Southern Region, Kingdom of Saudi Arabia from January 2012 to December 2014. Results: Ten term and near term infants presented with PPHN were included. Maternal diabetes and Down syndrome were the most common identified risk factors for PPHN in the study group. Nine infants were treated with oral sildenafil and did not require mechanical ventilation. Only one infant required mechanical ventilation and inhaled nitric oxide in addition to oral sildenafil. Conclusion: Most of the patients in this cohort with PPHN had risk factors, they did not require mechanical ventilation and responded well to oral sildenafil.

Association of Plasma Leptin Levels With Maternal Body Weight and Body Mass Index in Premature and Term Newborns

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Shih-Ping Ho

2010-02-01

Conclusion: Neonatal serum leptin concentrations within 24 hours of birth correlated with maternal body weight and BMI, especially in premature newborns. Premature newborns had significantly lower leptin levels than full-term newborns.

[Diagnosis of pulmonary hemorrhage of the newborn infants using lung ultrasonography].

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Liu, J; Fu, W; Chen, S W; Wang, Y

2017-01-02

Objective: To investigate the accuracy and reliability of lung ultrasound in diagnosis of pulmonary hemorrhage of the newborn infants. Method: From January 2014 to May 2016, 142 neonates from the Army General Hospital of the Chinese PLA were enrolled in the study. They were divided into two groups: a study group of 42 neonates, who were diagnosed with pulmonary hemorrhage according to their medical history, clinical manifestations and chest X-ray findings, and a control group of 100 neonates with no lung disease. All subjects underwent bedside lung ultrasound in a quiet state in a supine, lateral or prone posture, performed by a single experienced physician. The ultrasound findings were compared between the two groups.Fisher's exact test was uesd for comparison between two groups. Result: The lung ultrasound main findings associated with pulmonary hemorrhage included: (1) Shred sign: which was seen in 40 patients(95%). (2) Lung consolidation with air bronchograms: which were seen in 35 patients(83%). (3) Pleural effusion: which was seen in 34 infants(81%), pleurocentesis confirmed that the fluid was really bleeding.(4)Atelectasis: which was seen in 14 cases(33%). (5) Pleural line abnormalities and disappearing A-lines with an incidence of 100%. (6) Alveolar-interstitial syndrome: 5 patients(12%)had the main manifestations of alveolar-interstitial syndrome. The above signs were not seen in normal controls (all P hemorrhage, which is suitable for routine application for the diagnosis of pulmonary hemorrhage in the neonatal intensive care unit.

Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data.

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Ciuffini, F; Pietrasanta, C; Lavizzari, A; Musumeci, S; Gualdi, C; Sortino, S; Colnaghi, M; Mosca, F

2014-08-31

Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV) is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP) is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC) is emerging as a better tolerated form of NIV, allowing better access to the baby's face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS).

Comparison between two different modes of non-invasive ventilatory support in preterm newborn infants with respiratory distress syndrome mild to moderate: preliminary data

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F. Ciuffini

2014-08-01

Full Text Available Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC is emerging as a better tolerated form of NIV, allowing better access to the baby’s face, which may improve nursing, feeding and bonding. HFNC may be effective in the treatment of some neonatal respiratory conditions while being more user-friendly for care-givers than conventional NCPAP. Limited evidence is available to support the specific role, efficacy and safety of HFNC in newborns and to demonstrate efficacy compared with NCPAP; some studies suggest a potential role for HFNC in respiratory care of the neonate as a distinct non invasive ventilatory support. We present the preliminary data of a randomized clinical trial; the aim of this study was to assess efficacy and safety of HFNC compared to NCPAP in preterm newborns with mild to moderate respiratory distress syndrome (RDS.

Prevalence of exclusive breastfeeding in the healthy newborn.

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Mazo-Tomé, Pedro Luis Del; Suárez-Rodríguez, Marta

2018-01-01

The best nourishment for infants during the first 6 months of life is exclusive breastfeeding. It is recommended along with other food to complement the diet until the child is 2 years old, as long as the mother and the child are willing to continue with it. The objectives of this study were to determine he exclusive breastfeeding rate in full term newborns at hospital discharge and 15 days later and to analyze the factors that positively affect the exclusive breastfeeding. A prospective study was conducted in which a sample of postpartum women with full term newborns was recruited during hospital admission. Different variables were compiled and two interviews were made to determine the kind of feeding they were giving their children and if it was maintained at 15 days of birth. Exclusive breastfeeding rate at hospital discharge is much lower than recommended. It significantly decreases at 15 days of birth, increasing artificial feeding. It seems that having a vaginal birth, no complications giving birth, providing early breastfeeding and skin-to-skin contact in the delivery room are predisposing factors necessary to establish a good breastfeeding at hospital discharge. Despite the efforts of professionals, the percentage of newborns with exclusive breastfeeding at birth is not enough for the current recommendations. Copyright: © 2018 Permanyer.

Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns.

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Bergman, N J; Linley, L L; Fawcus, S R

2004-06-01

Conventional care of prematurely born infants involves extended maternal-infant separation and incubator care. Recent research has shown that separation causes adverse effects. Maternal-infant skin-to-skin contact (SSC) provides an alternative habitat to the incubator, with proven benefits for stable prematures; this has not been established for unstable or newborn low-birthweight infants. SSC from birth was therefore compared to incubator care for infants between 1200 and 2199 g at birth. This was a prospective, unblinded, randomized controlled clinical trial; potential subjects were identified before delivery and randomized by computerized minimization technique at 5 min if eligible. Standardized care and observations were maintained for 6 h. Stability was measured in terms of a set of pre-determined physiological parameters, and a composite cardio-respiratory stabilization score (SCRIP). 34 infants were analysed in comparable groups: 3/18 SSC compared to 12/13 incubator babies exceeded the pre-determined parameters (p incubator (maximum 78), mean difference 2.88 (95% CI: 0.3-5.46, p = 0.031). All 18 SSC subjects were stable in the sixth hour, compared to 6/13 incubator infants. Eight out of 13 incubator subjects experienced hypothermia. Newborn care provided by skin-to-skin contact on the mother's chest results in better physiological outcomes and stability than the same care provided in closed servo-controlled incubators. The cardio-respiratory instability seen in separated infants in the first 6 h is consistent with mammalian "protest-despair" biology, and with "hyper-arousal and dissociation" response patterns described in human infants: newborns should not be separated from their mothers.

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

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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.

Advanced neuroimaging techniques for the term newborn with encephalopathy.

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Chau, Vann; Poskitt, Kenneth John; Miller, Steven Paul

2009-03-01

Neonatal encephalopathy is associated with a high risk of morbidity and mortality in the neonatal period and of long-term neurodevelopmental disability in survivors. Advanced magnetic resonance techniques now play a major role in the clinical care of newborns with encephalopathy and in research addressing this important condition. From conventional magnetic resonance imaging, typical patterns of injury have been defined in neonatal encephalopathy. When applied in contemporary cohorts of newborns with encephalopathy, the patterns of brain injury on magnetic resonance imaging distinguish risk factors, clinical presentation, and risk of abnormal outcome. Advanced magnetic resonance techniques such as magnetic resonance spectroscopy, diffusion-weighted imaging, and diffusion tensor imaging provide novel perspectives on neonatal brain metabolism, microstructure, and connectivity. With the application of these imaging tools, it is increasingly apparent that brain injury commonly occurs at or near the time of birth and evolves over the first weeks of life. These observations have complemented findings from trials of emerging strategies of brain protection, such as hypothermia. Application of these advanced magnetic resonance techniques may enable the earliest possible identification of newborns at risk of neurodevelopmental impairment, thereby ensuring appropriate follow-up with rehabilitation and psychoeducational resources.

In utero exposure to dioxins and dioxin-like compounds and anogenital distance in newborns and infants.

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Vafeiadi, Marina; Agramunt, Silvia; Papadopoulou, Eleni; Besselink, Harrie; Mathianaki, Kleopatra; Karakosta, Polyxeni; Spanaki, Ariana; Koutis, Antonis; Chatzi, Leda; Vrijheid, Martine; Kogevinas, Manolis

2013-01-01

Anogenital distance in animals is used as a measure of fetal androgen action. Prenatal exposure to dioxins and dioxin-like compounds in rodents causes reproductive changes in male offspring and decreases anogenital distance. We assessed whether in utero exposure to dioxins and dioxin-like compounds adversely influences anogenital distance in newborns and young children (median age, 16 months; range, 1-31 months). We measured anogenital distance among participants of the "Rhea" mother-child cohort study in Crete and the Hospital del Mar (HMAR) cohort in Barcelona. Anogenital distance (AGD; anus to upper penis), anoscrotal distance (ASD; anus to scrotum), and penis width (PW) were measured in 119 newborn and 239 young boys; anoclitoral (ACD; anus to clitoris) and anofourchetal distance (AFD; anus to fourchette) were measured in 118 newborn and 223 young girls. We estimated plasma dioxin-like activity in maternal blood samples collected at delivery with the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR CALUX®) bioassay. Anogenital distances were sexually dimorphic, being longer in males than females. Plasma dioxin-like activity was negatively associated with AGD in male newborns. The estimated change in AGD per 10 pg CALUX®-toxic equivalent/g lipid increase was -0.44 mm (95% CI: -0.80, -0.08) after adjusting for confounders. Negative but smaller and nonsignificant associations were observed for AGD in young boys. No associations were found in girls. Male infants may be susceptible to endocrine-disrupting effects of dioxins. Our findings are consistent with the experimental animal evidence used by the Food and Agriculture Organization/World Health Organization to set recommendations for human dioxin intake.

Total oxidant/antioxidant status in jaundiced newborns before and after phototherapy.

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Aycicek, Ali; Erel, Ozcan

2007-01-01

To assess the effect of phototherapy on serum oxidant and antioxidant status in hyperbilirubinemic full-term newborns. Thirty-four full-term infants from 3 to 10 days of age exposed to phototherapy were studied. The serum antioxidant status was assessed by measuring the total antioxidant capacity (TAC) and individual antioxidant components: vitamin C, uric acid, albumin, thiol contents and total bilirubin. The oxidant status was assessed by determining the total oxidant status (TOS), oxidative stress index (OSI) and individual oxidant components: malondialdehyde (MDA), and lipid hydroperoxide levels. Vitamin C, uric acid, total bilirubin and MDA concentration were significantly lower, whereas serum TOS, lipid hydroperoxide and OSI levels were significantly higher after phototherapy (p total bilirubin and MDA (r = 0.434, p = 0.001). Although the MDA level was reduced after phototherapy, phototherapy has a negative impact on numerous parts of the oxidant/antioxidant defense system in jaundiced full-term newborns, exposing them to potential oxidative stress.

Newborn physiological responses to noise in the neonatal unit.

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Cardoso, Sandra Maria Schefer; Kozlowski, Lorena de Cássia; Lacerda, Adriana Bender Moreira de; Marques, Jair Mendes; Ribas, Angela

2015-01-01

The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Peripheral perfusion index-reference range in healthy Portuguese term newborns

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Joana Jardim

2014-01-01

Full Text Available Introduction: Peripheral perfusion index (PPI is a non-invasive numerical value of peripheral perfusion derived from a pulse oximeter signal. It has been suggested that PPI may be a valuable adjunct diagnostic tool to detect early clinically significant hemodynamic embarrassment. The aim of this paper was to determine normal PPI in healthy newborns, in order to establish cut-off values that can be use in different pathologic settings. Material and Methods: Prospective observational study performed with term newborns, born in a tertiary level care hospital between January 1st to December 31st 2012. Demographic data such as gender, gestational age, birth weight and Apgar score were collected. PPI, heart rate (HR and arterial blood oxygen saturation (SpO2 were evaluated simultaneous on the right hand (preductal and on the left foot (postductal of the newborn, before discharge from the hospital. Results: 2,032 newborns, 52% male, with a mean birth weight of 3,237 ± 432 g and median gestational age of 39 weeks, were evaluated. PPI values obtained were: preductal median of 1.6 with interquartile range of 1.2-2.3, postductal median of 1.4 with interquartile range of 1-2 (p < 0.001. Conclusions: PPI is an easily applicable non invasive method to monitor peripheral perfusion changes. We established normal PPI values in healthy Portuguese newborns. PPI was higher on the upper limb (preductal when compared to the lower limb (postductal.This finding has important implications, in the time of choosing a single probe placement, and in the interpretation of the results.

Psychophysical parameters of a multidimensional pain scale in newborns

International Nuclear Information System (INIS)

De Oliveira, M V M; De Jesus, J A L; Tristao, R M

2012-01-01

The Premature Infant Pain Profile (PIPP) is a promising multidimensional tool for comparison and testing of new technologies in newborn pain assessment studies since it may adhere to basic psychophysical parameters of intensity, direction, reactivity, regulation and slope described in analyses of physiological pain indicators. The aim of this study was to evaluate whether these psychophysical parameters can be achieved using the PIPP in acute pain assessment. Thirty-six healthy term newborn infants were conveniently sampled whilst being videotaped before, during and after heel prick blood sampling. The images were blind-scored by three trained independent raters and scored against the PIPP. The PIPP and its facial action indicators met the parameters of intensity, reactivity and regulation (all p < 0.001). The heart rate variability did not meet any parameter (all p > 0.05). The oxygen saturation variability met only the intensity parameter (p < 0.05). The behavioural state indicator met all parameters and had the best correlation to the psychophysical parameters of all indicators of PIPP (all p < 0.001). We concluded that the overall PIPP meets the assumptions of these psychophysical parameters, being the behavioural state indicator which best fit the model. (paper)

The relationship between planned and reported home infant sleep locations among mothers of late preterm and term infants.

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

2015-07-01

To compare maternal report of planned and practiced home sleep locations of infants born late preterm (34 0/7 to 36 6/7 gestational weeks) with those infants born term (≥37 0/7 gestational weeks) over the first postpartum month. Open-ended semi-structured maternal interviews were conducted in a US hospital following birth and by phone at 1 month postpartum during 2010-2012. Participants were 56 mother-infant dyads: 26 late preterm and 30 term. Most women planned to room share at home with their infants and reported doing so for some or all of the first postpartum month. More women reported bed sharing during the first postpartum month than had planned to do so in both the late preterm and term groups. The primary reason for unplanned bed sharing was to soothe nighttime infant fussiness. Those participants who avoided bed sharing at home commonly discussed their fear for infant safety. A few parents reported their infants were sleeping propped on pillows and co-sleeping on a recliner. Some women in both the late preterm and term groups reported lack of opportunity to obtain a bassinet prior to childbirth. The discrepancy between plans for infant sleep location at home and maternally reported practices were similar in late preterm and term groups. Close maternal proximity to their infants at night was derived from the need to assess infant well-being, caring for infants, and women's preferences. Bed sharing concerns related to infant safety and the establishment of an undesirable habit, and alternative arrangements included shared recliner sleep.

Comprehensive approach to newborns and infants with brachial plexus impairment – proposal of Slovenian guidelines

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Katja Groleger Sršen

2015-06-01

Full Text Available The impairment of brachial plexus (IBP in the neonate and infant remains an important problem. Risk factors for IBP are well known, but the mechanisms of impairment are not yet fully understood. It is important to identify early signs of IBP and to evaluate the hand function. In the guidelines we propose to use the Toronto scale for evaluation of hand function. The newborn with IBP should be referred to physiotherapy, and then regularly followed-up once a month. If the arm and hand function, especially flexion of the elbow, is not improving at the age of two months, the infant should be referred to the tertiary level rehabilitation centre and to department for plastic surgery at the University Medical Centre in Ljubljana. When necessary, the reconstructive procedure should be done by the age of three to six months. After reconstruction of brachial plexus, the child needs a comprehensive therapy program, which involves passive stretching, sensory stimulation, exercises to promote the development of active voluntary movements, bimanual activities, and symmetrical posture and movement patterns.

Setting the trajectory: racial disparities in newborn telomere length.

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Drury, Stacy S; Esteves, Kyle; Hatch, Virginia; Woodbury, Margaret; Borne, Sophie; Adamski, Alys; Theall, Katherine P

2015-05-01

To explore racial differences in newborn telomere length (TL) and the effect moderation of the sex of the infant while establishing the methodology for the use of newborn blood spots for TL analyses. Pregnant mothers were recruited from the Greater New Orleans area. TL was determined via monochrome multiplex quantitative real-time polymerase chain reaction on DNA extracted from infant blood spots. Demographic data and other covariates were obtained via maternal report before the infant's birth. Birth outcome data were obtained from medical records and maternal report. Black infants weighed significantly less than white infants at birth and had significantly longer TL than white infants (P=.0134), with the strongest effect observed in black female infants. No significant differences in gestational age were present. Significant racial differences in TL were present at birth in this sample, even after we controlled for a range of birth outcomes and demographic factors. Because longer initial TL is predictive of more rapid TL attrition across the life course, these findings provide evidence that, even at birth, biological vulnerability to early life stress may differ by race and sex. Copyright © 2015 Elsevier Inc. All rights reserved.

Setting the Trajectory: Racial Disparities in Newborn Telomere Length

Science.gov (United States)

Drury, Stacy S.; Esteves, Kyle; Hatch, Virginia; Woodbury, Margaret; Borne, Sophie; Adamski, Alys; Theall, Katherine P.

2015-01-01

Objective To explore racial differences in newborn telomere length (TL) and the effect moderation of the sex of the infant while establishing the methodology for the use of newborn blood spots for telomere length analyses. Study design Pregnant mothers were recruited from the Greater New Orleans area. TL was determined using MMQ-PCR on DNA extracted from infant blood spots. Demographic data and other covariates were obtained via maternal report prior to infant birth. Birth outcome data were obtained from medical records and maternal report. Results Black infants weighed significantly less than white infants at birth, and had significantly longer TL than White infants (p=0.0134), with the strongest effect observed in Black female infants. No significant differences in gestational age were present. Conclusions Significant racial differences in TL were present at birth in this sample, even after controlling for a range of birth outcomes and demographic factors. As longer initial TL is predictive of more rapid TL attrition across the life course, these findings provide evidence that, even at birth, biological vulnerability to early life stress may differ by race and sex. PMID:25681203

Iatrogenic Skin Disorders and Related Factors in Newborn Infants.

Science.gov (United States)

Csoma, Zsanett Renáta; Meszes, Angéla; Ábrahám, Rita; Kemény, Lajos; Tálosi, Gyula; Doró, Péter

2016-09-01

Recent technological advances and diagnostic and therapeutic innovations have resulted in an impressive improvement in the survival of newborn infants requiring intensive care. Consequently, with the use of modern invasive diagnostic and therapeutic procedures, the incidence of iatrogenic events has also increased. The aim of this study was to assess various iatrogenic complications in neonates requiring intensive care and determine possible contributing factors to the injuries. Our prospective cross-sectional cohort survey was conducted in a central regional level III neonatal intensive care unit (NICU). Correlations between intensive therapeutic interventions, complications, factors influencing attendance and prognosis, and the prevalence of iatrogenic skin injuries (ISIs) were investigated over a 2-year study period. Between January 31, 2012, and January 31, 2014, 460 neonates were admitted to the NICU, 83 of whom exhibited some kind of ISI. The major risk factors for ISIs were low birthweight, young gestational age, long NICU stay, use of the intubation-surfactant-extubation (INSURE) technique, surfactant use, mechanical ventilation, insertion of an umbilical arterial catheter, circulatory and cardiac support with dopamine or dobutamine, pulmonary hemorrhage, intracranial hemorrhage, patent ductus arteriosus, bronchopulmonary dysplasia, and positive microbiology culture results. To prevent ISIs, careful consideration of risk factors and the creation of protocols ensuring efficient treatment of injuries are needed. © 2016 Wiley Periodicals, Inc.

Newborn Screening for Severe Combined Immunodeficiency in 11 Screening Programs in the United States

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Kwan, Antonia; Abraham, Roshini S.; Currier, Robert; Brower, Amy; Andruszewski, Karen; Abbott, Jordan K.; Baker, Mei; Ballow, Mark; Bartoshesky, Louis E.; Bonagura, Vincent R.; Bonilla, Francisco A.; Brokopp, Charles; Brooks, Edward; Caggana, Michele; Celestin, Jocelyn; Church, Joseph A.; Comeau, Anne Marie; Connelly, James A.; Cowan, Morton J.; Cunningham-Rundles, Charlotte; Dasu, Trivikram; Dave, Nina; De La Morena, Maria T.; Duffner, Ulrich; Fong, Chin-To; Forbes, Lisa; Freedenberg, Debra; Gelfand, Erwin W.; Hale, Jaime E.; Celine Hanson, I.; Hay, Beverly N.; Hu, Diana; Infante, Anthony; Johnson, Daisy; Kapoor, Neena; Kay, Denise M.; Kohn, Donald B.; Lee, Rachel; Lehman, Heather; Lin, Zhili; Lorey, Fred; Abdel-Mageed, Aly; Manning, Adrienne; McGhee, Sean; Moore, Theodore B.; Naides, Stanley J.; Notarangelo, Luigi D.; Orange, Jordan S.; Pai, Sung-Yun; Porteus, Matthew; Rodriguez, Ray; Romberg, Neil; Routes, John; Ruehle, Mary; Rubenstein, Arye; Saavedra-Matiz, Carlos A.; Scott, Ginger; Scott, Patricia M.; Secord, Elizabeth; Seroogy, Christine; Shearer, William T.; Siegel, Subhadra; Silvers, Stacy K.; Stiehm, E. Richard; Sugerman, Robert W.; Sullivan, John L.; Tanksley, Susan; Tierce, Millard L.; Verbsky, James; Vogel, Beth; Walker, Rosalyn; Walkovich, Kelly; Walter, Jolan E.; Wasserman, Richard L.; Watson, Michael S.; Weinberg, Geoffrey A.; Weiner, Leonard B.; Wood, Heather; Yates, Anne B.; Puck, Jennifer M.

2015-01-01

IMPORTANCE Newborn screening for severe combined immunodeficiency (SCID) using assays to detect T-cell receptor excision circles (TRECs) began in Wisconsin in 2008, and SCID was added to the national recommended uniform panel for newborn screened disorders in 2010. Currently 23 states, the District of Columbia, and the Navajo Nation conduct population-wide newborn screening for SCID. The incidence of SCID is estimated at 1 in 100 000 births. OBJECTIVES To present data from a spectrum of SCID newborn screening programs, establish population-based incidence for SCID and other conditions with T-cell lymphopenia, and document early institution of effective treatments. DESIGN Epidemiological and retrospective observational study. SETTING Representatives in states conducting SCID newborn screening were invited to submit their SCID screening algorithms, test performance data, and deidentified clinical and laboratory information regarding infants screened and cases with nonnormal results. Infants born from the start of each participating program from January 2008 through the most recent evaluable date prior to July 2013 were included. Representatives from 10 states plus the Navajo Area Indian Health Service contributed data from 3 030 083 newborns screened with a TREC test. MAIN OUTCOMES AND MEASURES Infants with SCID and other diagnoses of T-cell lymphopenia were classified. Incidence and, where possible, etiologies were determined. Interventions and survival were tracked. RESULTS Screening detected 52 cases of typical SCID, leaky SCID, and Omenn syndrome, affecting 1 in 58 000 infants (95%CI, 1/46 000-1/80 000). Survival of SCID-affected infants through their diagnosis and immune reconstitution was 87%(45/52), 92%(45/49) for infants who received transplantation, enzyme replacement, and/or gene therapy. Additional interventions for SCID and non-SCID T-cell lymphopenia included immunoglobulin infusions, preventive antibiotics, and avoidance of live vaccines. Variations in

What follows newborn screening? An evaluation of a residential education program for parents of infants with newly diagnosed cystic fibrosis.

Science.gov (United States)

Sawyer, Susan M; Glazner, Judith A

2004-08-01

The diagnosis of a severe life-limiting condition, such as cystic fibrosis (CF), is generally followed by assessment and treatment of the child and education and counseling for parents. The introduction of newborn screening for CF provides an opportunity for standardized assessment and education. The aim of this study was to evaluate a 5-day residential assessment and education program for parents of infants who receive a diagnosis of CF after newborn screening. Eligible parents had a 6- to 30-month-old infant with CF diagnosed by newborn screening. Parents were interviewed by telephone using a structured questionnaire that addressed 3 main themes: 1) initial communication of the diagnosis of CF, 2) the perceived value of the 5-day assessment and education program, and 3) the perceived advantages and disadvantages of the residential component (Care-By-Parent unit) of the program. Fifteen of 17 eligible families took part in the 5-day assessment and education program, 12 of whom used the residential Care-By-Parent unit. At the end of the program, parents believed that they had the knowledge and skills required to manage their child's CF at home. One hundred percent endorsed the timing of the assessment and education program immediately after the child's diagnosis and would recommend it to other families in the same situation. Perceived advantages of the residential program were not having to travel (89%), being able to concentrate on CF (50%), and the benefit of a "home base" at the hospital (39%). Twenty-two percent reported that financial costs related to participation (paternal time off work) were a disadvantage, 17% reported additional strain on family members caring for siblings, and 17% mentioned lack of comfort within the unit. This time-intensive residential program was evaluated positively by parents of children with newly diagnosed CF. It provides a model for education programs after the diagnosis of CF by newborn screening, as well as for other pediatric

Management of Newborn Infants with Phenylketonuria.

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Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

The booklet covers the identification, diagnosis, and clinical treatment of newborns with Phenylketonuria (PKU), an inborn error of metabolism, which, if untreated, can lead to mental retardation. An initial section considers biochemical and genetic factors of PKU including a diagram of aromatic amino acid hydroxylation systems. Screening…

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

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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.

Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

International Nuclear Information System (INIS)

Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de; Nievelstein, Rutger-Jan A.; Han, Sen K.

2010-01-01

In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

Energy Technology Data Exchange (ETDEWEB)

Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

2010-06-15

In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

Newborn ankyloglossia and breastfeeding

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Zlata Felc

2007-12-01

Full Text Available Background: Tongue-tie (ankyloglossia is a relatively common finding in the newborn population and represents a significant proportion of breastfeeding problems. Ankyloglossia may result in difficulty with suckling and can lead to poor weight gain, sore nipples, low milk supply, maternal fatigue and frustration.Conclusions: By recognizing ankyloglossia early, the health care team is able to treat breastfeeding problems promptly and proactively. The pediatrician, oral-maxillofacial surgeon, and parents should work together as a team from the time of birth to determine a coordinated plan of treatment. Careful assessment of lingual function is important in selecting the correct treatment. Frenulotomy is indicated in newborns with a short and/or thick frenulum and limited lingual mobility. In newborn infants with ankyloglossia this minimal surgical procedure is an effective therapy for breastfeeding difficulties.

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

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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.

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...

Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors.

Science.gov (United States)

Syrengelas, Dimitrios; Kalampoki, Vassiliki; Kleisiouni, Paraskevi; Manta, Vassiliki; Mellos, Stavros; Pons, Roser; Chrousos, George P; Siahanidou, Tania

2016-07-01

Only a few studies have been conducted with the objective of creating norms of the Alberta Infant Motor Scale (AIMS) for the assessment of gross motor development of preterm infants. The AIMS performance of preterm infants has been compared with that of the Canadian norms of full-term infants, but not with that of full-term infants of the same nationality. Moreover, the possible impact of prematurity-related morbidity factors on AIMS performance is unknown. The aims of this study were: (1) to evaluate AIMS trajectory in a large population of Greek preterm infants and create norms, (2) to compare it with the AIMS trajectory of Greek full-term infants, and (3) to examine the possible influence of neonatal morbidity on AIMS scores in the preterm sample. This was a cross-sectional study. Mean AIMS scores were compared, per month (1-19), between 403 preterm infants (≤32 weeks of age, corrected for prematurity) and 1,038 full-term infants. In preterm infants, the association of AIMS scores with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) of grade ≤III, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and sepsis was assessed by hierarchical regression analysis. Alberta Infant Motor Scale scores were significantly lower in preterm infants than in full-term infants. Mean AIMS scores in preterm infants were significantly associated with RDS (b=-1.93; 95% CI=-2.70, -1.16), IVH (b=-0.97; 95% CI=-1.69, -0.25), and ROP (b=-1.12; 95% CI=-1.99, -0.24) but not with BPD or sepsis in hierarchical regression analysis. Alberta Infant Motor Scale norms were created for Greek preterm infants. This study confirms that AIMS trajectories of preterm infants are below those of full-term infants of the same nationality. The influence of morbidity factors, including RDS, IVH, and ROP, should be taken into account when administering the AIMS in preterm infants. © 2016 American Physical Therapy Association.

A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.

LENUS (Irish Health Repository)

McCarthy, Lisa K

2013-07-01

Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission.

A retrospective evaluation of term infants treated with surfactant therapy

Directory of Open Access Journals (Sweden)

Özge Sürmeli-Onay

2015-04-01

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

Molecular diagnostics and newborns at risk for genital herpes simplex virus.

Science.gov (United States)

Chua, Caroline; Arnolds, Marin; Niklas, Victoria

2015-05-01

Herpes simplex virus (HSV) infection in the newborn carries a high mortality rate and can result in lifelong neurologic impairment. The severity of HSV infection in the newborn has always dictated conservative management when prodromal symptoms or active genital lesions (or those suggestive of genital herpes) are present during labor and delivery. The risk of intrapartum infection, however, is related to the presence or absence of maternal immunity (neutralizing antibody) to HSV. The most significant risk of transmission is in first-episode primary infections with active lesions at delivery. Recent recommendations from the American Academy of Pediatrics Committees on Infectious Diseases and the Fetus and Newborn use rapid serologic and virologic screening in the management of asymptomatic infants born to mothers with active genital herpes. The revised guidelines highlight infants at greatest risk for HSV disease but do not apply to asymptomatic infants born to mothers with a history of HSV but no genital lesions at delivery. The current guidelines also stipulate that maternal serologic screening and molecular assays for HSV in newborn blood and cerebrospinal fluid must be available and reported in a timely fashion. Copyright 2015, SLACK Incorporated.

Clinical practices in the hospital care of healthy newborn infant in Brazil.

Science.gov (United States)

Moreira, Maria Elisabeth Lopes; Gama, Silvana Granado Nogueira da; Pereira, Ana Paula Esteves; Silva, Antonio Augusto Moura da; Lansky, Sônia; Souza Pinheiro, Rossiclei de; Carvalho Gonçalves, Annelise de; Carmo Leal, Maria do

2014-08-01

The aim of this study was to evaluate the care of healthy full-term newborns and to identify variations in childbirth care and practices in the first hour of life. We used data from the Birth in Brazil survey. Unadjusted and adjusted odds ratio (OR) of hospital-delivered care for the mother and during childbirth were estimated for the following outcomes: upper airways and gastric aspiration, use of inhaled oxygen, use of incubator, skin-to-skin contact after birth, rooming-in and breastfeeding in the delivery room and within the first hour of life. We observed wide variations in the care of healthy full-term newborn in the delivery room. Practices considered inadequate, such as use of inhaled oxygen, (9.5%) aspiration of airways (71.1%) and gastric suctioning (39.7%), and the use of incubator (8.8%) were excessively used. Breastfeeding in the delivery room was low (16%), even when the Baby-Friendly Hospital Initiative had been implemented (24%). The results suggest poor knowledge and compliance by health practitioners to good clinical practice. Such noncompliance was probably not due to the differences in resources, since most births take place in hospitals where the necessary resources are available.

Early feeding and neonatal hypoglycemia in infants of diabetic mothers

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Leandro Cordero

2013-12-01

Full Text Available Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30% had hypoglycemia, corrected by early feeding in 75 (86%, while 12 (14% required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%, prematurity (33% or prevention of hypoglycemia (27%. Although all newborn intensive care unit patients received intravenous dextrose, 22 (22% had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82% were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding.

Early feeding and neonatal hypoglycemia in infants of diabetic mothers

Science.gov (United States)

Ramesh, Shilpa; Hillier, Kirsty; Giannone, Peter J; Nankervis, Craig A

2013-01-01

Objectives: To examine the effects of early formula feeding or breast-feeding on hypoglycemia in infants born to 303 A1-A2 and 88 Class B-RF diabetics. Methods: Infants with hypoglycemia (blood glucose < 40 mg/dL) were breast-fed or formula-fed, and those with recurrences were given intravenous dextrose. Results: Of 293 infants admitted to the well-baby nursery, 87 (30%) had hypoglycemia, corrected by early feeding in 75 (86%), while 12 (14%) required intravenous dextrose. In all, 98 infants were admitted to the newborn intensive care unit for respiratory distress (40%), prematurity (33%) or prevention of hypoglycemia (27%). Although all newborn intensive care unit patients received intravenous dextrose, 22 (22%) had hypoglycemia. Of 109 hypoglycemia episodes, 89 (82%) were single low occurrences. At discharge, 56% of well-baby nursery and 43% of newborn intensive care unit infants initiated breast-feeding. Conclusions: Hypoglycemia among infants of diabetic mothers can be corrected by early breast-feeding or formula feeding. PMID:26770697

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.)

Prenatal intraventricular hemorrhage in a term infant with congenital ...

African Journals Online (AJOL)

Intraventricular hemorrhage (IVH) occurs rarely in term infant, since subependymal area is a transient structure in fetal life. IVH in term infant indicates generally that it happened prenatally. Congenital cytomegalovirus (CMV) infection is frequent, occurring in 1% of live births. It is a severe infection leading to developmental ...

Intracranial epidural hematoma in a newborn with DIC secondary to ...

African Journals Online (AJOL)

Epidural hematoma in newborns is rare, it occurs more frequently in infants born from nulliparous mothers with delivery difficulties. Intracranial hemorrhage in infants is usually secondary to vascular malformations, anticoagulation, inherited or acquired coagulopathy. Hematological disorders are infrequently associated with ...

Systematic Review of Pain assessment scales in newborns under maxillofacial surgery Admitted to the surgical ward

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Shapour Yaripoor

2016-10-01

Full Text Available Having standard tools for measuring pain in infants is essential. The aim of this study is to review the scale of pain in newborns under maxillofacial surgery Admitted to the surgical ward. Integrative review study of articles published from 2000 to 2015, carried out in the following databases: Scopus, PubMed, CINAHL, LILACS, Cochrane, medscape and google scholar. The sample consisted of 17 articles. MeSH headings searched included pain measurement, pain scale, newborn pain, infant pain scale, maxillofacial surgery and pain perception. 16 neonatal pain assessment tools were found. Of the 232 original articles, 17 review articles in the field of pain assessment tools in infant under maxillofacial surgery who had inclusion criteria were selected. The most studied was the Premature Infant Pain Profile (PIPP, The CRIES and the Neonatal Infant Pain Scale (NIPS. Infant pain assessment is not universally standardized. Practitioners may assess pain; however, they may not consistently use the same criteria to do so. The use of Neonatal Facial Coding System, the Neonatal Infant Pain Scale and the Premature Infant Pain Profile Can accurately show the amount of pain in newborns.

Oral sildenafil and inhaled iloprost in the treatment of pulmonary hypertension of the newborn.

Science.gov (United States)

Kahveci, Hasan; Yilmaz, Osman; Avsar, Ummu Zeynep; Ciftel, Murat; Kilic, Omer; Laloglu, Fuat; Ozturk, Kezban

2014-12-01

This study was performed to examine the effectiveness and safety of oral sildenafil and inhaled iloprost in term newborns with persistent pulmonary hypertension of the newborn (PPHN). Oral sildenafil and inhaled iloprost were administered to 27 and 20 neonates, respectively, for treatment of persistent pulmonary hypertension. All patients were term infants at 37 gestational weeks or older. In the sildenafil group, 14 patients had meconium aspiration syndrome, 8 had asphyxia (hypoxic ischemic encephalopathy stages II and III), 3 had congenital pneumonia, 1 had transient tachypnea, and 1 had idiopathic PPHN. In the iloprost group, 9 patients had meconium aspiration syndrome, 7 had asphyxia (hypoxic ischemic encephalopathy stages II and III), 3 had congenital pneumonia, and 1 had transient tachypnea. Sildenafil citrate was administered via an oral feeding tube. Iloprost was administered endotracheally to patients on mechanical ventilation using a jet nebulizer. Iloprost appeared to be more effective than sildenafil in the treatment of PPHN with regard to time to adequate clinical response, ventilatory parameters, duration of drug administration, duration of mechanical ventilation, duration of return to normal values of respiratory failure indices, use of MgSO4 as a second vasodilator and requirement for support with inotropic agents. We observed no side effects on blood pressure or homeostasis in any of the patients in the iloprost group. Systemic hypotension was significantly elevated in the sildenafil group. Four and three infants died of PPHN in the sildenafil and iloprost groups, respectively. Pulmonary systolic arterial pressure decreased to normal levels in the remaining 40 patients, and they were discharged from hospital. We suggested that inhaled iloprost may be a safe and effective treatment choice in newborn infants with persistent pulmonary hypertension. In cases where treatment with inhaled iloprost, ECMO or INO is not possible, oral sildenafil can be an

The association between higher maternal pre-pregnancy body mass index and increased birth weight, adiposity and inflammation in the newborn.

Science.gov (United States)

McCloskey, K; Ponsonby, A-L; Collier, F; Allen, K; Tang, M L K; Carlin, J B; Saffery, R; Skilton, M R; Cheung, M; Ranganathan, S; Dwyer, T; Burgner, D; Vuillermin, P

2018-01-01

Excess adiposity and adiposity-related inflammation are known risk factors for cardiovascular disease in adults; however, little is known regarding the determinants of adiposity-related inflammation at birth. The aim of this study was to investigate the association between maternal pre-pregnancy BMI and newborn adiposity and inflammation. Paired maternal (28-week gestation) and infant (umbilical cord) blood samples were collected from a population-derived birth cohort (Barwon Infant Study, n = 1074). Data on maternal comorbidities and infant birth anthropomorphic measures were compiled, and infant aortic intima-media thickness was measured by trans-abdominal ultrasound. In a selected subgroup of term infants (n = 161), matched maternal and cord lipids, high-sensitivity C-reactive protein (hsCRP) and maternal soluble CD14 were measured. Analysis was completed by using pairwise correlation and linear regression. Because of their non-normal distribution, pathology blood measures were log transformed prior to analysis. Maternal pre-pregnancy BMI was positively associated with increased birth weight (mean difference 17.8 g per kg m -2 , 95% CI 6.6 to 28.9; p = 0.002), newborn mean skin-fold thickness (mean difference 0.1 mm per kg m -2 , 95% CI 0.0 to 0.1; p pregnancy BMI, 95% CI 0.6 to 7.7%, p = 0.02), but not cord blood soluble CD14. Inclusion of maternal hsCRP as a covariate attenuated the associations between pre-pregnancy BMI and both newborn skin-fold thickness and cord blood hsCRP. Higher maternal pre-pregnancy BMI is associated with increased newborn adiposity and inflammation. These associations may be partially mediated by maternal inflammation during pregnancy. © 2016 World Obesity Federation.

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

Science.gov (United States)

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.

Ethical issues in the application of medical technology to paediatric intensive care: two views of the newborn.

Science.gov (United States)

Wyatt, J S

1996-04-01

Recent advances in medical technology have led to a marked improvement in the chances of survival of sick or preterm infants, thereby stimulating renewed ethical debate on the status of the newborn. Two contradictory attitudes to the medical care of preterm or congenitally malformed newborn infants can be discerned in our pluralistic society. The two attitudes have their historical roots in the classical Graeco-Roman and Judaeo-Christian ethical traditions respectively. The former views newborn infants as of potential value only whereas the latter emphasises the intrinsic worth and dignity of the individual made in God's image. Recent secular philosophical reflection has provided a rationale for infanticide of the sick or abnormal newborn. A Christian approach to the care of the newborn prohibits intentional killing yet may encompass the withdrawal of treatment that is inappropriate or unduly burdensome. Medical care should be based upon respect for the value of the individual, protection of the defenceless from abuse or exploitation, and wise stewardship of limited health-care resources.

Vitamin A nutritional status in high- and low-income postpartum women and its effect on colostrum and the requirements of the term newborn.

Science.gov (United States)

Gurgel, Cristiane Santos Sânzio; Grilo, Evellyn C; Lira, Larissa Q; Assunção, Débora G F; Oliveira, Priscila G; Melo, Larisse R M de; de Medeiros, Silvia V; Pessanha, Luanna C; Dimenstein, Roberto; Lyra, Clélia O

To evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. Cross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20μg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400μgRAE/day were considered as insufficient for term newborns. The mean maternal vitamin A intake during pregnancy was 872.2±639.2μgRAE/day in low-income women and 1169.2±695.2μgRAE/day for high-income women (p<0.005). The prevalence of vitamin A deficiency was 6.9% (n=18) in the low-income group and 3.7% (n=6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3μgRAE/day (85.8% AI) and 427.2μgRAE/day (106.8% AI), respectively. Serum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low-income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high-income mothers. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Association between Infant Feeding and Early Postpartum Infant Body Composition: A Pilot Prospective Study

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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.

The relative kicking frequency of infants born full-term and preterm during learning and short-term and long-term memory periods of the mobile paradigm.

Science.gov (United States)

Heathcock, Jill C; Bhat, Anjana N; Lobo, Michele A; Galloway, James C

2005-01-01

Infants born preterm differ in their spontaneous kicking, as well as their learning and memory abilities in the mobile paradigm, compared with infants born full-term. In the mobile paradigm, a supine infant's ankle is tethered to a mobile so that leg kicks cause a proportional amount of mobile movement. The purpose of this study was to investigate the relative kicking frequency of the tethered (right) and nontethered (left) legs in these 2 groups of infants. Ten infants born full-term and 10 infants born preterm (infants participated in the study. The relative kicking frequencies of the tethered and nontethered legs were analyzed during learning and short-term and long-term memory periods of the mobile paradigm. Infants born full-term showed an increase in the relative kicking frequency of the tethered leg during the learning period and the short-term memory period but not for the long-term memory period. Infants born preterm did not show a change in kicking pattern for learning or memory periods, and consistently kicked both legs in relatively equal amounts. Infants born full-term adapted their baseline kicking frequencies in a task-specific manner to move the mobile and then retained this adaptation for the short-term memory period. In contrast, infants born preterm showed no adaptation, suggesting a lack of purposeful leg control. This lack of control may reflect a general decrease in the ability of infants born preterm to use their limb movements to interact with their environment. As such, the mobile paradigm may be clinically useful in the early assessment and intervention of infants born preterm and at risk for future impairment.

Short-Term Neonatal Outcome in Late Preterm vs. Term Infants

International Nuclear Information System (INIS)

Haroon, A.; Ali, S. R.; Ahmed, S.; Maheen, H.

2014-01-01

Objective: To determine the short-term neonatal outcomes in late preterm infants (LPIs) as compared to term infants and their association with maternal risk factors. Study Design: A case control, descriptive study. Place and Duration of Study: The Aga Khan University Hospital, Karachi, Pakistan, from January to December 2009. Methodology: The study included 326 late preterm babies (defined as those born between 34 to 37 weeks of gestation) and equal number of term control babies at the Aga Khan University Hospital, Karachi, Pakistan. Data, including obstetric history, maternal complications, neonatal morbidities, etc., was retrieved from patients medical records. The data was compared with the control group for complications, fetal morbidity and maternal morbidity. Results: Late preterm infants constituted 10.6% of all deliveries and 77% of all live preterm births during the study period. Respiratory distress syndrome (RDS) (16.5% vs. 0.3%, p < 0.001), growth retardation (24.8% vs. 4%, p < 0.001), hyperbilirubinemia requiring phototherapy (37.9% vs. 11%, p < 0.001), and sepsis (4.9% vs. 0.3%, p < 0.001) were found to be the major morbidities in the study group. The need for resuscitation was 12.7 times higher in the study group as compared to the term babies (21.4% vs. 1.2%, p < 0.001). NICU admissions in the study group were also higher (18.8% vs. 2.4%, p < 0.001). Hypertension (12.5% vs. 1.5%, p < 0.001), diabetes (12.5% vs. 9.2%, p < 0.001), antenatal history of UTI (1.5% vs. 0.3%, p < 0.001), and prolong rupture of membrane (8.9% vs. 4%, p < 0.001) were significant maternal morbidities in the late preterm group. Conclusion: The late preterm group had greater morbidity, compared to term neonates. Prior awareness of the morbidities associated with late preterm babies is helpful for the health care providers to anticipate and manage potential complications in late preterm infants. (author)

Survey of Clinical Evidence in Newborns with Hypernatremic Dehydration

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Hasan Boskabadi

2016-01-01

Full Text Available Background & objectives: Weight loss and hypernatremic dehydration is a common problem in infants with inadequate nutrition. Determination of risk factors and clinical characteristics of these neonates may help to prevent or early detection of hypernatremia. This study designed to determine the prevalence of clinical signs and risk factors for hypernatremic dehydration. Methods: This study is a sectional descriptive study that conducted on 418 newborns during 1385 to 1393 AHS that referred to Ghaem hospital in Mashhad. The hypernatremic group consisted of 197 neonates with serum sodium level higher than 150 mg/dl and 221 isonatremic newborns with sodium level less than 150 mmol/L were included as controls. Both groups were compared in terms of clinical symptoms of dehydration and maternal risk factors. All data were recorded and coded. Data analysis performed using paired T test and chi square tests by SPSS 16 software. Results: In the present study, 2.8% of infants were hypernatremic. The most common symptoms were neonatal jaundice (62.2%, hyperthermia (25.8%, lethargy (23.6%, agitation (20.8 % and mucous membranes dryness (17.2%. Problems in pregnancy (p=0.002, inappropriate feeding techniques (p=0.000, the first lactation duration (p=0.022 and frequency per day (p=0.000 had statistically significant difference between case and control groups. Conclusion: Prevalence of hypernatremic dehydrationis considerable in our study and identifying the risk factors may help to reduce its incidence or exacerbation. Weight loss, especially in newborns having jaundice, hyperthermia and irritability, may be helpful in the early diagnosis of hypernatremic dehydration

Comparison of Growth of Healthy Term Infants Fed Extensively Hydrolyzed Protein- and Amino Acid-Based Infant Formulas

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Marlene W. Borschel

2018-03-01

Full Text Available The aim of this narrative review was to assess published growth data for healthy, term, infants consuming extensively hydrolyzed protein-based (EHF, or amino acid-based formulas (AAF. These data may be of use to clinicians managing infants with medical conditions consuming these products. A search was conducted using key terms: amino acid-based, hydrolysate, hydrolyzed, hydrolysed, infant formula, infant formulae or formulas, baby formula, or formulae or formulas, infant, infants, infantile, and growth. Seven controlled, randomized, prospective growth trials of healthy term infants fed EHFs or AAFs at similar time points during the first four months of age met these and other criteria, including that the trial was published in a peer-reviewed journal, subjects were enrolled by ≤14 days of age and were exclusively formula-fed at entry and throughout the duration of the trial, and infants were assessed at regular intervals with weight measures available ideally at 14 days, one, two, three, and four months of age. Results suggested that healthy infants receiving commonly available EHFs and AAFs do not appear to experience accelerated growth as reported for infants fed many standard formulas. Differences in growth patterns were observed with some formulas supporting normative growth patterns during the first four months but others appearing to support markedly lower growth patterns. These observations should be confirmed in well-designed prospective randomized trials. Until that time, it is recommended that EHFs and AAFs be chosen carefully with individual patient needs considered.

Amplitude-integrated Electroencephalography in Full-term Newborns without Severe Hypoxic-ischemic Encephalopathy: Case Series

OpenAIRE

Osredkar, Damjan; Derganc, Metka; Paro-Panjan, Darja; Neubauer, David

2006-01-01

Aim: To assess the diagnostic value of amplitude-integrated electroencephalography (EEG) in comparison to standard EEG in newborns without severe hypoxic-ischemic encephalopathy who were at risk for seizures. Methods: The study included a consecutive series of 18 term newborns without severe hypoxic-ischemic encephalopathy, but with clinical signs suspicious of epileptic seizures, history of loss of social contact, disturbance of muscle tone, hyperirritability, and/or jitteriness. Amplitud...

Traumatic brain lesions in newborns

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Nícollas Nunes Rabelo

Full Text Available ABSTRACT The neonatal period is a highly vulnerable time for an infant. The high neonatal morbidity and mortality rates attest to the fragility of life during this period. The incidence of birth trauma is 0.8%, varying from 0.2-2 per 1,000 births. The aim of this study is to describe brain traumas, and their mechanism, anatomy considerations, and physiopathology of the newborn traumatic brain injury. Methods A literature review using the PubMed data base, MEDLINE, EMBASE, Science Direct, The Cochrane Database, Google Scholar, and clinical trials. Selected papers from 1922 to 2016 were studied. We selected 109 papers, through key-words, with inclusion and exclusion criteria. Discussion This paper discusses the risk factors for birth trauma, the anatomy of the occipito-anterior and vertex presentation, and traumatic brain lesions. Conclusion Birth-related traumatic brain injury may cause serious complications in newborn infants. Its successful management includes special training, teamwork, and an individual approach.

Slight Hydronephrosis in Newborns and Breast-fed Infants: Can the Presence of Vesicoureteral Reflux Be Predicted?

International Nuclear Information System (INIS)

Berrocal, T.; Pablo, T. de; Gutierrez, J.; Prieto, C.; Hoyo, M. L. del

2003-01-01

The purpose of this study was to determine the value of slight-to moderate echo graphically detected hydronephrosis in newborns and breast-fed infants that might serve as indicator for Vesicoureteral reflux (VUR), and to evaluate the necessity of performing micturating cystourethrougraphy (MCUG) in these patients. There were reviewed MCUG of 237 patients (174 boys and 63 girls between the ages of 0 and 18 months) with slight echo graphically detected hydronephrosis in order to evaluate the presence of primary VUR. Patients with secondary reflux or those that presented anomalies which made impossible an exact reflux gradind were excluded. However, normal kidneys with reflux which were contralateral to hydronephrotic kidneys were included in the study. For a statistical analysis of the data, each kidney was considered separately, thereby forming a total of 474 kidneys. Slight hydronephrosis was diagnosed when the renal pelvis anteroposterior diameter was observed to measure between 0.5 and 1.5 cm. The International Grading System was used to grade reflux during MCUG. Of the 474 kidneys evaluated, 306 showed slight hydromephrosis in the echography. Only 98 of these presented reflux (32%) (14 grade 1.50 grade II, 32 grade III and 2 grade IV). The echography was normal (i. e. hydronephrosis not present) in 52 kidneys with reflux (31%) which were contralateral to hydronephrotic kidneys, although 38 of these had reflux of grade II or higher. The echography showed slight hydronephrosis in 208 kidneys that did not have reflux during MCUG (68%). There were no significant differences in the incidence of VUR among normal or hydronephrotic kidneys. There is a poor correlation between slight hydronephrosis and presence or grade of reflux in newborns and breast-fed infants. The latter should not, therefore, be considered an indication for MCUC. (Author) 33 refs

EEG and MR Spectroscopy in Hypoxic-Ischemic Encephalopathy in Term Newborns

OpenAIRE

J Gordon Millichap

2010-01-01

Researchers from the University of Bologna, Italy, studied the relation of amplitude integrated EEG findings in the first 24 hrs of life to brain metabolic changes, detected by proton MR spectroscopy (H-MRS) at 7-10 days of life, in 32 term newborns with hypoxic-ischemic encephalopathy (HIE).

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

OpenAIRE

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

2009-01-01

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

Relations between maternal attachment representations and the quality of mother-infant interaction in preterm and full-term infants.

Science.gov (United States)

Korja, Riikka; Ahlqvist-Björkroth, Sari; Savonlahti, Elina; Stolt, Suvi; Haataja, Leena; Lapinleimu, Helena; Piha, Jorma; Lehtonen, Liisa

2010-06-01

The aim of the study was to assess the relationship between maternal representations and the quality of mother-infant interaction in a group of preterm and full-term infants. The study groups consisted of 38 mothers and their preterm infants (quality of mother-infant interaction was studied using the Parent-Child Early Relational Assessment (PCERA) method at 6 and 12 months of the infant's corrected age. The results showed that maternal representations are related to the quality of mother-infant interaction in a parallel manner in preterm and full-term infants and their mothers. Furthermore, distorted representations were more strongly related to a higher number of areas of concern in mother-infant interaction than other representation classifications. Our results underline the importance of combined assessment of the subjective experiences of the mother and the quality of mother-infant interaction in clinical follow-up. This is the first study to describe the relation between maternal attachment representations and the quality of mother-infant interaction involving preterm infants. Copyright 2010 Elsevier Inc. All rights reserved.

Life-threatening intracranial bleeding in a newborn with congenital cytomegalovirus infection: late-onset neonatal hemorrhagic disease.

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Dallar, Yildiz; Tiras, Ulku; Catakli, Tulin; Gulal, Gonul; Sayar, Yavuz; Selvar, Beray; Alioglu, Bulent

2011-02-01

The authors present a case of a 36-day-old infant with intracranial and intramuscular hemorrhage due to vitamin K deficiency bleeding, who received intramuscular vitamin K prophylaxis at birth. In this case, laboratory tests showed anemia, liver dysfunction with cholestasis, and coagulopathy, consistent with vitamin K deficiency abnormality. Serological analyses showed that cytomegalovirus immunoglobulin (Ig)M and IgG avidity were both positive. The infant was treated successfully with intravenous ganciclovir and blood products. This case suggests that it is imperative to meticulously investigate the etiology in neonates with late-onset hemorrhagic disease of the newborn. Cholestatic liver disease caused by congenital cytomegalovirus infection should be in mind in term infants who presented with late-onset hemorrhagic disease.

Glutamine supplementation of parenteral nutrition does not improve intestinal permeability, nitrogen balance, or outcome in newborns and infants undergoing digestive-tract surgery: results from a double-blind, randomized, controlled trial

NARCIS (Netherlands)

E.W. Steyerberg (Ewout); F.W.J. Hazebroek (Frans); M. Mourik; G.J.J.M. Borsboom (Gerard); T. Rietveld (Trinet); J.G.M. Huijmans (Jan); D. Tibboel (Dick); M.J.I.J. Albers (Marcel)

2005-01-01

textabstractOBJECTIVE: To assess the effect of isocaloric isonitrogenous parenteral glutamine supplementation on intestinal permeability and nitrogen loss in newborns and infants after major digestive-tract surgery. SUMMARY BACKGROUND DATA: Glutamine supplementation in critically

The use of ultrasonography in pediatric ophthalmology - diagnostics of ophthalmic disorders in newborns and infants

International Nuclear Information System (INIS)

Modrzejewska, M.; Karczewicz, D.; Wilk, G.

2006-01-01

Ultrasonographic (US) examinations in ophthalmology play a major role as one of the additional examination modes in the diagnostics of orbital diseases, and in cases of changes of a vascular origin it is useful in the evaluation of blood flow velocity. The special value of this examination in the assessment of the opaque optical structures on the fundus of the eye is emphasized. The aim of the study was 1) to present the ultrasonographic images and the efficacy of the method in the evaluation of some congenital and acquired bulbar diseases and 2) on the bases of the advantages of the examination, to determine whether ultrasonography could be included as a screening method in the diagnostics of preterm infants as well as a method of choice in term infants with ophthalmologic diseases. One thousand sixty-two children between the ages of 3 weeks to 12 months, of whom 1135 were preterm and 27 term infants, with ophthalmologic changes were examined. A real-time ultrasonographic apparatus with color Doppler (5-7.5 MHz sectoral and 7.5-10 MHz linear transducers). The US examinations of preterm infants were conducted four times and in term infants twice. In 105 children (8.99%) and in 184 eyes, premature retinopathy, intra-bulbar tumors, retinal ablation, posttraumatic changes, inflammatory processes in the posterior chamber of the eyeball, and congenital anomalies of the bulbar structures were diagnosed. Bulbar ultrasonography, being a safe, quick, and efficient examination, should be included as an additional screening method in preterm infants. Ultrasonography with color Doppler is an efficient method of choice for diagnosing problematic diseases of the eyeballs of infants. (author)

Sedatives for opiate withdrawal in newborn infants.

Science.gov (United States)

Osborn, David A; Jeffery, Heather E; Cole, Michael J

2010-10-06

Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. Treatments used to ameliorate symptoms and reduce morbidity include opiates, sedatives and non-pharmacological treatments. To assess the effectiveness and safety of using a sedative compared to a non-opiate control for NAS due to withdrawal from opiates, and to determine which type of sedative is most effective and safe. This update included searches of the Cochrane Central Register of Controlled Trials (Issue 1, 2010), MEDLINE 1966 to April 2010 and abstracts of conference proceedings. Trials enrolling infants with NAS born to mothers with an opiate dependence with > 80% follow-up and using random or quasi-random allocation to sedative or control. Control could include another sedative or non-pharmacological treatment. Each author assessed study quality and extracted data independently. Seven studies enrolling 385 patients were included. There were substantial methodological concerns for most studies including the use of quasi-random allocation methods and sizeable, largely unexplained differences in reported numbers allocated to each group.One study reported phenobarbitone compared to supportive care alone did not reduce treatment failure or time to regain birthweight, but resulted in a significant reduction in duration of supportive care (MD -162.1 min/day, 95% CI -249.2, -75.1). Comparing phenobarbitone to diazepam, meta-analysis of two studies found phenobarbitone resulted in a significant reduction in treatment failure (typical RR 0.39, 95% CI 0.24, 0.62). Comparing phenobarbitone with chlorpromazine, one study reported no significant difference in treatment failure.In infants treated with an opiate, one study reported addition of clonidine resulted in no significant difference in treatment failure, seizures or mortality. In infants treated with an opiate, one study

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

Science.gov (United States)

Capeding, Rosario; Gepanayao, Connie P; Calimon, Nerrisa; Lebumfacil, Jowena; Davis, Anne M; Stouffer, Nicole; Harris, Bruce J

2010-05-21

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. 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) infantslutein-fortified S-26 Gold demonstrated growth equivalent to that of infants fed unfortified lutein formula.

Noninvasive ventilatory strategies in the management of a newborn infant and three children with congenital central hypoventilation syndrome.

Science.gov (United States)

Tibballs, James; Henning, Robert D

2003-12-01

Four children with congenital central hypoventilation syndrome (CCHS) treated with noninvasive techniques of ventilation are presented. Two infants (one in the newborn period) were treated with nasal mask bilevel positive airway pressure (BiPAP), and then both were transitioned to negative pressure chamber ventilation at several years of age because of possible midface hypoplasia. Tracheostomies were not performed. Two older children were transitioned from mechanical ventilation via tracheostomy to nasal mask BiPAP, and then in one case to negative pressure chamber ventilation, and in the other to phrenic nerve pacing. Their tracheostomies were removed. Copyright 2003 Wiley-Liss, Inc.

Bone mineralization in newborns whose mothers received magnesium sulphate for tocolysis of premature labour

International Nuclear Information System (INIS)

Malaeb, Shadi N.; Rassi, Adriana I.; Yunis, Khalid A.; Haddad, Maurice C.; Seoud, Muhieddine A.

2004-01-01

Prolonged maternal magnesium sulphate infusion therapy for tocolysis of premature labour may result in secondary fetal hypermagnesaemia, which has been associated with bony abnormalities in the newborn. We report on four infants, members of two twin pregnancies, who were exposed to prolonged fetal hypermagnesaemia. Three of the infants, all appropriate for gestational age, showed abnormal radiological findings consisting of abnormal mineralisation of long-bone metaphyses owing to fetal hypermagnesaemia. The fourth infant, who was growth retarded, had normal bones. Intrauterine growth restriction appears to be protective against magnesium sulphate-induced abnormal bone mineralisation in the newborn. (orig.)

Bone mineralization in newborns whose mothers received magnesium sulphate for tocolysis of premature labour

Energy Technology Data Exchange (ETDEWEB)

Malaeb, Shadi N.; Rassi, Adriana I.; Yunis, Khalid A. [Department of Pediatrics, American University of Beirut Medical Center, PO Box 11-0236, Beirut (Lebanon); Haddad, Maurice C. [Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut (Lebanon); Seoud, Muhieddine A. [Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut (Lebanon)

2004-05-01

Prolonged maternal magnesium sulphate infusion therapy for tocolysis of premature labour may result in secondary fetal hypermagnesaemia, which has been associated with bony abnormalities in the newborn. We report on four infants, members of two twin pregnancies, who were exposed to prolonged fetal hypermagnesaemia. Three of the infants, all appropriate for gestational age, showed abnormal radiological findings consisting of abnormal mineralisation of long-bone metaphyses owing to fetal hypermagnesaemia. The fourth infant, who was growth retarded, had normal bones. Intrauterine growth restriction appears to be protective against magnesium sulphate-induced abnormal bone mineralisation in the newborn. (orig.)

Serial cytokine alterations and abnormal neuroimaging in newborn infants with encephalopathy.

Science.gov (United States)

O'Hare, Fiona M; Watson, R William G; O'Neill, Amanda; Segurado, Ricardo; Sweetman, Deirdre; Downey, Paul; Mooney, Eoghan; Murphy, John; Donoghue, Veronica; Molloy, Eleanor J

2017-04-01

Inflammatory cytokines may play a role in the final common pathway in the pathogenesis of hypoxic-ischaemic injury in experimental models. We aimed to profile the systemic pro-and anti-inflammatory response over the first week of life in term infants at risk of neonatal encephalopathy. In a tertiary referral university neonatal intensive care unit, serial blood samples were analysed from 41 term infants (requiring resuscitation at birth) in this prospective observational pilot study. Serum levels of 10 pro-and anti-inflammatory cytokines were evaluated including interleukin(IL)-1α, IL-1β, IL-6, IL-8, IL-10, tumour necrosis factor(TNF)-α, interferon (IFN)-γ, vascular endothelial growth factor (VEGF), granulocyte/colony-stimulating factor (G-CSF) and granulocyte macrophage/colony-stimulating factor (GM-CSF). Infants with neonatal encephalopathy and abnormal neuroimaging (n = 15) had significantly elevated granulocyte macrophage/colony-stimulating factor at 0-24 h and interleukin-8, interleukin-6 and interleukin-10 at 24-48 hour. Tumour necrosis factor-α and vascular endothelial growth factor levels were lower at 72-96 hour (p < 0.05). Significantly elevated levels of interleukin-10 were associated with mortality. Serum cytokine changes and innate immune dysregulation in the first week of life may be indicators of outcome in neonatal encephalopathy but require validation in larger studies. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Oxidative stress in resuscitation and in ventilation of newborns.

Science.gov (United States)

Gitto, E; Pellegrino, S; D'Arrigo, S; Barberi, I; Reiter, R J

2009-12-01

The lungs of newborns are especially prone to oxidative damage induced by both reactive oxygen and reactive nitrogen species. Yet, these infants are often 1) exposed to high oxygen concentrations, 2) have infections or inflammation, 3) have reduced antioxidant defense, and 4) have high free iron levels which enhance toxic radical generation. Oxidative stress has been postulated to be implicated in several newborn conditions with the phrase "oxygen radical diseases of neonatology" having been coined. There is, however, reason to believe that oxidative stress is increased more when resuscitation is performed with pure oxygen compared with ambient air and that the most effective ventilatory strategy is the avoidance of mechanical ventilation with the use of nasopharyngeal continuous positive airway pressure whenever possible. Multiple ventilation strategies have been attempted to reduce injury and improve outcomes in newborn infants. In this review, the authors summarise the scientific evidence concerning oxidative stress as it relates to resuscitation in the delivery room and to the various modalities of ventilation.

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

Directory of Open Access Journals (Sweden)

Tooten Anneke

2012-06-01

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

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

Science.gov (United States)

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

2016-01-01

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

[Early discharge of newborns: what problems should we anticipate?].

Science.gov (United States)

Straczek, H; Vieux, R; Hubert, C; Miton, A; Hascoet, J-M

2008-06-01

Following Nordic and Anglo-Saxon countries, France is directing towards an early discharge policy from maternity hospitals. French National Authority for Health has published recommendations focusing on the importance to highlight the dangers of such a policy so as to be able to anticipate them. To describe the complications diagnosed in the newborn infants from day 2 to the current hospital's discharge (noteworthy, if infants are discharged early, these complications may occur at home) to determine predictive factors and to validate those proposed by the French National Authority for Health. Prospective study conducted in the maternity ward of Nancy's level III facility, from January 6th to May 6th 2005. Nine hundred and three newborn infants were included. Forty-two (4.6%) presented with complications diagnosed from day 2 to hospital's discharge, among which 4 required urgent neonatal care. The most frequent complication was hyperbilirubinemia: 23 newborns were treated with phototherapy between day 2 and day 10. Statistically significant risk factors of hyperbilirubinemia after day 2 in multivariate analysis were instrumental vaginal delivery (OR=2.94; CI 95% [1.04-8.34]) and jaundice before day 2 (OR=7.39; CI 95% [2.66-20.55]). According to the French National Authority for Health's policy, 33 among 42 infants presenting with a complication would have been withdrawn from an early discharge program. In our population, French National Authority for Health's recommendations were relevant to guide an early discharge project.

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

Science.gov (United States)

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

2014-03-01

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

Neurocomportamento de recém-nascidos a termo, pequenos para a idade gestacional, filhos de mães adolescentes Neurobehavior of full-term small for gestational age newborn infants of adolescent mothers

Directory of Open Access Journals (Sweden)

Marina C. de Moraes Barros

2008-06-01

Full Text Available OBJETIVO: Comparar o neurocomportamento de recém-nascidos a termo pequenos (PIG e adequados (AIG para a idade gestacional, filhos de mães adolescentes. MÉTODOS: Estudo transversal prospectivo de nascidos a termo AIG e PIG, com 24-72 horas de vida, sem afecções do sistema nervoso central. Os neonatos foram avaliados por meio da Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS para: habituação, atenção, despertar, controle, manobras para a orientação, qualidade dos movimentos, excitabilidade, letargia, reflexos não ótimos, assimetria, hipertonia, hipotonia e sinais de estresse e abstinência. A comparação dos grupos AIG e PIG foi feita por análise de variância e teste do qui-quadrado. Aplicou-se a regressão multivariada para analisar os fatores associados ao escore de cada variável do NNNS. RESULTADOS: Dos 3.685 nascidos no local do estudo, 928 (25% eram de mães adolescentes. Desses, 477 satisfizeram os critérios de inclusão, sendo 419 (88% AIG e 58 (12% PIG. A análise univariada não mostrou diferença em nenhuma das variáveis da NNNS entre os PIG e os AIG. Na análise multivariada, os PIG nascidos de parto vaginal apresentaram menor escore na variável qualidade de movimentos do que os nascidos por cesárea. Os PIG nascidos com anestesia local ou sem anestesia apresentaram maior escore na variável excitabilidade do que os nascidos sob anestesia loco-regional. Os PIG femininos tiveram menor escore na variável sinais de estresse/abstinência que os masculinos. CONCLUSÃO: Os recém-nascidos PIG de mães adolescentes mostraram menor qualidade de movimento, mais excitabilidade e mais sinais de estresse, em associação com o sexo do neonato e com variáveis relacionadas ao parto.OBJECTIVE: To compare the neurobehavior of small (SGA and adequate (AGA for gestational age full-term neonates born to adolescent mothers. METHODS: This prospective cross-sectional study included full-term newborn infants aged 24

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

Phenotypic differences in leucocyte populations among healthy preterm and full-term newborns.

Science.gov (United States)

Quinello, C; Silveira-Lessa, A L; Ceccon, M E J R; Cianciarullo, M A; Carneiro-Sampaio, M; Palmeira, P

2014-07-01

The immune system of neonates has been considered functionally immature, and due to their high susceptibility to infections, the aim of this study was to analyse the phenotypic differences in leucocyte populations in healthy preterm and full-term newborns. We evaluated the absolute numbers and frequencies of dendritic cells (DCs) and DC subsets, monocytes and T and B lymphocytes and subsets in the cord blood of healthy moderate and very preterm (Group 1), late preterm (Group 2) and full-term (Group 3) newborns and in healthy adults, as controls, by flow cytometry. The analyses revealed statistically higher absolute cell numbers in neonates compared with adults due to the characteristic leucocytosis of neonates. We observed a lower frequency of CD80(+) myeloid and plasmacytoid DCs in Group 1 and reduced expression of TLR-4 on myeloid DCs in all neonates compared with adults. TLR-2(+) monocytes were reduced in Group 1 compared with Groups 2 and 3, and TLR-4(+) monocytes were reduced in Groups 1 and 2 compared with Group 3. The frequencies and numbers of naïve CD4(+) T and CD19(+) B cells were higher in the three groups of neonates compared with adults, while CD4(+) effector and effector memory T cells and CD19(+) memory B cells were elevated in adults compared with neonates, as expected. Our study provides reference values for leucocytes in cord blood from term and preterm newborns, which may facilitate the identification of immunological deficiencies in protection against extracellular pathogens. © 2014 John Wiley & Sons Ltd.

[Renal response to intravenous administration of sodium bicarbonate in newborn infants of different gestational ages].

Science.gov (United States)

Jasso-Gutiérrez, L; Araujo, B; Fuse-Moteji, R; del Castillo, E D

1976-01-01

The study comprised a series of 16 neonates made up of 5 patients of 33 weeks of gestation, 5 infants of 35 weeks and 6 more of 40 weeks of gestation. Blood pH, PaCO2 and HCO3- were measured together with bicarbonate, ammonium, titrable acidity and hydrogen ions in urine before and after intravenous infusion of sodium bicarbonate. Before infusion of bicarbonate, titrable acidity, ammonium and net acidity in urine were higher in accordance with a greater gestational age. As the administration of bicarbonate elapsed, titrable acidity, ammonium and net acidity dropped with increase in concentration of bicarbonate. A hypothesis is set forth that the differences found in the factors evaluated in urine before administration of bicarbonate depend on the physiologic characteristics set in the newborn by gestational age.

Birth-weight, insulin levels, and HOMA-IR in newborns at term.

Science.gov (United States)

Simental-Mendía, Luis E; Castañeda-Chacón, Argelia; Rodríguez-Morán, Martha; Guerrero-Romero, Fernando

2012-07-07

Recent studies have demonstrated that low and high birth-weight at birth are risk factors of developing diabetes. The aim of this study was to determine if the abnormal birth-weight is related with hyperinsulinemia and elevated index of the Homeostasis Model assessment for Insulin Resistance (HOMA-IR) at birth, in at term newborns. Newborns with gestational age between 38 and 41 weeks, products of normal pregnancies of healthy mothers aged 18 to 39 years, were eligible to participate. Small-for-gestational age (SGA) and large-for-gestational age (LGA) newborns were compared with appropriate-for-gestational (AGA) age newborns. Incomplete or unclear data about mother's health status, diabetes, gestational diabetes, history of gestational diabetes, hypertension, pre-eclampsia, eclampsia, and other conditions that affect glucose metabolism were exclusion criteria. Hyperinsulinemia was defined by serum insulin levels ≥13.0 μU/mL and IR by HOMA-IR ≥2.60. Multiple logistic regression analysis was used to determine the odds ratio (OR) that computes the association between birth-weight (independent variable) with hyperinsulinemia and HOMA-IR index (dependent variables). A total of 107 newborns were enrolled; 13, 22, and 72 with SGA, LGA, and AGA, respectively. Hyperinsulinemia was identified in 2 (15.4%), 6 (27.3%), and 5 (6.9%) with SGA, LGA, and AGA (p=0.03), whereas IR in 3 (23.1%), 8 (36.4%), and 10 (13.9%) newborns with SGA, LGA and AGA (p=0.06). The LGA showed a strong association with hyperinsulinemia (OR 5.02; CI 95%, 1.15-22.3; p=0.01) and HOMA-IR (OR 3.54; CI 95%, 1.03-12.16; p=0.02); although without statistical significance, the SGA showed a tendency of association with hyperinsulinemia (OR 2.43; CI 95%, 0.43-17.3 p=0.29) and HOMA-IR (OR 1.86; CI 95%, 0.33-9.37; p=0.41). Our results suggest that LGA is associated with hyperinsulinemia and elevated HOMA-IR at birth whereas the SGA show a tendency of association.

HAEMOLYTIC DISEASE OF THE NEWBORN

African Journals Online (AJOL)

Addington Children's Hospital, Durban. In 1951, the Director of the ... 10 assess, since the number of cases diagnosed in these districts is ... Rhesus antibodies develop admission to hospital is advised in the 38th ... laboratory the newborn infant is subjected to a careful ..... is now gross mental defect and blindness. A happy.

Newborn hearing screening.

Science.gov (United States)

Stewart, D L; Pearlman, A

1994-11-01

Congenital deafness is a relatively common problem with an incidence of 1/300 to 1/1000. Most states have no mass screening program for hearing loss, but the state of Kentucky compiles a High Risk Registry which is a historical survey of parents relating to risk factors for hearing loss. Unfortunately this survey can miss 50% of those who have a hearing deficit. If not detected prior to discharge, there is often a delay in diagnosis of deafness which prevents early intervention. We report 2 years' experience at Kosair Children's Hospital where 1,987 infants admitted to well baby, intermediate, or intensive care nurseries were screened using the ALGO-1 screener (Natus Medical Inc, Foster City, CA) which is a modified auditory brain stem evoked response (ABR). Our screening of this population led to an 11% incidence of referral for complete audiological evaluation. There were no significant complications. Forty-eight infants were found to have nonspecified, sensorineural, or conductive hearing loss. The positive predictive value of the test was 96%. Therefore, we feel that the use of the modified ABR in the newborn is a timely, cost efficient method of screening for hearing loss and should be used for mass screening of all newborns.

Effects of Fructans from Mexican Agave in Newborns Fed with Infant Formula: A Randomized Controlled Trial

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Gabriel López-Velázquez

2015-10-01

Full Text Available Background: The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin® and Metlos® was demonstrated. Methods: This study aimed to demonstrate the efficacy as prebiotics of Metlin® and Metlos® in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. Results: There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin® and Metlos®. Conclusions: Our results support the efficacy of Metlin® and Metlos® as prebiotics in humans, and stand the bases to recommend their consumption. Trial Registration: ClinicalTrials.gov, NCT 01251783.

Effects of Fructans from Mexican Agave in Newborns Fed with Infant Formula: A Randomized Controlled Trial.

Science.gov (United States)

López-Velázquez, Gabriel; Parra-Ortiz, Minerva; Mora, Ignacio De la Mora-De la; García-Torres, Itzhel; Enríquez-Flores, Sergio; Alcántara-Ortigoza, Miguel Angel; Angel, Ariadna González-Del; Velázquez-Aragón, José; Ortiz-Hernández, Rosario; Cruz-Rubio, José Manuel; Villa-Barragán, Pablo; Jiménez-Gutiérrez, Carlos; Gutiérrez-Castrellón, Pedro

2015-10-29

The importance of prebiotics consumption is increasing all over the world due to their beneficial effects on health. Production of better prebiotics from endemic plants raises possibilities to enhance nutritional effects in vulnerable population groups. Fructans derived from Agave Plant have demonstrated their safety and efficacy as prebiotics in animal models. Recently, the safety in humans of two fructans obtained from Agave tequilana (Metlin(®) and Metlos(®)) was demonstrated. This study aimed to demonstrate the efficacy as prebiotics of Metlin(®) and Metlos(®) in newborns of a randomized, double blind, controlled trial with a pilot study design. Biological samples were taken at 20 ± 7 days, and three months of age from healthy babies. Outcomes of efficacy include impact on immune response, serum ferritin, C-reactive protein, bone metabolism, and gut bacteria changes. There were differences statistically significant for the groups of infants fed only with infant formula and with formula enriched with Metlin(®) and Metlos(®). Our results support the efficacy of Metlin(®) and Metlos(®) as prebiotics in humans, and stand the bases to recommend their consumption. ClinicalTrials.gov, NCT 01251783.

Intersensory Function in Newborns: Effect of Sound on Visual Preferences.

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Lawson, Katharine Rieke; Turkewitz, Gerald

1980-01-01

Newborn infants' fixation of a graduated series of visual stimuli significantly differed in the absence and presence of white-noise bursts. Relative to the no-sound condition, sound resulted in the infants' tendency to look more at the low-intensity visual stimulus and less at the high- intensity visual stimulus. (Author/DB)

Changes in superior sagittal sinus blood velocities due to postural alterations and pressure on the head of the newborn infant.

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Cowan, F; Thoresen, M

1985-06-01

A pulsed Doppler bidirectional ultrasound system has been used to measure alterations in the blood velocities in the superior sagittal sinus of the healthy term newborn infant in response to unilateral and bilateral jugular venous occlusion. These maneuvers were performed with the baby lying in different positions: supine, prone, and on the side (both left and right), the neck flexed or extended, and with the head in the midline or turned 90 degrees to the side (both left and right). Transfontanel pressure was also measured in these positions during occlusions. Results show that turning the head effectively occludes the jugular vein on the side to which the head is turned and that occluding the other jugular vein does not force blood through this functional obstruction. The effect of different forms of external pressure to the head on the superior sagittal sinus velocities was also examined. Alterations in velocities were frequently profound although they varied considerably from baby to baby. This work shows how readily large fluctuations in cranial venous velocities and pressures can occur in the course of normal handling of babies.

Haematological reference values for full-term, healthy, newborns of Karachi, Pakistan.

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Qaiser, Danish Hasan; Sandila, Mohammad Perwaiz; Ahmed, Syed Tousif; Kazmi, Tahseen

2009-09-01

To establish reference haematological values (complete blood count) in healthy full-term newborns of Karachi. This is a cross sectional study design based on cord blood sample of 404 newborns and their mothers recruited from Sindh Government Qatar Hospital, Ziauddin University Hospital gole market campus, Sindh Government hospital, Liaquatabad and Chinniot maternity and child hospital. Karachi from July 2006 to April 2008. Both mother's and the new born baby's blood was collected in EDTA containing tubes and analyzed for different haematological parameters. The data entry and analysis was done on computer package SPSS (Statistical Packages of Social Sciences) version 12.0. The results were given in the text as mean, standard deviation and 95% confidence intervals of haematological values (complete blood count). The mean haemoglobin was found to be (14.99 +/- 1.47 gm), which is lower than the standard value described in literature. However the total WBCs count and platelet count were found to be (13.61 +/- 4.23) and (256. 25 +/- 76.54) respectively, which were similar to the other studies. Our values provide reference range for haematological values in healthy newborns of Karachi, for clinical use by our physicians.

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

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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.

Pulmonary and chest wall mechanics in the control of respiration in the newborn.

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Davis, G M; Bureau, M A

1987-09-01

Although the respiratory system is not fully developed at birth, the human newborn infant has flexible strategies to sustain breathing and defend blood gas homeostasis in both health and disease conditions. Initially the thresholds for chemoreceptor response to PO2 and PCO2 closely mimic those of the fetus, but the threshold resets to sustain ventilation adequate for blood gas homeostasis appropriate to the extrauterine milieu. The muscles of respiration have been "trained" in utero and effectively assume the function of the respiratory pump, despite their marginal reserve against fatigue. The pliable chest wall is functionally stabilized by the tonic activity of the intercostal muscles, thereby allowing effective ventilation. Finally, expiration is prolonged by the postinspiratory activity of the diaphragm and laryngeal braking as a means of maintaining an elevated lung volume and augmenting FRC. The ventilatory response of the newborn to respiratory disease is limited. The magnitude of the VE response is smaller than that of the adult, and is characterized by an increase in the respiratory rate and a limited increase in the VT. The poor effort reserve of the muscles, especially the diaphragm, predisposes the newborn to muscle fatigue and ventilatory failure. To avoid fatigue, recruitment of accessory muscles occurs, along with laryngeal braking of expiration, thereby decreasing the work of the diaphragm, recruiting new alveoli by an auto-PEEP effect, increasing the FRC volume, and improving gas exchange by an increase in the pulmonary surface area. These mechanisms help to avoid muscle exhaustion and facilitate adequate gas exchange in the presence of lung disease. We do not know precisely the postconceptual age at which the newborn is sufficiently developed to adopt these various defensive strategies of breathing, but the presence of tachypnea and grunting in 28-week-old premature infants suggests that long before term the human infant is capable of remarkable

INCIDENCE OF BRONCHOPULMONARY DYSPLASIA IN PRETERM NEWBORNS SUBMITTED TO MECHANICAL VENTILATION: A RETROSPECTIVE STUDY OF 1250 PRETERM NEWBORNS

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Leilianna de Souza Vieira

2014-03-01

Full Text Available Objective: To determine the incidence of preterm newborn infants in mechanical ventilation who developed bronchopulmonary dysplasia in a public hospital at Fortaleza/CE. Method: Descriptive, retrospective and longitudinal quantitative analysis with 1250 preterm infants admitted to the Intensive Care Unit, Dr. César Cals General Hospital, at Fortaleza, from July 2006 to June 2007. Data collection occurred during two months, with visits to units twice a week, where the medical records were done. Were included in these sample newborns that were in mechanical ventilation and developed bronchopulmonary dysplasia. Then the gestational average was 28.6 weeks; the mean weight of infants was 1125.33 grams, born vaginally or cesarean section, of both sexes and with various primary diseases such as respiratory distress syndrome, jaundice and neonatal infection. Results: In the sample from the total admissions, 34.48% were for mechanical ventilation and 3.48% developed bronchopulmonary dysplasia. Conclusion: Despite the low prevalence, bronchopulmonary dysplasia is a important complication of prematurity, directly related to the duration of mechanical ventilation, thus the team must be committed on weaning and extubation of those as soon as possible, preferably within the first week of life.

Detecting congenital hypothyroidism with newborn screening: the relevance of thyroid-stimulating hormone cutoff values.

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Silvestrin, Stela Maris; Leone, Claudio; Leone, Cléa Rodrigues

To assess the prevalence of congenital hypothyroidism and the ability of various neonatal thyroid-stimulating hormone (TSHneo) cutoff values to detect this disease. This cohort study was based on the retrospective collection of information available from the Reference Service for Newborn Screening database for all live births from January 1, 2010, to December 31, 2012, assessed using the Newborn Screening Program of a Brazilian state, Brazil. The infants were divided into two groups: I - Control: infants with normal newborn screening tests and II - Study: infants with congenital hypothyroidism. Analysis included comparing the TSHneo levels from both groups. A receiver operating characteristic (ROC) curve was constructed to assess the TSHneo cutoff values. Using a TSHneo cutoff value of 5.0μIU/mL, 50 out of 111,705 screened infants had diagnosis of congenital hypothyroidism (prevalence 1:2234 live births). The ROC curve showed that TSHneo value of 5.03μIU/mL had 100% sensitivity and the greatest associated specificity (93.7%). The area under the curve was 0.9898 (pvalue of 5.0μIU/mL adopted by the Newborn Screening Program of a Brazilian state was the most appropriate for detecting congenital hypothyroidism and most likely explains the high prevalence that was found. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

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

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Svetlana V. Garina

2016-06-01

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

Nonsteroidal antiinflammatory drugs in late pregnancy and persistent pulmonary hypertension of the newborn.

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Van Marter, Linda J; Hernandez-Diaz, Sonia; Werler, Martha M; Louik, Carol; Mitchell, Allen A

2013-01-01

Persistent pulmonary hypertension of the newborn (PPHN) is a clinical syndrome of late-preterm and full-term infants associated with failure of the normal fetal-to-neonatal circulatory transition. This study was designed to test the hypothesis that risk for PPHN is increased after antenatal exposure to nonsteroidal antiinflammatory drugs (NSAIDs), with particular emphasis on late gestational exposures. Between 1998 and 2003, we interviewed 377 women whose infants had PPHN and 836 control mothers of infants matched to cases by hospital and birth date. Interviews captured information on prescription and over-the-counter medication use in pregnancy as well as a variety of potential confounding factors. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for third-trimester maternal NSAID use were estimated by using multivariate conditional logistic regression. During the third trimester of gestation, 33 infants (8.8%) with PPHN were exposed to any NSAID compared with 80 (9.6%) controls (OR 0.8; 95% CI 0.5-1.3). We observed an elevated OR for PPHN risk among infants whose mothers consumed aspirin during the third-trimester; however, the lower 95% CI included the null. Neither nonaspirin NSAIDs at any time during pregnancy nor ibuprofen use during the third trimester was associated with an elevated risk of PPHN. Similarly, no association was observed between a mother's third-trimester acetaminophen use and the occurrence of PPHN in her newborn. This large multicenter epidemiologic study of PPHN risk revealed no evidence to support the hypothesis that maternal consumption during pregnancy of NSAIDs overall or ibuprofen in particular is associated with PPHN risk.

Results of exchange transfusions in newborns without blood group incompatibility

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Servet Yel

2013-01-01

Full Text Available Objective: Hyperbilirubinemia is a common problem ofneonatal period that has high morbidity and mortality.Blood exchange is the most effective and urgent treatmentmodality for very high bilirubin levels that can lead toneurotoxicity called as kernicterus. The aim of this studywas to compare 90 minutes exchange transfusion withthat of 120 minutes.Methods: This study was performed at Dicle UniversityMedical Faculty, Neonatal Unit between July 2007 andJune 2008. A total of 36 term newborn (38 - 42 gestationalweek without blood group incompatibility and withtotal serum bilirubin levels over 25 mg/dl were included.Newborns were randomly assigned in two groups eachof them comprise 18 babies as Group 1 underwent 90minute-exchange and Group 2 120 minute. Effectivenessand complications of exchange transfusion were recorded.Newborns with Rh, ABO or subgroup incompatibilities,prematurity or small for gestational age, septicemia,hypothyroidism, G6PD enzyme deficiency, intrauterineinfections, diabetic mother’s baby, hemolytic disease ormetabolic diseases were excluded.Results: There were no significant differences in thebody weight, gestational age, postnatal age, age of mother,total bilirubin and albumin levels, the number of bloodexchange, hospital stay days and complications betweentwo groups (p>0.05. However, mean phototherapy durationwas significantly shorter in 120 minutes transfusiongroup compared with 90 minutes group (p<0.001.Conclusion: Our results indicated that 90 minutes wassufficient for an effective exchange transfusion in severehyperbilirubinemic newborn infants. However longer exchangetransfusion durations may shorten the duration ofphototherapy.Key words: Indirect hyperbilirubinemia, exchange transfusion,newborns, outcome

First Year of Israeli Newborn Screening for Severe Combined Immunodeficiency—Clinical Achievements and Insights

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Erez Rechavi

2017-11-01

Full Text Available Severe combined immunodeficiency (SCID, the most severe form of T cell immunodeficiency, is detectable through quantification of T cell receptor excision circles (TRECs in dried blood spots obtained at birth. Herein, we describe the results of the first year of the Israeli SCID newborn screening (NBS program. This important, life-saving screening test is available at no cost for every newborn in Israel. Eight SCID patients were diagnosed through the NBS program in its first year, revealing an incidence of 1:22,500 births in the Israeli population. Consanguine marriages and Muslim ethnic origin were found to be a risk factor in affected newborns, and a founder effect was detected for both IL7Rα and DCLRE1C deficiency SCID. Lymphocyte subset analysis and TREC quantification in the peripheral blood appear to be sufficient for confirmation of typical and leaky SCID and ruling out false positive (FP results. Detection of secondary targets (infants with non-SCID lymphopenia did not significantly affect the management or outcomes of these infants in our cohort. In the general, non-immunodeficient population, TREC rises along with gestational age and birth weight, and is significantly higher in females and the firstborn of twin pairs. Low TREC correlates with both gestational age and birth weight in extremely premature newborns. Additionally, the rate of TREC increase per week consistently accelerates with gestational age. Together, these findings mandate a lower cutoff or a more lenient screening algorithm for extremely premature infants, in order to reduce the high rate of FPs within this group. A significant surge in TREC values was observed between 28 and 30 weeks of gestation, where median TREC copy numbers rise by 50% over 2 weeks. These findings suggest a maturational step in T cell development around week 29 gestation, and imply moderate to late preterms should be screened with the same cutoff as term infants. The SCID NBS program is still

Biomarkers S100B and neuron-specific enolase predict outcome in hypothermia-treated encephalopathic newborns*.

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Massaro, An N; Chang, Taeun; Baumgart, Stephen; McCarter, Robert; Nelson, Karin B; Glass, Penny

2014-09-01

To evaluate if serum S100B protein and neuron-specific enolase measured during therapeutic hypothermia are predictive of neurodevelopmental outcome at 15 months in children with neonatal encephalopathy. Prospective longitudinal cohort study. A level IV neonatal ICU in a freestanding children's hospital. Term newborns with moderate to severe neonatal encephalopathy referred for therapeutic hypothermia during the study period. Serum neuron-specific enolase and S100B were measured at 0, 12, 24, and 72 hours of hypothermia. Of the 83 infants enrolled, 15 (18%) died in the newborn period. Survivors were evaluated by the Bayley Scales of Infant Development-II at 15 months. Outcomes were assessed in 49 of 68 survivors (72%) at a mean age of 15.2 ± 2.7 months. Neurodevelopmental outcome was classified by Bayley Scales of Infant Development-II Mental Developmental Index and Psychomotor Developmental Index scores, reflecting cognitive and motor outcomes, respectively. Four-level outcome classifications were defined a priori: normal = Mental Developmental Index/Psychomotor Developmental Index within 1 SD (> 85), mild = Mental Developmental Index/Psychomotor Developmental Index less than 1 SD (70-85), moderate/severe = Mental Developmental Index/Psychomotor Developmental Index less than 2 SD (encephalopathy are associated with neurodevelopmental outcome at 15 months. These putative biomarkers of brain injury may help direct care during therapeutic hypothermia.

Newborn exoplanet eyed for moons and rings

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Clery, Daniel

2018-01-01

Astronomers are staring at a nearby star in hopes of seeing a giant baby of a planet—perhaps accompanied by dust clouds, rings, or newborn moons—pass across its face. Last week, the newest and tiniest telescope joined the vigil, when the French-built PicSat rode into orbit on an Indian rocket. It will be able to continuously monitor the star, β Pictoris, until chances of seeing the once-in-20-year transit event diminish in a few months' time. Astronomers are fascinated by β Pictoris, a bright star just 63 light-years away, because it is a natural laboratory for how solar systems form given its age of only 24 million years—an infant in stellar terms.

[The newborn infant of a mother with tuberculosis].

Science.gov (United States)

Pedicino, R; Bressan, K; Bedetta, M

2010-06-01

TBC is a major infectious emergency in the world. OMS suggest that there are 8 millions of affected every year and 2 millions of deaths. Italy is considered a country with low prevalence, but the increase of the immigration from Africa Asia and Est Europa (country with high risk) imposes attention to the problem. The delivery is a critical moment to investigate people at risk of disease. The infection of the newborn can happen intrauterine or in the expulsive period, but is possible also at home, from somebody affected by an active pulmonary disease. Diagnosis in the newborn is not easy for the aspecificity of clinical signs and for the frequent initial negativeness of Mantoux test. Culture of placenta, gastric aspirate, tracheal secretions, urine would be requested, cerebrospinal fluid if necessary. Neonatal disease needs therapy with isoniazide, rifampicine, pirazinamide and, or ethambutol, or streptomycin. Profilaxis of a newborn from a woman affected by an active form of tuberculosis or living with people affected by an active pulmonary form consists in giving isoniazide until diagnostic tests are negative and in removing the sicks (only with pulmonary disease). New dangerous kinds of pharmacological multiresistent tuberculosis are appeared in the last years in the world and, with the coinfection HIV-TBC and the reorganization of the surveillance system, represents the major obligation for the next years.

Newborn screening for galactosaemia.

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Lak, Rohollah; Yazdizadeh, Bahareh; Davari, Majid; Nouhi, Mojtaba; Kelishadi, Roya

2017-12-23

Classical galactosaemia is an autosomal recessive inborn error of metabolism caused by a deficiency of the enzyme galactose-1-phosphate uridyltransferase. This is a rare and potentially lethal condition that classically presents in the first week of life once milk feeds have commenced. Affected babies may present with any or all of the following: cataracts; fulminant liver failure; prolonged jaundice; or Escherichia coli sepsis. Once the diagnosis is suspected, feeds containing galactose must be stopped immediately and replaced with a soya-based formula. The majority of babies will recover, however a number will not survive. There are long-term complications of galactosaemia, despite treatment, including learning disabilities and female infertility. It has been postulated that galactosaemia could be detected on newborn screening and this would prevent the immediate severe liver dysfunction and sepsis. To assess whether there is evidence that newborn screening for galactosaemia prevents or reduces mortality and morbidity and improves clinical outcomes in affected neonates and the quality of life in older children. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from electronic database searches, handsearches of relevant journals and conference abstract books. We also searched online trials registries and the reference lists of relevant articles and reviews.Date of the most recent search of Cochrane Cystic Fibrosis Group's Trials Register: 18 December 2017.Date of the most recent search of additional resources: 11 October 2017. Randomised controlled studies and controlled clinical studies, published or unpublished comparing the use of any newborn screening test to diagnose infants with galactosaemia and presenting a comparison between a screened population versus a non-screened population. No studies of newborn screening for galactosaemia were found. No studies were identified for inclusion in the

Phenobarbital and Phototherapy Combination Enhances Decline of Total Serum Bilirubin and May Decrease the Need for Blood Exchange Transfusion in Newborns with Isoimmune Hemolytic Disease

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Mahmoud A. F. Kaabneh

2015-01-01

Full Text Available Objective The objective of this study was to evaluate the effect of phenobarbital and phototherapy combination on the total serum bilirubin of the newborn infants with isoimmune hemolytic disease (IHD and its impact on blood exchange transfusion rates. Patients and Method This single-blinded, prospective, randomized, controlled trial was conducted between March 2013 and December 2014 at the pediatric ward of two Military Hospitals in Jordan. A total of 200 full-term neonates with IHD were divided randomly into two groups: (1 the phenobarbital plus phototherapy group ( n = 103, and (2 the phototherapy-only group ( n = 97. Infants in group 1 received an oral dose of 2.5 mg/kg phenobarbital every 12 hours for 3 days in addition to phototherapy. The total serum bilirubin was observed. Results Of the total 200 included newborn infants, 186 infants completed the study: 97 infants were included in group 1 and 89 infants in group 2. The difference between the mean total serum bilirubin levels at 24, 48, and 72 hours after starting the trial was clinically and statistically significant at P < 0.05. The differences between the two groups were also statistically significant at P < 0.05. Of the total 186 who completed the study, only 22 underwent blood exchange transfusion [7 from group 1, and 15 from group 2 ( P = 0.0478]. Conclusion In a limited-resources setting, phenobarbital in combination with phototherapy may be helpful to newborn infants with IHD, as it results in a faster decline in total serum bilirubin, thus decreasing the need for blood exchange transfusion than phototherapy alone.

Oral dextrose gel for the treatment of hypoglycaemia in newborn infants.

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Weston, Philip J; Harris, Deborah L; Battin, Malcolm; Brown, Julie; Hegarty, Joanne E; Harding, Jane E

2016-05-04

Neonatal hypoglycaemia, a common condition, can be associated with brain injury. It is frequently managed by providing infants with an alternative source of glucose, given enterally with formula or intravenously with dextrose solution. This often requires that mother and baby are cared for in separate environments and may inhibit breast feeding. Dextrose gel is simple and inexpensive and can be administered directly to the buccal mucosa for rapid correction of hypoglycaemia, in association with continued breast feeding and maternal care. To assess the effectiveness of dextrose gel in correcting hypoglycaemia and in reducing long-term neurodevelopmental impairment. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science from inception of the database to February 2016. We also searched international clinical trials networks and handsearched proceedings of specific scientific meetings. Randomised and quasi-randomised studies comparing dextrose gel versus placebo, no treatment or other therapies for treatment of neonatal hypoglycaemia. Two review authors independently assessed trial quality and extracted data and did not assess publications for which they themselves were study authors. We included two trials involving 312 infants. No data were available for correction of hypoglycaemia for each hypoglycaemic event. We found no evidence of a difference between dextrose gel and placebo gel for major neurosensory disability at two-year follow-up (risk ratio (RR) 6.27, 95% confidence interval (CI) 0.77 to 51.03; one trial, n = 184; quality of evidence very low). Dextrose gel compared with placebo gel or no gel did not alter the need for intravenous treatment for hypoglycaemia (typical RR 0.78, 95% CI 0.46 to 1.32; two trials, 312 infants; quality of evidence very low). Infants treated with dextrose gel were less likely to be separated from their

Sensorial saturation for infants' pain.

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Bellieni, Carlo Valerio; Tei, Monica; Coccina, Francesca; Buonocore, Giuseppe

2012-04-01

Sensorial saturation (SS) is a multisensorial stimulation consisting of delicate tactile, gustative, auditory and visual stimuli. This procedure consists of simultaneously: attracting the infant's attention by massaging the infant's face; speaking to the infant gently, but firmly, and instilling a sweet solution on the infant's tongue. We performed a systematic Medline search of for articles focusing on human neonatal studies related to SS. The search was performed within the last 10 years and was current as of January 2012. We retrieved 8 articles that used a complete form of SS and 2 articles with an incomplete SS. Data show that the use of SS is effective in relieving newborns' pain. Oral solution alone are less effective than SS, but the stimuli without oral sweet solution are ineffective. the partial forms of SS have some effectiveness, but minor than the complete SS. Only one article showed lack of SS as analgesic method, after endotracheal suctioning. SS can be used for all newborns undergoing blood samples or other minor painful procedures. It is more effective than oral sugar alone. SS also promotes interaction between nurse and infant and is a simple effective form of analgesia for the neonatal intensive care unit.

Identification of coronary artery anatomy on dual-source cardiac computed tomography before arterial switch operation in newborns and young infants. Comparison with transthoracic echocardiography

International Nuclear Information System (INIS)

Goo, Hyun Woo

2018-01-01

Considering inherent limitations of transthoracic echocardiography, the diagnostic accuracy of cardiac CT in identifying coronary artery anatomy before arterial switch operation needs to be investigated with recently improved coronary artery visibility using electrocardiogram (ECG)-synchronized dual-source CT. To compare diagnostic accuracy between cardiac CT using a dual-source scanner and transthoracic echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. The study included 101 infants (median age 4 days, range 0 days to 10 months; M:F=78:23) who underwent ECG-synchronized cardiac dual-source CT and transthoracic echocardiography before arterial switch operation between July 2011 and December 2016. We evaluated and classified coronary artery anatomy on cardiac CT and transthoracic echocardiography. With the surgical findings as the reference standard, we compared the diagnostic accuracy for identifying coronary artery anatomy between cardiac CT and transthoracic echocardiography. The most common coronary artery pattern was the usual pattern (left coronary artery from sinus 1 and right coronary artery from sinus 2; 64.4%, 65/101), followed by a single coronary artery from sinus 2 and a conal branch from sinus 1 (7.9%, 8/101), the inverted pattern (5.9%, 6/101), the right coronary artery and left anterior descending artery from sinus 1 and the left circumflex artery from sinus 2 (5.9%, 6/101), and others. In 96 infants with surgically proven coronary artery anatomy, the diagnostic accuracy of cardiac CT was significantly higher than that of transthoracic echocardiography (91.7%, 88/96 vs. 54.2%, 52/96; P<0.0001). Diagnostic accuracy of cardiac CT is significantly higher than that of echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. (orig.)

Identification of coronary artery anatomy on dual-source cardiac computed tomography before arterial switch operation in newborns and young infants. Comparison with transthoracic echocardiography

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Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

2018-02-15

Considering inherent limitations of transthoracic echocardiography, the diagnostic accuracy of cardiac CT in identifying coronary artery anatomy before arterial switch operation needs to be investigated with recently improved coronary artery visibility using electrocardiogram (ECG)-synchronized dual-source CT. To compare diagnostic accuracy between cardiac CT using a dual-source scanner and transthoracic echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. The study included 101 infants (median age 4 days, range 0 days to 10 months; M:F=78:23) who underwent ECG-synchronized cardiac dual-source CT and transthoracic echocardiography before arterial switch operation between July 2011 and December 2016. We evaluated and classified coronary artery anatomy on cardiac CT and transthoracic echocardiography. With the surgical findings as the reference standard, we compared the diagnostic accuracy for identifying coronary artery anatomy between cardiac CT and transthoracic echocardiography. The most common coronary artery pattern was the usual pattern (left coronary artery from sinus 1 and right coronary artery from sinus 2; 64.4%, 65/101), followed by a single coronary artery from sinus 2 and a conal branch from sinus 1 (7.9%, 8/101), the inverted pattern (5.9%, 6/101), the right coronary artery and left anterior descending artery from sinus 1 and the left circumflex artery from sinus 2 (5.9%, 6/101), and others. In 96 infants with surgically proven coronary artery anatomy, the diagnostic accuracy of cardiac CT was significantly higher than that of transthoracic echocardiography (91.7%, 88/96 vs. 54.2%, 52/96; P<0.0001). Diagnostic accuracy of cardiac CT is significantly higher than that of echocardiography in identifying coronary artery anatomy before arterial switch operation in newborns and young infants. (orig.)

Parents' Gender-Stereotyped Perceptions of Newborns: The Eye of the Beholder Revisited.

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Karraker, Katherine Hildebrandt; And Others

1995-01-01

Assessed parental gender-stereotyped perceptions of their newborn infant within a group of 40, mostly Caucasian, pairs of parents. Findings show stereotyped descriptions (that is, finer features, less strong, more delicate, and so on) were used when comparing newborn girls with boys. These perceptions persisted across a one-week time interval.…

Pre-operative MRI of anorectal anomalies in the newborn period

International Nuclear Information System (INIS)

McHugh, K.; Dudley, N.E.; Tam, P.

1995-01-01

Nine infants (six boys, three girls) with anorectal anomalies were examined in the immediate newborn period, prior to corrective surgery, with MRI. Three high, one intermediate and five low anomalies were found at MRI - one patient with a 'low' lesion was subsequently found at surgery 2 months later to have a high anorectal anomaly. This infant had passed meconium per urethram soon after the MRI study, prompting the need for a protective colostomy and stressing the importance of a thorough clinical examination of babies with anorectal malformations. The MRI results and findings at surgery were in agreement in all other patients (n=8). Hydronephrosis was evident in two and renal agenesis in one patient. Sacrococcygeal hypoplasia was found in two and two hemivertebrae in one infant. No spinal cord lesion was identified. One fistula was evident on MRI but four were later found at surgery. Uniformly hyperintense T1 signal meconium was seen in all nine newborns, allowing for easy differentiation of rectal contents from rectal wall and the adjacent musculature. MRI can provide useful information regarding the development of the puborectal and external anal sphincter muscles, can help guide the pull-through procedure and help predict future continence pre-operatively in the newborn period. (orig.)

Pre-operative MRI of anorectal anomalies in the newborn period

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McHugh, K. [Dept. of Radiology, John Radcliffe Hospital, Oxford (United Kingdom); Dudley, N.E. [Dept. of Paediatric Surgery, John Radcliffe Hospital, Oxford (United Kingdom); Tam, P. [Dept. of Paediatric Surgery, John Radcliffe Hospital, Oxford (United Kingdom)

1995-11-01

Nine infants (six boys, three girls) with anorectal anomalies were examined in the immediate newborn period, prior to corrective surgery, with MRI. Three high, one intermediate and five low anomalies were found at MRI - one patient with a `low` lesion was subsequently found at surgery 2 months later to have a high anorectal anomaly. This infant had passed meconium per urethram soon after the MRI study, prompting the need for a protective colostomy and stressing the importance of a thorough clinical examination of babies with anorectal malformations. The MRI results and findings at surgery were in agreement in all other patients (n=8). Hydronephrosis was evident in two and renal agenesis in one patient. Sacrococcygeal hypoplasia was found in two and two hemivertebrae in one infant. No spinal cord lesion was identified. One fistula was evident on MRI but four were later found at surgery. Uniformly hyperintense T1 signal meconium was seen in all nine newborns, allowing for easy differentiation of rectal contents from rectal wall and the adjacent musculature. MRI can provide useful information regarding the development of the puborectal and external anal sphincter muscles, can help guide the pull-through procedure and help predict future continence pre-operatively in the newborn period. (orig.)

Market mechanisms for newborn health in Nepal.

Science.gov (United States)

Lunze, Karsten; Dawkins, Rosie; Tapia, Abeezer; Anand, Sidharth; Chu, Michael; Bloom, David E

2017-12-19

In Nepal, hypothermia is a major risk factor for newborn survival, but the country's public health care sector has insufficient capacity to improve newborn survival given the burden imposed by distance to health facilities and cost. Low-cost technology to provide newborn thermal care in resource-limited environments exists, but lacks effective distribution channels. This study aims to develop a private sector distribution model for dedicated newborn thermal care technology to ensure equitable access to thermal protection and ultimately improve newborn health in Nepal. We conducted a document analysis of newborn health policy in Nepal and a scoping literature review of approaches to newborn hypothermia in the region, followed by qualitative interviews with key stakeholders of newborn health in Nepal. Current solutions addressing newborn hypothermia range from high-technology, high-cost incubators to low-cost behavioral interventions such as skin-to-skin care. However, none of these interventions  are currently implemented at scale. A distribution model that provides incentives for community health volunteers and existing public health services in Nepal can deliver existing low-cost infant warmers to disadvantaged mothers where and when needed. Newborn technology can serve as an adjunct to skin-to-skin care and potentially create demand for newborn care practices. Harnessing market forces could promote public health by raising awareness of newborn challenges, such as newborn hypothermia, and triggering demand for appropriate health technology and related health promotion behaviors. Market approaches to promoting public health have been somewhat neglected, especially in economically disadvantaged and vulnerable populations, and deserve greater attention in Nepal and other settings with limited public health service delivery capacity.

Birth-weight, insulin levels, and HOMA-IR in newborns at term

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Simental-Mendía Luis E

2012-07-01

Full Text Available Abstract Background Recent studies have demonstrated that low and high birth-weight at birth are risk factors of developing diabetes. The aim of this study was to determine if the abnormal birth-weight is related with hyperinsulinemia and elevated index of the Homeostasis Model assessment for Insulin Resistance (HOMA-IR at birth, in at term newborns. Methods Newborns with gestational age between 38 and 41 weeks, products of normal pregnancies of healthy mothers aged 18 to 39 years, were eligible to participate. Small-for-gestational age (SGA and large-for-gestational age (LGA newborns were compared with appropriate-for-gestational (AGA age newborns. Incomplete or unclear data about mother’s health status, diabetes, gestational diabetes, history of gestational diabetes, hypertension, pre-eclampsia, eclampsia, and other conditions that affect glucose metabolism were exclusion criteria. Hyperinsulinemia was defined by serum insulin levels ≥13.0 μU/mL and IR by HOMA-IR ≥2.60. Multiple logistic regression analysis was used to determine the odds ratio (OR that computes the association between birth-weight (independent variable with hyperinsulinemia and HOMA-IR index (dependent variables. Results A total of 107 newborns were enrolled; 13, 22, and 72 with SGA, LGA, and AGA, respectively. Hyperinsulinemia was identified in 2 (15.4%, 6 (27.3%, and 5 (6.9% with SGA, LGA, and AGA (p=0.03, whereas IR in 3 (23.1%, 8 (36.4%, and 10 (13.9% newborns with SGA, LGA and AGA (p=0.06. The LGA showed a strong association with hyperinsulinemia (OR 5.02; CI 95%, 1.15-22.3; p=0.01 and HOMA-IR (OR 3.54; CI 95%, 1.03-12.16; p=0.02; although without statistical significance, the SGA showed a tendency of association with hyperinsulinemia (OR 2.43; CI 95%, 0.43-17.3 p=0.29 and HOMA-IR (OR 1.86; CI 95%, 0.33-9.37; p=0.41. Conclusions Our results suggest that LGA is associated with hyperinsulinemia and elevated HOMA-IR at birth whereas the SGA show a tendency of

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.

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

Remote control of microcontroller-based infant stimulating system.

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Burunkaya, M; Güler, I

2000-04-01

In this paper, a remote-controlled and microcontroller-based cradle is designed and constructed. This system is also called Remote Control of Microcontroller-Based Infant Stimulation System or the RECOMBIS System. Cradle is an infant stimulating system that provides relaxation and sleeping for the baby. RECOMBIS system is designed for healthy full-term newborns to provide safe infant care and provide relaxation and sleeping for the baby. A microcontroller-based electronic circuit was designed and implemented for RECOMBIS system. Electromagnets were controlled by 8-bit PIC16F84 microcontroller, which is programmed using MPASM package. The system works by entering preset values from the keyboard, or pulse code modulated radio frequency remote control system. The control of the system and the motion range were tested. The test results showed that the system provided a good performance.

Contemporary epidemiology and characterization of newborn males with prune belly syndrome.

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Routh, Jonathan C; Huang, Lin; Retik, Alan B; Nelson, Caleb P

2010-07-01

Prune belly syndrome (PBS) is a rare condition characterized by the congenital absence or deficiency of the abdominal wall musculature, with associated abnormalities of the genitourinary tract, including hydronephrosis and cryptorchidism. Few population-based epidemiology or mortality data are available. We retrospectively reviewed the Kids' Inpatient Database to evaluate PBS among newborn infants during their initial hospitalization in 2000, 2003, and 2006. The International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify patients and to determine the comorbidity status. The PBS incidence, demographics, comorbid conditions, and disposition were assessed. A total of 133 newborn male infants diagnosed with PBS were identified of 1,420,991 live male births, for a weighted incidence estimate of 3.8 cases/100,000 live births. Of the newborns with PBS, 50% were white, 31% black, and 10% were Hispanic. In-hospital mortality was high (39 of 133, 29%). Of the 133 patients with PBS, 55 (41%) were discharged home and 39 (29%) required inpatient transfer or home nursing care. Fifty-seven patients (43%) were born premature; 56% of the PBS deaths occurred in premature infants. Mechanical ventilation was required in 64 newborns (48%), and 33 (24%) had coexisting congenital cardiovascular anomalies. Renal failure was uncommon, occurring in only 5 newborns (4%); none required dialysis. Only 13 patients (10%) underwent urinary diversion (vesicostomy or ureterostomy). The incidence of PBS was 3.8 cases/100,000 live births. Despite advances in care for children with PBS, this condition continues to be associated with high perinatal mortality, likely related to the associated prematurity and pulmonary complications. Renal failure was rare, as was immediate urinary diversion. Copyright 2010 Elsevier Inc. All rights reserved.

Cardiorespiratory disorders of infants of diabetic mothers

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Hrabovski Ivan

2015-01-01

Full Text Available Introduction. One of the characteristics of modern era is the explosion of diabetes in the world. Today more than 400,000,000 people suffer from diabetes in the entire world. During the last decade the number of women with the disorder of glucose homeostasis is six to seven times greater than in the previous period. Therefore, the re-evaluation of the impact of glucose intolerance on the course and outcome of pregnancy is very current. Objective. The aim of the study was to evaluate the data on the influence of mothers’ glucose homeostasis disturbances on the occurrence of cardiorespiratory disorders in newborns, as well as their influence on the perinatal outcome. Methods. Prospective examination included 102 newborns in total - 31 infants of mothers with glucose homeostasis disorder (Group I and 71 infants of healthy mothers (Group II. Average age, body height, body weight, body mass index, parity and illness duration of the pregnant women had been determined, as well as the delivery method. Every newborn was provided with physical examination, Apgar score was calculated, body weight and body length were measured. Also, electrocardiography and brain ultrasound, as well as the basic hematology biochemical and microbiological analysis, were performed within the examinations of the infants. Results. The average weight and obesity incidence with diabetic women was higher than in the control group and their infants were heavier and with lower gestational age. Heart failures were diagnosed in five (16.1% infants of diabetic mothers and in one (1.4% infant of a healthy woman (p<0.01. Respiratory disorders were diagnosed in 48.4% infants of diabetic mothers and in 12.6% of healthy mothers (p<0.01. Forty-two percent of infants of diabetic mothers and 19.7% infants of healthy mothers needed additional oxygen. Conclusion. Congenital anomalies of the cardiovascular system and respiratory disorders in the infants of diabetic mothers were six to eight

Infant difficult behaviors in the context of perinatal biomedical conditions and early child environment

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Sirvinskiene Giedre

2012-04-01

Full Text Available Abstract Background Problems experienced within the first year of an infant's life can be precursors of later mental health conditions. The purpose of this study was to examine the frequency and continuity of difficult behaviors in infants at 3 and 6 months of age and the associations of these difficulties with biomedical and psychosocial factors. Methods This study was a part of an ongoing prospective birth-cohort study. Study participants were 189 uniparous mothers and their full-term newborns. The index of infant difficult behavior was constructed. This index was then associated with the following factors: delivery mode, newborn function after birth, maternal emotional well-being, risk behavior, subjective evaluation of the quality of the relationship of the couple, and attitudes toward infant-rearing. Results Common difficult behaviors, including crying, sleeping and eating problems, were characteristic for 30.2% of 3 month old and for 22.2% of 6 month old full-term infants. The expression of infant difficult behaviors at the age of 3 months increased the likelihood of the expression of these difficulties at 6 months by more than 5 times. Factors including younger maternal age, poor prenatal and postnatal emotional well-being, prenatal alcohol consumption, low satisfaction with the couple's relationship before pregnancy, and deficiency of infant-centered maternal attitudes towards infant-rearing increased the likelihood of difficult behaviors in infants at the age of 3 months. Low maternal satisfaction with the relationship of the couple before pregnancy, negative emotional reactions of both parents toward pregnancy (as reported by the mother and the deficiency of an infant-centered maternal attitude towards infant-rearing increased the likelihood of infant difficult behaviors continuing between the ages of 3 to 6 months. Perinatal biomedical conditions were not related to the difficult behaviors in infants. Conclusions Our study suggests

Severe hemolytic disease of the newborn from anti-e.

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McAdams, R M; Dotzler, S A; Winter, L W; Kerecman, J D

2008-03-01

Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rhesus (Rh) antibodies is a significant cause of hemolytic disease of the newborn (HDN). Here, we report a rare case of severe HDN associated with maternal antibody to Rh e. In addition to severe anemia, the infant developed thrombocytopenia, conjugated hyperbilirubinemia and cholelithiasis. Resolution of the infant's cholelithiasis occurred following treatment with ursodeoxycholic acid.

The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease.

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Stoniene, Dalia; Buinauskiene, Jūrate; Markūniene, Egle

2009-01-01

OBJECTIVE OF THE STUDY. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. MATERIAL AND METHODS. During a prospective study, 130 full-term (>or=37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer's instructions within +/-30 min after getting a blood sample. RESULTS. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] micromol/L) closely correlated with TcB level (111.51 [61.31] micromol/L) (r=0.92, Por=98 micromol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn's age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. CONCLUSION. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous bilirubin level should be used to evaluate hyperbilirubinemia using only a noninvasive method.

Association of brain injury and neonatal cytokine response during therapeutic hypothermia in newborns with hypoxic-ischemic encephalopathy.

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Orrock, Janet E; Panchapakesan, Karuna; Vezina, Gilbert; Chang, Taeun; Harris, Kari; Wang, Yunfei; Knoblach, Susan; Massaro, An N

2016-05-01

Cytokines have been proposed as mediators of neonatal brain injury via neuroinflammatory pathways triggered by hypoxia-ischemia. Limited data are available on cytokine profiles in larger cohorts of newborns with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). Serum cytokines interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-13, tumor necrosis factor-α, and interferon-γ were measured in newborns with HIE at 24 and 72 h of TH. Differences between infants with favorable (survivors with mild/no magnetic resonance imaging (MRI) injury) vs. adverse outcome (death or moderate/severe MRI injury) were compared using mixed models to adjust for covariates. Data from 36 term newborns with HIE (favorable outcome: n = 20, adverse outcome: n = 16) were evaluated. Cytokines IL-1β, IL-2, IL-6, IL-8, IL-10, and IL-13 were elevated in the adverse relative to favorable outcome group at 24 h. IL-6 remained significantly elevated in the adverse outcome group at 72 h. IL-6 and IL-10 remained significantly associated with outcome group after controlling for covariates. Inflammatory cytokines are elevated in HIE newborns with brain injury by MRI. In particular, IL-6 and IL-10 were associated with adverse outcomes after controlling for baseline characteristics and severity of presentation. These data suggest that cytokine response may identify infants in need of additional neuroprotective interventions.

The rediscovery of infant feeding formula with magnetic resonance imaging

International Nuclear Information System (INIS)

Gerscovich, E.O.; McGahan, J.P.; Buonocore, M.H.; Ablin, D.S.; Lindfors, K.K.

1990-01-01

In six newborns, regular infant feeding formula given approximately one-half hour to four hours prior to MR examination, demonstrated a high intensity signal within the infant's stomach, small bowel, and colon. This effect was observed on both 0.5 Tesla and 1.5 Tesla magnets on T1 (SE TR/TE 433-600/20-25) and on T2 (SE TR/TE 1500/30-80) weighted images. Infant feeding formula has the potential to be used as an oral contrast agent for visualization of the newborn gastrointestinal tract. Chloral hydrate and other agents were also tested. (orig.)

Outcomes of very low birth weight infants in a newborn tertiary center in Turkey, 1997-2000.

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Atasay, Begüm; Günlemez, Ayla; Unal, Sevim; Arsan, Saadet

2003-01-01

.3%) of the infants, respectively. Overall survival rate was 83.5% (111/133); most of the deceased cases were under 750 g (12/22). It was prospectively shown that 111 (100%) of the surviving infants could be regularly followed in a newborn follow-up clinic to provide health maintenance, developmental assessment and support. Compared with reports from other developing countries, VLBW infants at our center had higher survival rates. Compared to developed countries, survival rate was lower, especially for extremely very low birth weight infants. There is interaction between birth weight and survival rate. Among selected neonatal outcomes, chronic lung disease, threshold retinopathy, severe intraventricular hemorrhage (IVH > or = grade III) and nosocomial infection rates at this center were comparable with some reports from developed nations.

International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project.

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Villar, José; Cheikh Ismail, Leila; Victora, Cesar G; Ohuma, Eric O; Bertino, Enrico; Altman, Doug G; Lambert, Ann; Papageorghiou, Aris T; Carvalho, Maria; Jaffer, Yasmin A; Gravett, Michael G; Purwar, Manorama; Frederick, Ihunnaya O; Noble, Alison J; Pang, Ruyan; Barros, Fernando C; Chumlea, Cameron; Bhutta, Zulfiqar A; Kennedy, Stephen H

2014-09-06

In 2006, WHO published international growth standards for children younger than 5 years, which are now accepted worldwide. In the INTERGROWTH-21(st) Project, our aim was to complement them by developing international standards for fetuses, newborn infants, and the postnatal growth period of preterm infants. INTERGROWTH-21(st) is a population-based project that assessed fetal growth and newborn size in eight geographically defined urban populations. These groups were selected because most of the health and nutrition needs of mothers were met, adequate antenatal care was provided, and there were no major environmental constraints on growth. As part of the Newborn Cross-Sectional Study (NCSS), a component of INTERGROWTH-21(st) Project, we measured weight, length, and head circumference in all newborn infants, in addition to collecting data prospectively for pregnancy and the perinatal period. To construct the newborn standards, we selected all pregnancies in women meeting (in addition to the underlying population characteristics) strict individual eligibility criteria for a population at low risk of impaired fetal growth (labelled the NCSS prescriptive subpopulation). Women had a reliable ultrasound estimate of gestational age using crown-rump length before 14 weeks of gestation or biparietal diameter if antenatal care started between 14 weeks and 24 weeks or less of gestation. Newborn anthropometric measures were obtained within 12 h of birth by identically trained anthropometric teams using the same equipment at all sites. Fractional polynomials assuming a skewed t distribution were used to estimate the fitted centiles. We identified 20,486 (35%) eligible women from the 59,137 pregnant women enrolled in NCSS between May 14, 2009, and Aug 2, 2013. We calculated sex-specific observed and smoothed centiles for weight, length, and head circumference for gestational age at birth. The observed and smoothed centiles were almost identical. We present the 3rd, 10th, 50th, 90

Maternal status regulates cortical responses to the body odor of newborns

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Johan N Lundström

2013-09-01

Full Text Available Studies in non-human mammals have identified olfactory signals as prime mediators of mother-infant bonding and they have been linked with maternal attitudes and behavior in our own species as well. However, although the neuronal network processing infant cues has been studied for visual and auditory signals; to date, no such information exists for chemosensory signals. We contrasted the cerebral activity underlying the processing of infant odor properties in 15 women newly given birth for the first time and 15 women not given birth while smelling the body odor of unfamiliar 2 day-old newborn infants. Maternal status-dependent activity was demonstrated in the thalamus when exposed to the body odor of a newly born infant. Subsequent regions of interest analyses indicated that dopaminergic neostriatal areas are active in maternal-dependent responses. Taken together, these data suggests that body odors from 2 day-old newborns elicit activation in reward-related cerebral areas in women, regardless of their maternal status. These tentative data suggests that certain body odors might act as a catalyst for bonding mechanisms and highlights the need for future research on odor-dependent mother-infant bonding using parametric designs controlling for biological saliency and general odor perception effects.

Importance of neonatal immunoglobulin transfer for hippocampal development and behaviour in the newborn pig.

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Kateryna Goncharova

Full Text Available Neurological disorders are among the main clinical problems affecting preterm children and often result in the development of communication and learning disabilities later in life. Several factors are of importance for brain development, however the role of immunoglobulins (passive immunity transfer has not yet been investigated. Piglets are born agammaglobulinemic, as a result of the lack of transfer of maternal immunoglobulins in utero, thus, they serve as an ideal model to mimic the condition of immunoglobulin deficiency in preterm infants. Thirty six, unsuckled newborn piglets were fed an infant formula or colostrum and supplemented orally or intravenously with either species-specific or foreign immunoglobulin and then compared to both newborn and sow-reared piglets. Two days after the piglets were born behavioural tests (novel recognition and olfactory discrimination of conspecifics scent were performed, after which the piglets were sacrificed and blood, cerebrospinal fluid and hippocampi samples were collected for analyses. Both parameters of neuronal plasticity (neuronal maturation and synapse-associated proteins and behavioural test parameters appeared to be improved by the appearance of species-specific porcine immunoglulin in the circulation and cerebrospinal fluid of the piglets. In conclusion, we postulate possible positive clinical effects following intravenous infusion of human immunoglobulin in terms of neuronal plasticity and cognitive function in preterm infants born with low blood immunoglobulin levels.

The newborn oxygram: automated processing of transcutaneous oxygen data.

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Horbar, J D; Clark, J T; Lucey, J F

1980-12-01

Hypoxemic and hyperoxemic episodes are common in newborns with respiratory disorders. We have developed a microprocessor-based data system for use with transcutaneous oxygen (TcPO2) monitors in an attempt to quantitate these episodes. The amount of time spent by an infant in each of ten preset TcPO2 ranges can be automatically recorded. These data are referred to as the oxygram. Fourteen newborn infants were monitored for a total of 552 hours using this system. They spent a mean of 2.96% of the time with a TcPO2 less than or equal to 40 torr and 0.26% of the time with a TcPO2 greater than 100 torr. Representative oxygrams are presented. Clinical and research applications of the data system are discussed.

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…

Bioactive Proteins in Human Milk: Health, Nutrition, and Implications for Infant Formulas.

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Lönnerdal, Bo

2016-06-01

Breast milk confers many benefits to the newborn and developing infant. There is substantial support for better long-term outcomes, such as less obesity, diabetes, and cardiovascular disease, in breastfed compared with formula-fed infants. More short-term outcomes, such as incidence and duration of illness, nutrient status, and cognitive development during the first year of life also demonstrate benefits of breastfeeding. Several proteins in breast milk, including lactoferrin, α-lactalbumin, milk fat globule membrane proteins, and osteopontin, have been shown to have bioactivities that range from involvement in the protection against infection to the acquisition of nutrients from breast milk. In some cases, bovine counterparts of these proteins exert similar bioactivities. It is possible by dairy technology to add protein fractions highly enriched in these proteins to infant formula. Copyright © 2016 Elsevier Inc. All rights reserved.

Passive hypothermia (≥35 - newborns with hypoxic-ischaemic encephalopathy.

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Sellam, Aurélie; Lode, Noëlla; Ayachi, Azzedine; Jourdain, Gilles; Dauger, Stéphane; Jones, Peter

2017-01-01

Hypothermia initiated in the first six hours of life in term infants with hypoxic ischemic encephalopathy reduces the risk of death and severe neurological sequelae. Our study's principal objective was to evaluate transport predictors potentially influencing arrival in NICU (Neonatal Intensive Care Unit) at a temperature ≥35-Newborns were selected for inclusion according to biological and clinical criteria before transport using passive hypothermia using a target temperature of ≥35-<36°C. Data on 120 of 126 inclusions were available for analysis. Thirty-three percent of the children arrived in NICU with the target temperature of ≥35-<36°C. The mean temperature for the whole group of infants on arrival in NICU was 35.4°C (34.3-36.5). The median age of all infants on arrival in NICU was 3h03min [2h25min-3h56min]. Three infants arrived in NICU with a temperature of <33°C and eleven with a temperature ≥37°C. Adrenaline during resuscitation was associated with a lower mean temperature on arrival in NICU. Our strategy using ≥35-<36°C passive hypothermia combined with short transport times had little effect on temperature after the arrival of Neonatal Transport Team although did reduce numbers of infants arriving in NICU in deep hypothermia. For those infants where hypothermia was discontinued in NICU our strategy facilitated re-warming. Re-adjustment to a lower target temperature to ≥34.5-<35.5°C may reduce the proportion of infants with high/normothermic temperatures.

Increased Brain Perfusion Persists over the First Month of Life in Term Asphyxiated Newborns Treated with Hypothermia: Does it Reflect Activated Angiogenesis?

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Shaikh, Henna; Lechpammer, Mirna; Jensen, Frances E; Warfield, Simon K; Hansen, Anne H; Kosaras, Bela; Shevell, Michael; Wintermark, Pia

2015-06-01

Many asphyxiated newborns still develop brain injury despite hypothermia therapy. The development of brain injury in these newborns has been related partly to brain perfusion abnormalities. The purposes of this study were to assess brain hyperperfusion over the first month of life in term asphyxiated newborns and to search for some histopathological clues indicating whether this hyperperfusion may be related to activated angiogenesis following asphyxia. In this prospective cohort study, regional cerebral blood flow was measured in term asphyxiated newborns treated with hypothermia around day 10 of life and around 1 month of life using magnetic resonance imaging (MRI) and arterial spin labeling. A total of 32 MRI scans were obtained from 24 term newborns. Asphyxiated newborns treated with hypothermia displayed an increased cerebral blood flow in the injured brain areas around day 10 of life and up to 1 month of life. In addition, we looked at the histopathological clues in a human asphyxiated newborn and in a rat model of neonatal encephalopathy. Vascular endothelial growth factor (VEGF) was expressed in the injured brain of an asphyxiated newborn treated with hypothermia in the first days of life and of rat pups 24-48 h after the hypoxic-ischemic event, and the endothelial cell count increased in the injured cortex of the pups 7 and 11 days after hypoxia-ischemia. Our data showed that the hyperperfusion measured by imaging persisted in the injured areas up to 1 month of life and that angiogenesis was activated in the injured brain of asphyxiated newborns.

The impact of maternal HIV infection on cord blood lymphocyte subsets and cytokine profile in exposed non-infected newborns

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Reis-Alves Suiellen C

2011-02-01

Full Text Available Abstract Background Children born to HIV+ mothers are exposed intra-utero to several drugs and cytokines that can modify the developing immune system, and influence the newborn's immune response to infections and vaccines. We analyzed the relation between the distribution of cord blood lymphocyte subsets and cytokine profile in term newborns of HIV+ mothers using HAART during pregnancy and compared them to normal newborns. Methods In a prospective, controlled study, 36 mother-child pairs from HIV+ mothers and 15 HIV-uninfected mothers were studied. Hematological features and cytokine profiles of mothers at 35 weeks of pregnancy were examined. Maternal and cord lymphocyte subsets as well as B-cell maturation in cord blood were analyzed by flow cytometry. The non-stimulated, as well as BCG- and PHA-stimulated production of IL2, IL4, IL7, IL10, IL12, IFN-γ and TNF-alpha in mononuclear cell cultures from mothers and infants were quantified using ELISA. Results After one year follow-up none of the exposed infants became seropositive for HIV. An increase in B lymphocytes, especially the CD19/CD5+ ones, was observed in cord blood of HIV-exposed newborns. Children of HIV+ hard drug using mothers had also an increase of immature B-cells. Cord blood mononuclear cells of HIV-exposed newborns produced less IL-4 and IL-7 and more IL-10 and IFN-γ in culture than those of uninfected mothers. Cytokine values in supernatants were similar in infants and their mothers except for IFN-γ and TNF-alpha that were higher in HIV+ mothers, especially in drug abusing ones. Cord blood CD19/CD5+ lymphocytes showed a positive correlation with cord IL-7 and IL-10. A higher maternal age and smoking was associated with a decrease of cord blood CD4+ cells. Conclusions in uninfected infants born to HIV+ women, several immunological abnormalities were found, related to the residual maternal immune changes induced by the HIV infection and those associated with antiretroviral

Oxidative stress and total antioxidant status in term newborns and their mothers

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Maria Wilinska

2015-12-01

Full Text Available The peripartum period and delivery are considered critical for maintaining a balance between the production of free oxygen radicals and functional incompetence of the antioxidant system of a foetus and a neonate. [b]Objective.[/b] The aim of the study was to evaluate the oxidoreductive state of mothers and their newborns immediately after delivery and in the first few days after birth. [b]Method.[/b] Eighty-five mothers and their healthy, term newborns were included into the prospective study. Total antioxidant capacity (TAC and thiobarbituric acid reactive substances (TBARS in maternal placenta and milk, as well as blood and urine of the neonates on the first and third day after birth, were examined. [b]Results.[/b] Elevated levels of TBARS were found in maternal placenta and neonatal blood on the third day after birth, but low concentrations were observed in maternal milk. On the contrary, total antioxidant status (TAS showed a declining tendency in neonatal blood and an increasing tendency in breast milk. Markers of oxidative stress and antioxidant capacity were independent of the mode of delivery. [b]Conclusions.[/b] Values of oxidative stress markers in mothers and newborns immediately after birth were elevated and increased further during the first few days of neonatal life. Breast milk was the only nutritional substance with high antioxidant activity. At the same time, TBARS levels in breast milk decreased, which might indicate its protective role in reducing oxidative stress in newborns.

Significant decrease in congenital malformations in newborn infants of an unselected population of diabetic women

DEFF Research Database (Denmark)

Damm, P; Mølsted-Pedersen, L

1989-01-01

In an unselected and consecutive series of 1858 newborn infants of diabetic mothers, born in the Rigshospital, Copenhagen, in the period 1967 to 1986, congenital malformations were studied. The malformation rate in White Classes B to F was remarkably constant from 1967 to 1981, but a significant...... decrease in major congenital malformations was found in the period 1982 to 1986 versus 1977 to 1981 (2.7% vs. 7.4%, p less than 0.05). This decrease was mainly due to a fourfold decline in major congenital malformations in White Classes D and F (p less than 0.01), and consequently a correlation between...... the severity of maternal diabetes and the frequency of congenital malformations was no longer present. In the offspring of a control group of 1715 nondiabetic women, major congenital malformations were found in 1.7% (p greater than 0.05). Seventy-five percent of the diabetic pregnancies were planned...

Preventive effect of ursodeoxycholic acid on parenteral nutrition-associated liver disease in infants

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Simić Dušica

2014-01-01

Full Text Available Introduction. Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition. Objectives. The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA use on cholestasis in newborns on prolonged TPN. Methods. A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g birth weight infants (n=30, as well as the group of pediatric (n=11 and surgical patients (n=15 treated with UDCA. Blood chemistries were obtained two times weekly. Results. All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively. The peak serum conjugated bilirubin (CB, AST, ALT and alkaline phosphatase (AP levels were significantly lower in the treated groups. There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups. There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group. Conclusion. Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.

Immunoglobulin transfusion in hemolytic disease of the newborn: place in therapy

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Mundy CA

2015-06-01

Full Text Available Cynthia A Mundy, Jatinder Bhatia Department of Pediatrics, Division of Neonatology, Georgia Regents University, Children's Hospital of Georgia, GA, USA Abstract: Hemolytic disease of the newborn continues to be a common neonatal disorder that requires a comprehensive understanding on the part of those caring for infants. Common treatments include hydration and phototherapy. Exchange transfusion is used in severe hemolytic disease, but infants undergoing this treatment are exposed to many adverse effects. Intravenous immunoglobulin is a newer strategy that is showing promise in the treatment of the disease. This review discusses the current use and future expectations of intravenous immunoglobulin therapy in newborns. Keywords: hyperbilirubinemia, ABO incompatibility, neonatal jaundice 

Follow-Up of the Cues and Care Trial: Mother and Infant Outcomes at 6 Months

Science.gov (United States)

Feeley, Nancy; Zelkowitz, Phyllis; Shrier, Ian; Stremler, Robyn; Westreich, Ruta; Dunkley, David; Steele, Russell; Rosberger, Zeev; Lefebvre, Francine; Papageorgiou, Apostolos

2012-01-01

The long-term effects of the Cues intervention to reduce anxiety and enhance the interactive behavior of mothers of very low birth weight (VLBW) infants were investigated. A randomized trial comparing the Cues intervention to an attention control condition was conducted. A total of 122 mothers of newborns weighing less than 1,500 g were…

Considering ethical dilemmas related to brain death in newborns

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Ilias Chatziioannidis

2014-01-01

Full Text Available Brain death (BD, as the irreversible and permanent loss of cerebral and brainstem function, is relatively uncommon among newborns who need life support. It is considered the result of an acute and irreversible central nervous system insult. Asphyxia, severe intracranial hemorrhage and infection are the most common causes of  BD in children. BD diagnosis is usually based on clinical criteria. Dilemmas about life prolonging treatment for severely compromised infants – as brain dead infants are – has become challenging since neonatal intensive care unit (NICU care has developed, quality of life and resource issues are nowadays continuously underlined. Caring for premature babies is expensive and costs have risen especially since an increased number of infants with handicaps survives. Intensivists’ main duty is first to save lives and then to interrupt treatment in certain conditions like detrimental brain damage. The objective of this article is to present ethical decisions regarding brain dead newborns in order to balance between organ donation necessities and withholding/withdrawing treatment, with respect to the important role of infants’ parents in the process.

DETERMINATION OF REFERENCE VALUES FOR TREC AND KREC IN DRY BLOOD SPOTS OF NEWBORNS FROM DIFFERENT GESTATION AGES IN SVERDLOVSK REGION

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S. S. Deryabina

2018-01-01

Full Text Available As a preparatory stage for implementation of genetic testing for severe combined immunodeficiency under a neonatal screening program, a study was performed in Sverdlovsk Region which concerned quantitative determination of T and B cell neogenesis markers (TREC and KREC, respectively in blood of conditionally healthy newborns. Archived samples of dry blood spots collected in test-forms for routine neonatal screening were used as biological material for the study of full-term 26 girls and 26 boys who did not exhibit serious illnesses during first year of their life. In addition, we investigated potential effects of foetal gestational age upon the number of TREC and KREC in preterm infants. Blood samples from 55 preterm infants (23 to 36 gestational weeks were also examined. It was shown that the levels of TREC and KREC increased sequentially with the increased gestation terms, but the quantitative changes of markers showed different dynamics. In this respect, the recommended terms of blood sample collection for SCID screening is entirely consistent with timing of blood sampling for routine newborn screening. An alternative result was obtained with a complete absence of TREC or KREC in blood sample of a newborn, irrespectively of prematurity degree (at valid copy numbers of a control gene which should serve as an indication for immediate consulting of the child by immunologist and in-depth immunological examination, because it may be a first prognostic sign of a fatal disease. In order to obtain correct cut-off levels for TREC/KREC, additional studies are needed on a larger sample of newborns (1.000 to 5.000, followed by validation of the obtained reference boundaries in studies involving patients with different forms of primary immunodeficiencies. 

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.

Developmental characteristics of temporal sharp transients in the EEG of normal preterm and term newborns

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Nunes Magda Lahorgue

2003-01-01

Full Text Available OBJECTIVE: To describe developmental characteristics, morphological aspects and incidence of temporal sharp transients (TST in normal preterm and term newborns at matched conceptional ages (CA. METHOD: Neonatal EEGs from two groups of normal newborns were evaluated in order to identify and characterize TST. Group I (n=40 consisted of newborns from 34 to 40 weeks of gestational age (GA that were submitted to a single EEG between 24 and 48 hours of life. Group II consisted of 10 preterm newborns with GA between 30-32 weeks, followed with a weekly EEG until they reached term. Morphology of TST was divided in 3 groups (temporal sawtooth, isolated transients or repetitive transients. TST index, density and total number were calculated in each polysomnography and related to sleep stages and CA. Laterality (right/left was also evaluated. The groups were compared at 34, 36, 38 and 40 weeks of CA. RESULTS: TST index and density decreased with the increase of CA in both groups (p<0.0001. The temporal sawtooth feature was registered in both groups only at 34 weeks. Although rare, repetitive and isolated TST were the most prevalent morphology between 36 - 40 weeks CA. Significant intragroup difference was observed in the comparison of TST density in REM and transitional sleep in GI. Moreover, isolated TST morphology was significant higher in GI at 34 weeks when compared to the others CA. No intragroup differences were observed on GII. No significant differences between the groups were observed considering TST number, index, density, morphology or laterality, at the matched CA. CONCLUSION: TST are normal features of neonatal EEG, as they are registered in normal newborns. Its incidence varies accordingly to morphology and they tend to disappear following the increase of CA. Temporal sawtooth appears more often in preterm newborns. Our results suggest that TST index, density and morphology variability may be a function of CA.

Prenatal air pollution exposure and newborn blood pressure

NARCIS (Netherlands)

van Rossem, Lenie; Rifas-Shiman, Sheryl L.; Melly, Steven J.; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel D.; Mittleman, Murray A.; Oken, Emily; Gillman, Matthew W.; Koutrakis, Petros; Gold, Diane R.

2015-01-01

Background: Air pollution exposure has been associated with increased blood pressure in adults. oBjective: We examined associations of antenatal exposure to ambient air pollution with newborn systolic blood pressure (SBP). Methods: We studied 1,131 mother–infant pairs in a Boston, Massachusetts,

Infant feeding practices within a large electronic medical record database.

Science.gov (United States)

Bartsch, Emily; Park, Alison L; Young, Jacqueline; Ray, Joel G; Tu, Karen

2018-01-02

The emerging adoption of the electronic medical record (EMR) in primary care enables clinicians and researchers to efficiently examine epidemiological trends in child health, including infant feeding practices. We completed a population-based retrospective cohort study of 8815 singleton infants born at term in Ontario, Canada, April 2002 to March 2013. Newborn records were linked to the Electronic Medical Record Administrative data Linked Database (EMRALD™), which uses patient-level information from participating family practice EMRs across Ontario. We assessed exclusive breastfeeding patterns using an automated electronic search algorithm, with manual review of EMRs when the latter was not possible. We examined the rate of breastfeeding at visits corresponding to 2, 4 and 6 months of age, as well as sociodemographic factors associated with exclusive breastfeeding. Of the 8815 newborns, 1044 (11.8%) lacked breastfeeding information in their EMR. Rates of exclusive breastfeeding were 39.5% at 2 months, 32.4% at 4 months and 25.1% at 6 months. At age 6 months, exclusive breastfeeding rates were highest among mothers aged ≥40 vs. database.

Neurobehavioural and cognitive development in infants born to mothers with eating disorders.

Science.gov (United States)

Barona, Manuela; Taborelli, Emma; Corfield, Freya; Pawlby, Susan; Easter, Abigail; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

2017-08-01

Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs. Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8 days postpartum (active ED, n = 15; past ED, n = 20; healthy controls, n = 28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1-year postpartum (active ED, n = 18; past ED, n = 19; healthy controls, n = 28). In order to maintain the largest possible sample at each time point, sample size varied across time points. Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B = -0.34 (-1.81, -0.26)]. Infants of mothers with a past ED had poorer language [B = -0.33 (-13.6, -1.9)] and motor development [B = -0.32 (-18.4, -1.3)] compared with healthy controls. Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1 year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED. © 2017 Association for Child and Adolescent Mental Health.

Consensus Based Definition of Growth Restriction in the Newborn.

Science.gov (United States)

Beune, Irene M; Bloomfield, Frank H; Ganzevoort, Wessel; Embleton, Nicholas D; Rozance, Paul J; van Wassenaer-Leemhuis, Aleid G; Wynia, Klaske; Gordijn, Sanne J

2018-05-01

To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight definition for growth restriction in the newborn. This definition recognizes that infants with birth weights 10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction. Copyright © 2017 Elsevier Inc. All rights reserved.

Percutaneous dilational tracheotomy for airway management in a newborn with Pierre-Robin syndrome and a glossopharyngeal web.

Science.gov (United States)

Pirat, Arash; Candan, Selim; Unlükaplan, Aytekin; Kömürcü, Ozgür; Kuşlu, Selim; Arslan, Gülnaz

2012-04-01