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Sample records for weight brazilian infants

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

    Science.gov (United States)

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

    2014-12-01

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

  2. Association between socioeconomic and biological factors and infant weight gain: Brazilian Demographic and Health Survey - PNDS-2006/07

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    Jonas Augusto C. Silveira

    2015-06-01

    Full Text Available OBJECTIVE: To examine the associations between socioeconomic and biological factors and infant weight gain. METHODS: All infants (0-23 months of age with available birth and postnatal weight data (n = 1763 were selected from the last nationally representative survey with complex probability sampling conducted in Brazil (2006/07. The outcome variable was conditional weight gain (CWG, which represents how much an individual has deviated from his/her expected weight gain, given the birth weight. Associations were estimated using simple and hierarchical multiple linear regression, considering the survey sampling design, and presented in standard deviations of CWG with their respective 95% of confidence intervals. Hierarchical models were designed considering the UNICEF Conceptual Framework for Malnutrition (basic, underlying and immediate causes. RESULTS: The poorest Brazilian regions (-0.14 [-0.25; -0.04] and rural areas (-0.14 [-0.26;-0.02] were inversely associated with CWG in the basic causes model. However, this association disappeared after adjusting for maternal and household characteristics. In the final hierarchical model, lower economic status (-0.09 [-0.15; -0.03], human capital outcomes (maternal education < 4th grade (-0.14[-0.29; 0.01], higher maternal height (0.02[0.01; 0.03], and fever in the past 2 weeks (-0.13[-0.26; -0.01] were associated with postnatal weight gain. CONCLUSION: The results showed that poverty and lower human capital are still key factors associated with poor postnatal weight gain. The approach used in these analyses was sensitive to characterize inequalities among different socioeconomic contexts and to identify factors associated with CWG in different levels of determination.

  3. Association between socioeconomic and biological factors and infant weight gain: Brazilian Demographic and Health Survey - PNDS-2006/07

    OpenAIRE

    2015-01-01

    OBJECTIVE: To examine the associations between socioeconomic and biological factors and infant weight gain. METHODS: All infants (0-23 months of age) with available birth and postnatal weight data (n = 1763) were selected from the last nationally representative survey with complex probability sampling conducted in Brazil (2006/07). The outcome variable was conditional weight gain (CWG), which represents how much an individual has deviated from his/her expected weight gain, given the birth wei...

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

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

    2009-01-01

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

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

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

    2013-01-01

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

  6. Brazilian infant and preschool children feeding: literature review

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    Carolina Santos Mello

    Full Text Available Abstract Objective To assess the feeding profile of Brazilian infants and preschool children aged 6 months to 6 years, based on the qualitative and quantitative analysis of food and nutrient intake. Data source This review analyzed studies carried out in Brazil that had food survey data on infants and preschool children. The search was limited to publications from the last 10 years included in the LILACS and MEDLINE electronic databases. Data summary The initial search identified 1480 articles, of which 1411 were excluded after the analysis of abstracts, as they were repeated or did not meet the inclusion criteria. Of the 69 articles assessed in full, 31 articles contained data on food survey and were selected. Only three studies concurrently assessed children from different Brazilian geographical regions. Of the assessed articles, eight had qualitative data, with descriptive analysis of food consumption frequency, and 23 had predominantly quantitative data, with information on energy and nutrient consumption. Conclusions The articles assessed in this review showed very heterogeneous results, making it difficult to compare findings. Overall, the feeding of infants and preschool children is characterized by low consumption of meat, fruits, and vegetables; high consumption of cow's milk and inadequate preparation of bottles; as well as early and high intake of fried foods, candies/sweets, soft drinks, and salt. These results provide aid for the development of strategies that aim to achieve better quality feeding of Brazilian infants and preschoolers.

  7. Postnatal Growth and Psychomotor Development in Small for Gestational Age Brazilian Infants.

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    Paine, Patricia Ann; Pasquali, Luiz

    1984-01-01

    The early psychomotor development (DQ) of 29 term small-for-gestational-age Brazilian infants was shown to be more dependent on postnatal growth than the DQ of 51 term appropriate-for-gestational-age infants. (Author/RH)

  8. Breast-feeding among Mothers of Low Birth Weight Infants

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    Lefebvre, Francine

    1990-01-01

    The physical and emotional condition of the mother delivering a premature or low birth weight infant may be quite different than that of the mother of a healthy term infant when initiating breast-feeding. Despite this difference, incidence and duration of lactation among mothers of pre-term or low birth weight infants was found to be quite good compared with that of mothers of term infants. Considerable problems, however, are encountered by premature or low birth weight infants when breast-fe...

  9. Significant weight loss in breastfed term infants readmitted for hyperbilirubinemia

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    De-Villegas Carlos A

    2009-12-01

    Full Text Available Abstract Background Weight loss of greater than 7% from birth weight indicates possible feeding problems. Inadequate oral intake causes weight loss and increases the bilirubin enterohepatic circulation. The objective of this study was to describe the association between total serum bilirubin (TSB levels and weight loss in healthy term infants readmitted for hyperbilirubinemia after birth hospitalization. Methods We reviewed medical records of breastfed term infants who received phototherapy according to TSB levels readmitted to Caja Petrolera de Salud Clinic in La Paz, Bolivia during January 2005 through October 2008. Results Seventy-nine infants were studied (64.6% were males. The hyperbilirubinemia readmission rate was 5% among breastfed infants. Term infants were readmitted at a median age of 4 days. Mean TSB level was 18.6 ± 3 mg/dL. Thirty (38% had significant weight loss. A weak correlation between TSB levels and percent of weight loss was identified (r = 0.20; p 20 mg/dL was notably higher among infants with significant weight loss (46.7% vs. 18.4%; p Conclusions Significant weight loss could be a useful parameter to identify breastfed term infants at risk of severe hyperbilirubinemia either during birth hospitalization or outpatient follow-up visits in settings where routine pre-discharge TSB levels have not been implemented yet.

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

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

    2012-05-01

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

  11. Maternal Behavior and Infant Weight Gain in the First Year

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    Worobey, John; Lopez, Maria Islas; Hoffman, Daniel J.

    2009-01-01

    Objective: To examine the relative contributions of maternal characteristics and behaviors in predicting infant weight gain over the first year of postpartum life. Design: Longitudinal study of maternal feeding style throughout infancy. Setting: A Special Supplemental Nutrition Program for Women, Infants, and Children center. Participants:…

  12. Prospective associations of eating behaviors with weight gain in infants

    OpenAIRE

    Shepard, Desti N.; Paula C. Chandler-Laney

    2015-01-01

    Objective To examine whether maternal reports of infant eating behaviors are stable over time and whether eating behaviors are prospectively associated with weight gain. Methods In an ongoing study of infant growth, weight and length were measured at 2-weeks, 3-months, and 5-months of age. Food responsiveness (FR), satiety responsiveness (SR), enjoyment of feeding (EF), and slow eating (SE) were assessed with the Baby Eating Behavior Questionnaire. Repeated measures ANOVA were used to examine...

  13. Cross-cultural analysis of the motor development of Brazilian, Greek and Canadian infants assessed with the Alberta Infant Motor Scale

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    Saccani, Raquel; Valentini, Nadia Cristina

    2013-01-01

    OBJECTIVE: To compare the motor development of infants from three population samples (Brazil, Canada and Greece), to investigate differences in the percentile curves of motor development in these samples, and to investigate the prevalence of motor delays in Brazilian children. METHODS: Observational, descriptive and cross-sectional study with 795 Brazilian infants from zero to 18 months of age, assessed by the Alberta Infant Motor Scale (AIMS) at day care centers, nurseries, basic health units and at home. The Brazilian infants' motor scores were compared to the results of two population samples from Greece (424 infants) and Canada (2,400 infants). Descriptive statistics was used, with one-sample t-test and binomial tests, being significant p≤0.05. RESULTS: 65.4% of Brazilian children showed typical motor development, although with lower mean scores. In the beginning of the second year of life, the differences in the motor development among Brazilian, Canadian and Greek infants were milder; at 15 months of age, the motor development became similar in the three groups. A non-linear motor development trend was observed. CONCLUSIONS: The lowest motor percentiles of the Brazilian sample emphasized the need for national norms in order to correctly categorize the infant motor development. The different ways of motor development may be a consequence of cultural differences in infant care. PMID:24142318

  14. Cross-cultural analysis of the motor development of Brazilian, Greek and Canadian infants assessed with the Alberta Infant Motor Scale

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    Raquel Saccani

    2013-09-01

    Full Text Available OBJECTIVE: To compare the motor development of infants from three population samples (Brazil, Canada and Greece, to investigate differences in the percentile curves of motor development in these samples, and to investigate the prevalence of motor delays in Brazilian children. METHODS: Observational, descriptive and cross-sectional study with 795 Brazilian infants from zero to 18 months of age, assessed by the Alberta Infant Motor Scale (AIMS at day care centers, nurseries, basic health units and at home. The Brazilian infants' motor scores were compared to the results of two population samples from Greece (424 infants and Canada (2,400 infants. Descriptive statistics was used, with one-sample t-test and binomial tests, being significant p≤0.05. RESULTS: 65.4% of Brazilian children showed typical motor development, although with lower mean scores. In the beginning of the second year of life, the differences in the motor development among Brazilian, Canadian and Greek infants were milder; at 15 months of age, the motor development became similar in the three groups. A non-linear motor development trend was observed. CONCLUSIONS: The lowest motor percentiles of the Brazilian sample emphasized the need for national norms in order to correctly categorize the infant motor development. The different ways of motor development may be a consequence of cultural differences in infant care.

  15. Hearing loss in low-birth-weight infants.

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    Anagnostakis, D; Petmezakis, J; Papazissis, G; Messaritakis, J; Matsaniotis, N

    1982-07-01

    The hearing of 98 perinatal intensive care survivors with a mean birth weight of 1,540 g was assessed at a mean age of 6 1/2 years. They represented 73% of the long-term survivors with birth weights of 1,800 g or less who had been cared for in our neonatal unit during the three-year period 1971 through 1973. Nine of the 98 infants had sensorineural hearing loss, and 14 had exudative otitis media. During their neonatal period, the infants with hearing loss experienced more frequent apneic attacks, hyperbilirubinemia (serum bilirubin level, greater than 14 mg/dL), and hypothermia compared with their healthy counterparts. There was no evidence that the duration of stay in the incubator or the use of stay in the incubator or the use of ototoxic drugs had affected the hearing of these low-birth-weight infants.

  16. The Relationship between Folic Acid Intake and Infant Birth Weight

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    Fariba Esmailzadeh

    2016-12-01

    Full Text Available Background and Objectives: Folic acid is a B vitamin which 5mg daily intake before gestation and until the tenth week of pregnancy is recommended. Since no study has been conducted in some regions of East Azerbaijan including Bostanabad, Khosroshahr and Sarab and no prevalence was spotted in country specific studies, therefore, the aim of this study was to determine the relationship between folic acid intake and infant birth weight. Material and Methods: This study was a retrospective cohort. In this study, 1939 of pregnant women who were referred to health care centers before pregnancy were selected randomly. They were divided into two groups: first group of pregnant women who regularly took folic acid before pregnancy and second group included the women who did not take folic acid supplements. Data were analyzed by SPSS 16 using T-Test and ANOVA. Results: This study was conducted on 1939 mothers who had an average age of 25.98 years and average infants birth weight was 3.209 kg. Totally, 92.9% of the mothers had regular consumption of folic acid during pregnancy. Analysis of the results showed that with increasing maternal BMI, birth weight also increased. It showed a significant relationship between regular folic acid intake and increase in infant birth weight. Conclusion : Our results showed that both high maternal pre-pregnancy weight and folic acid intake lead to higher birth weight infants.

  17. Association between gestational age and birth weight on the language development of Brazilian children: a systematic review.

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    Zerbeto, Amanda B; Cortelo, Fernando M; C Filho, Élio B

    2015-01-01

    To review the literature that addresses the relationship between prematurity, birth weight, and development of language in Brazilian children. A systematic review of studies published between 2003 and 2012 in English and Portuguese and indexed in PubMed, LILACS, and SciELO. The following key words were used in the searches: Prematuro, Prematuridade, Linguagem, Prematurity, Language, Speech-Language Pathology. Fifty-seven articles were retrieved, 13 of which were included in the systematic review. The results showed an association between prematurity, low birth weight, and language development. In studies that made comparisons between preterm and term infants, there was evidence that preterm infants had poorer performance on indicators of language. It was also observed that children born with lower birth weight had a poorer performance on measures of language when compared to children with higher weight and closer to 37 weeks of gestational age. Regarding the type of language assessed, expression proved to be more impaired than reception. Higher parental education and family income were indicated as protective factors for the development of language. Conversely, lower birth weight and higher degree of prematurity emerged as risk factors. Preterm birth and low birth weight poses risks for the language development of children, especially in the first years of life. Therefore, it is essential that pediatricians are aware of the language development of these children to ensure proper treatment. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. Preterm birth, infant weight gain, and childhood asthma risk

    DEFF Research Database (Denmark)

    Sonnenschein-van der Voort, Agnes M M; Arends, Lidia R; de Jongste, Johan C

    2014-01-01

    BACKGROUND: Preterm birth, low birth weight, and infant catch-up growth seem associated with an increased risk of respiratory diseases in later life, but individual studies showed conflicting results. OBJECTIVES: We performed an individual participant data meta-analysis for 147,252 children of 31...

  19. Maternal panic disorder: Infant prematurity and low birth weight.

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    Warren, Susan L; Racu, Camellia; Gregg, Vanessa; Simmens, Samuel J

    2006-01-01

    The aim of this pilot research was to investigate whether infants of mothers with panic disorder (PD) would be at higher risk for prematurity and low birth weight (corrected for gestational age) than controls. Medical records were reviewed for 25 mothers with PD and 33 mothers without a lifetime history of anxiety disorders or other major psychopathology as determined by diagnostic interview. Mothers also completed questionnaires concerning demographic information and life stresses. Compared to controls, infants with PD mothers were not significantly more likely to be born prematurely or earlier than controls but did show smaller birth weight corrected for gestational age, even after accounting for possible confounding influences. Additional research is needed to confirm these preliminary findings. Studying PD mothers during pregnancy could provide insight concerning mechanisms for the development of low birth weight and psychopathology.

  20. The association between inadequate gestational weight gain and infant mortality among U.S. infants born in 2002.

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    Davis, Regina R; Hofferth, Sandra L

    2012-01-01

    The purpose of this study was to determine the relative importance of inadequate gestational weight gain as a cause of infant mortality. Birth and infant death certificate data were obtained from a random sample of 100,000 records from the National Center for Health Statistics (NCHS) 2002 Birth Cohort Linked Birth/Infant Death Data File. Descriptive and proportional hazards regression analyses were used to assess the odds of infant mortality associated with inadequate gestational weight gain compared to normal weight gain. Nearly 30% of women experienced inadequate weight gain. Infants born to women with inadequate gestational weight gain had odds of infant death that were 2.23 times the odds for infants born to women with normal weight gain. Increased odds remained after adjustment for gestational age, low birth weight, maternal age, maternal education, and maternal race. Among racial or ethnic subgroups, African American women were 1.3 times as likely as white women to have an infant die, but they were no more likely to have an infant die than white women if they had inadequate weight gain. There is a substantial and significant association between inadequate gestational weight gain and infant death that does not differ by race, ethnic group membership, or maternal age.

  1. Guidelines for Feeding Very Low Birth Weight Infants

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    Sourabh Dutta

    2015-01-01

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

  2. Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

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    Adolfo Correa

    2012-09-01

    Full Text Available Epidemiologic evidence provides some support for a causal association between maternal secondhand smoke (SHS exposure during pregnancy and reduction in infant birth weight. The purpose of this cross-sectional study is to examine the magnitude of this association in China, where both prevalence and dose of SHS exposure are thought to be higher than in U.S. populations. Women who gave birth in Beijing and Changchun September 2000–November 2001 were interviewed to quantify self-reported prenatal SHS exposure. Their medical records were reviewed for data on pregnancy complications and birth outcomes. Non-smoking women who delivered term babies (≥37 weeks gestation were included in the study (N = 2,770. Nearly a quarter of the women (24% reported daily SHS exposure, 47% reported no prenatal exposure, and 75% denied any SHS exposure from the husband smoking at home. Overall, no deficit in mean birth weight was observed with exposure from all sources of SHS combined (+11 grams, 95% CI: +2, +21. Infants had higher mean birth weights among the exposed than the unexposed for all measures of SHS exposure. Future studies on SHS exposure and infant birth weight in China should emphasize more objective measures of exposure to quantify and account for any exposure misclassification.

  3. Weight charts of infants dying of sudden infant death in England.

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    Scheimberg, Irene; Ashal, Husna; Kotiloglu-Karaa, Esin; French, Paul; Kay, Philippa; Cohen, Marta C

    2014-01-01

    The organ weights in cases of sudden infant death syndrome (SIDS) and undetermined deaths in previously healthy infants do not correspond to "the normal range" of organ weights in international standard charts for infants currently in use in some institutions. The aim of our study was to ascertain the organ weights of infants dying suddenly and unexpectedly in England and for whom a cause of death was not found, therefore falling under the category of SIDS or undetermined. We collated the organs weights from 2 institutions covering between them the South East and North of England including London, Yorkshire, and Derbyshire. The cases from The Royal London Hospital were autopsied between 1997 and 2013, and the cases from Sheffield Children's Hospital were autopsied between 2006 and 2013. There were 188 babies who had been born at term (62 female and 126 male) and 26 ex-premature babies (15 female and 11 male). Organs of male babies were slightly heavier than those of female babies but as there was no significant differences male and female babies were considered together. Comparison with standard charts (from 1932 and 1962) and with more recent charts confirmed the discrepancy between the older charts commonly in use with more recent measurements, including ours. The main reason for these differences is that babies in the recent charts were previously healthy babies with no long term disease and improved in the health of the population.

  4. First Trimester Phthalate Exposure and Infant Birth Weight in the Infant Development and Environment Study

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    Sathyanarayana, Sheela; Barrett, Emily; Nguyen, Ruby; Redmon, Bruce; Haaland, Wren; Swan, Shanna H.

    2016-01-01

    Phthalate exposure is widespread among pregnant women but whether it is related to fetal growth and birth weight remains to be determined. We examined whether first trimester prenatal phthalate exposure was associated with birth weight in a pregnancy cohort study. We recruited first trimester pregnant women from 2010–2012 from four centers and analyzed mother/infant dyads who had complete urinary phthalate and birth record data (N = 753). We conducted multiple linear regression to examine if prenatal log specific gravity adjusted urinary phthalate exposure was related to birthweight in term and preterm (≤37 weeks) infants, stratified by sex. We observed a significant association between mono carboxy-isononyl phthalate (MCOP) exposure and increased birthweight in term males, 0.13 kg (95% CI 0.03, 0.23). In preterm infants, we observed a 0.49 kg (95% CI 0.09, 0.89) increase in birthweight in relation to a one log unit change in the sum of di-ethylhexyl phthalate (DEHP) metabolite concentrations in females (N = 33). In summary, we observed few associations between prenatal phthalate exposure and birthweight. Positive associations may be attributable to unresolved confounding in term infants and limited sample size in preterm infants. PMID:27669283

  5. Influence of additional weight on the frequency of kicks in infants with Down syndrome and infants with typical development

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    Gabriela L. Santos

    2014-07-01

    Full Text Available BACKGROUND: Infants with Down syndrome present with organic and neurological changes that may lead to a delay in the acquisition of motor skills such as kicking, a fundamental skill that is a precursor of gait and is influenced by intrinsic and extrinsic factors. Therefore, this movement should be taken into account in early physical therapy interventions in infants. OBJECTIVE: To analyze and to compare the effect of additional weight on the frequency of kicks in infants with Down syndrome and infants with typical development at 3 and 4 months of age. METHOD: Five infants with Down syndrome and five with typical development at 3 and 4 months of age were filmed. The experiment was divided into four experimental conditions lasting 1 minute each: training, baseline, weight (addition of ankle weight with 1/3 the weight of the lower limb, and post-weight. RESULTS: There were significant differences between groups for all variables (p<0.05, with lower frequencies observed for infants with Down syndrome in all variables. There were significant differences between the experimental conditions baseline and post-weight (p<0.001 for both groups in the frequency of contact and success, with a higher frequency in the post-weight condition. CONCLUSIONS: The weight acted as an important stimulus for both groups, directing the kicks toward the target and improving the infants' performance in the task through repetition, however, the infants with Down syndrome had lower frequencies of kicks.

  6. Influence of additional weight on the frequency of kicks in infants with Down syndrome and infants with typical development.

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    Santos, Gabriela L; Bueno, Thaís B; Tudella, Eloisa; Dionisio, Jadiane

    2014-01-01

    Infants with Down syndrome present with organic and neurological changes that may lead to a delay in the acquisition of motor skills such as kicking, a fundamental skill that is a precursor of gait and is influenced by intrinsic and extrinsic factors. Therefore, this movement should be taken into account in early physical therapy interventions in infants. To analyze and to compare the effect of additional weight on the frequency of kicks in infants with Down syndrome and infants with typical development at 3 and 4 months of age. Five infants with Down syndrome and five with typical development at 3 and 4 months of age were filmed. The experiment was divided into four experimental conditions lasting 1 minute each: training, baseline, weight (addition of ankle weight with 1/3 the weight of the lower limb), and post-weight. There were significant differences between groups for all variables (p<0.05), with lower frequencies observed for infants with Down syndrome in all variables. There were significant differences between the experimental conditions baseline and post-weight (p<0.001) for both groups in the frequency of contact and success, with a higher frequency in the post-weight condition. The weight acted as an important stimulus for both groups, directing the kicks toward the target and improving the infants' performance in the task through repetition, however, the infants with Down syndrome had lower frequencies of kicks.

  7. Genotypes and clinical data of respiratory syncytial virus and metapneumovirus in brazilian infants: a new perspective

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    Adriana Gut Lopes Riccetto

    2009-02-01

    Full Text Available The aim of this study was to determine if there was a correlation between respiratory syncytial virus (RSV and metapneumovirus (MPV genotypes and clinical data of Brazilian infants hospitalized for acute lower respiratory infection. The viruses in the patients' nasopharyngeal secretions were studied using the polymerase chain reaction and phylogenetic analysis. The study assessed 144 infants; 31.9% were RSV positive and 5.6% were MPV positive. Statistical analysis was performed using the chi-squared test, Fisher's test, Odds ratio, univariate logistic regression, non-conditional multivariate logistic regression and the forward - stepwise method. Multivariate analysis confirmed a significant relationship between a positive PCR test for RSV and hospitalization during the month of May and with pulse oximetry less than 90%. The phylogenetic analysis indicated the genotypes GA2, GA5, SAA1 (Group A, SAB1, SAB3 and BA (Group B for RSV and Group B, subgroup B1, for MPV.

  8. Maternal obesity and gestational weight gain are risk factors for infant death.

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    Bodnar, Lisa M; Siminerio, Lara L; Himes, Katherine P; Hutcheon, Jennifer A; Lash, Timothy L; Parisi, Sara M; Abrams, Barbara

    2016-02-01

    Assessment of the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality was performed. This study used Pennsylvania linked birth-infant death records (2003-2011) from infants without anomalies born to mothers with prepregnancy BMI categorized as underweight (n = 58,973), normal weight (n = 610,118), overweight (n = 296,630), grade 1 obesity (n = 147,608), grade 2 obesity (n = 71,740), and grade 3 obesity (n = 47,277). Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z scores of gestational weight gain and infant death after confounder adjustment. Infant mortality risk was lowest among normal-weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grades 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal-weight women. Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. © 2015 The Obesity Society.

  9. Early weight changes after birth and serum high-molecular-weight adiponectin level in preterm infants.

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

    2011-12-01

    Extra-uterine growth retardation (EUGR) is associated with an increased risk for cardiometabolic diseases later in life. The aim of the present study was to examine the relationship between early weight change after birth in preterm infants and adiponectin (adn) multimeric complexes. Subjects included 28 preterm infants born between weeks 24 and 33 of gestation. Serum adn multimeric complexes and the anthropometric parameters were measured in preterm infants at birth and at corrected term. Bodyweight (BW) decreased during the first week of life, with birthweight restored at approximately 19 days after birth. Nineteen of the subjects had EUGR at corrected term. Total (T)-adn, high-molecular-weight (H)-adn, and the ratio of H-adn to T-adn (H/T-adn) were significantly elevated at corrected term than at birth. Postmenstrual age, birthweight, birth length and lowest BW after birth were positively correlated with H-adn and H/T-adn. Weight reduction after birth was negatively correlated with H-adn. Age to restore birthweight was negatively correlated with T-adn, H-adn and H/T-adn. Stepwise multiple regression analysis indicated age to restore birthweight as the major predictor of T-adn and H-adn. Early weight changes after birth may alter serum adn level in preterm infants at corrected term. The appropriate nutritional support in the early postnatal period could reduce the prevalence of EUGR and the future risk for cardiometabolic diseases. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

  10. Intraclass reliability of the Alberta Infant Motor Scale in the Brazilian version

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    Larissa Paiva Silva

    2013-10-01

    Full Text Available This study had as its objective to analyze the intraclass reliability of the Alberta Infant Motor Scale (AIMS, in the Brazilian version, in preterm and term infants. It was a methodological study, conducted from November 2009 to April 2010, with 50 children receiving care in two public institutions in Fortaleza, Ceará, Brazil. Children were grouped according to gestational age as preterm and term, and evaluated by three evaluators in the communication laboratory of a public institution or at home. The intraclass correlation indices for the categories prone, supine, sitting and standing ranged from 0.553 to 0.952; most remained above 0.800, except for the standing category of the third evaluator, in which the index was 0.553. As for the total score and percentile, rates ranged from 0.843 to 0.954. The scale proved to be a reliable instrument for assessing gross motor performance of Brazilian children, particularly in Ceará, regardless of gestational age at birth.

  11. Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants

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    Firas S. Azzeh

    Full Text Available Introduction: Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated. Objective: To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia. Methods: A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i Low Birth Weight (LBW infants (15012500 g birth weight, (ii Very Low Birth Weight (VLBW infants (1001-1500 g birth weight and (iii Extremely Low Birth Weight (ELBW infants ( 0.05 were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p < 0.05 than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05 in ELBW group. Conclusion: Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups.

  12. Birth statistics of high birth weight infants (macrosomia in Korea

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    Byung-Ho Kang

    2012-08-01

    Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; The authors analyzed the trend from the birth-related statistics of high birth weight infants (HBWIs over 50 years in Korea from 1960 to 2010. &lt;B&gt;Methods:&lt;/B&gt; We used 2 data sources, namely, the hospital units (1960’s to 1990’s and Statistics Korea (1993 to 2010. The analyses include the incidence of HBWIs, birth weight distribution, sex ratio, and the relationship of HBWI to maternal age. &lt;B&gt;Results:&lt;/B&gt; The hospital unit data indicated the incidence of HBWI as 3 to 7% in the 1960’s and 1970’s and 4 to 7% in the 1980’s and 1990’s. Data from Statistics Korea indicated the percentages of HBWIs among total live births decreased over the years: 6.7% (1993, 6.3% (1995, 5.1 % (2000, 4.5% (2000, and 3.5% (2010. In HBWIs, the birth weight rages and percentage of incidence in infants’ were 4.0 to 4.4 kg (90.3%, 4.5 to 4.9 kg (8.8%, 5.0 to 5.4 kg (0.8%, 5.5 to 5.9 kg (0.1%, and &gt;6.0 kg (0.0% in 2000 but were 92.2%, 7.2%, 0.6%, 0.0%, and 0.0% in 2009. The male to female ratio of HBWIs was 1.89 in 1993 and 1.84 in 2010. In 2010, the mother's age distribution correlated with low (4.9%, normal (91.0%, and high birth weights (3.6%: an increase in mother's age resulted in an increase in the frequency of low birth weight infants (LBWIs and HBWIs. &lt;B&gt;Conclusion:&lt;/B&gt; The incidence of HBWIs for the past 50 years has been dropping in Korea. The older the mother, the higher was the risk of a HBWI and LBWI. We hope that these findings would be utilized as basic data that will aid those managing HBWIs.

  13. Maternal Characteristics of a Cohort of Preterm Infants with a Birth Weight

    NARCIS (Netherlands)

    Claas, Marieke J.; de Vries, Linda S.; Bruinse, Hein W.

    2011-01-01

    Our objectives were to describe the obstetric complications of women who delivered an extremely low-birth-weight infant by comparing two consecutive 5-year periods and infants appropriate for gestational age (AGA) versus infants small for gestational age (SGA). This descriptive study included women

  14. Developmental Outcomes of Premature and Low Birth Weight Infants

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    Reza Saeidi

    2016-03-01

    Full Text Available Background: Prematurity is the most common cause of death and disability And Preterm infants, are prone to developmental complications. For this reason this study was designed for follow up of these babies until 2 years by modified DDST-2. Methods: This study was a prospective longitudinal descriptive study from March 2009 to March 2011 in clinic of sheikh and Imam Reza Hospitals, mashhad, Iran. Sample size with Confidence coefficient of 95% and power 80%, was determined 100 hundred babies. Infants were seen by a pediatrician at a follow up clinic at 1, 3, 6, 9,12,15,18, 24, months.The developmental assessment was done using Denver-2 Developmental Screening Test. Results: mean age for smiling was 4/6 ± 2/1  months which significantly differed with appropriate age (p = 0.000, mean age for telling two syllables words 11/7±  1/9 months, without significant difference of appropriate age.(p = 0.139. Average age for understanding NO was 10/4±  2/0 months that significantly differed with appropriate age(p = 0.000. The average age for telling 6 word was 17/8±  3/0, without significant difference with appropriate age (p = 0.510. Conclusion: Children with history of prematurity and low birth weight have more disability and developmental delay so they need to developmental screening tests.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. Impact of birth weight and early infant weight gain on insulin resistance and associated cardiovascular risk factors in adolescence

    DEFF Research Database (Denmark)

    Fabricius-Bjerre, Signe; Jensen, Rikke Beck; Færch, Kristine

    2011-01-01

    Low birth weight followed by accelerated weight gain during early childhood has been associated with adverse metabolic and cardiovascular outcomes later in life. The aim of this study was to examine the impact of early infant weight gain on glucose metabolism and cardiovascular risk factors...

  17. Is the association of breastfeeding with child obesity explained by infant weight change?

    NARCIS (Netherlands)

    L. van Rossem (Lenie); E.M. Taveras (Elsie M.); M.W. Gillman (Matthew W.); K.P. Kleinman (Ken P.); S.L. Rifas-Shiman (Sheryl L.); H. Raat (Hein); E. Oken (Emily)

    2011-01-01

    textabstractObjective. Breastfeeding and infant weight change are both associated with adiposity. We examined the extent to which infant weight change mediates the association between breastfeeding and adiposity at age 3 years. Methods. We studied 884 children in a prospective cohort study. We deter

  18. Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review

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    Mugambi Mary N

    2012-08-01

    Full Text Available Abstract Background Previous reviews (2005 to 2009 on preterm infants given probiotics or prebiotics with breast milk or mixed feeds focused on prevention of Necrotizing Enterocolitis, sepsis and diarrhea. This review assessed if probiotics, prebiotics led to improved growth and clinical outcomes in formula fed preterm infants. Methods Cochrane methodology was followed using randomized controlled trials (RCTs which compared preterm formula containing probiotic(s or prebiotic(s to conventional preterm formula in preterm 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. Heterogeneity was assessed by visual inspection of forest plots and a chi2 test. An I2 test assessed inconsistencies across studies. I2> 50% represented substantial heterogeneity. Results Four probiotics studies (N=212, 4 prebiotics studies (N=126 were included. Probiotics: There were no significant differences in weight gain (MD 1.96, 95% CI: -2.64 to 6.56, 2 studies, n=34 or in maximal enteral feed (MD 35.20, 95% CI: -7.61 to 78.02, 2 studies, n=34, number of stools per day increased significantly in probiotic group (MD 1.60, 95% CI: 1.20 to 2.00, 1 study, n=20. Prebiotics: Galacto-oligosaccharide / Fructo-oligosaccharide (GOS/FOS yielded no significant difference in weight gain (MD 0.04, 95% CI: -2.65 to 2.73, 2 studies, n=50, GOS/FOS yielded no significant differences in length gain (MD 0.01, 95% CI: -0.03 to 0.04, 2 studies, n=50. There were no significant differences in head growth (MD −0.01, 95% CI: -0.02 to 0.00, 2 studies, n=76 or age at full enteral feed (MD −0.79, 95% CI: -2.20 to 0.61, 2 studies, n=86. Stool frequency increased significantly in prebiotic group (MD 0.80, 95% CI: 0.48 to 1.1, 2 studies, n=86. GOS/FOS and FOS yielded higher bifidobacteria counts in prebiotics group (MD 2.10, 95% CI: 0.96 to 3.24, n=27 and (MD 0.48, 95

  19. Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review.

    Science.gov (United States)

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

    2012-08-28

    Previous reviews (2005 to 2009) on preterm infants given probiotics or prebiotics with breast milk or mixed feeds focused on prevention of Necrotizing Enterocolitis, sepsis and diarrhea. This review assessed if probiotics, prebiotics led to improved growth and clinical outcomes in formula fed preterm infants. Cochrane methodology was followed using randomized controlled trials (RCTs) which compared preterm formula containing probiotic(s) or prebiotic(s) to conventional preterm formula in preterm 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. Heterogeneity was assessed by visual inspection of forest plots and a chi² test. An I² test assessed inconsistencies across studies. I²> 50% represented substantial heterogeneity. Four probiotics studies (N=212), 4 prebiotics studies (N=126) were included. Probiotics: There were no significant differences in weight gain (MD 1.96, 95% CI: -2.64 to 6.56, 2 studies, n=34) or in maximal enteral feed (MD 35.20, 95% CI: -7.61 to 78.02, 2 studies, n=34), number of stools per day increased significantly in probiotic group (MD 1.60, 95% CI: 1.20 to 2.00, 1 study, n=20). Prebiotics: Galacto-oligosaccharide/Fructo-oligosaccharide (GOS/FOS) yielded no significant difference in weight gain (MD 0.04, 95% CI: -2.65 to 2.73, 2 studies, n=50), GOS/FOS yielded no significant differences in length gain (MD 0.01, 95% CI: -0.03 to 0.04, 2 studies, n=50). There were no significant differences in head growth (MD -0.01, 95% CI: -0.02 to 0.00, 2 studies, n=76) or age at full enteral feed (MD -0.79, 95% CI: -2.20 to 0.61, 2 studies, n=86). Stool frequency increased significantly in prebiotic group (MD 0.80, 95% CI: 0.48 to 1.1, 2 studies, n=86). GOS/FOS and FOS yielded higher bifidobacteria counts in prebiotics group (MD 2.10, 95% CI: 0.96 to 3.24, n=27) and (MD 0.48, 95% CI: 0.28 to 0.68, n=56). There is not

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

    Science.gov (United States)

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

    2007-12-01

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

  1. Poor birth weight recovery among low birth weight/preterm infants following hospital discharge in Kampala, Uganda

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    Namiiro Flavia B

    2012-01-01

    Full Text Available Abstract Background Healthy infants typically regain their birth weight by 21 days of age; however, failure to do so may be due to medical, nutritional or environmental factors. Globally, the incidence of low birth weight deliveries is high, but few studies have assessed the postnatal weight changes in this category of infants, especially in Africa. The aim was to determine what proportion of LBW infants had not regained their birth weight by 21 days of age after discharge from the Special Care Unit of Mulago hospital, Kampala. Methods A cross sectional study was conducted assessing weight recovery of 235 LBW infants attending the Kangaroo Clinic in the Special Care Unit of Mulago Hospital between January and April 2010. Infants aged 21 days with a documented birth weight and whose mothers gave consent to participate were included in the study. Baseline information was collected on demographic characteristics, history on pregnancy, delivery and postnatal outcome through interviews. Pertinent infant information like gestation age, diagnosis and management was obtained from the medical records and summarized in the case report forms. Results Of the 235 LBW infants, 113 (48.1% had not regained their birth weight by 21 days. Duration of hospitalization for more than 7 days (AOR: 4.2; 95% CI: 2.3 - 7.6; p value Conclusion Failure to regain birth weight among LBW infants by 21 days of age is a common problem in Mulago Hospital occurring in almost half of the neonates attending the Kangaroo clinic. Currently, the burden of morbidity in this group of high-risk infants is undetected and unaddressed in many developing countries. Measures for consideration to improve care of these infants would include; discharge after regaining birth weight and use of total parenteral nutrition. However, due to the pressure of space, keeping the baby and mother is not feasible at the moment hence the need for a strong community system to boost care of the infant. Close

  2. Duration of breastfeeding has a positive effect on infant weight gain

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    Dedi Kurniawan Saputra

    2010-04-01

    Full Text Available With increasing maternal age hopefully the mother knows more about raising a baby and supervising their growth and development. With normal birth weight and adequate duration of exclusive breastfeeding the baby can be expected to have optimal growth and development. The goal of this historical-cohort prospective study was to analyze the relation between maternal age, infant birth weight and duration of breastfeeding on the one hand with infant weight gain on the other. The population under study were six-month-old infants in the catchment area of Pagar Gading Community Health Center, Pino Raya Region, South Bengkulu Regency. The total sample consisted of 31 six-month-old infants, selected by consecutive nonrandom sampling of subjects meeting the inclusion criteria. Statistical analysis was performed by means of the correlation-regression test. There was a significant correlation between duration of breastfeeding and infant weight gain using the correlation test (p0.05. Furthermore, with the multiple linear regression test, duration of breastfeeding affected infant weight gain (p0.05. The conclusion of this study is that duration of exclusive breastfeeding affects infant weight gain. Breastfeeding of infants should be prolonged beyond the age of 6 months.

  3. A pilot study comparing opaque, weighted bottles with conventional, clear bottles for infant feeding.

    Science.gov (United States)

    Ventura, Alison K; Pollack Golen, Rebecca

    2015-02-01

    It is hypothesized that the visual and weight cues afforded by bottle-feeding may lead mothers to overfeed in response to the amount of liquid in the bottle. The aim of the present pilot study was to test this hypothesis by comparing mothers' sensitivity and responsiveness to infant cues and infants' intakes when mothers use opaque, weighted bottles (that remove visual and weight cues) compared to conventional, clear bottles to feed their infants. We also tested the hypothesis that mothers' pressuring feeding style would moderate the effect of bottle type. Formula-feeding dyads (N = 25) visited our laboratory on two separate days. Mothers fed their infants from a clear bottle one day and an opaque, weighted bottle on the other; bottle-order was counterbalanced across the two days. Infant intake was assessed by weighing each bottle before and after the feeding. Maternal sensitivity and responsiveness to infant cues was objectively assessed using the Nursing Child Assessment Feeding Scale. Mothers were significantly more responsive to infant cues when they used opaque compared to clear bottles (p = .04). There was also a trend for infants to consume significantly less formula when fed from opaque compared to clear bottles (p = .08). Mothers' pressuring feeding style moderated the effect of bottle type on maternal responsiveness to infant cues (p = .02) and infant intake (p = .03). Specifically, mothers who reported higher levels of pressuring feeding were significantly more responsive to their infants' cues (p = .02) and fed their infants significantly less formula when using opaque versus clear bottles (p = .01); no differences were seen for mothers who reported lower levels of pressuring feeding. This study highlights a simple, yet effective intervention for improving the bottle-feeding practices of mothers who have pressuring feeding styles.

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

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    Daijiro Takahashi

    2009-01-01

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

  5. The factors affecting morbidity and mortality in low birth-weight infants

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    Mervan Bekdaş

    2013-01-01

    Full Text Available jective: To investigate the frequency of short term morbidity and mortality and the factors affecting them for the infants born with low birth-weight at our hospitalMethods: At our hospital, 195 infants born with low birthweight within a period of 18 months were identified and 150 infants born with normal birth-weights were selected as the control group. Results: Within the mentioned period of time, 4.4% (n=168 of the infants born in our hospital had low birthweight, 0.7% (n=27 had very low birth-weight (VLBW. Multiple pregnancies and asphyxiating birth rates were significantly high in these infants as compared to the control group. (p=0.029, p=0.011, respectively. For VLBW infants, the rates of asphyxiating birth (OR=14.2, 95% CI (6.6-30.7, p<0.001, hospitalization at the neonatal intensive care unit (OR=34.8, 95% CI (4.7-256.3, p<0,001 and diagnosis of respiratory distress syndrome (OR=11.5, 95% CI (4-33.5, p<0.001 were significantly high. In all infants, the transient metabolic disorders were identified at a significantly high rate (p=0.045. The birth-weight and gestational age of infants were inversely correlated with their fetal and neonatal mortalities (for all p<0.001. Conclusion: This study demonstrated that the most important factor affecting infants was multiple pregnancies. The birth-weight and gestational age of infants were inversely correlated with their morbidity and mortality rates.Key words: Low birth weight, perinatal risk factors, morbidity, mortality

  6. Maternal weight status and responsiveness to preterm infant behavioral cues during feeding.

    Science.gov (United States)

    Arianas, Evanthia A; Rankin, Kristin M; Norr, Kathleen F; White-Traut, Rosemary C

    2017-04-11

    Parental obesity is highly predictive of child obesity, and preterm infants are at greater risk of obesity, but little is known about obese and non-obese mothers' responsiveness to preterm infant cues during feeding. The relationship between maternal weight status and response to preterm infant behavioral cues during feeding at 6-weeks corrected age was examined. This secondary analysis used data from a randomized clinical trial. Maternal weight was coded during a play session. Mother-infant interaction during feeding was coded using the Nursing Child Assessment Satellite Training Feeding Scale (NCAST). We used multivariate linear regressions to examine NCAST scores and multivariate logistic regressions for the two individual items, satiation cues and termination of feeding. Of the 139 mothers, 56 (40.3%) were obese, two underweight women were excluded. Obese mothers did not differ from overweight/normal weight mothers for overall NCAST scores, but they had higher scores on response to infant's distress subscale (mean = 10.2 vs. 9.6, p = 0.01). The proportion of infants who exhibited satiation cues did not differ by maternal weight. Obese mothers were more likely than overweight/normal weight mothers to terminate the feeding when the infant showed satiation cues (82.1% vs. 66.3%, p = 0.04, adjusted OR = 2.31, 95% CI = 0.97, 5.48). Limitations include lack of BMI measures and small sample size. Additional research is needed about maternal weight status and whether it influences responsiveness to preterm infant satiation cues. Results highlight the need for educating all mothers of preterm infants regarding preterm infant cues. NCT02041923 . Feeding and Transition to Home for Preterms at Social Risk (H-HOPE). Registered 15 January 2014.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  9. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    Science.gov (United States)

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

  10. General movements in the first fourteen days of life in extremely low birth weight (ELBW) infants

    NARCIS (Netherlands)

    de Vries, N. K. S.; Erwich, J. J. H. M.; Bos, A. F.

    2008-01-01

    Objective: To assess the quality of general movements (GMs) in the first fourteen days of life in relation to obstetric and postnatal risk factors and neurodevelopmental outcome in extremely low birth weight (ELBW) infants. Study design: The GMs of nineteen infants were assessed on days 2, 4, 6, 10

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  13. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    Science.gov (United States)

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  15. Effect of olive oil massage on weight gain in preterm infants: A randomized controlled clinical trial

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    Mahnaz Jabraeile

    2016-01-01

    Full Text Available Background: Despite the fact that effect of massage with or without oil on the baby′s weight gain is not clear, but recent studies have shown that massage with essential oils make lipid absorption through the skin. The aim of this study was to evaluate the effect of olive oil massage on weight gain in preterm infants. Materials and Methods: This study was a single-blind, randomized controlled clinical trial. In this study, infants who met inclusion criteria for the study were divided into two groups by using random numbers table. Newborns in intervention group were under massage for 10 days and 3 times for 15 min daily; the mother of these newborns had been trained already using olive oil. Moreover, the infants of the control group were under massaging without oil same as the above-mentioned method. Researchers weighed babies daily during 10 days and recorded it at the checklist. Data from the study were reviewed and analyzed by descriptive statistics and repeated measure test using the statistical software SPSS/13. Results: This study showed that the neonatal weight gain in the infants with the oil massage was 21 g daily in average, whereas the increase in infant massage without oil was 7 g. This difference was statistically significant (P < 0.001. Conclusion: Considering the positive effect of infant massage on weight gain in premature infants with olive oil, it is recommended that nurses use oil in infant massage in the neonatal units.

  16. Body image and extreme attitudes toward weight in Brazilian schoolchildren (PeNSE 2012

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    Rafael Moreira Claro

    2014-01-01

    Full Text Available INTRODUCTION: Adolescence is a period characterized by changes such as accelerated physical growth and sexual development. Besides having to deal with these changes, adolescents are faced with beauty standards and extreme valorization of physical appearance. OBJECTIVE: This article aims to describe body image and the practice of extreme attitudes regarding weight in Brazilian students. METHODS: Data from the National Survey of School Health (PeNSE 2012 were used in this study. PeNSE 2012 has a representative sample of students in the 9th grade of elementary school in public and private schools across the country. A self-administered questionnaire on body image, practice of extreme measures in relation to weight and sociodemographic data was used. Body image and the practice of extreme attitudes were described for the total sample and according to gender. Poisson regression analyzes were used to identify differences in the practices of extreme attitudes between the different types of body image. RESULTS: More than 38% of the adolescents did not consider their body image as normal. Over 15% of the students referred to carry out extreme weight control practices, combining practices to loose and gain weight. Adolescents who considered themselves fat presented frequency of extreme practices for weight loss 92% higher than that shown by individuals who considered themselves normal. Similarly, adolescents who considered themselves thin presented frequency of extreme attitudes to gain weight (9.7% higher than that shown by students who considered themselves normal (5.6%. CONCLUSIONS: The high frequency of extreme weight control practices among Brazilian adolescents is alarming and should be subject of measures in health and education fields.

  17. Infant Temperament and Maternal Parenting Self-efficacy Predict Child Weight Outcomes

    OpenAIRE

    Anzman-Frasca, Stephanie; Stifter, Cynthia A.; Paul, Ian M.; Birch, Leann L.

    2013-01-01

    Relationships between infant negative reactivity and self-regulation, parenting self-efficacy, and child weight outcomes were examined. Greater observed negative reactivity predicted more child weight gain when mothers had lower parenting self-efficacy. Lower mother-reported self-regulation predicted a greater child weight status. Results highlight potential early risk/protective factors.

  18. Associations between infant feeding practices and length, weight, and disease in developing countries

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    Benjamin eYarnoff

    2013-09-01

    Full Text Available The health benefits of exclusive breastfeeding are well known, but the relative detrimental impacts of other foods on infant health are unknown. Because infants in developing countries are fed a wide range of food, quantifying the burden of these diverse feeding practices on infant health is essential for public health policy. We used data from the Demographic Health Survey from 20 developing countries over multiple years to examine the independent association of six different types of food (exclusive breastfeeding, nonexclusive breastfeeding, infant formula, milk liquids, non-milk liquids, and solid foods with five measures of infant health (length, weight, diarrhea, fever, and cough. We estimated associations with regression analysis, controlling for confounding factors with infant, mother, and household factors and community-year fixed effects. We used these estimates in a simulation model to quantify the burden of different combinations of food on infant health. We show that for an infant younger than 6 months old, following current guidelines and exclusively breastfeeding instead of giving the infant solid foods may increase length by 0.75 centimeters and weight by 0.25 kilograms and decrease diarrhea, fever, and cough prevalence by 8%, 12%, and 11%, respectively. We found that the burden on infant health of some feeding practices is less than others. Although all other feeding practices are associated with worse health outcomes than exclusive breastfeeding, breastfeeding supplemented with liquids has a lower burden on infant health than solid foods and infant formula has a lower burden than milk or nonmilk liquids as measured by four of five health metrics. Providing specific quantified burden estimates of these practices can help inform public health policy related to infant feeding practices.

  19. Early Vocalization of Preterm Infants with Extremely Low Birth Weight (ELBW), Part I: From Birth to Expansion Stage

    Science.gov (United States)

    Torola, Helena; Lehtihalmes, Matti; Heikkinen, Hanna; Olsen, Paivi; Yliherva, Anneli

    2012-01-01

    The vocalization of preterm infants with extremely low birth weight (ELBW) up to the expansion stage was systematically described and compared with those of healthy full-term infants. The sample consisted of 18 preterm ELBW infants and the control group of 11 full-term infants. The follow-up was performed intensively using video-recordings. The…

  20. Infant mortality by color or race from Rondônia, Brazilian Amazon.

    Science.gov (United States)

    Gava, Caroline; Cardoso, Andrey Moreira; Basta, Paulo Cesar

    2017-04-10

    To analyze the quality of records for live births and infant deaths and to estimate the infant mortality rate for skin color or race, in order to explore possible racial inequalities in health. Descriptive study that analyzed the quality of records of the Live Births Information System and Mortality Information System in Rondônia, Brazilian Amazonian, between 2006-2009. The infant mortality rates were estimated for skin color or race with the direct method and corrected by: (1) proportional distribution of deaths with missing data related to skin color or race; and (2) application of correction factors. We also calculated proportional mortality by causes and age groups. The capture of live births and deaths improved in relation to 2006-2007, which required lower correction factors to estimate infant mortality rate. The risk of death of indigenous infant (31.3/1,000 live births) was higher than that noted for the other skin color or race groups, exceeding by 60% the infant mortality rate in Rondônia (19.9/1,000 live births). Black children had the highest neonatal infant mortality rate, while the indigenous had the highest post-neonatal infant mortality rate. Among the indigenous deaths, 15.2% were due to ill-defined causes, while the other groups did not exceed 5.4%. The proportional infant mortality due to infectious and parasitic diseases was higher among indigenous children (12.1%), while among black children it occurred due to external causes (8.7%). Expressive inequalities in infant mortality were noted between skin color or race categories, more unfavorable for indigenous infants. Correction factors proposed in the literature lack to consider differences in underreporting of deaths for skin color or race. The specific correction among the color or race categories would likely result in exacerbation of the observed inequalities. Analisar a qualidade dos registros de nascidos vivos e de óbitos infantis e estimar a taxa de mortalidade infantil segundo cor ou

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

    Science.gov (United States)

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

    2008-09-01

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

  2. Hepatitis B Postexposure Prophylaxis in Preterm and Low-Birth-Weight Infants

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    Markus Waitz

    2015-04-01

    Full Text Available Objective - Recommendations for immunoprophylaxis in low-birth-weight (LBW infants born to hepatitis B surface antigen (HBsAg-positive mothers vary. We successfully immunized an HBsAg-exposed infant (birth weight: 400 g and performed a literature review on the outcome of postexposure immunoprophylaxis in HBsAg-exposed preterm and LBW infants. Methods - By use of PubMed we identified articles relevant to the topic. Studies were included if the intended vaccine schedule was completed and follow-up data were reported. Results - Antibody response was reported in 31 LBW infants (birth weight < 2,500 g and 49 infants with gestational age of < 38 weeks. Low anti-HBs antibody levels (< 100 IU/L were found in 9 (29% of the 31 LBW infants. Overall, 2 of 20 (10% preterm infants and 2 of 17 (12% LBW were HBsAg-positive on follow-up. In one study, none of the 26 exposed very LBW infants became infected. Conclusion - Due to heterogeneity in immunization schedules, lack of information on transmission rates, and the small number of included subjects, no firm conclusions can be drawn regarding the optimal postexposure prophylaxis in LBW infants. We propose that active and passive immunization at birth should be completed by three further active doses (0–1–2–12 month schedule until further prospective studies are available.

  3. Trimester-Specific Gestational Weight Gain and Infant Size for Gestational Age

    Science.gov (United States)

    Sridhar, Sneha B.; Xu, Fei; Hedderson, Monique M.

    2016-01-01

    Gestational weight gain is known to influence fetal growth. However, it is unclear whether the associations between gestational weight gain and fetal growth vary by trimester. In a diverse cohort of 8,977 women who delivered a singleton between 2011 and 2013, we evaluated the associations between trimester-specific gestational weight gain and infant size for gestational age. Gestational weight gain was categorized per the 2009 Institute of Medicine (IOM) recommendations; meeting the recommendations was the referent. Large for gestational age and small for gestational age were defined as birthweight > 90th percentile or <10th percentile, respectively, based on a national reference standard birthweight distribution. Logistic regression models estimated the odds of having a large or small for gestational age versus an appropriate for gestational age infant. Only gestational weight gain exceeding the IOM recommendations in the 2nd and 3rd trimesters independently increased the odds of delivering a large for gestational age infant (Odds Ratio (95% Confidence Interval): 1st: 1.17 [0.94, 1.44], 2nd: 1.47 [1.13, 1.92], 3rd: 1.70 [1.30, 2.22]). Gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester only (1.76 [1.23, 2.52]). There was effect modification, and gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester and only among women with a pre-pregnancy body mass index from 18.5–24.9 kg/m2 (2.06 [1.35, 3.15]). These findings indicate that gestational weight gain during the 2nd and 3rd trimesters is more strongly associated with infant growth. Interventions to achieve appropriate gestational weight gain may optimize infant size at birth. PMID:27442137

  4. When and why Filipino mothers of term low birth weight infants interrupted breastfeeding exclusively.

    Science.gov (United States)

    Agrasada, Grace V; Kylberg, Elisabeth

    2009-11-01

    This paper makes use of data collected in a randomised controlled trial that was designed to test the efficacy of postpartum breastfeeding counselling to increase exclusive breastfeeding among term low birth weight infants in Manila during the first six months. Mothers were randomised to a control group or one of two home visit interventions: by trained breastfeeding counsellors or child care counsellors without breastfeeding support training. Sixty mothers received peer breastfeeding counselling while a further 119 mothers did not. The median duration of exclusive breastfeeding among mothers who received counselling was five weeks versus two weeks among those who received no counselling (pbreastfeeding was interrupted to offer infants water, traditional herbal extracts or artificial baby milk. Mothers who interrupted exclusive breastfeeding claimed they had insufficient milk or that their infants had slow weight gain. Early and sustained breastfeeding support will enable mothers to exclusively breastfeed low birth weight infants for the first six months.

  5. Maternal education, birth weight, and infant mortality in the United States.

    Science.gov (United States)

    Gage, Timothy B; Fang, Fu; O'Neill, Erin; Dirienzo, Greg

    2013-04-01

    This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its "indirect" effect (operating through birth weight) and/or to its "direct" effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27-108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40-0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.

  6. Clinical Outcome of Cytomegalovirus Infection on Low Birth Weight Infants

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    Ali Usman

    2014-09-01

    Full Text Available Abstract Cytomegalovirus (CMV is a DNA virus and a marker of the herpes virus groups. This virus was found only in human and the infection occurs for a long time. The transmission of CMV infection to fetus/neonates is via congenital infections or perinatal infections. Clinical manifestation of symptomatic CMV infection of the fetus has two presentations, early and second early manifestations. Diagnosis of neonatal CMV infection may be done by serologic test based on detection of IgM of CMV infection. The objective of this study is to asses clinical outcome of CMV infection of low birth weight infants delivery with long term sequelae. An observational study was conducted since March 2010 until December 2011 in Advent and Hermina Pasteur Hospital, all subjects were low birth weight infants (LBWI. The inclusion criterias are all LBWI who were delivered in those hospital or were a referred neonates. The exclusion criterias are major congenital defect, which is not related to congenital CMV infection and neonates’ death before one week of life. Every neonate was examine both their physical and peripher blood count, glucose, Ca. Liver function test done for neonates with acute hepatitis and titre IgG and IgM CMV serial, head ultrasound serial and head CT scan/MRI used for babies with intracranial bleeding and hydrocephaly.  During the period of this study there were 50 cases of LBWI, consisted of 41 preterm babies, and 30 small for gestational age babies. Clinical manifestation of acute hepatitis were found in 20% subjects, all of them with the  elevation of liver function test. Microcephaly which occured in the first untill three weeks of life were 8%. Ventricular dilatation were 10% in the first week of life and increased up to 48% after three weeks. Cases with intracranial haemorrhage were found in 6% and 10% with cerebral calcification on head while sensorineural hearing loss were 8%. All of LBWI have 100% serorespon immune IgG. IgM CMV

  7. Effects of the pacifier activated lullaby on weight gain of premature infants.

    Science.gov (United States)

    Cevasco, Andrea M; Grant, Roy E

    2005-01-01

    Within the past 5 years there has been an increase of premature infants surviving in the neonatal intensive care unit as well as an increasing cost for each day the infant is kept there. It is important for the premature infant to acquire the feeding skills necessary for weight gain, which lead to discharge from the hospital, and recent advancements have indicated the effectiveness in using contingent music to teach sucking skills to premature infants. The purpose of the first analysis in this study was to determine the effects of Pacifier Activated Lullaby (PAL) trials on weight gain of premature infants. During a 2-year time period, 62 infants from a sample of 188 met criteria for analysis. A one-way analysis of variance showed no significance in daily weight gain for the number of PAL trials completed. The mean weight gains for infants with 1 PAL trial = 13.85 grams, 2 trials = 26.67, 3 trials = 29.64, and 4 or more = 22.89. The Pearson product-moment correlation between the mean percent of music earned via nonnutritive sucking (NNS) and mean weight gain of all trials approached significance (p = .077, r = 0.18). In a second analysis, weight gained prior to use of PAL, during use of PAL, and post use of PAL was analyzed. Results indicated no significant difference between weight gain 1 day prior to use of PAL, the day of PAL trial, and 1 day post use of PAL. Mean weight gain for those infants who participated in 1 PAL trial was 8.49 grams for 1 day prior to use of PAL, 18.73 the day of PAL trial, and 24.81 for 1 day post use of PAL. Mean weight gain for 3 days prior to using the PAL was 10.78, 11.30 on the day of PAL trial, and 24.78 grams for 3 days post PAL use. The analyses show definite trends of greater weight gain with PAL use; however, individual variability within groups was greater than group differences leading to no significance in statistical analysis. In the third analysis the effect of proximity between premature infants' feeding schedule and PAL

  8. Differences in mortality and morbidity according to gestational ages and birth weights in infants with trisomy 18.

    Science.gov (United States)

    Imai, Ken; Uchiyama, Atsushi; Okamura, Tomoka; Ago, Mako; Suenaga, Hideyo; Sugita, Eri; Ono, Hideko; Shuri, Kyoko; Masumoto, Kenichi; Totsu, Satsuki; Nakanishi, Hidehiko; Kusuda, Satoshi

    2015-11-01

    The aim of this study was to clarify the effects of gestational age and birth weight on outcomes of the infants. Medical records of 36 infants with trisomy 18 admitted to Tokyo Women's Medical University Hospital from 1991 to 2012 were reviewed retrospectively. We compared clinical characteristics between term infants (n = 15) and preterm infants (n = 21). There were one very-low-birth-weight (VLBW) term infant (5%) and 12 VLBW preterm infants (80%). Although there were no significant differences in clinical characteristics and provided management between the two groups, none of the preterm infants achieved survival to discharge. On the other hand, 6 of 21 term infants (29%) achieved survival to discharge (P trisomy 18. In both preterm and term groups, the infants who died before 30 days commonly died of respiratory failure or apnea. Whereas, the infants who survived more than 30 days mostly died of heart failure.

  9. Impact of birth weight and early infant weight gain on insulin resistance and associated cardiovascular risk factors in adolescence.

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    Signe Fabricius-Bjerre

    Full Text Available BACKGROUND: Low birth weight followed by accelerated weight gain during early childhood has been associated with adverse metabolic and cardiovascular outcomes later in life. The aim of this study was to examine the impact of early infant weight gain on glucose metabolism and cardiovascular risk factors in adolescence and to study if the effect differed between adolescents born small for gestational age (SGA vs. appropriate for gestational age (AGA. METHODOLOGY/PRINCIPAL FINDINGS: Data from 30 SGA and 57 AGA healthy young Danish adolescents were analysed. They had a mean age of 17.6 years and all were born at term. Data on early infant weight gain from birth to three months as well as from birth to one year were available in the majority of subjects. In adolescence, glucose metabolism was assessed by a simplified intravenous glucose tolerance test and body composition was assessed by dual-energy X-ray absorptiometry. Blood pressures as well as plasma concentrations of triglycerides and cholesterol were measured. Early infant weight gain from birth to three months was positively associated with the fasting insulin concentration, HOMA-IR, basal lipid levels and systolic blood pressure at 17 years. There was a differential effect of postnatal weight gain on HOMA-IR in AGA and SGA participants (P for interaction = 0.03. No significant associations were seen between postnatal weight gain and body composition or parameters of glucose metabolism assessed by the simplified intravenous glucose tolerance test. In subgroup analysis, all associations with early infant weight gain were absent in the AGA group, but the associations with basal insulin and HOMA-IR were still present in the SGA group. CONCLUSION: This study suggests that accelerated growth during the first three months of life may confer an increased risk of later metabolic disturbances--particularly of glucose metabolism--in individuals born SGA.

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

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    Yoga Putra

    2013-04-01

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

  11. Indomethacin prophylaxis or expectant treatment of patent ductus arteriosus in extremely low birth weight infants?

    Science.gov (United States)

    Cordero, L; Nankervis, C A; Delooze, D; Giannone, P J

    2007-03-01

    Indomethacin prophylaxis or expectant treatment are common strategies for the prevention or management of symptomatic patent ductus arteriosus (sPDA). To compare the clinical responses of extremely low birth weight (ELBW) infants to indomethacin prophylaxis with that of other infants who were managed expectantly by being treated with indomethacin or surgically only after an sPDA was detected. Retrospective cohort investigation of 167 ELBW infants who received indomethacin prophylaxis (study) and 167 ELBW infants (control) treated expectantly who were matched by year of birth (1999 to 2006), birth weight, gestational age (GA) and gender. Mothers of the two groups of infants were comparable demographically and on the history of preterm labor, pre-eclampsia, antepartum steroids and cesarean delivery. Study and control infants were similar in birth weight, GA, low 5 min Apgar scores, surfactant administration, the need for arterial blood pressure control, bronchopulmonary dysplasia and neonatal mortality. Necrotizing enterocolitis, spontaneous intestinal perforations, intraventricular hemorrhage grade III to IV, periventricular leukomalacia and stage 3 to 5 retinopathy of prematurity occurred also with similar frequency in both groups of infants. In the indomethacin prophylaxis group, 29% of the infants developed sPDA, and of them 38% responded to indomethacin treatment. In the expectantly treated group, 37% developed sPDA, and of them 59% responded to indomethacin treatment. Overall, surgical ligation rate for sPDA was similar between both groups of patients. In our experience, indomethacin prophylaxis does not show any advantages over expectant early treatment on the management of sPDA in ELBW infants. Although no deleterious effects were observed, prophylaxis exposed a significant number of infants who may have never developed sPDA, to potential indomethacin-related complications.

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

    Science.gov (United States)

    Abel, Deborah Marie

    2012-01-01

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

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

    Science.gov (United States)

    Abel, Deborah Marie

    2012-01-01

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

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

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    Morteza Ghojazadeh

    2014-01-01

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

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

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    Amir Mohammad Armanian

    2016-10-01

    Full Text Available Background: Thyroid function disorders, particularly congenital hypothyroidism (CHT, are important endocrine dysfunctions associated with permanent morbidities. CHT is more prevalent among preterm low-birth-weight neonates compared to term infants with normal weight. Methods: This prospective cohort study was conducted on 126 very-low-birth-weight (VLBW neonates referred to the neonatal intensive care units (NICUs of two tertiary referral hospitals affiliated to Isfahan University of Medical Sciences in Isfahan, Iran during 2012-2014. On day five of birth and two, four, and six weeks after birth, blood samples were collected from the infants to determine thyroid function disorders, including transient hypothyroxinemia, neonatal hypothyroidism, transient primary neonatal hypothyroidism, and transient hyperthyrotropinemia. Results: In total, 126 infants with mean gestational age of 30.5±2.29 weeks and mean birth weight of 1246.90±193.58 g were enrolled in this study. Thyroid-stimulating hormone (TSH level of Conclusion: According to the results of this study, thyroid function disorders are relatively common in preterm VLBW neonates, and serum T4 level is correlated with gestational age in these infants. Therefore, thyroid function tests with a consistent protocol are required for premature infants. It is recommended that further research be performed on larger sample sizes to investigate the prevalence of thyroid function disorders in preterm infants.

  16. Sociocultural and Environmental Influences on Brazilian Immigrant Mothers' Beliefs and Practices Related to Child Feeding and Weight Status.

    Science.gov (United States)

    Lindsay, Ana Cristina; Wallington, Sherrie F; Greaney, Mary L; Hasselman, Maria H; Machado, Marcia M T; Mezzavilla, Raquel S; Detro, Barbara M

    2017-05-01

    Background Length of residence in the United States (US), changes in dietary and physical activity behaviors, and economic and social barriers contribute to high childhood obesity rates among children from immigrant families in the US. Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on health issues affecting Brazilian children in immigrant families. Understanding sociocultural and environmental influences on parents' beliefs and practices related to child feeding and weight status is essential to altering obesity trends in this group. Methods Qualitative study consisting of five focus groups with a convenience sample of 29 Brazilian immigrant mothers. Results Analyses revealed that the sociocultural and environment transitions faced by Brazilian immigrant mothers' influence their beliefs and practices related to child feeding and weight status. Additionally, acculturation emerged as a factor affecting mothers' feeding practices and their children's eating habits, with mothers preferring Brazilian food environments and that their children preferring American food environments. Mothers viewed themselves as being responsible for promoting and maintaining their children's healthy eating and feeding behaviors, but changes in their social and cultural environments due to immigration and the pressures and demands of raising a family in a new country make this difficult. Conclusions Health promotion interventions to improve healthful eating and feeding practices of Brazilian children in immigrant families must account for social and cultural changes and daily life demands due to immigration as well as potential variation in the levels of acculturation between mothers and their children.

  17. Effects of maternal and infant characteristics on birth weight and gestation length in a colony of rhesus macaques (Macaca mulatta).

    Science.gov (United States)

    Hopper, Kelly J; Capozzi, Denise K; Newsome, Joseph T

    2008-12-01

    A retrospective study using maternal and birth statistics from an open, captive rhesus macaque colony was done to determine the effects of parity, exposure to simian retrovirus (SRV), housing, maternal parity, and maternal birth weight on infant birth weight, viability and gestation length. Retrospective colony statistics for a 23-y period indicated that birth weight, but not gestation length, differed between genders. Adjusted mean birth weights were higher in nonviable infants. Mothers positive for SRV had shorter gestations, but SRV exposure did not affect neonatal birth weights or viability. Infants born in cages had longer gestations than did those born in pens, but neither birth weight nor viability differed between these groups. Maternal birth weight did not correlate with infant birth weight but positively correlated with gestation length. Parity was correlated with birth weight and decreased viability. Increased parity of the mother was associated with higher birth weight of the infant. A transgenerational trend toward increasing birth weight was noted. The birth statistics of this colony were consistent with those of other macaque colonies. Unlike findings for humans, maternal birth weight had little predictive value for infant outcomes in rhesus macaques. Nonviable rhesus infants had higher birth weights, unlike their human counterparts, perhaps due to gestational diabetes occurring in a sedentary caged population. Similar to the situation for humans, multiparity had a protective effect on infant viability in rhesus macaques.

  18. Polymorphisms in FTO and MAF Genes and Birth Weight, BMI, Ponderal Index, Weight Gain in a Large Cohort of Infants with a Birth Weight below 1500 Grams.

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    Sebastian Haller

    Full Text Available The FTO gene, located on chromosome 16q12.2, and the MAF gene, located on chromosome 16q22-23, were identified as genes harboring common variants with an impact on obesity predisposition. We studied the association of common variants with birth weight, gain of body weight, body mass index (BMI, Ponderal index and relevant neonatal outcomes in a large German cohort of infants with a birth weight below 1500 grams.The single nucleotide polymorphisms rs9939609 (FTO gene and rs1424233 (MAF gene were genotyped using allelic discrimination assays in a prospective multicenter cohort study conducted in 15 neonatal intensive care units in Germany from September 2003 until January 2008. DNA samples were extracted from buccal swabs according to standard protocols.1946 infants were successfully genotyped at FTO and 2149 infants at MAF. Allele frequencies were not significantly different from other European cohorts. The polymorphisms were in Hardy-Weinberg equilibrium. The polymorphisms did not show associations with birth weight, BMI and Ponderal Index at discharge, and weight gain, neither testing for a dominant, additive nor for a recessive model.Since an association of the polymorphisms with weight gain has been demonstrated in multiple populations, the lack of association in a population of preterm infants with regular tube feeding after birth and highly controlled feeding volumes provides evidence for the hypothesis that these polymorphisms affect food intake behavior and hunger rather than metabolism and energy consumption.

  19. Unhealthy maternal lifestyle leads to rapid infant weight gain: prevention of future chronic diseases.

    Science.gov (United States)

    Oyama, Mari; Nakamura, Kazutoshi; Tsuchiya, Yasuo; Yamamoto, Masaharu

    2009-01-01

    Infants' rapid (catch-up) weight gain is associated with later obesity and chronic adult diseases. The aim of this study was to determine maternal and environmental factors related to rapid weight gain at one month and 18 months after full-term birth in Japan. Subjects were 1,524 infants and their mothers who visited the 18-month check-up in Niigata City between October 1, 2007 and September 30, 2008. An anonymous questionnaire elicited information on the infant's weight (at birth, 1 month, and 18 months), sex, feeding method, presence of food allergy, gestational age, and caregiver. Mother's information was height, pre-pregnancy weight, pregnancy weight gain, age at delivery, pregnancy toxicosis, number of daily meals during pregnancy, smoking and drinking habits. Some questionnaire items were obtained from a maternal and child health handbook. Independence of predictors for rapid weight gain (vs. slow or average weight gain), i.e. a score gain of 0.67 SD, during the first month and first 18 months was tested by multiple logistic regression analysis. In the first month, having a meal once or twice daily during pregnancy (P = 0.0016) and daily smoking in pre-pregnancy (P = 0.0175) were associated with rapid weight gain. In the first 18 months, use of daycare (P = 0.0083) and daily drinking in pre-pregnancy (P = 0.0130) were associated with rapid weight gain. We conclude that mother's pre-pregnancy smoking and drinking, dieting during pregnancy, and infant daycare attendance lead to rapid infant weight gain. Controlling these factors may prevent future chronic adult lifestyle-related diseases.

  20. Aquired Cytomegalovirus Infection of Extremely Low Birth Weight Infant

    Directory of Open Access Journals (Sweden)

    Serdar Alan

    2013-12-01

    Full Text Available Breast milk is a major source for acquired cytomegalovirus infection especially in premature infants and acquired CMV infection occurs in infants whose mothers were seropositive for CMV. Although most of mothers of premature infants are seropositive in Turkey, acquired life-threatening breast milk acquired CMV infection was reported occasionally. Treatment of preterm with symptomatic breast milk acquired CMV infection should be done according to the severity of clinical signs. In this report, a preterm case with a diagnosis of breast milk-acquired CMV meningitis and sepsis without multiorgan failure on the 111th day of life, who did not require antiviral therapy was presented and discussed in the context of the acquired CMV literature. In preterm babies, when there is sepsis with no apparent causes, unexplained thrombocytopenia, elevated liver transaminases and direct hyperbilirubinemia acquired CMV infection should be suspected. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2013; 11: 138-41

  1. The effect of glossopexy on weight velocity in infants with Pierre Robin syndrome.

    Science.gov (United States)

    Cozzi, Francesco; Totonelli, Giorgia; Frediani, Simone; Zani, Augusto; Spagnol, Lorna; Cozzi, Denis A

    2008-02-01

    In infants with Pierre Robin syndrome (PRS), mandibular distraction may be more advantageous than glossopexy as it not only relieves oropharyngeal airway obstruction but also reverses body growth retardation. Because no data are available on body weight velocity after glossopexy, we assessed longitudinally the body weight velocity in a cohort of children undergoing glossopexy. The records of 48 infants with PRS undergoing glossopexy after unsuccessful nonoperative treatment between 1981 and 2005 were reviewed. Weight measurements were analyzed at 4 time-points: at birth, on admission for glossopexy, on admission for lysis of lip-tongue adhesion (TLA), and at follow-up. Weight velocity was assessed using Tanner's tables. Adhesion dehiscence occurred in 9 patients (18.7%). Lip-tongue adhesion resolved airway compromise in 36 infants (75%). Release of TLA was accomplished in 34 patients. Data on weight velocity from birth to follow-up (mean, 5.57 +/- 0.59 years) were available for 31 patients. After glossopexy, mean body weight increased from the 9.7 +/- 2.6th to the 17.5 +/- 4.6th percentile (P > .05), whereas mean weight velocity increased from the 19.1 +/- 4.9th to the 74.2 +/- 4.7th percentile (P < .001). No temporal correlation was found between glossopexy and oropharyngeal dysphagia. In infants with PRS, glossopexy is a valid alternative to mandibular distraction because it does not cause decline in body growth.

  2. Maternal BMI, IGF-I Levels, and Birth Weight in African American and White Infants

    Directory of Open Access Journals (Sweden)

    Adriana C. Vidal

    2013-01-01

    Full Text Available At birth, elevated IGF-I levels have been linked to birth weight extremes; high birth weight and low birth weight are risk factors for adult-onset chronic diseases including obesity, cardiovascular disease, and type 2 diabetes. We examined associations between plasma IGF-I levels and birth weight among infants born to African American and White obese and nonobese women. Prepregnancy weight and height were assessed among 251 pregnant women and anthropometric measurements of full term infants (≥37 weeks of gestation were taken at birth. Circulating IGF-I was measured by ELISA in umbilical cord blood plasma. Linear regression models were utilized to examine associations between birth weight and high IGF-I, using the bottom two tertiles as referents. Compared with infants with lower IGF-I levels (≤3rd tertile, those with higher IGF-I levels (>3rd tertile were 130 g heavier at birth, (β-coefficient=230, se=58.0, P=0.0001, after adjusting for gender, race/ethnicity, gestational age, delivery route, maternal BMI and smoking. Stratified analyses suggested that these associations are more pronounced in infants born to African American women and women with BMI ≥30 kg/m2; the cross product term for IGF-I and maternal BMI was statistically significant (P≤0.0004. Our findings suggest that the association between IGF-I levels and birth weight depends more on maternal obesity than African American race/ethnicity.

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

    Directory of Open Access Journals (Sweden)

    Cooper Peter A

    2011-05-01

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

  4. The Development of Nursing Care Services Model for Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Dessie Wanda

    2017-01-01

    Full Text Available Introduction: Low birth weight (LBW infants deal with various problems during transitional period from intra-uterine and extra-uterine because of immature organs’ functions. This leads to LBW as the second death cause in Indonesia, particularly in the fi rst seventh days of infants’ lifes. The problem continues to occur at home when the infants have discharged. This research was aimed to develop the nursing care services model for LBW infants and to test the model. Method: The research design was an action research using quantitative and qualitative approach. This design was chosen as it facilitated improvement in health care system, which was involving nurses and other health providers. Results: Nursing care services provided by the nursing team are hindered by several factors, such as various level of nurses’ knowledge, not optimal health education activities, incomplete standard operational procedure, ethical dilemma, paramedic functions, and documentation system. This model was developed based on conservation and becoming a mother/maternal role attainment theory, family-centered care principles, and input from the experts through focus group discussion. Discussion: The result of this research is going to increase the quality of nursing care for LBW infants by achieving nurses’ and parents’ satisfaction in giving care for their infants which can lead to lower infant death rate.Key words: Model, Low birth weight infant, Nursing services, Action research

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Fatih Aygün

    2012-04-01

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

  7. Effect of Nutrition Education by Paraprofessionals on Dietary Intake, Maternal Weight Gain, and Infant Birth Weight in Pregnant Native American and Caucasian Adolescents.

    Science.gov (United States)

    Hermann, Janice; Williams, Glenna; Hunt, Donna

    2001-01-01

    Evaluation of nutrition instruction provided to 366 pregnant Native American and Caucasian teens by paraprofessionals determined that it effectively improved their dietary intake, maternal weight gain, and infant birth weight. Further modifications for Native Americans were suggested. (SK)

  8. Role of lipooligosaccharide in virulence of the Brazilian purpuric fever clone of Haemophilus influenzae biogroup aegyptius for infant rats.

    Science.gov (United States)

    Rubin, L G; St Geme, J W

    1993-02-01

    Clonally related strains of Haemophilus influenzae biogroup aegyptius have recently been associated with Brazilian purpuric fever (BPF), a fulminant, systemic disease in children. Using an infant rat bacteremia model for BPF, we found that a rat blood-passaged BPF isolate of H. influenzae biogroup aegyptius was more virulent than the original strain was. When compared with the original strain, the animal-passaged variant was found to display an altered lipooligosaccharide (LOS) phenotype and to lack pili. To examine the role of LOS phenotype and pili in virulence, we isolated isogenic variants differing in LOS phenotype or expression of pili. The virulence of variants was compared by examining the results of blood cultures obtained 24 h after intraperitoneal inoculation with 10(5) CFU. Our results indicate that the LOS phenotype is a critical determinant of BPF clone virulence for infant rats. To a lesser extent, the absence of piliation and an undefined additional factor(s) contribute to virulence.

  9. [Sampling plan, weighting process and design effects of the Brazilian Oral Health Survey].

    Science.gov (United States)

    Silva, Nilza Nunes da; Roncalli, Angelo Giuseppe

    2013-12-01

    To present aspects of the sampling plan of the Brazilian Oral Health Survey (SBBrasil Project). with theoretical and operational issues that should be taken into account in the primary data analyses. The studied population was composed of five demographic groups from urban areas of Brazil in 2010. Two and three stage cluster sampling was used. adopting different primary units. Sample weighting and design effects (deff) were used to evaluate sample consistency. In total. 37,519 individuals were reached. Although the majority of deff estimates were acceptable. some domains showed distortions. The majority (90%) of the samples showed results in concordance with the precision proposed in the sampling plan. The measures to prevent losses and the effects the cluster sampling process in the minimum sample sizes proved to be effective for the deff. which did not exceeded 2. even for results derived from weighting. The samples achieved in the SBBrasil 2010 survey were close to the main proposals for accuracy of the design. Some probabilities proved to be unequal among the primary units of the same domain. Users of this database should bear this in mind, introducing sample weighting in calculations of point estimates, standard errors, confidence intervals and design effects.

  10. Green teeth are a late complication of prolonged conjugated hyperbilirubinemia in extremely low birth weight infants.

    Science.gov (United States)

    Battineni, Sireesha; Clarke, Paul

    2012-01-01

    Eruption of green, discolored teeth affecting the primary dentition has been described in association with congenital viral infection, sepsis, hemolytic jaundice, and cholestasis. The purpose of this paper was to present the cases of 3 extremely low birth weight preterm infants who were noted to have green teeth at the corrected ages of 10 to 12 months. All had a history of prolonged conjugated hyperbilirubinemia during their time in neonatal intensive care. For infants with prolonged conjugated hyperbilirubinemia, extreme preterm birth and/or extremely low birth weight may be additional risk factors predisposing to the eruption of green teeth in later infancy.

  11. The effect of kangaroo mother care on mental health of mothers with low birth weight infants

    Directory of Open Access Journals (Sweden)

    Zohreh Badiee

    2014-01-01

    Full Text Available Background: The mothers of premature infants are at risk of psychological stress because of separation from their infants. One of the methods influencing the maternal mental health in the postpartum period is kangaroo mother care (KMC. This study was conducted to evaluate the effect of KMC of low birth weight infants on their maternal mental health. Materials and Methods: The study was conducted in the Department of Pediatrics of Isfahan University of Medical Sciences, Isfahan, Iran. Premature infants were randomly allocated into two groups. The control group received standard caring in the incubator. In the experimental group, caring with three sessions of 60 min KMC daily for 1 week was practiced. Mental health scores of the mothers were evaluated by using the 28-item General Health Questionnaire. Statistical analysis was performed by the analysis of covariance using SPSS. Results: The scores of 50 infant-mother pairs were analyzed totally (25 in KMC group and 25 in standard care group. Results of covariance analysis showed the positive effects of KMC on the rate of maternal mental health scores. There were statistically significant differences between the mean scores of the experimental group and control subjects in the posttest period (P < 0.001. Conclusion: KMC for low birth weight infants is a safe way to improve maternal mental health. Therefore, it is suggested as a useful method that can be recommended for improving the mental health of mothers.

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

    Science.gov (United States)

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

    2012-04-01

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

  13. The Influence of Family Empowerment on the Health Status of Low Birth Weight Infant in Jakarta

    Directory of Open Access Journals (Sweden)

    Yeni Rustina

    2014-04-01

    Full Text Available Low birth weight (LBW infant is susceptible to health problems since the infant born, during in the hospital and continue after discharge. The purpose of this study was to identify the influence of family empowerment on the health status of LBW infant. Action research using qualitative and quantitative method was used in this study. Qualitative approach was used to identify the experience of mothers of LBW infants as a data based for intervention development, and quantitative approach was used to evaluate the influence of family empowerment program on the health status of LBW infants. There were 7 participants, 20 mothers and their infants in the intervention group and 27 in the control group involved in this study. The study showed that family empowerment was effective in improving the immunization status and follow- up care attendance, reducing the frequency of acute care visits, increasing mothers' knowledge and skill in providing care. In conclusion, mothers need information on providing a proper care for LBW, and family empowerment can significantly improve maternal knowledge and health status of LBW infants.

  14. Comparative Effect of Massage Therapy versus Kangaroo Mother Care on Body Weight and Length of Hospital Stay in Low Birth Weight Preterm Infants.

    Science.gov (United States)

    Rangey, Priya Singh; Sheth, Megha

    2014-01-01

    Background. Massage therapy (MT) and kangaroo mother care (KMC) are both effective in increasing the weight and reducing length of hospital stay in low birth weight preterm infants but they have not been compared. Aim. Comparison of effectiveness of MT and KMC on body weight and length of hospital stay in low birth weight preterm (LBWPT) infants. Method. 30 LBWPT infants using convenience sampling from Neonatal Intensive Care Unit, V.S. hospital, were randomly divided into 2 equal groups. Group 1 received MT and Group 2 received KMC for 15 minutes, thrice daily for 5 days. Medically stable babies with gestational age Limitation. Long term follow-up was not taken.

  15. Low birth weight of Vietnamese infants is related to their mother's dioxin and glucocorticoid levels.

    Science.gov (United States)

    Van Tung, Dao; Kido, Teruhiko; Honma, Seijiro; Manh, Ho Dung; Nhu, Dang Duc; Okamoto, Rie; Maruzeni, Shoko; Nishijo, Muneko; Nakagawa, Hideaki; Ngoc, Pham Thien; Van Toan, Ngo; Hung, Nguyen Ngoc; Minh, Nguyen Hung; Son, Le Ke

    2016-06-01

    We aimed to determine the relationship between dioxin congeners in maternal breast milk and maternal glucocorticoid levels with newborn birth weight after nearly 45 years of use of herbicides in the Vietnam War. The study subjects comprised 58 mother-infant pairs in a region with high dioxin levels in the soil (hotspot) and 62 pairs from a control region. Dioxin levels in maternal breast milk were measured by HRGC-HRMS. Salivary glucocorticoid levels were determined by LC-MS/MS. Dioxin congener levels in mothers from the hotspot were found to be two to fivefold higher than those in mothers from the control region. Birth weight was inversely correlated with 2,3,7,8-TeCDD and 2,3,4,7,8-PeCDF congener levels. The rate of newborns whose birth weight was less than 2500 g was threefold higher in the hotspot (12 %) than in the control region (4 %). Salivary glucocorticoid levels in mothers with low birth weight infants were significantly higher than those in the normal birth weight group. Low birth weight of Vietnamese newborns in a hotspot for dioxin levels is related to some dioxin congener levels and high glucocorticoid levels in mothers. This finding in mother-infant pairs suggests that excess maternal glucocorticoid levels are related to dioxin burden and they result in low birth weight.

  16. Brazilian infant motor and cognitive development: Longitudinal influence of risk factors.

    Science.gov (United States)

    Pereira, Keila Rg; Valentini, Nadia C; Saccani, Raquel

    2016-12-01

    Infant developmental delays have been associated with several risk factors, such as familial environmental, individual and demographic characteristics. The goal of this study was to longitudinally investigate the effects of maternal knowledge and practices, home environment and biological factors on infant motor and cognitive outcomes. This was a prospective cohort study with a sample of 49 infants from Southern Brazil. The infants were assessed three times over 4 months using the Alberta Infant Motor Scale and the Bayley Scale of Infant Development (Mental Development Scale). Parents completed the Daily Activities Scale of Infants, the Affordances in The Home Environment for Motor Development - Infant Scale, the Knowledge of Infant Development Inventory and a demographic questionnaire. Generalized estimating equation with Bonferroni method as the follow-up test and Spearman correlation and multivariate linear backward regression were used. Cognitive and motor scores were strongly associated longitudinally and increased over time. Associations between the home affordances, parental practices and knowledge, and motor and cognitive development over time were observed. This relationship explained more variability in motor and cognitive scores compared with biological factors. Variability in motor and cognitive development is better explained by environment and parental knowledge and practice. The investigation of factors associated with infant development allows the identification of infants at risk and the implementation of educational programs and parental training to minimize the effects of developmental delay. © 2016 Japan Pediatric Society.

  17. The Effect of an Increased Minimum Wage on Infant Mortality and Birth Weight.

    Science.gov (United States)

    Komro, Kelli A; Livingston, Melvin D; Markowitz, Sara; Wagenaar, Alexander C

    2016-08-01

    To investigate the effects of state minimum wage laws on low birth weight and infant mortality in the United States. We estimated the effects of state-level minimum wage laws using a difference-in-differences approach on rates of low birth weight (minimum wage above the federal level was associated with a 1% to 2% decrease in low birth weight births and a 4% decrease in postneonatal mortality. If all states in 2014 had increased their minimum wages by 1 dollar, there would likely have been 2790 fewer low birth weight births and 518 fewer postneonatal deaths for the year.

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

    Science.gov (United States)

    Groothuis, Jessie R; Makari, Doris

    2012-04-01

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

  19. Risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants

    Directory of Open Access Journals (Sweden)

    M.K. Çaglar

    2006-04-01

    Full Text Available Data were prospectively obtained from exclusively breast-fed healthy term neonates at birth and from healthy mothers with no obstetric complication to determine risk factors for excess weight loss and hypernatremia in exclusively breast-fed infants. Thirty-four neonates with a weight loss > or = 10% were diagnosed between April 2001 and January 2005. Six of 18 infants who were eligible for the study had hypernatremia. Breast conditions associated with breast-feeding difficulties (P < 0.05, primiparity (P < 0.005, less than four stools (P < 0.001, pink diaper (P < 0.001, delay at initiation of first breast giving (P < 0.01, birth by cesarean section (P < 0.05, extra heater usage (P < 0.005, extra heater usage among mothers who had appropriate conditions associated with breast-feeding (P < 0.001, mean weight loss in neonates with pink diaper (P < 0.05, mean uric acid concentration in neonates with pink diaper (P < 0.0001, fever in hypernatremic neonates (P < 0.02, and the correlation of weight loss with both serum sodium and uric acid concentrations (P < 0.02 were determined. Excessive weight loss occurs in exclusively breast-fed infants and can be complicated by hypernatremia and other morbidities. Prompt initiation of breast-feeding after delivery and prompt intervention if problems occur with breast-feeding, in particular poor breast attachment, breast engorgement, delayed breast milk "coming in", and nipple problems will help promote successful breast-feeding. Careful follow-up of breast-feeding dyads after discharge from hospital, especially regarding infant weight, is important to help detect inadequate breast-feeding. Environmental factors such as heaters may exacerbate infant dehydration.

  20. Additional Protein Fortification Is Necessary in Extremely Low-Birth-Weight Infants Fed Human Milk.

    Science.gov (United States)

    Picaud, Jean-Charles; Houeto, Nellie; Buffin, Rachel; Loys, Claire-Marie; Godbert, Isabelle; Haÿs, Stephane

    2016-07-01

    In the present study, approximately one in three (49/152, 32.2%) extremely low-birth-weight infants were demonstrated to require additional protein intake to supplement the standard fortification to achieve satisfactory weight gain. This additional protein fortification also resulted in a rapid increase in length-for-age (P < 0.001) and head circumference-for-age (P = 0.02) z scores.

  1. Low birth weight and fetal anaemia as risk factors for infant morbidity ...

    African Journals Online (AJOL)

    Low birth weight (LBW) and fetal anaemia (FA) are common in malaria ... been related to malaria in pregnancy7-9, it is important to establish their ... Laboratory investigations. Maternal ... of age, for older infants, a cut-off value of 50 per minute ..... from maternal iron deficiency anaemia and dense placental .... Changes in the.

  2. Effect of Body Weight on Temperature Control and Energy Expenditure in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Tzu-Hui Lei

    2010-06-01

    Conclusion: REE increased significantly in infants during weaning from an incubator. The increase in REE increment was similar in smaller (1800–2000 g and larger (2000–2200 g babies in this study. Weaning of preterm babies from an incubator may be safely started when their body weight reaches 1800 g.

  3. Relation between birth weight and blood pressure: longitudinal study of infants and children

    NARCIS (Netherlands)

    L.J. Launer (Lenore); D.E. Grobbee (Diederick); A. Hofman (Albert)

    1993-01-01

    textabstractOBJECTIVE--To study the relation between birth weight and systolic blood pressure in infancy and early childhood. DESIGN--Longitudinal study of infants from birth to 4 years of age. SETTING--A middle class community in the Netherlands. PARTICIPANTS--476

  4. morbidity and mortality of low birth weight infants in the new born ...

    African Journals Online (AJOL)

    hi-tech

    2004-07-01

    Jul 1, 2004 ... weight infants only has 10% of the world's resources for their care. ... Data management: The data was entered in a computer and .... As an example, of the 163 .... resolve the issue so as to determine the significant ..... racial and ethnic specific rates for the health status indicators. ... Malaysia very low birth.

  5. Serum magnesium in the first week of life in extremely low birth weight infants.

    LENUS (Irish Health Repository)

    Noone, D

    2012-01-01

    Evidence that antenatal administration of magnesium sulfate (MgSO(4)) to women in preterm labor may confer fetal neuroprotection is growing. MgSO(4) crosses the placenta and can affect the neonate. Magnesium homeostasis in extremely low birth weight (ELBW) infants remains to be clarified.

  6. Long-chain polyunsaturated fatty acid status and early growth of low birth weight infants

    NARCIS (Netherlands)

    Woltil, HA; van Beusekom, CM; Schaafsma, A; Muskiet, FAJ; Okken, A

    1998-01-01

    We correlated arachidonic acid (AA) and docosahexaenoic acid (DHA) status with anthropometric measures and growth rates in a group of low birth weight infants (less than or equal to 2500 g; gestational ages 30-41 weeks; n = 143). AA and DHA status were measured in erythrocytes (RBC) and plasma chole

  7. Infant orthopedics in UCLP: effect on feeding, weight, and length: a randomized clinical trial (Dutchcleft).

    NARCIS (Netherlands)

    Prahl, C.; Kuijpers-Jagtman, A.M.; Hof, M.A. van 't; Prahl-Andersen, B.

    2005-01-01

    OBJECTIVE: To study the effects of infant orthopedics (IO) on feeding, weight, and length. DESIGN: Prospective two-arm randomized controlled trial in three academic Cleft Palate Centers. Treatment allocation was concealed and performed by means of a computerized balanced allocation method. SETTING:

  8. Relation between birth weight and blood pressure: longitudinal study of infants and children

    NARCIS (Netherlands)

    L.J. Launer (Lenore); D.E. Grobbee (Diederick); A. Hofman (Albert)

    1993-01-01

    textabstractOBJECTIVE--To study the relation between birth weight and systolic blood pressure in infancy and early childhood. DESIGN--Longitudinal study of infants from birth to 4 years of age. SETTING--A middle class community in the Netherlands. PARTICIPANTS--476 Dutc

  9. Low birth weight infants and Calmette-Guérin bacillus vaccination at birth

    DEFF Research Database (Denmark)

    Roth, Adam Anders Edvin; Jensen, Henrik; Garly, May-Lill

    2004-01-01

    In developing countries, low birth weight (LBW) children are often not vaccinated with Calmette-Guérin bacillus (BCG) at birth. Recent studies have suggested that BCG may have a nonspecific beneficial effect on infant mortality. We evaluated the consequences of not vaccinating LBW children at birth...

  10. Gluconeogenesis is Not Regulated by Either Glucose or Insulin in Extremely Low Birth Weight Infants Receiving Total Parenteral Nutrition

    NARCIS (Netherlands)

    Chacko, Shaji K.; Ordonez, Jorge; Sauer, Pieter J. J.; Sunehag, Agneta L.

    2011-01-01

    Objective To determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition. Study design Seven infants (birth weight, 0.824 +/- 0.068 kg; gestational age, 25.4 +/- 0.5 weeks; postnatal age, 3.3 +/- 0.2 days) were studied for 1

  11. Comparison of caloric intake and weight outcomes of an ad lib feeding regimen for preterm infants in two nurseries.

    Science.gov (United States)

    Pridham, K F; Kosorok, M R; Greer, F; Kayata, S; Bhattacharya, A; Grunwald, P

    2001-09-01

    Effects on caloric intake and weight gain of an ad libitum (ad lib) feeding regimen for preterm infants may be specific to a special care nursery. To explore across two nurseries the similarity of effect on caloric intake and weight gain of an ad lib feeding regimen compared with a prescribed regimen and the similarity of effect of caloric intake on weight gain. All infants participating in the multi-site randomized clinical trial (RCT) of the ad lib feeding regimen were lib. After accounting for caloric intake, the ad lib regimen did not affect weight gain. The time-by-regimen interaction effect on caloric intake was significant in both nurseries. Caloric intake for infants fed ad lib increased significantly over 5 days. Despite differences between nurseries in infant characteristics and in protocol implementation, the feeding regimen effect was consistent for caloric intake and weight gain. Further support was found for the development of infant self-regulatory capacity.

  12. Influence of Additional Ankle Weights on Kinematic Variables of Late Preterm Infants Aged 3-4 Months.

    Science.gov (United States)

    Dionisio, Jadiane; Santos, Gabriela Lopes Dos; Tudella, Eloisa

    2017-01-01

    The authors analyzed and compared the effect of additional weight on the spatiotemporal parameters of the kicking movement of late preterm and full-term infants. The experiment was divided into 4 conditions: training, baseline, weight, and postweight. In the W condition, a weight of one third the lower limb mass was added to the infant's ankle. During the baseline and postweight conditions, the ankle weight was removed. Late preterm infants do not differ from full-term infants in relation to spatiotemporal variables at 3 and 4 months. However, during the weight condition, the straightness index and the hip-ankle and knee-ankle correlations decreased in the preterm infants at both ages. In contrast, the straightness index increased in the postweight condition compared to the baseline values at both ages.

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

    Directory of Open Access Journals (Sweden)

    Tahereh Larijani

    2007-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Elin W. Blakstad

    2016-12-01

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

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

    Science.gov (United States)

    Campfield, T; Braden, G

    1989-11-01

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

  16. Twelve-month-old infants anticipatorily plan their actions according to expected object weight in a novel motor context.

    Science.gov (United States)

    Upshaw, Michaela Boone; Sommerville, Jessica A

    2015-01-01

    Planning actions in anticipation of object weight is fundamental to skilled action production. The present study investigated whether infants can apply weight information gained from direct actions on objects in order to plan their actions according to object weight in a novel and indirect motor context. In the present study, two groups of 12-month-old infants were provided with experience acting directly on two blocks of different weights and colors (70 versus 470 g; red versus yellow). Subsequently, infants were administered a novel task in which the same blocks (standard condition; n = 60), or blocks of the reversed color-weight pairings (switch condition; n = 60), were placed out-of-reach, on top of a cloth, and infants were encouraged to retrieve the block by acting on the cloth. Infants in the switch condition produced more failed cloth pulls when retrieving the 470 g block, due to inadequate generation of anticipatory force, relative to infants in the standard condition. This demonstrates that infants' force on the cloth was prospectively generated based on their mental representation of the supported block's weight, which was formed through their previous direct actions on the object. Thus, infants use information about the weight of an object in order to anticipate how to obtain that object in a novel and indirect problem-solving context.

  17. Educational Intervention to Modify Bottle-Feeding Behaviors among Formula-Feeding Mothers in the WIC Program: Impact on Infant Formula Intake and Weight Gain

    Science.gov (United States)

    Kavanagh, Katherine F.; Cohen, Roberta J.; Heinig, M. Jane; Dewey, Kathryn G.

    2008-01-01

    Objective: Formula-fed infants gain weight faster than breastfed infants. This study evaluated whether encouraging formula-feeding caregivers to be sensitive to infant satiety cues would alter feeding practices and reduce infant formula intake and weight gain. Design: Double-blind, randomized educational intervention, with intake and growth…

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

    Science.gov (United States)

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

    2015-03-01

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

  19. Beyond bacteria: a study of the enteric microbial consortium in extremely low birth weight infants.

    Directory of Open Access Journals (Sweden)

    Mariam Susan LaTuga

    Full Text Available Extremely low birth weight (ELBW infants have high morbidity and mortality, frequently due to invasive infections from bacteria, fungi, and viruses. The microbial communities present in the gastrointestinal tracts of preterm infants may serve as a reservoir for invasive organisms and remain poorly characterized. We used deep pyrosequencing to examine the gut-associated microbiome of 11 ELBW infants in the first postnatal month, with a first time determination of the eukaryote microbiota such as fungi and nematodes, including bacteria and viruses that have not been previously described. Among the fungi observed, Candida sp. and Clavispora sp. dominated the sequences, but a range of environmental molds were also observed. Surprisingly, seventy-one percent of the infant fecal samples tested contained ribosomal sequences corresponding to the parasitic organism Trichinella. Ribosomal DNA sequences for the roundworm symbiont Xenorhabdus accompanied these sequences in the infant with the greatest proportion of Trichinella sequences. When examining ribosomal DNA sequences in aggregate, Enterobacteriales, Pseudomonas, Staphylococcus, and Enterococcus were the most abundant bacterial taxa in a low diversity bacterial community (mean Shannon-Weaver Index of 1.02 ± 0.69, with relatively little change within individual infants through time. To supplement the ribosomal sequence data, shotgun sequencing was performed on DNA from multiple displacement amplification (MDA of total fecal genomic DNA from two infants. In addition to the organisms mentioned previously, the metagenome also revealed sequences for gram positive and gram negative bacteriophages, as well as human adenovirus C. Together, these data reveal surprising eukaryotic and viral microbial diversity in ELBW enteric microbiota dominated bytypes of bacteria known to cause invasive disease in these infants.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  2. Growth of preterm low birth weight infants until 24 months corrected age: effect of maternal hypertension.

    Science.gov (United States)

    Kiy, Alice M; Rugolo, Ligia M S S; Luca, Ana K C De; Corrente, José E

    2015-01-01

    To evaluate the growth pattern of low birth weight preterm infants born to hypertensive mothers, the occurrence of growth disorders, and risk factors for inadequate growth at 24 months of corrected age (CA). Cohort study of preterm low birth weight infants followed until 24 months CA, in a university hospital between January 2009 and December 2010. gestational age < 37 weeks and birth weight of 1,500-2,499 g. multiple pregnancies, major congenital anomalies, and loss to follow up in the 2nd year of life. The following were evaluated: weight, length, and BMI. growth failure and risk of overweight at 0, 12, and 24 months CA. Student's t-test, Repeated measures ANOVA (RM-ANOVA), and multiple logistic regression were used. A total of 80 preterm low birth weight infants born to hypertensive mothers and 101 born to normotensive mothers were studied. There was a higher risk of overweight in children of hypertensive mothers at 24 months; however, maternal hypertension was not a risk factor for inadequate growth. Logistic regression showed that being born small for gestational age and inadequate growth in the first 12 months of life were associated with poorer growth at 24 months. Preterm low birth weight born infants to hypertensive mothers have an increased risk of overweight at 24 months CA. Being born small for gestational age and inadequate growth in the 1st year of life are risk factors for growth disorders at 24 months CA. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  3. Socio-economic and environmental factors influence energy utilization in Brazilian breast-fed infants

    NARCIS (Netherlands)

    Haisma, Hinke; Coward, W. Andrew; Visser, G. Henk; Vonk, Roel; Wells, Jonathan C. K.; Wright, A.; Victora, Cesar G.

    2006-01-01

    Energy intake recommendations for infants are based on data from industrialized countries. FAO/WHO/UNU expressed the need for studies on total energy expenditure (TEE) and basal metabolic rate from developing countries covering current and changing lifestyles. For this observational study, 65 infant

  4. Socio-economic and environmental factors influence energy utilization in Brazilian breast-fed infants

    NARCIS (Netherlands)

    Haisma, Hinke; Coward, W. Andrew; Visser, G. Henk; Vonk, Roel; Wells, Jonathan C. K.; Wright, A.; Victora, Cesar G.

    2006-01-01

    Energy intake recommendations for infants are based on data from industrialized countries. FAO/WHO/UNU expressed the need for studies on total energy expenditure (TEE) and basal metabolic rate from developing countries covering current and changing lifestyles. For this observational study, 65 infant

  5. TP53 gene polymorphism: Importance to cancer, ethnicity and birth weight in a Brazilian cohort

    Indian Academy of Sciences (India)

    Helena S Thurow; Ricardo Haack; Fernando P Hartwig; Isabel Ode Oliveira; Odir A Dellagostin; Denise P Gigante; Bernardo L Horta; Tiago Collares; Fabiana K Seixas

    2011-12-01

    Arg72Pro SNP of p53 has been associated with many types of cancer as well as with survival and longevity. We evaluated the Arg72Pro SNP frequencies of a Brazilian birth cohort and their association with current, demographic and birth epidemiological parameters available. In 1982, all hospital births of Pelotas, southern Brazil, were identified and studied prospectively. In 2004–5, blood samples were collected and DNA extracted. PCR-RFLP was used to genotype the Arg72Pro SNP in 3794 individual samples of the Brazil birth cohort and DNA sequencing was performed to confirm the genotypes. The genotype distribution, which was in Hardy–Weinberg equilibrium, showed a predominance of the arginine amino acid with a frequency of 46.9% Arg/Arg, 42.2% Arg/Pro and 10.9% Pro/Pro. The allele frequency was 0.68 of Arginine and 0.32 of Proline. The Arg72Pro SNP genotype and allelic frequency were related to skin colour where proline amino acid was observed more among black subjects, while arginine amino acid was observed more among white subjects. The individuals without family history of cancer and those with low birth weight were associated with arginine amino acid. The Arg72Pro SNP was strongly associated with important epidemiological variables confirming that genetic profiles on cohort studies can improve our understanding of the susceptibility of diseases and its risk factors.

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

    Science.gov (United States)

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

    2017-01-01

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

  7. Maternal prepregnant body mass index, duration of breastfeeding, and timing of complementary food introduction are associated with infant weight gain

    DEFF Research Database (Denmark)

    Baker, Jennifer Lyn; Michaelsen, Kim F; Rasmussen, Kathleen M;

    2004-01-01

    later in life. OBJECTIVE: We examined how maternal prepregnant body mass index (BMI; in kg/m2) and infant feeding pattern are associated with infant weight gain. DESIGN: In this prospective, observational study, we used multiple regression analyses adjusted for potential confounding factors to examine...... these associations among 3768 mother-infant dyads from the Danish National Birth Cohort. RESULTS: In multiple regression analyses, increasing maternal prepregnant BMI, decreasing durations of breastfeeding, and earlier complementary food introduction were associated with increased infant weight gain. An interaction......). In this sample, prepregnant obesity (BMI > or = 30.0), short durations of breastfeeding, and earlier introduction of complementary food were associated with 0.7 kg of additional weight gain during infancy. CONCLUSIONS: Infant weight gain is associated with maternal prepregnant BMI and with an interaction between...

  8. An extremely low body weight infant born to a mother with measles.

    Science.gov (United States)

    Go, H; Hashimoto, K; Imamura, T; Sato, M; Kawasaki, Y; Momoi, N; Hosoya, M

    2010-02-01

    The incidence of measles epidemics has decreased recently owing to the development and widespread use of measles vaccine in the United States of America and Europe. However, repeated measles epidemics have been reported in Japan. Here, the authors report a case of an extremely low body weight infant (ELBWI) whose mother had a measles virus infection. Real-time PCR was performed on the infant's blood and urine samples and skin, nasal secretion, and anal swabs, as well as on the mother's breast milk, blood samples and throat swabs. The infant was found to be positive for measles virus by PCR, but not immunoglobulin M positive. An earlier report showed that there were no such cases in which the patient was found to be positive for measles virus by real-time PCR but was not infected by the measles virus.

  9. Late-onset neonatal sepsis in preterm infants with birth weight under 1.500 g

    Directory of Open Access Journals (Sweden)

    Stella Marys Rigatti Silva

    Full Text Available Objective: the research objective was to characterize preterm infants with birth weight under 1500 g, and to identify the incidence of late-onset neonatal sepsis among this population. Methods: a prospective cohort study with a sample of 30 preterm newborns that weighed under 1500 g and were hospitalized in the NICU of the university hospital. Data were collected from January to December 2013 using a structured instrument. Results: of the 30 neonates included in the study, 14 developed late-onset neonatal sepsis with a prevalence of coagulase-negative staphylococci. Conclusions: the incidence of late-onset neonatal sepsis indicates a vulnerability in preterm infants due to immunological immaturity. These results reveal that knowledge of the profile of newborn infants admitted to the NICU and the risk factors to which they are exposed are central to the planning of nursing care for these patients. Future studies should address strategies for preventing nosocomial infection.

  10. [Nutritional dilemmas in extremely low birth weight infants and their effects on childhood, adolescence and adulthood].

    Science.gov (United States)

    Camelo, José Simon; Martinez, Francisco Eulógio

    2005-03-01

    To review the recent medical literature on nutrition of extremely low birth weight infants, focusing on nutritional disorders and their effects on childhood, adolescence and adulthood. An extensive review of the related literature was performed using MEDLINE, the Cochrane Database of Systematic Reviews and the Best Evidence database. There is a growing body of evidence that early nutritional practices may affect short-term growth and development outcome. In addition, these practices may play a role in determining adult health and disease. There is still much to be learned about safe and efficacious nutrient administration in preterm infants; about techniques to assess the effect of different nutritional strategies; and about the long-term effects of these regimens on development outcome, growth and disease. Despite recent progress in neonatal nutrition, there is a lack of basic and clinical research to better define the nutritional requirements of preterm infants and the best way to meet these requirements, avoiding long-term undesirable consequences.

  11. High versus standard volume enteral feeds to promote growth in preterm or low birth weight infants.

    Science.gov (United States)

    Abiramalatha, Thangaraj; Thomas, Niranjan; Gupta, Vijay; Viswanathan, Anand; McGuire, William

    2017-09-12

    Breast milk alone, given at standard recommended volumes (150 to 180 mL/kg/d), is not adequate to meet the protein, energy, and other nutrient requirements of growing preterm or low birth weight infants. One strategy that may be used to address these potential nutrient deficits is to give infants enteral feeds in excess of 200 mL/kg/d ('high-volume' feeds). This approach may increase nutrient uptake and growth rates, but concerns include that high-volume enteral feeds may cause feed intolerance, gastro-oesophageal reflux, aspiration pneumonia, necrotising enterocolitis, or complications related to fluid overload, including patent ductus arteriosus and bronchopulmonary dysplasia. To assess the effect on growth and safety of feeding preterm or low birth weight infants with high (> 200 mL/kg/d) versus standard (≤ 200 mL/kg/d) volume of enteral feeds. Infants in intervention and control groups should have received the same type of milk (breast milk, formula, or both), the same fortification or micronutrient supplements, and the same enteral feeding regimen (bolus, continuous) and rate of feed volume advancement.To conduct subgroup analyses based on type of milk (breast milk vs formula), gestational age or birth weight category of included infants (very preterm or VLBW vs preterm or LBW), presence of intrauterine growth restriction (using birth weight relative to the reference population as a surrogate), and income level of the country in which the trial was conducted (low or middle income vs high income) (see 'Subgroup analysis and investigation of heterogeneity'). We used the Cochrane Neonatal standard search strategy, which included searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2) in the Cochrane Library; MEDLINE (1946 to November 2016); Embase (1974 to November 2016); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to November 2016), as well as conference proceedings, previous reviews, and trial

  12. Optimizing Nutrition in Preterm Low Birth Weight Infants-Consensus Summary.

    Science.gov (United States)

    Kumar, R Kishore; Singhal, Atul; Vaidya, Umesh; Banerjee, Saswata; Anwar, Fahmina; Rao, Shashidhar

    2017-01-01

    Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants. The following were the primary recommendations of the panel: (1) enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter; however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases; (2) early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively; (3) routine use of nasogastric tubes is not advisable; (4) preterm infants can be fed while on ventilator or continuous positive airway pressure; (5) routine evaluation of gastric residuals and abdominal girth should be avoided; (6) expressed breast milk (EBM) is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes; the second choice is donor pasteurized human milk; (7) EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants; (8) standard fortification is effective and safe but does not fulfill the high protein needs; (9) use of targeted and adjustable fortification, where possible, helps provide optimal nutrition; (10) optimizing weight gain in preterm infants prevents long-term cardiovascular complications; (11

  13. Low birth weight in perinatally HIV-exposed uninfected infants: observations in urban settings in Cameroon.

    Directory of Open Access Journals (Sweden)

    Casimir Ledoux Sofeu

    Full Text Available BACKGROUND: The consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG. METHODS: The data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007-2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (-2SD. Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG. RESULTS: Among the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6-6.0, and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001 and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001 than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0-8.1 and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4-0.8 than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3-2.7 and the presence of any disease during pregnancy (aOR: 1.4; 1.0-2.0 were identified as other contributors to SGAG. CONCLUSION: Maternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are

  14. Low Birth Weight in Perinatally HIV-Exposed Uninfected Infants: Observations in Urban Settings in Cameroon

    Science.gov (United States)

    Sofeu, Casimir Ledoux; Warszawski, Josiane; Ateba Ndongo, Francis; Penda, Ida Calixte; Tetang Ndiang, Suzie; Guemkam, Georgette; Makwet, Nicaise; Owona, Félicité; Kfutwah, Anfumbom; Tchendjou, Patrice; Texier, Gaëtan; Tchuente, Maurice; Faye, Albert; Tejiokem, Mathurin Cyrille

    2014-01-01

    Background The consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG) among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG. Methods The data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007–2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (−2SD). Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG. Results Among the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6–6.0), and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001) and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001) than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0–8.1) and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4–0.8) than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3–2.7) and the presence of any disease during pregnancy (aOR: 1.4; 1.0–2.0) were identified as other contributors to SGAG. Conclusion Maternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are

  15. Twelve-month-old infants anticipatorily plan their actions according to expected object weight in a novel motor context

    Directory of Open Access Journals (Sweden)

    Michaela Boone Upshaw

    2015-02-01

    Full Text Available Planning actions in anticipation of object weight is fundamental to skilled action production. The present study investigated whether infants can apply weight information gained from direct actions on objects in order to plan their actions according to object weight in a novel and indirect motor context. In the present study, two groups of 12-month-old infants were provided with experience acting directly on two blocks of different weights and colors (70 g versus 470 g; red versus yellow. Subsequently, infants were administered a novel task in which the same blocks (standard condition; n = 60, or blocks of the reversed color-weight pairings (switch condition; n = 60, were placed out-of-reach, on top of a cloth, and infants were encouraged to retrieve the block by acting on the cloth. Infants in the switch condition produced more failed cloth pulls when retrieving the 470 g block, due to inadequate generation of anticipatory force, relative to infants in the standard condition. This demonstrates that infants’ force on the cloth was prospectively generated based on their mental representation of the supported block’s weight, which was formed through their previous direct actions on the object. Thus, infants use information about the weight of an object in order to anticipate how to obtain that object in a novel and indirect problem-solving context.

  16. Twelve-Month-Old Infants Anticipatorily Plan Their Actions According to Expected Object Weight in a Novel Motor Context

    Science.gov (United States)

    Upshaw, Michaela Boone; Sommerville, Jessica A.

    2015-01-01

    Planning actions in anticipation of object weight is fundamental to skilled action production. The present study investigated whether infants can apply weight information gained from direct actions on objects in order to plan their actions according to object weight in a novel and indirect motor context. In the present study, two groups of 12-month-old infants were provided with experience acting directly on two blocks of different weights and colors (70 versus 470 g; red versus yellow). Subsequently, infants were administered a novel task in which the same blocks (standard condition; n = 60), or blocks of the reversed color–weight pairings (switch condition; n = 60), were placed out-of-reach, on top of a cloth, and infants were encouraged to retrieve the block by acting on the cloth. Infants in the switch condition produced more failed cloth pulls when retrieving the 470 g block, due to inadequate generation of anticipatory force, relative to infants in the standard condition. This demonstrates that infants’ force on the cloth was prospectively generated based on their mental representation of the supported block’s weight, which was formed through their previous direct actions on the object. Thus, infants use information about the weight of an object in order to anticipate how to obtain that object in a novel and indirect problem-solving context. PMID:25756040

  17. Effectiveness of prediction equations in estimating energy expenditure sample of Brazilian and Spanish women with excess body weight

    Directory of Open Access Journals (Sweden)

    Eliane Lopes Rosado

    2014-03-01

    Full Text Available Objective: To assess the adequacy of predictive equations for estimation of energy expenditure (EE, compared with the EE using indirect calorimetry in a sample of Brazilian and Spanish women with excess body weight Methods: It is a cross-sectional study with 92 obese adult women [26 Brazilian -G1- and 66 Spanish - G2- (aged 20-50]. Weight and height were evaluated during fasting for the calculation of body mass index and predictive equations. EE was evaluated using the open-circuit indirect calorimetry with respiratory hood. Results: In G1 and G2, it was found that the estimates obtained by Harris-Benedict, Shofield, FAO/WHO/ ONU and Henry & Rees did not differ from EE using indirect calorimetry, which presented higher values than the equations proposed by Owen, Mifflin-St Jeor and Oxford. For G1 and G2 the predictive equation closest to the value obtained by the indirect calorimetry was the FAO/WHO/ONU (7.9% and 0.46% underestimation, respectively, followed by Harris-Benedict (8.6% and 1.5% underestimation, respectively. Conclusion: The equations proposed by FAO/WHO/ ONU, Harris-Benedict, Shofield and Henry & Rees were adequate to estimate the EE in a sample of Brazilian and Spanish women with excess body weight. The other equations underestimated the EE.

  18. Punctate white matter lesions in infants: new insights using susceptibility-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Niwa, Tetsu [University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, PO Box 85500, Utrecht (Netherlands); Kanagawa Children' s Medical Center, Departments of Radiology, Yokohama (Japan); Vries, Linda S. de; Benders, Manon J.N.L.; Groenendaal, Floris [Wilhelmina Children' s Hospital/University Medical Center Utrecht, Department of Neonatology, KE 04.123.1, PO Box 85090, Utrecht (Netherlands); Takahara, Taro [University Medical Center Utrecht, Department of Radiology, Heidelberglaan 100, PO Box 85500, Utrecht (Netherlands); Nikkels, Peter G.J. [University Medical Center Utrecht, Department of Pathology, Heidelberglaan 100, PO Box 85500, Utrecht (Netherlands)

    2011-09-15

    Punctate white matter lesions (PWML) are recognized with magnetic resonance imaging (MRI) as hypersignal on T1-weighted imaging and hyposignal on T2-weighted imaging. Our aim was to assess how often a hemorrhagic component was present in PWML using susceptibility-weighted imaging (SWI). Seventeen preterm (gestational age, 25-34 weeks) and seven full-term infants (age at MRI, 37-42 weeks) with PWML were included. Seven preterm infants had sequential MRIs. PWML were diagnosed with conventional MRI and compared with SWI, where signal loss is suggestive of hemorrhage. The pattern of associated brain lesions was taken into account, and the percentage of lesions with signal loss on SWI was calculated for each infant. A significantly higher percentage of signal loss on SWI (median, 93.9%) was found among infants with germinal matrix and intraventricular hemorrhage as the primary diagnosis (n = 8) compared to those with a primary diagnosis of white matter injury (n = 14; median, 14.2%; p < 0.01). In the infants with serial MRIs, a reduction in the number of PWML and/or signal loss on SWI was noted at term equivalent age. In the patient who died, cystic lesions, associated with hemorrhage and gliosis, were demonstrated on histology. SWI can distinguish hemorrhagic and non-hemorrhagic PWML. Signal loss on SWI was more common when PWML were associated with an intraventricular hemorrhage. Longitudinal imaging showed a decrease in the number of PWML over time, with some PWML no longer showing signal loss on SWI, suggesting early gliosis. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-12-15

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

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

    Science.gov (United States)

    Topper, W H; Stewart, T P

    1984-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Gaurav Sanghi

    2014-01-01

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

  2. Early BCG vaccine to low-birth-weight infants and the effects on growth in the first year of life

    DEFF Research Database (Denmark)

    Biering-Sørensen, Sofie; Andersen, Andreas; Ravn, Henrik

    2015-01-01

    BACKGROUND: Randomised trials have shown that early Bacille Calmette-Guérin (BCG) vaccine reduces overall neonatal and infant mortality. However, no study has examined how BCG affects growth. We investigated the effect on infant growth of early BCG vaccine given to low-birth-weight (LBW) infants....... METHODS: Two-thousand three hundred forty-three LBW infants were randomly allocated 1:1 to "early BCG" (intervention group) or "late BCG" (current practice). Furthermore, a subgroup (N = 1717) were included in a two-by-two randomised trial in which they were additionally randomised 1:1 to vitamin...... but not among boys (interaction between "early BCG" and sex: weight p = 0.03 and MUAC p = 0.04). This beneficial effect among girls was particularly seen among the largest infants weighing 2.0 kg or more at inclusion. CONCLUSION: Though BCG vaccination is not recommended to be given to LBW infants at birth...

  3. Effect of Kangaroo Mother Care on Growth and Morbidity Pattern in Low Birth Weight Infants

    Directory of Open Access Journals (Sweden)

    Keerti Swarnkar

    2016-01-01

    Full Text Available Background: Kangaroo Mother Care (KMC is dened as skin-to-skin contact between a mother and her newborn baby derived from practical similarities to marsupial care giving, proximately exclusive breastfeeding and early discharge from hospital. This concept was proposed as an alternative to conventional methods of care for low birth weight (LBW infants, and in replication to quandaries of earnest overcrowding in Neonatal Intensive Care Units (NICUs. KMC essentially utilizes the mother as a natural incubator Aim and Objectives: The aim was to assess the feasibility, acceptability and the effectiveness of KMC in LBW infants. It avoids agitation routinely experienced in busy ward. Material and Methods: A pilot open-labeled quasi-randomised clinical trial was conducted in Level III NICU of a teaching institution. 60 newborn infants <2500 g, meeting inclusion criteria were alternatively randomised into two groups: Kangaroo Mother Care (KMC and Conventional Methods of Care (CMC. Kangaroo mother care was practiced with minimum total period of eight hours a day intermittently for the intervention group while the controls remained in incubators or cots. Weight, head circumference, length, morbidity episodes, hospital stay, feeding patterns were monitored for all infants till postmenstrual age of 42 weeks in preterm babies or till a weight of 2500 g is achieved in term SGA babies. Results: The pilot study conrmed that trial processes were efcient, the intervention was acceptable (to mothers and nurses and that the outcome measures were appropriate; KMC babies achieved signicantly better growth at the end of the study (For preterm babies, weight, length and head circumference gain were signicantly higher in the KMC group (weight 19.28±2.9g/day, length 0.99±0.56cm/week and head circumference 0.72±0.07 cm/week than in the CMC group (P <0.001. A signicantly higher number of babies in the CMC group suffered from hypothermia, hypoglycemia, and

  4. Low birth weight and fetal anaemia as risk factors for infant morbidity in rural Malawi.

    Science.gov (United States)

    Kalanda, Boniface; Verhoeff, Francine; le Cessie, Saskia; Brabin, John

    2009-06-01

    Low birth weight (LBW) and fetal anaemia (FA) are common in malaria endemic areas. To investigate the incidence of infectious morbidity in infants in rural Malawi in relation to birth weight and fetal anaemia, a cohort of babies was followed for a year on the basis of LBW (<2500) and FA (cord haemoglobin < 12.5 g/dl). A matched group of normal birth weight (NBW), non-anaemic (NFA) new-borns were enrolled as controls. Morbidity episodes were recorded at 4-weekly intervals and at each extra visit made to a health centre with any illness. Infants in the NBW NFA group experienced an average of 1.15 (95% C.I. 0.99, 1.31), 1.04 (0.89, 1.19), 0.92 (0.73, 1.11) episodes per year of malaria, respiratory infection and diarrhoea respectively. Corresponding values for the LBW FA group were 0.83 (0.5, 1.16), 0.82 (0.5, 1.16) and 0.76 (0.33, 1.19). FA was not associated with a higher incidence of morbidity, but was significantly associated with a shorter time to first illness episode (p = 0.014). LBW was not a significant risk factor for higher morbidity incidence. LBW and FA were not significant risk factors for incidence of illness episodes in infants.

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

    Science.gov (United States)

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

    2017-08-01

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

  6. Development of a Diet Quality Score for Infants and Toddlers and its association with weight

    Science.gov (United States)

    Ríos, Elaine M.; Sinigaglia, Olga; Diaz, Beatriz; Campos, Maribel; Palacios, Cristina

    2017-01-01

    Objective To create a Diet Quality Index Score (DQIS) for infants and toddlers and to assess its relative validity. Design Three DQIS were created (0–5, 8–11 and 12–24 months) based on a validated food frequency questionnaire (FFQ). Nine components were included, scored from 0 (inadequate) to 5 (adequate consumption) based on guidelines for timing of food’s introduction and portion sizes; the component on breastfeeding (Yes/No) was scored (0–15). Infants 6–7 months were excluded as new foods are introduced during this period. The total score (0–55 points) was categorized as Excellent (≥45), Good (35–44), Needs improvement (25–34), and Poor (diets. In infants 8–11 months (n=42), mean DQIS was 36.1±7.7 and most had ‘Good’ diets (47.6%). Among toddlers 12–24 months (n=117), mean DQIS was 25.7±8.0 and most had ‘Poor’ diets (50.4%). There was a trend for a higher odd of Excessive weight in those with ‘Poor’ diets compared to those with ‘Excellent’ diets, after controlling for confounders (OR 2.01; 95% CI: 0.85, 5.18). Conclusions These scores could be used to assess diet quality in infants and toddlers. There was a trend for a higher odd of Excessive weight among those with ‘Poor’ diets. To our knowledge, this is the first algorithm for the assessment of diet quality in infants and toddlers considering intake of each food group and their portion sizes.

  7. Perinatal and infant mortality and low birth weight among residents near cokeworks in Great Britain

    Energy Technology Data Exchange (ETDEWEB)

    Dolk, H.; Pattenden, S.; Vrijheid, M.; Thakrar, B.; Armstrong, B.

    2000-02-01

    With growing evidence of the adverse health effects of air pollution--especially fine particulates--investigators must concentrate on the fetus, neonate, and infant as potentially vulnerable groups. Cokeworks are a major source of smoke and sulfur dioxide. In the current study, the authors investigated whether populations residing near cokeworks had a higher risk of adverse perinatal and infant outcomes. Zones of 7.5-km radius around 22 cokeworks in Great Britain were studied, within which the authors assumed that exposure declined from highest levels within 2 km to background levels. Routinely recorded birth and death data for Great Britain during the period 1981--1992 were analyzed. Each individual record had a postcode that referred to a small geographical area of typically 15--17 addresses. The authors calculated expected numbers on the basis of regional rates, stratified by year, sex, and a small-area socio-economic deprivation score. For all cokeworks combined, the observed/expected ratio within 2 km of cokeworks was 1.00 for low-birth-weight infants; 0.94 for still births; 0.95 for infant mortality; 0.86 for neonatal mortality; 1.10 for postneonatal mortality; 0.79 for respiratory postneonatal mortality; and 1.07 for postneonatal Sudden Infant Death Syndrome. Respiratory postneonatal mortality was low throughout the entire 0--7.5-km study area. There was no statistically significant decline in risk with distance from cokeworks for any of the outcomes studied. The authors concluded that there was no evidence of an increased risk of low birth weight, stillbirths, and/or neonatal mortality near cokeworks, and there was no strong evidence for any association between residence near cokeworks and postneonatal mortality. One must remember, however, the limited statistical power of the study to detect small risks.

  8. Blood Reference Intervals for Preterm Low-Birth-Weight Infants: A Multicenter Cohort Study in Japan

    Science.gov (United States)

    Inoue, Hirosuke; Kusuda, Takeshi; Kang, Dongchon; Ichihara, Kiyoshi; Nakashima, Naoki; Ihara, Kenji; Ohga, Shouichi; Hara, Toshiro

    2016-01-01

    Preterm low-birth-weight infants remain difficult to manage based on adequate laboratory tests. The aim of this study was to establish blood reference intervals (RIs) in those newborns who were admitted to and survived in the neonatal intensive care unit (NICU). A multicenter prospective study was conducted among all infants admitted to 11 affiliated NICUs from 2010 to 2013. The clinical information and laboratory data were registered in a network database designed for this study. The RIs for 26 items were derived using the parametric method after applying the latent abnormal values exclusion method. The influence of birth weight (BW) and gestational age (GA) on the test results was expressed in terms of the standard deviation ratio (SDR), as SDRBW and SDRGA, respectively. A total of 3189 infants were admitted during the study period; 246 were excluded due to a lack of blood sampling data, and 234 were excluded for chromosomal abnormalities (n = 108), congenital anomalies requiring treatment with surgical procedures (n = 76), and death or transfer to another hospital (n = 50). As a result, 2709 infants were enrolled in this study. Both the SDRGA and SDRBW were above 0.4 in the test results for total protein (TP), albumin (ALB), alanine aminotransferase (ALT), and red blood cells (RBC); their values increased in proportion to the BW and GA. We derived 26 blood RIs for infants who were admitted to NICUs. These RIs should help in the performance of proper clinical assessments and research in the field of perinatal-neonatal medicine. PMID:27552225

  9. Changes in Survival and Neonatal Morbidity in Infants with a Birth Weight of 750 g or Less

    NARCIS (Netherlands)

    Claas, M. J.; Bruinse, H. W.; van der Heide-Jalving, M.; Termote, J. U. M.; de Vries, L. S.

    2010-01-01

    Background: Improvement in perinatal and neonatal care has resulted in increased survival of extremely low birth weight (ELBW) infants. Objectives: To describe survival and neonatal morbidity in a cohort of ELBW infants, to compare two consecutive 5-year periods, and compare appropriate (AGA) with s

  10. Randomised trial of continuous nasogastric, bolus nasogastric, and transpyloric feeding in infants of birth weight under 1400 g.

    Science.gov (United States)

    Macdonald, P D; Skeoch, C H; Carse, H; Dryburgh, F; Alroomi, L G; Galea, P; Gettinby, G

    1992-04-01

    Forty three infants under 1400 g were fed by a bolus nasogastric, continuous nasogastric, or transpyloric route. There were more complications with transpyloric feeding and no identifiable benefits in the growth rate, oral energy input, or chosen biochemical indices of nutrition. Bolus or continuous nasogastric feeds rather than transpyloric are better routine methods in infants of low birth weight.

  11. Early corticosteroid treatment does not affect severity of unconjugated hyperbilirubinemia in extreme low birth weight preterm infants

    NARCIS (Netherlands)

    Hulzebos, Christian V.; Bos, Arend F.; Anttila, Eija; Hallman, Mikko; Verkade, Henkjan J.

    2011-01-01

    Aim: To determine the relationship between early postnatal dexamethasone (DXM) treatment and the severity of hyperbilirubinemia in extreme low birth weight (ELBW) preterm infants. Methods: In 54 ELBW preterm infants, total serum bilirubin concentrations (TSB) and phototherapy (PT) data during the fi

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

    Science.gov (United States)

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

    2011-08-01

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

  13. Maternal serum leptin during pregnancy and infant birth weight: the influence of maternal overweight and obesity.

    Science.gov (United States)

    Misra, Vinod K; Straughen, Jennifer K; Trudeau, Sheri

    2013-05-01

    Few studies have examined whether the distinct metabolic patterns found in obese and nonobese pregnant women have different effects on the growing fetus. Our objective was to estimate the influence of longitudinal variation in maternal serum leptin levels on variation in infant birth weight in overweight/obese versus normal-weight women. In a prospective cohort of 286 gravidas, maternal weight and serum leptin levels at 6-10, 10-14, 16-20, 22-26, and 32-36 weeks gestation were measured. Effects of leptin levels on infant birth weight adjusted for gestational age at delivery (aBW) were analyzed using a linear regression model that accounted for the relationship of time-varying predictors to the log-transformed leptin concentrations. Different relationships of aBW to maternal serum leptin and its rate of change across pregnancy were exhibited by overweight/obese and normal-weight gravidas. For normal-weight women, aBW is not associated with either the magnitude of the logarithm of the leptin concentration or with its rate of change in either the first or second half of pregnancy. Conversely, for overweight/obese women, an increase in the rate of change in maternal serum leptin in the second half of pregnancy is significantly associated with a decrease in aBW. This effect is distinct from that of maternal weight. Differences in the effect of maternal serum leptin on fetal growth between overweight/ obese and normal-weight women suggest metabolic and physiologic heterogeneity between these groups. Such differences may be involved in the long-term physiologic effects of the obese intrauterine environment on the health of the offspring. Copyright © 2012 The Obesity Society.

  14. Prevalence of and risk factors for late diagnosis of HIV infection in Brazilian infants and children

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    Lígia Mara Dolce de Lemos

    2015-06-01

    Full Text Available INTRODUCTION: Late human immunodeficiency virus (HIV diagnosis is an important cause of HIV-related morbidity and mortality in infants and children. METHODS: This retrospective cohort study of HIV-infected children diagnosed in Sergipe, in northeastern Brazil, between 2002 and 2011 aimed to determine the prevalence of and risk factors for late HIV diagnosis. RESULTS: Of 55 infants and children with confirmed infection, 42 (76.5% were diagnosed at ≥ 12 months old. No antiretroviral prophylaxis during delivery (OR 5.48, 95% CI 1.11-32.34 was associated with late diagnosis. CONCLUSIONS: More than 75% of cases were diagnosed late. Efforts are needed to improve early HIV diagnosis in infants.

  15. Depressive Symptoms Prior to Pregnancy and Infant Low Birth Weight in South Africa.

    Science.gov (United States)

    Tomita, Andrew; Labys, Charlotte A; Burns, Jonathan K

    2015-10-01

    Despite improvements in service delivery and patient management, low birth weight among infants has been a persistent challenge in South Africa. The study aimed to explore the relationship between depression before pregnancy and the low birth weight (LBW) of infants in post-apartheid South Africa. This study utilized data from Waves 1 and 2 of the South African National Income Dynamics Study, the main outcome being a dichotomous measure of child LBW (<2500 g) drawn from the Wave 2 child questionnaire. Depressive symptoms of non-pregnant women was the main predictor drawn from the Wave 1 adult questionnaire. Depressive symptoms were screened using the 10-item four-point Likert version of the Center for Epidemiologic Studies Depression Scale (CES-D) instrument. A total score of 10 or greater on the CES-D indicates a positive screen for depressive symptoms. An adjusted logistic regression model was used to examine the relationship between women's depression before pregnancy and infant LBW. A sample size of 651 women in Wave 1 was linked to 672 newborns in Wave 2. The results of the adjusted logistic regression model indicated depressive symptoms (CES-D ≥ 10) prior to pregnancy were associated with infant LBW (adjusted OR 2.84, 95 % CI 1.08-7.46). Another significant covariate in the model was multiple childbirths. Our finding indicates that women's depressive symptoms prior to pregnancy are associated with the low birth weight of newborns and suggests that this association may not be limited to depression present during the ante-natal phase.

  16. Infant mortality rates according to socioeconomic status in a Brazilian city

    Directory of Open Access Journals (Sweden)

    Goldani Marcelo Zubaran

    2001-01-01

    Full Text Available OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381 and infant deaths (total of 731 that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05. These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head, in particular the post-neonatal mortality rate (chi-square for trend, p<0.05. Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.

  17. Infant mortality rates according to socioeconomic status in a Brazilian city

    Directory of Open Access Journals (Sweden)

    Marcelo Zubaran Goldani

    2001-06-01

    Full Text Available OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381 and infant deaths (total of 731 that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, p<0.05. These rates were inversely correlated with the distribution of lower salaries in the geoeconomic areas (less than 5 minimum wages per family head, in particular the post-neonatal mortality rate (chi-square for trend, p<0.05. Finally, the poor area showed a steady increase in excess infant mortality. CONCLUSIONS: The results indicate that infant mortality rates are associated with social inequality and can be monitored using municipal databases. The findings also suggest an increase in the impact of social inequality on infant health in Ribeirão Preto, especially in the poor area. The monitoring of health inequalities using municipal databases may be an increasingly more useful tool given the continuous decentralization of health management at the municipal level in Brazil.

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

    Science.gov (United States)

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

    1994-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-15

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

  20. Do early infant feeding patterns relate to breast-feeding continuation and weight gain ? data from a longitudinal cohort study.

    OpenAIRE

    Casiday, R. E.; Wright, C. M.; Panter-Brick, C.; Parkinson, K.

    2004-01-01

    Objectives: To describe the first-week feeding patterns for breast- vs bottle-fed babies, and their association with sustained breast-feeding and infant weight gain at 6 weeks. Design: A longitudinal cohort study. Setting: Feeding diaries were completed by mothers in an urban UK community shortly after birth; follow-up weight and feeding data were collected at routine health checks. Subjects: Mothers of 923 full-term infants born during the recruiting period agreed to join the stud...

  1. [Understanding the low prevalence of weight-for-height deficit in lower-income Brazilian children: correlations among anthropometric values].

    Science.gov (United States)

    Post, C L; Victora, C G; Barros, A J

    2000-01-01

    The sample for this study consisted of 386 children from six to 59 months of age. The objective was to study the association between wasting and abdominal circumference. Thirteen anthropometric measurements were taken: weight, height or length, crown-rump length, 4 circumferences, 4 skin fold thicknesses, and 2 breadths. Muscle, fat, and total upper arm areas and leg length were calculated. Indices of body proportionality were obtained by dividing the anthropometric variables by height. Height-for-age, weight-for-age, and weight-for-height deficits were 25.9%, 14.4%, and 3.5%, respectively. The smallest and lightest children were those with the highest abdominal circumferences divided by height. According to this study, abdominal circumference for Brazilian children without height-for-age deficit is, on average, 1.2 cm larger than for US children. Using this as a basis, the study calculated that prevalence of weight-for-height deficit would increase from 3.5% to 7.0% by increasing 2 cm in the abdominal circumference. The low prevalence of wasting and the high prevalence of stunting as indicated by several Brazilian studies could be explained partially by larger mean abdominal circumference values.

  2. Breast milk and complementary food intake in Brazilian infants according to socio-economic position

    NARCIS (Netherlands)

    Romulus-Nieuwelink, Johanna J. C.; Doak, Colleen; Albernaz, Elaine; Victora, Cesar G.; Haisma, Hinke

    Objective. (a) To compare breast milk and complementary food intake between breast-fed infants from high and low socio-economic status (SES) aged 8 months of age; (b) To compare these intakes with PAHO/WHO recommendations. Methods. Cross-sectional, community-based study in Pelotas, Brazil. Breast

  3. Breast milk and complementary food intake in Brazilian infants according to socio-economic position

    NARCIS (Netherlands)

    Romulus-Nieuwelink, Johanna J. C.; Doak, Colleen; Albernaz, Elaine; Victora, Cesar G.; Haisma, Hinke

    2011-01-01

    Objective. (a) To compare breast milk and complementary food intake between breast-fed infants from high and low socio-economic status (SES) aged 8 months of age; (b) To compare these intakes with PAHO/WHO recommendations. Methods. Cross-sectional, community-based study in Pelotas, Brazil. Breast mi

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

    Directory of Open Access Journals (Sweden)

    Thayana Regina de Souza Grance

    2015-03-01

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

  5. Catch up growth in low birth weight infants: striking a healthy balance.

    Science.gov (United States)

    Jain, Vandana; Singhal, Atul

    2012-06-01

    Catch-up growth in the first few months of life is seen almost ubiquitously in infants born small for their gestational age and conventionally considered highly desirable as it erases the growth deficit. However, recently such growth has been linked to an increased risk of later adiposity, insulin resistance and cardiovascular disease in both low income and high-income countries. In India, a third of all babies are born with a low birth weight, but the optimal growth pattern for such infants is uncertain. As a response to the high rates of infectious morbidities, undernutrition and stunting in children, the current policy is to promote rapid growth in infancy. However, with socio-economic transition and urbanization making the Indian environment more obesogenic, and the increasing prevalence of type 2 diabetes and cardiovascular disease, affecting progressively younger population, the long term adverse programming effect of fast/excessive weight gain in infancy on later body composition and metabolism may outweigh short-term benefits. This review discusses the above issues focusing on the need to strike a healthy balance between the risks and benefits of catch-up growth in Indian infants.

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

    Science.gov (United States)

    DeMaio-Feldman, D

    1994-07-01

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

  7. The Status at Two Years of Low-Birth-Weight Infants Born in 1974 with Birth Weights of Less Than 1,001 gm

    Science.gov (United States)

    Pape, K. E.; And Others

    1978-01-01

    For availibility see EC 103 548 Among findings of a 2-year followup study of 43 infants of birth weight less than 1000 grams were the following: average height at age 2 years was between the tenth and twenty-fifth percentiles; average weight was between the third and tenth percentiles; 15 Ss developed lower respiratory tract infections during the…

  8. Prediction Value of CRIB-II in Outcome of Preterm and Low Birth Weight Infants: a Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Mohammad Heidarzadeh

    2016-04-01

    Full Text Available Background: One of the most common methods of identifying mortality risk is the Clinical Risk Index for Babies scoring system (CRIB- II. The aim of this study was assessing the value of CRIB- II in predicting mortality risk in preterm and low birth weight infants in East Azerbaijan- Iran. Materials and Methods: This prospective cohort study was carried out in 2013-2014 during 6 months in NICUs of Alzahra, Taleqani and Children hospitals of Tabriz-Iran. All infants ≤ 32 weeks’ gestational age or ≤ 1500gr birth weight were included in the study using consecutive method. After calculating CRIB- II score, the infants were followed up at 3 months of age and their outcome was determined. The data was analyzed using SPSS-13, t- test, receiver operating characteristics (ROC and area under curve (AUC and relative risk (RR. Results: Of total 215 infants, 64 infants (29.7% died in the hospital and one infant (0.4% died after discharging from the hospital. 150 (68.8% infants, were alive at 3 months age follow up. The mean of CRIB- II score in the group of dead infants was higher and statistically significant compared to the group of alive infants (P

  9. Maternal serum lipids during pregnancy and infant birth weight: the influence of prepregnancy BMI.

    Science.gov (United States)

    Misra, Vinod K; Trudeau, Sheri; Perni, Uma

    2011-07-01

    Maternal obesity may be associated with metabolic factors that affect the intrauterine environment, fetal growth, and the offspring's long-term risk for chronic disease. Among these factors, maternal serum lipids play a particularly important role. Our objective was to estimate the influence of variation in maternal serum lipid levels on variation in infant birth weight (BW) in overweight/obese and normal weight women. In a prospective cohort of 143 gravidas, we measured maternal serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) at 6-10, 10-14, 16-20, 22-26, and 32-36 weeks gestation. Effects of maternal serum lipid levels on infant BW adjusted for gestational age at delivery (aBW) were analyzed using linear regression models. In analyses stratified by maternal prepregnancy BMI categorized as normal (≤25.0 kg/m(2)) and overweight/obese (>25.0 kg/m(2)), we found a significant (P aBW and HDL-C at all time points starting at 10 weeks gestation in overweight/obese women. No significant effect was found in normal weight women. In contrast, increased maternal serum TG was significantly associated with increased aBW only for normal weight women at 10-14 and 22-26 weeks gestation. Variation in aBW is not associated with variation in maternal serum TC or LDL-C for either stratum at any time point. We postulate that such differences may be involved in the "physiological programming" that influences later risk of chronic disease in the infants of overweight/obese mothers.

  10. Disseminated candidemia refractory to caspofungin therapy in an infant with extremely low birth weight

    Directory of Open Access Journals (Sweden)

    Meng-Ju Li

    2012-01-01

    Full Text Available Systemic fungal infections have high morbidity and mortality rates in neonates, especially neonates with an extremely low birth weight (ELBW. Here, we describe a 21-day-old ELBW female infant with an amphotericin B-unresponsive congenital Candida albicans infection that was treated with caspofungin. Blood sterilization was performed during the first episode, but a second episode of candidemia occurred after the discontinuation of caspofungin. Blood sterilization was again performed during the second round of caspofungin treatment, but fungal endocarditis and renal fungal balls still developed during the second episode. Caspofungin can be considered for invasive candidiasis in premature infants, especially in life-threatening situations. As for the focal lesions, more aggressive treatments other than just parenteral antibiotics should be considered. The literature regarding caspofungin therapy for neonatal candidiasis is also reviewed.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Locke Robert G

    2006-02-01

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

  13. Infant mortality and low birth weight in cities of Northeastern and Southeastern Brazil

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    Silva Antônio Augusto Moura da

    2003-01-01

    Full Text Available OBJECTIVE: To compare estimates of low birth weight (LBW, preterm birth, small for gestational age (SGA, and infant mortality in two birth cohorts in Brazil. METHODS: The two cohorts were performed during the 1990s, in São Luís, located in a less developed area in Northeastern Brazil, and Ribeirão Preto, situated in a more developed region in Southeastern Brazil. Data from one-third of all live births in Ribeirão Preto in 1994 were collected (2,839 single deliveries. In São Luís, systematic sampling of deliveries stratified by maternity hospital was performed from 1997 to 1998 (2,439 single deliveries. The chi-squared (for categories and trends and Student t tests were used in the statistical analyses. RESULTS: The LBW rate was lower in São Luís, thus presenting an epidemiological paradox. The preterm birth rates were similar, although expected to be higher in Ribeirão Preto because of the direct relationship between preterm birth and LBW. Dissociation between LBW and infant mortality was observed, since São Luís showed a lower LBW rate and higher infant mortality, while the opposite occurred in Ribeirão Preto. CONCLUSIONS: Higher prevalence of maternal smoking and better access to and quality of perinatal care, thereby leading to earlier medical interventions (cesarean section and induced preterm births that resulted in more low weight live births than stillbirths in Ribeirão Preto, may explain these paradoxes. The ecological dissociation observed between LBW and infant mortality indicates that the LBW rate should no longer be systematically considered as an indicator of social development.

  14. Could elective cesarean sections influence the birth weight of full-term infants?

    Directory of Open Access Journals (Sweden)

    Eddie Fernando Candido Murta

    Full Text Available CONTEXT AND OBJECTIVE: There are no studies on birth weights among full-term infants born by means of elective cesarean section. We aimed to study this in private and public hospitals. DESIGN AND SETTING: Retrospective study at Universidade Federal do Triângulo Mineiro, Uberaba, Brazil. METHODS: Data were collected from the municipal medical birth register of Uberaba from January to December 2000. The data obtained (maternal age, type of delivery, number of prenatal care visits and birth weight, from full-term pregnancy from the university hospital (UH, which is a tertiary hospital that only attends patients within the National Health System (SUS, were compared with data from four private hospitals (PHs that attend health insurance plans and private patients. Student's t test, chi2 test and multiple logistic regression were used for statistical analysis, with the significance level set at p < 0.05. RESULTS: In the PHs, 1,100 out of 1,354 births (81.2% were by cesarean section and in the UH, 373 out of 1,332 (28%. Birth weight increased significantly in association with increasing numbers of prenatal care visits, except for cesarean section cases in PHs. Birth weights among vaginal delivery cases in PHs were greater than in the UH (p < 0.05, but this was not observed among cesarean section cases. Multiple logistic regression showed that there was greater risk of low birth weight in PHs (odds ratio: 2.33; 95% confidence interval: 1.19 to 4.55. CONCLUSION: Elective cesarean section performed in PHs may be associated with low birth weight among full-term infants.

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

    Science.gov (United States)

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

    2017-06-19

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

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

    Directory of Open Access Journals (Sweden)

    Regina Coeli Azeredo Cardoso

    2013-09-01

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

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

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    Niloofar Satarzadeh

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Chien-Yi Chen

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-08-01

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

  20. Cup or bottle for preterm infants: effects on oxygen saturation, weight gain, and breastfeeding.

    Science.gov (United States)

    Rocha, Neide M N; Martinez, Francisco E; Jorge, Salim M

    2002-05-01

    The impact of cup-feeding or bottle-feeding on weight gain, oxygen saturation, and breastfeeding rates of preterm infants was studied in 34 bottle-fed and 44 cup-fed preterm infants. At initiation of oral feeding, postconceptional age and weight were 37.2 +/- 2.2 weeks and 1676 +/- 83 g for the bottle-fed group (BF) and 37.0 +/- 1.6 weeks and 1637 +/- 40 g for the cup-fed (CF) group, respectively. No significant differences between groups were found with regard to time spent feeding, feeding problems, weight gain, or breastfeeding prevalence at discharge or at 3-month follow-up. Possible beneficial effects of cup-feeding were lower incidence of desaturation episodes (13.6% vs 35.3%, CF vs BF, P = .024) and a higher prevalence of breastfeeding at 3 months among those still breastfeeding at the first follow-up visit (68.4% vs 33.3%, CF vs BF, P = .04).

  1. Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh.

    Science.gov (United States)

    Sharma, Arpana; Kader, Manzur

    2013-01-01

    Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14-45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting.

  2. Weight Gain and Obesity in Infants and Young Children Exposed to Prolonged Antibiotic Prophylaxis.

    Science.gov (United States)

    Edmonson, M Bruce; Eickhoff, Jens C

    2017-02-01

    An association between antibiotic use and excessive weight gain or obesity in healthy infants and young children has been reported, but evidence is inconsistent and based on observational studies of growth in relation to incidental antibiotic exposures. To evaluate whether prolonged antibiotic exposure is associated with weight gain in children participating in a clinical trial of antibiotic prophylaxis to prevent recurrent urinary tract infection. Secondary analysis of data from the Randomized Intervention for Children With Vesicoureteral Reflux Study, a 2-year randomized clinical trial that enrolled participants from 2007 to 2011. All 607 children who were randomized to receive antibiotic (n = 302) or placebo (n = 305) were included. Children with urinary tract anomalies, premature birth, or major comorbidities were excluded from participation. Trimethoprim-sulfamethoxazole or placebo taken orally, once daily, for 2 years. Weight gain as measured by change in weight-for-age z score from baseline to the end-of-study visit at 24 months. Secondary outcomes included weight gain at 6, 12, and 18 months and the prevalence of overweight or obesity at 24 months. Participants had a median age of 12 months (range, 2-71 months) and 558 of 607 (91.9%) were female. Anthropometric data were complete at the 24-month visit for 428 children (214 in the trimethoprim-sulfamethoxazole group and 214 in the placebo group). Weight gain in the trimethoprim-sulfamethoxazole group and the placebo group was similar (mean [SD] change in weight-for-age z score: +0.14 [0.83] and +0.18 [0.85], respectively; difference, -0.04 [95% CI, -0.19 to 0.12]; P = .65). There was no significant difference in weight gain at 6, 12, or 18 months or in the prevalence of overweight or obesity at 24 months (24.8% vs 25.7%; P = .82). Subgroup analyses showed no significant interaction between weight gain effect and age, sex, history of breastfeeding, prior antibiotic use, adherence to study

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

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    Pedro Neves Tavares

    2013-06-01

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

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

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    Allevato, Anthony J.

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

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

    Science.gov (United States)

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

    1997-11-01

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

  6. Comparative Effect of Massage Therapy versus Kangaroo Mother Care on Body Weight and Length of Hospital Stay in Low Birth Weight Preterm Infants

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    Priya Singh Rangey

    2014-01-01

    Full Text Available Background. Massage therapy (MT and kangaroo mother care (KMC are both effective in increasing the weight and reducing length of hospital stay in low birth weight preterm infants but they have not been compared. Aim. Comparison of effectiveness of MT and KMC on body weight and length of hospital stay in low birth weight preterm (LBWPT infants. Method. 30 LBWPT infants using convenience sampling from Neonatal Intensive Care Unit, V.S. hospital, were randomly divided into 2 equal groups. Group 1 received MT and Group 2 received KMC for 15 minutes, thrice daily for 5 days. Medically stable babies with gestational age < 37 weeks and birth weight < 2500 g were included. Those on ventilators and with congenital, orthopedic, or genetic abnormality were excluded. Outcome measures, body weight and length of hospital stay, were taken before intervention day 1 and after intervention day 5. Level of significance was 5%. Result. Data was analyzed using SPSS16. Both MT and KMC were found to be effective in improving body weight (P = 0.001, P = 0.001. Both were found to be equally effective for improving body weight (P = 0.328 and reducing length of hospital stay (P = 0.868. Conclusion. MT and KMC were found to be equally effective in improving body weight and reducing length of hospital stay. Limitation. Long term follow-up was not taken.

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

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

    2015-06-01

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

  8. Mother-preterm infant interactions at three months of corrected age: influence of maternal depression, anxiety and neonatal birth weight

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    Erica eNeri

    2015-09-01

    Full Text Available Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of Extremely Low Birth Weight-ELBW and Very Low Birth Weight-VLBW preterm infants with full-term ones. 77 preterm infants (32 ELBW; 45 VLBW and 120 full term (FT infants and their mothers were recruited. At 3 months of corrected age, 5 minutes of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviours were impaired only in case of comorbidity. ELBW’s mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother–infant interactions and on maternal affective state. Early diagnosis help to plan

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

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

    2015-01-01

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

  10. [Follow-up of infants with birth weight under 1,500 g].

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    Weldt, E; Valenzuela, B; Angulo, G; Muñoz, E; Gómez, S; Levy, M L; Rosselot, S; Norambuena, N

    1989-01-01

    A prospective study of 199 children with birth weight less than 1,500 g was done. 86 boys and 113 girls, 141 (71%) adequate for gestational age and 58 (29%) small for gestational age. At follow-up 43 (21.6%) infants were lost to control, 17 (7%) moved to other places and 7 (3.5%) died in the first year of life. In the first year of life, infants whose birthweights were adequate for gestational age had been hospitalized more frequently and the small for dates showed higher percentage of undernutrition. After the second year of life, it was possible to know the impairment. It was found 7.4% of cerebral palsy, 2.9% of hipoacusia and 2.2% of retinopathy of prematurity, these diagnosis were most frequent in children that were adequate for gestational age. We concluded that small for dates infants are at risk of undernutrition and that those adequate for gestational age are at risk of permanent sequelae.

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

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

    2010-06-01

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

  12. The Impact of Body Mass Index and Weight Changes on Disability Transitions and Mortality in Brazilian Older Adults

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    Flávia Cristina Drumond Andrade

    2013-01-01

    Full Text Available The aim of this study was to examine the association between body mass index and weight changes on disability transitions and mortality among Brazilian older adults. Longitudinal data from the Health, Well-Being, and Aging in Latin America and the Caribbean Study conducted in São Paulo, Brazil (2000 and 2006, were used to examine the impact of obesity on disability and mortality and of weight changes on health transitions related to disability. Logistic and multinomial regression models were used in the analyses. Individuals who were obese were more likely than those of normal weight to have limitations on activities of daily living (ADL, instrumental activity of daily living (IADL, and Nagi's limitations. Obesity was associated with higher incidence of ADL and IADL limitations and with lower recovery from Nagi's limitations. Compared to those who maintained their weight, those who gained weight experienced higher incidence of ADL and Nagi's limitations, even after controlling for initial body mass index. Higher mortality among overweight individuals was only found when the reference category was “remaining free of Nagi limitations.” The findings of the study underline the importance of maintaining normal weight for preventing disability at older ages.

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

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    Yanamandra Krishna

    2006-04-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

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    Mukhopadhyay, Sagori; Puopolo, Karen M

    2017-05-01

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

  18. Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight.

    Science.gov (United States)

    Brown, Amy; Harries, Victoria

    2015-06-01

    Infant sleep is a common concern for new parents. Although many expect a newborn infant to wake frequently, encouraging a baby to sleep through the night by a few months of age is seen as both a developmental aim and a parenting success. Many new mothers believe that their infants' diet is related to their sleep; formula milk or increased levels of solid food are often given in an attempt to promote sleep. However, the impact of these in later infancy is not understood. In the current study 715 mothers with an infant 6-12 months of age reported their infants' typical night wakings and night feeds alongside any breastfeeding and frequency of solid meals. Of infants in this age range, 78.6% still regularly woke at least once a night, with 61.4% receiving one or more milk feeds. Both night wakings and night feeds decreased with age. No difference in night wakings or night feeds was found between mothers who were currently breastfeeding or formula feeding. However, infants who received more milk or solid feeds during the day were less likely to feed at night but not less likely to wake. The findings have important implications for health professionals who support new mothers with infant sleep and diet in the first year. Increasing infant calories during the day may therefore reduce the likelihood of night feeding but will not reduce the need for parents to attend to the infant in the night. Breastfeeding has no impact on infant sleep in the second 6 months postpartum.

  19. Low body weight/thinness, overweight and obesity of children and adolescents from a Brazilian region of low economic status

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    Dartagnan Pinto Guedes

    2013-12-01

    Full Text Available OBJECTIVE: To assess the prevalence of low body weight/thinness, overweight and obesity in a representative sample of children and adolescents from a Brazilian region with low economic development. METHODS: A total of 982 girls and 986 boys, aged seven to 17 years old and assisted by Segundo Tempo Program, from Montes Claros, Minas Gerais, Brazil, were included in the study. Low body weight/thinness, overweight and obesity were defined based on body mass cut-off indexes recommended by the International Obesity Task Force. The prevalence of the nutritional status according to sex and age was compared by chi-square test. RESULTS: In girls, the frequency of low body weight/thinness, overweight and obesity was 4.1, 18.4 and 3.8%, respectively; in boys, these percentages were 6.3, 13.2 and 2.9%, respectively. The low body weight/thinness for girls raised from 2.7% (7-10 years old to 5.5% (15-17 years old; the body weight excess (overweight and obesity decreased from 30.1 to 16.2% for the same age groups. In boys, the corresponding trends were from 3.2 to 9.4% for low body weight/thinness, and from 23.4 to 9.2%, for body weight excess. CONCLUSIONS: The data indicate that, even in a region with low economic status, the body weight excess was the main problem associated with nutritional health. The high overweight and obesity prevalence rates indicate the need of public policies for promoting healthy feeding behaviors and physical activity.

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

    Science.gov (United States)

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

    2015-10-01

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

  1. High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support

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    Parker Bruce R

    2009-07-01

    Full Text Available Abstract Background Osteopenia and rickets are common among extremely low birth weight infants (ELBW, Methods We evaluated all ELBW infants admitted to Texas Children's Hospital NICU in 2006 and 2007. Of 211 admissions, we excluded 98 patients who were admitted at >30 days of age or did not survive/stay for >6 weeks. Bone radiographs obtained in 32 infants were reviewed by a radiologist masked to laboratory values. Results In this cohort of 113 infants, P-APA was found to have a significant inverse relationship with BW, gestational age and serum phosphorus. In paired comparisons, P-APA of infants Conclusion Elevation of P-APA >600 IU/L was very common in ELBW infants. BW was significantly inversely related to both P-APA and radiologic rickets. No single value of P-APA was related to radiological findings of rickets. Given the very high risk of osteopenia and rickets among ELBW infants, we recommend consideration of early screening and early mineral supplementation, especially among infants

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

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

    2017-04-01

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

  3. [Changes in homecare for preterm and low-birth-weight infants from 2002 to 2014].

    Science.gov (United States)

    Figueras Aloy, Josep; Esqué Ruiz, M Teresa; Arroyo Gili, Lourdes; Bella Rodriguez, Julia; Álvarez Miró, Roser; Carbonell Estrany, Xavier

    2016-09-01

    Homecare (HC) is a service offering home medical and nursing care to the patient at home in equal quantity and quality as in the hospital. The aim of the article is to describe the changes in the HC of preterm and full-term low-birth-weight infants in our department from 2002-2014. The HC database is revised. The characteristics of the newborns and the social characteristics of the family in three consecutive time periods are analysed. A satisfaction survey of parents is also presented. The main changes in HC include a decrease in the weight at discharge (from 1880g in the 2002-2006 period to 1850g in the 2011-2014 period; P=.006) and at the end of HC (from 2187g to 2163g; P=.001), an increase in the duration of HC (from 10 to 11 days; P=.007) and a lower incidence of new hospitalization (from 3.4% to 1.3%; P=.019) The social characteristics of the family show a higher maternal age with more previous alive children, a family context better suited with a more appropriate housing, and an increase in exclusive breastfeeding at hospital discharge (from 25.5% to 49.0%; P<.001). The overall assessment of the program is ≥7/10 in 98.8% of responses. The results of the HC of preterm and low-birth-weight infants have improved over time, saving approximately 10-11 days of hospitalisation, and without compromising the quality of care or reducing family satisfaction. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Closed Catheter Access System Implementation in Reducing Bloodstream Infection Rate in Low Birth Weight Preterm Infants

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    Lily eRundjan

    2015-03-01

    Full Text Available Background Bloodstream infection (BSI is one of the significant causes of morbidity and mortality encountered in a neonatal intensive care unit (NICU, especially in developing countries. Despite the implementation of infection control practices, such as strict hand hygiene, the BSI rate in our hospital is still high. The use of a closed catheter access system to reduce BSI related to intravascular catheter has hitherto never been evaluated in our hospital. Objective To determine the effects of closed catheter access system implementation in reducing the BSI rate in preterm neonates with low birth weight.Methods Randomized clinical trial was conducted on 60 low birth weight preterm infants hospitalized in the neonatal unit at Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September, 2013. Randomized subjects either received a closed or non-closed catheter access system. Subjects were monitored for 2 weeks for the development of BSI based on clinical signs, abnormal infection parameters, and blood culture. Results Closed catheter access system implementation gave a protective effect towards the occurrence of culture-proven BSI (relative risk 0.095, 95% CI 0.011 to 0.85, p=0.026. Risk of culture-proven BSI in the control group was 10.545 (95% CI 1.227 to 90.662, p=0.026. BSI occurred in 75% of neonates without risk factors of infection in the control group compared to none in the study group.Conclusions The use of a closed catheter access system reduced the BSI in low birth weight preterm infants. Choosing the right device design, proper disinfection of device and appropriate frequency of connector change should be done simultaneously.

  5. Maternal hypoxic ventilatory response, ventilation, and infant birth weight at 4,300 m.

    Science.gov (United States)

    Moore, L G; Brodeur, P; Chumbe, O; D'Brot, J; Hofmeister, S; Monge, C

    1986-04-01

    To test the hypothesis that increased hypoxic ventilatory responsiveness (HVR) raised maternal ventilation and arterial oxygenation during high-altitude pregnancy and related to the birth weight of the offspring, we studied 21 residents of Cerro de Pasco, Peru (4,300 m), while eight of them were 36 +/- 0 wk pregnant and 15 of them 13 +/- 0 wk postpartum. HVR was low in the nonpregnant women (mean +/- SE shape parameter A = 23 +/- 8) but increased nearly fourfold with pregnancy (A = 87 +/- 17). The increase in HVR appeared to account for the 25% rise in resting ventilation with pregnancy (delta VE observed = 2.4 +/- 0.7 l/min BTPS vs. delta VE predicted from delta HVR = 2.6 +/- 1.7 l/min BTPS, P = NS). Hyperoxia decreased ventilation in the pregnant women (P less than 0.01) to levels similar to those measured when nonpregnant. The increased ventilation of pregnancy raised arterial O2 saturation (SaO2) from 83 +/- 1 to 87 +/- 0%, and SaO2 was correlated positively with HVR in the pregnant women. The rise in SaO2 compensated for a 0.9 g/100 ml decrease in hemoglobin concentration to preserve arterial O2 content at levels present when nonpregnant. Cardiac output in the 36th wk of pregnancy did not differ significantly from values measured postpartum. The increase in HVR correlated positively with infant birth weight. An increase in HVR may be an important contributor to increased maternal ventilation with pregnancy and infant birth weight at high altitude.

  6. The low prevalence of weight-for-height deficits in Brazilian children is related to body proportions.

    Science.gov (United States)

    Post, C L; Victora, C G

    2001-04-01

    Compared with children from other regions, Latin American children living in poverty have much lower prevalences of weight-for-height deficits than would be expected given the observed rates of stunting. This study was aimed at investigating whether variations in body proportions, particularly abdominal circumference, could explain this paradoxical finding. In a cross-sectional study, children aged 12-35 mo (n = 197) were studied in Southern Brazil. Half of these children were from a high socioeconomic status (SES) group whose growth closely resembled that of the National Center for Health Statistics (NCHS)/WHO reference; the other half were from low income families. The following 11 anthropometric measurements were collected: weight, height, sitting height/crown-rump length, head, chest, upper arm and abdominal circumference, triceps, biceps, subscapular and suprailiac skinfolds. These measures were compared between the two groups of children and with values for North American children [mostly from Second National Health and Nutrition Examination Survey (NHANES II)]. For nearly all measures, low SES Brazilian children tended to be smaller than both high SES and North American children. However, when body proportionality was assessed by dividing the measurements by the child's height, these differences tended to disappear or even to change direction, as was the case for head, chest and abdominal circumferences. Mean abdominal circumference was virtually identical between low and high SES children, and the former had larger abdomens for a given height. Despite slight differences in measuring techniques, Brazilian children had larger abdomens than North Americans. These findings may explain in part why deprived Latin American children have higher weights for their height compared with the NCHS/WHO reference.

  7. The effect of music on weight gain of preterm infants older than 32 weeks: a randomized clinical trial

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    Flávia Maria L. Auto

    2015-12-01

    Full Text Available Objective: To evaluate the effect of recorded music with multimodal stimulation on the weight gain of preterm infants included in the Kangaroo-Mother Program. Methods: Randomized clinical trial with 61 premature infants, of both sexes, with postconceptional age greater or equal to 32 weeks and at least ten days of life, without detected abnormalities in the visual and hearing systems, and hospitalized in the Kangaroo-Mother Unit. Patients were randomized in two groups: of 31 preterm infants received multimodal stimulation with music daily, for seven days; 30 preterm infants received only multimodal stimulation. The following characteristics were evaluated: weight gain, energy consumption, heart rate and respiratory rate, stress signs and feeding method. Comparison between groups was made by Student’s t-test, Mann Whitney test and chi-square test, being significant p<0.05. Results: The two groups did not present significant differences in relation to the feeding method and energy consumption (p=0.46; however, weight gain was greater in the Experimental Group (p=0.002, which also presented better stability in cardiac and respiratory rates (p<0.001 and a significant reduction of stress signs (p=0.007, compared with the Control Group. Conclusions: The recorded music with multimodal stimulation is associated with a greater gain in body weight of hospitalized preterm infants as well as presents a positive influence on vital and stress signs (Clinical Trials Registry - UTN: U1111-1153-9301.

  8. Chronic maternal depression is associated with reduced weight gain in latino infants from birth to 2 years of age.

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    Janet M Wojcicki

    Full Text Available BACKGROUND: Latino children are at increased risk for mirconutrient deficiencies and problems of overweight and obesity. Exposures in pregnancy and early postpartum may impact future growth trajectories. OBJECTIVES: To evaluate the relationship between prenatal and postnatal maternal depressive symptoms experienced in pregnancy and infant growth from birth to 2 years of age in a cohort of Latino infants. METHODS: We recruited pregnant Latina mothers at two San Francisco hospitals and followed their healthy infants to 24 months of age. At 6, 12 and 24 months of age, infants were weighed and measured. Maternal depressive symptoms were assessed prenatally and at 4-6 weeks postpartum. Women who had high depressive symptoms at both time periods were defined as having chronic depression. Logistic mixed models were applied to compare growth curves and risk for overweight and underweight based on exposure to maternal depression. RESULTS: We followed 181 infants to 24 months. At 12 and 24 months, respectively, 27.4% and 40.5% were overweight, and 5.6% and 2.2% were underweight. Exposure to chronic maternal depression was associated with underweight (OR = 12.12, 95%CI 1.86-78.78 and with reduced weight gain in the first 2 years of life (Coef = -0.48, 95% CI -0.94-0.01 compared with unexposed infants or infants exposed to episodic depression (depression at one time point. Exposure to chronic depression was also associated with reduced risk for overweight in the first 2 years of life (OR 0.28, 95%CI 0.03-0.92. CONCLUSIONS: Exposure to chronic maternal depression in the pre- and postnatal period was associated with reduced weight gain in the first two years of life and greater risk for failure to thrive, in comparison with unexposed infants or those exposed episodically. The infants of mothers with chronic depression may need additional nutritional monitoring and intervention.

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

    Science.gov (United States)

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

    2013-06-01

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

  10. Changes in infant disposable diaper weights at selected intervals post-wetting.

    Science.gov (United States)

    Carlisle, Joan; Moore, Amanda; Cooper, Alyssa; Henderson, Terri; Mayfield, Debbie; Taylor, Randa; Thomas, Jennifer; Van Fleet, Laduska; Askanazi, David; Fineberg, Naomi; Sun, Yanhui

    2012-01-01

    Pediatric acute care nurses questioned the practice of weighing disposable infant diapers immediately after voiding. This study asked the research question, "Does volume of saline, diaper configuration, and/or size of diaper statistically effect changes in diaper weights over time?" The method was an experimental, laboratory model. Pre-set volumes of saline were added to disposable diapers that were then left folded or unfolded. Each diaper was weighed immediately post-wetting and re-weighed at hourly intervals for seven hours. Data were analyzed using a repeated measures analysis of variance (RMANOVA) with balanced data (F-test). Diaper weight changes over time were statistically significant for all time points and for all volumes regardless of diaper size; however, the changes in weight were small and without clinical significance. It is appropriate to weigh diapers at the end of eight hours without risk of altering subsequent fluid management of patients in open-air, non-humidified environments. This practice has led to more efficient use of nurses' time with fewer interruptions for patients and families.

  11. Oropharyngeal administration of mother's milk to prevent necrotizing enterocolitis in extremely low-birth-weight infants: theoretical perspectives.

    Science.gov (United States)

    Rodriguez, Nancy A; Caplan, Michael S

    2015-01-01

    The oropharyngeal administration of mother's milk-placing drops of milk onto the infant's oral mucosa-may serve as a preventative strategy against necrotizing enterocolitis (NEC) for extremely low-birth-weight (ELBW: birth weight milk to ELBW infants may serve to expose the infant's oropharynx to protective (immune and trophic) biofactors (also present in amniotic fluid) and may protect the infant against NEC. Emerging evidence suggests that this intervention may have many benefits for extremely premature infants including protection against bacteremia, NEC, and ventilator-associated pneumonia, an earlier attainment of full enteral feeds, enhanced maturation of oral feeding skills, improved growth, and enhanced breast-feeding outcomes. While more research is needed to definitively establish safety and efficacy of this intervention, this article will examine biological plausibility and will describe the theoretical mechanisms of protection against NEC for ELBW infants who receive this intervention. Nurses play a key role in advancing the science and practice of this intervention. Future directions for research and implications for nursing practice will also be presented.

  12. Weight and height of people living with HIV/AIDS attended by the Brazilian National Health System

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    Katia Cristina Bassichetto

    2013-09-01

    Full Text Available The nutritional status of people living with HIV/AIDS (PLWHA is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H, height for age (H/A, body mass index for age (BMI/A and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66. In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001. The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group.

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

    Science.gov (United States)

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

    2016-04-07

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

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

    Science.gov (United States)

    Niven, Erin

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

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

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    Nadja Haiden

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

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    Mahmoud Nouri Shadkam

    2015-12-01

    Full Text Available Background: Feeding intolerance is a common problem among premature infants. There is limited information on the safety and effects of oral probiotic supplements, especially products containing Lactobacillus reuteri, and the incidence of necrotizing enterocolitis (NEC in low birth weight preterm infants. This study aimed to evaluate the effects of Lactobacillus reuteri on the gastrointestinal complications and feeding tolerance in premature infants. Methods: This randomized triple-blind clinical trial was conducted on 60 premature infants divided into two groups of intervention and placebo. Subjects in the intervention group received one drop/kg of supplementary oral probiotic with 0.5 ml of distilled water, and infants in the placebo group only received 0.5 ml of distilled water. Probiotic administration continued to reach full enteral feeding. Results: In this study, mean time to reach full enteral feeding was 12.83 and 16.75 days in the intervention and placebo groups, respectively, which was indicative of a significant difference (P=0.01. However, mean of neonatal weight at discharge had no significant difference between the two groups. In addition, 6.7% and 36.7% of infants in the intervention and placebo groups were diagnosed with NEC, respectively, which showed a significant difference (P=0.005. Also, prevalence of jaundice and sepsis was not significantly different between the study groups. Conclusion: According to the results of this study, Lactobacillus reuteri could reduce the time to reach full enteral feeding while diminishing the incidence of NEC in very low birth weight premature infants.

  18. [Laser Doppler flowmetry in newborn infants with low birth weight. The effect of differences in humidity on peripheral circulation].

    Science.gov (United States)

    Hanssler, L; Roll, C; Breukmann, H

    1992-01-01

    In a group of 10 low birth weight infants we measured skin temperature using infrared thermography and laser Doppler flow in central and peripheral regions of the body. After elevation of incubator humidity from 40 to 80% skin temperature of the foot rose significantly (p less than 0.01). At the same time there was a significant increase (p less than 0.05) of laser Doppler flow. Temperature and laser Doppler flow in the area of the abdomen did not show significant changes. Low birth weight infants are able to regulate peripheral blood flow after changes of ambient humidity. With the method of laser Doppler flowmetry thermoregulatory responses in the microvascular bed can be measured in these infants.

  19. The 'Effects of Transfusion Thresholds on Neurocognitive Outcome of Extremely Low Birth-Weight Infants (ETTNO)' Study

    DEFF Research Database (Denmark)

    Reinholdt, Jes; Veiergang, Gitte

    2012-01-01

    Background: Infants with extremely low birth weight uniformly develop anemia of prematurity and frequently require red blood cell transfusions (RBCTs). Although RBCT is widely practiced, the indications remain controversial in the absence of conclusive data on the long-term effects of RBCT...

  20. Growth and Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants: A Single Center’s Experience

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    Yung-Chieh Lin

    2011-12-01

    Conclusion: ELBW infants have a high incidence of growth and developmental delay at corrected age of 2 years, particularly in male infants or those with BW less than 750 g. This study reveals that ELBW infants require well predischarge planning and postdischarge follow-up.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  2. High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

    Science.gov (United States)

    Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-12-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

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

    Science.gov (United States)

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

    2008-08-01

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

  4. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Science.gov (United States)

    Lin, Hui-Jia; Du, Li-Zhong; Ma, Xiao-Lu; Shi, Li-Ping; Pan, Jia-Hua; Tong, Xiao-Mei; Li, Qiu-Ping; Zhou, Jian-Guo; Yi, Bing; Liu, Ling; Chen, Yun-Bing; Wei, Qiu-Fen; Wu, Hui-Qing; Li, Mei; Liu, Cui-Qing; Gao, Xi-Rong; Xia, Shi-Wen; Li, Wen-Bin; Yan, Chao-Ying; He, Ling; Liang, Kun; Zhou, Xiao-Yu; Han, Shu-Ping; Lyu, Qin; Qiu, Yin-Ping; Li, Wen; Chen, Dong-Mei; Lu, Hong-Ru; Liu, Xiao-Hong; Liu, Hong; Lin, Zhen-Lang; Liu, Li; Zhu, Jia-Jun; Xiong, Hong; Yue, Shao-Jie; Zhuang, Si-Qi

    2015-01-01

    Background: With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW) survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China. Methods: All infants admitted to 26 NICUs with a birth weight (BW) < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results: A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019). BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions: Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed

  5. Efficacy of a Brazilian calcium montmorillonite against toxic effects of dietary aflatoxins on broilers reared to market weight.

    Science.gov (United States)

    Eckhardt, J C; Santurio, J M; Zanette, R A; Rosa, A P; Scher, A; Dal Pozzo, M; Alves, S H; Ferreiro, L

    2014-01-01

    1. The protective effect of a natural Brazilian calcium montmorillonite (CaMont) against aflatoxins was studied in broiler chickens. 2. A total of 1056-d-old Cobb male broilers were housed in experimental pens (22 chickens per pen) for 42 d. Three levels of CaMont (0, 2.5 and 5 g/kg) and two levels of aflatoxins (0 and 3 mg/kg) were assayed. Each treatment had 8 replicate pens of 22 broiler chickens each. 3. Of all the chickens tested in the experiment, the ones treated with aflatoxins were the most adversely affected. CaMont treatment at concentrations of 2.5 and 5 g/kg improved body weight of chickens at 42 d of age by 13.3% and 22.7%, increased daily feed intake by 9.7% and 24.7%, and improved the productive efficiency index of chickens by 53% and 66.5%, respectively. 4. Dietary CaMont positively affected parameters such as weight of liver, heart and gizzard; however, serum potassium concentration decreased by 15.3% compared with that of chickens given only the aflatoxin-contaminated diet. 5. CaMont did not cause adverse effects in chickens that did not receive aflatoxins. 6. CaMont at pH 8.5 partially reduced the toxic effects of aflatoxins in broilers when included at levels of 2.5 and 5 g/kg in the diet.

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

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

    2016-03-01

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

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

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    Costa-Orvay Juan Antonio

    2011-12-01

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

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

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    Schmalisch Gerd

    2012-03-01

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

  9. The relationship of birth weight, gestational age, and postmenstrual age with ocular biometry parameters in premature infants

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    Ozdemir Ozdemir

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze ocular biometry parameters and evaluate their relationship with gestational age, birth weight, and postmenstrual age in prematurely born infants. Methods: The right eyes of 361 premature infants born before the 36th gestational week were evaluated. Birth weight, gestational week, and gender were recorded. An A-scan Biometer was used for obtaining axial measurements, including anterior chamber depth, lens thickness, vitreous length, and total axial length. Results: Gestational age and birth weight values ranged from 23 to 36 weeks and from 560 to 2,670 g, respectively. The mean gestational age and birth weight were 30.8 ± 2.8 weeks and 1,497.9 ± 483.6 g, respectively. During the first examination (4-5 weeks of postnatal age, birth weight and gestational age of the infants correlated significantly and positively with lens thickness, vitreous length, and axial length (r>0.5, p<0.001, but not with anterior chamber depth (r<0.5. Increased vitreous and axial lengths correlated significantly with increasing postmenstrual age of the infants (r=0.669, p<0.001; r=0.845, p<0.001, respectively. Conclusions: Lens thickness, vitreous length, and axial length, but not anterior chamber depth, were significantly correlated with birth weight and gestational age. All four parameters increased with increasing postmenstrual age, with higher correlations for vitreous and axial lengths than for anterior chamber depth and lens thickness. It was concluded that axial elongation resulted primarily from increasing posterior chamber length.

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

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    Ying Dong

    2012-09-01

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

  11. Bone metabolism biomarkers, body weight, and bone age in healthy Brazilian male adolescents.

    Science.gov (United States)

    da Silva, Carla Cristiane; Kurokawa, Cilmery Suemi; Nga, Hong Si; Moretto, Maria Regina; Dalmas, José Carlos; Goldberg, Tamara Beres Lederer

    2012-01-01

    Eighty-seven male volunteers were grouped according to bone age (BA): 10-12 years (n=25), 13-15 years (n=36), and 16-18 years (n=26), and the following were recorded for each: weight (kg), height (m), BMI (kg/m(2)), calcium intake from three 24-h food recalls (mg/day), puberty evaluation by Tanner stages, bone biomarker (BB) evaluation, serum osteocalcin (OC), bone alkaline phosphatase (BAP), carboxyterminal telopeptide (S-CTx), and bone mineral density (BMD) evaluations by dual-energy X-ray absorptiometry (g x cm(2)) in the lumbar spine, proximal femur, and the whole body. BBs showed similar behaviors, and very high median values were observed for individuals aged 13-15 years (BAP = 155.50 IU/L, OC = 41.63 ng/mL, S-CT x =2.09 ng/mL). Lower median BB values were observed with advancing BA between 16 and 18 years (BA P =79.80 IU/L, O C =27.80 ng/mL, S-CT x =1.65 ng/mL). Stepwise multiple regression analysis showed body weight associated with BA as independent variables with greater determination power for S-CTx (r(2) = 0.40) and OC (r(2)=0.21). For BAP, stepwise analysis showed body weight and whole-body BMD (r(2) = 0.34). All predictive models showed significance ( p Weight and BA were significant in determining predictive equations of OC and of S-CTx, whereas for BAP, weight and BMD of full body were selected.

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

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

    1998-04-01

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

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

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

    2016-10-01

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

  14. Outcomes of very-low-birthweight infants after discharge with a discharge weight of 1500 grams.

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    Ahmadpour-Kacho, Mousa; Pasha, Yadollah Zahed; Aliabadi, Behdis Motevalli

    2012-04-01

    Discharge of very-low-birthweight (VLBW) neonates from hospital is an important issue and has a standard criterion worldwide. According to this criterion, VLBW infants will be discharged from hospital when weighing 1800-2100 g but in the newborn services at Amirkola Children's Hospital (ACH), VLBW neonates are discharged when reaching 1500 g. The aim of this study was to determine the safety of this policy. In this analytic-prospective study, 100 premature neonates with discharging weight (DW) of 1500 g and a control group of 150 neonates with DW of 1600-2500 g were included. Both groups showed similar socioeconomic, perinatal and postnatal conditions. They were admitted and treated in the newborn services at ACH. The outcome variables, including death after discharge, readmission and need for emergency visit for an acute problem up to 3 months after discharge, were studied. The information was analyzed by SPSS-16 software and a P-value discharge reached a significant difference between the two groups (31 in the case group vs 21 in the control group, P= 0.000), but there were no significant differences in the readmission rate and death after discharge (two deaths and 15 readmissions in the case group vs two deaths and 21 readmissions in the control group, P= 0.855) In order to decrease the need for emergency visits, we suggest a program of early hospital discharge with home nursing visits and neonatologist support. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

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

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    Rosane Reis de Mello

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

  16. Azithromycin in the extremely low birth weight infant for the prevention of Bronchopulmonary Dysplasia: a pilot study

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    Anstead Michael I

    2007-06-01

    Full Text Available Abstract Background Azithromycin reduces the severity of illness in patients with inflammatory lung disease such as cystic fibrosis and diffuse panbronchiolitis. Bronchopulmonary dysplasia (BPD is a pulmonary disorder which causes significant morbidity and mortality in premature infants. BPD is pathologically characterized by inflammation, fibrosis and impaired alveolar development. The purpose of this study was to obtain pilot data on the effectiveness and safety of prophylactic azithromycin in reducing the incidence and severity of BPD in an extremely low birth weight (≤ 1000 grams population. Methods Infants ≤ 1000 g birth weight admitted to the University of Kentucky Neonatal Intensive Care Unit (level III, regional referral center from 9/1/02-6/30/03 were eligible for this pilot study. The pilot study was double-blinded, randomized, and placebo-controlled. Infants were randomized to treatment or placebo within 12 hours of beginning mechanical ventilation (IMV and within 72 hours of birth. The treatment group received azithromycin 10 mg/kg/day for 7 days followed by 5 mg/kg/day for the duration of the study. Azithromycin or placebo was continued until the infant no longer required IMV or supplemental oxygen, to a maximum of 6 weeks. Primary endpoints were incidence of BPD as defined by oxygen requirement at 36 weeks gestation, post-natal steroid use, days of IMV, and mortality. Data was analyzed by intention to treat using Chi-square and ANOVA. Results A total of 43 extremely premature infants were enrolled in this pilot study. Mean gestational age and birth weight were similar between groups. Mortality, incidence of BPD, days of IMV, and other morbidities were not significantly different between groups. Post-natal steroid use was significantly less in the treatment group [31% (6/19] vs. placebo group [62% (10/16] (p = 0.05. Duration of mechanical ventilation was significantly less in treatment survivors, with a median of 13 days (1–47

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

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

    2003-07-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

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    Rachel C. Ferreira

    2014-06-01

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

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

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    Priscila Castro Cordeiro Fernandes

    2011-08-01

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

  1. Morbidity and mortality of low birth weight infants in the new born unit of Kenyatta National Hospital, Nairobi.

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    Simiyu, D E

    2004-07-01

    Morbidity and mortality of low birth weight (LBW) infants at Kenyatta National Hospital (KNH) has previously been found to be high. Other centres have shown that even with lack of neonatal intensive care facilities, selective interventions can be implemented that improve neonatal survival rates. It is important to identify those factors at KNH that when selectively modified, will improve the quality of care hence survival rates. To quantify the morbidity and mortality of LBW infants in KNH. To audit the quality of care and identify factors that can be selectively modified to improve the quality of care and improve the currently low survival rates. Retrospective study utilising case notes. New born unit, Kenyatta National Hospital, Nairobi. All LBW infants admitted to the NBU at KNH from January to December 2000. Out of an expected 694 files, 533 (77%) were studied. The male to female ratio and LBW to VLBW ratio was 1:1 respectively. Small for gestational age (SGA) accounted for 11.6%. Overall mortality was 57.4% (574/1000 admissions) while mortality for SGA was 37%. Infants born out of KNH had significantly higher mortality (p=0.0047). Compared to Caeserian delivery, infants born via spontaneous vertex delivery had higher mortality (p=0.0087). The leading diagnoses on admission or death were respiratory distress(69%), apnoeic attacks (42%) suspected sepsis and jaundice (37% each), hypothermia(27%) and anaemia(17%). By time of death or discharge, 43% had no laboratory investigations done. While 37% had suspected sepsis, only 14% had blood culture done. Antibiotics were started in 460 (86%) of infants yet only 37% had diagnosis of suspected sepsis. Change of antibiotics was guided by culture and sensitivity reports in only 62(13.5%). Apnoeic spells were managed with rectal aminophyline in 156(29%) infants of whom 19(12%) survived. The terminal events for the dead infants included recurrent apnoeic spells. The only mode of nutrition was enteric feeding in 59% with

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

    Science.gov (United States)

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

    2009-03-01

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

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

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

    2016-12-16

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

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

    Science.gov (United States)

    Dempsey, Eugene; Miletin, Jan

    2010-06-16

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

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

    LENUS (Irish Health Repository)

    Dempsey, Eugene

    2012-01-31

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

  6. Ethnic variation in infant-feeding practices in the Netherlands and Weight Gain at 4 months

    NARCIS (Netherlands)

    Bulk-Bunschoten, A.M.W.; Pasker-Jong, P.C.M. de; Wouwe, J.P. van; Groot, C.J. de

    2008-01-01

    This prospective study of 4438 infants (0-4 months) examined differences in infant-feeding patterns in relation to the ethnic origin of their mothers, based on the mother's native language: Dutch (87%), Turkish (4%), Moroccan (3%), other European languages (3%), and various other languages (4%). Bre

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

    LENUS (Irish Health Repository)

    Barrett, M

    2011-11-01

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

  8. Early home intervention with low-birth-weight infants and their parents.

    Science.gov (United States)

    Barrera, M E; Rosenbaum, P L; Cunningham, C E

    1986-02-01

    We investigated the effects of a year-long home intervention with a sample of preterm infants randomly assigned to 1 of 3 groups: a developmental intervention, a parent-infant intervention, and a no-treatment control group. A full-term no-treatment control was also used. Both intervention approaches focused on the parent-child unit, providing training for parents to improve observational skills, emotional support, and information about community resources. However, whereas specific tasks to facilitate the child's development were provided in the developmental intervention group, the quality of the parent-infant interaction was the target for treatment in the other group. All infants were assessed at 4, 8, 12, and 16 months of age corrected for prematurity. The results suggest that although both intervention approaches were effective in modifying some aspects of the home environment and, to a lesser degree, in improving infants' cognitive development, the parent-infant interaction approach seemed to have the greater impact. These findings confirm previous observations regarding the cognitive development of preterm and full-term infants during the first 18 months of life and demonstrate changes in behavior and behavior styles in both pre- and full-term infants as they become older.

  9. Ethnic variation in infant-feeding practices in the Netherlands and weight gain at 4 months.

    NARCIS (Netherlands)

    Bulk-Bunschoten, A.M.; Pasker-de Jong, P.C.M.; Wouwe, JP van; Groot, C.J. de

    2008-01-01

    This prospective study of 4438 infants (0-4 months) examined differences in infant-feeding patterns in relation to the ethnic origin of their mothers, based on the mother's native language: Dutch (87%), Turkish (4%), Moroccan (3%), other European languages (3%), and various other languages (4%).

  10. Ethnic variation in infant-feeding practices in the Netherlands and Weight Gain at 4 months

    NARCIS (Netherlands)

    Bulk-Bunschoten, A.M.W.; Pasker-Jong, P.C.M. de; Wouwe, J.P. van; Groot, C.J. de

    2008-01-01

    This prospective study of 4438 infants (0-4 months) examined differences in infant-feeding patterns in relation to the ethnic origin of their mothers, based on the mother's native language: Dutch (87%), Turkish (4%), Moroccan (3%), other European languages (3%), and various other languages (4%). Bre

  11. Ethnic variation in infant-feeding practices in the Netherlands and weight gain at 4 months.

    NARCIS (Netherlands)

    Bulk-Bunschoten, A.M.; Pasker-de Jong, P.C.M.; Wouwe, JP van; Groot, C.J. de

    2008-01-01

    This prospective study of 4438 infants (0-4 months) examined differences in infant-feeding patterns in relation to the ethnic origin of their mothers, based on the mother's native language: Dutch (87%), Turkish (4%), Moroccan (3%), other European languages (3%), and various other languages (4%). Bre

  12. Ethnic variation in infant-feeding practices in the Netherlands and Weight Gain at 4 months

    NARCIS (Netherlands)

    Bulk-Bunschoten, A.M.W.; Pasker-Jong, P.C.M. de; Wouwe, J.P. van; Groot, C.J. de

    2008-01-01

    This prospective study of 4438 infants (0-4 months) examined differences in infant-feeding patterns in relation to the ethnic origin of their mothers, based on the mother's native language: Dutch (87%), Turkish (4%), Moroccan (3%), other European languages (3%), and various other languages (4%).

  13. An increasing proportion of infants weight more than 4000 grams at birth

    DEFF Research Database (Denmark)

    Ørskou, J.; Kesmodel, Ulrik; Henriksen, Tine Brink

    2001-01-01

    Background. To investigate how mean birthweight has changed in the past decade, and to describe changes in the proportion of infants with a birthweight above 4000 grams (g). Methods. We analyzed data on 43,561 singleton infants born between 1990 and 1999 at Aarhus University Hospital, Denmark. In...

  14. Bloodstream Infections in Very Low Birth Weight Infants with Intestinal Failure

    NARCIS (Netherlands)

    Cole, Conrad R.; Hansen, Nellie I.; Higgins, Rosemary D.; Bell, Edward F.; Shankaran, Seetha; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Das, Abhik; Stoll, Barbara J.

    2012-01-01

    Objective To examine pathogens and other characteristics associated with late-onset bloodstream infections (BSIs) in infants with intestinal failure (IF) as a consequence of necrotizing enterocolitis (NEC). Study design Infants weighing 401-1500 g at birth who survived for >72 hours and received car

  15. The effect of kangaroo ward care in comparison with "intermediate intensive care" on the growth velocity in preterm infant with birth weight control trial.

    Science.gov (United States)

    Sharma, Deepak; Murki, Srinivas; Pratap, Oleti Tejo

    2016-10-01

    Kangaroo mother care (KMC) reduces neonatal mortality, neonatal sepsis and improves growth outcome in preterm infants. In this study, we compared the efficacy of "baby care in kangaroo ward (KWC)" with "baby care in intermediate intensive care (IIC)" in stable preterm infants (birth weight birth weight <1100 g) infants at term gestational age. Clinical trial registry of India CTRI/2014/05/004625 WHAT IS KNOWN: • Kangaroo mother care (KMC) reduces neonatal mortality, neonatal sepsis and improves growth outcome in VLBW infants. What is new: • Baby care by mother can be given safely in kangaroo ward from a weight of 1150 g in stable preterm infants without any adverse effects.

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

    Science.gov (United States)

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

    2014-08-01

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

  17. Birth weight for gestational age norms for a large cohort of infants born to HIV-negative women in Botswana compared with norms for U.S.-born black infants

    Directory of Open Access Journals (Sweden)

    Matthews Lynn T

    2011-12-01

    Full Text Available Abstract Background Standard values for birth weight by gestational age are not available for sub-Saharan Africa, but are needed to evaluate incidence and risk factors for intrauterine growth retardation in settings where HIV, antiretrovirals, and other in utero exposures may impact birth outcomes. Methods Birth weight data were collected from six hospitals in Botswana. Infants born to HIV-negative women between 26-44 weeks gestation were analyzed to construct birth weight for gestational age charts. These data were compared with published norms for black infants in the United States. Results During a 29 month period from 2007-2010, birth records were reviewed in real-time from 6 hospitals and clinics in Botswana. Of these, 11,753 live infants born to HIV-negative women were included in the analysis. The median gestational age at birth was 39 weeks (1st quartile 38, 3rd quartile 40 weeks, and the median birth weight was 3100 grams (1st quartile 2800, 3rd quartile 3400 grams. We constructed estimated percentile curves for birth weight by gestational age which demonstrate increasing slope during the third trimester and leveling off beyond 40 weeks. Compared with black infants in the United States, Botswana-born infants had lower median birth weight for gestational age from weeks 37 through 42 (p Conclusions We present birth weight for gestational age norms for Botswana, which are lower at term than norms for black infants in the United States. These findings suggest the importance of regional birth weight norms to identify and define risk factors for higher risk births. These data serve as a reference for Botswana, may apply to southern Africa, and may help to identify infants at risk for perinatal complications and inform comparisons among infants exposed to HIV and antiretrovirals in utero.

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  19. Growth and Development in Extremely Low Birth Weight Infants After the Introduction of Exclusive Human Milk Feedings.

    Science.gov (United States)

    Colacci, Michael; Murthy, Karna; DeRegnier, Raye-Ann O; Khan, Janine Y; Robinson, Daniel T

    2017-01-01

    Objective To estimate associations of exclusive human milk (EHM) feedings with growth and neurodevelopment through 18 months corrected age (CA) in extremely low birth weight (ELBW) infants. Study Design ELBW infants admitted from July 2011 to June 2013 who survived were reviewed. Infants managed from July 2011 to June 2012 were fed with bovine milk-based fortifiers and formula (BOV). Beginning in July 2012, initial feedings used a human milk-based fortifier to provide EHM feedings. Infants were grouped on the basis of feeding regimen. Primary outcomes were the Bayley-III cognitive scores at 6, 12, and 18 months and growth. Results Infants (n = 85; 46% received EHM) were born at 26 ± 1.9 weeks (p = 0.92 between groups) weighing 776 ± 139 g (p = 0.67 between groups). Cognitive domain scores were similar at 6 months (BOV: 96 ± 7; EHM: 95 ± 14; p = 0.70), 12 months (BOV: 97 ± 10; EHM: 98 ± 9; p = 0.86), and 18 months (BOV: 97 ± 16; EHM: 98 ± 14; p = 0.71) CA. Growth velocity prior to discharge (BOV: 12.1 ± 5.2 g/kg/day; EHM: 13.1 ± 4.0 g/kg/day; p = 0.33) and subsequent growth was similar between groups. Conclusion EHM feedings appear to support similar growth and neurodevelopment in ELBW infants as compared with feedings containing primarily bovine milk-based products.

  20. 'Resuscitation' of extremely preterm and/or low-birth-weight infants - time to 'call it'?

    Science.gov (United States)

    O'Donnell, Colm P F

    2008-01-01

    Since ancient times, various methods have been used to revive apparently stillborn infants; many were of dubious efficacy and had the potential to cause harm. Based largely on studies of acutely asphyxiated term animal models, clinical assessment and positive pressure ventilation have become the cornerstones of neonatal resuscitation over the last 40 years. Over the last 25 years, care of extremely preterm infants in the delivery room has evolved from a policy of indifference to one of increasingly aggressive support. The survival of these infants has improved considerably in recent years; this has not, however, necessarily been due to more aggressive resuscitation. Urban myths have evolved that all extremely preterm infants died before they were intubated, and that all such infants need to immediately intubated or they will quickly die. This has never been true. Clinical assessment of infants at birth is subjective. Also, many techniques used to support preterm infants at birth have not been well studied and there is evidence that they may be harmful. It may thus be argued that many of our well-intentioned resuscitation interventions are of dubious efficacy and have the potential to cause harm. 'Resuscitation' is an emotive term which means 'restoration of life'. Death, thankfully, is a rare presentation in the delivery room. Therefore, concerning neonatal 'resuscitation', it is time to 'call it' something else. This will allow us to dispassionately distinguish preterm infants who are dead, or nearly dead, from those who are merely at high risk of parenchymal lung disease. We may then be able to refine our interventions and determine what methods of support benefit these infants most.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-08-15

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Grandi

    2015-06-01

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

  4. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Directory of Open Access Journals (Sweden)

    Hui-Jia Lin

    2015-01-01

    Full Text Available Background: With the progress of perinatal medicine and neonatal technology, more and more extremely low birth weight (ELBW survived all over the world. This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU stay in the mainland of China. Methods: All infants admitted to 26 NICUs with a birth weight (BW < l000 g were included between January l, 2011 and December 31, 2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results: A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age (GA was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants (23.3% died and another 69 infants (26.7% died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas (53.6% vs. 35.3%, P = 0.019. BW < 750 g and GA < 28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions: Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other

  5. Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China: A Multi-center Study

    Institute of Scientific and Technical Information of China (English)

    Hui-Jia Lin; Li-Zhong Du; Xiao-Lu Ma; Li-Ping Shi; Jia-Hua Pan; Xiao-Mei Tong; Qiu-Ping Li

    2015-01-01

    Background:With the progress ofperinatal medicine and neonatal technology,more and more extremely low birth weight (ELBW) survived all over the world.This study was designed to investigate the short-term outcomes of ELBW infants during their Neonatal Intensive Care Unit (NICU) stay in the mainland of China.Methods:All infants admitted to 26 NICUs with a birth weight (BW) <1000 g were included between January 1,2011 and December 3 1,201 1.All the data were collected retrospectively from clinical records by a prospectively designed questionnaire.The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed.Categorical variables were performed with Pearson Chi-square test.Binary Logistic regression analysis was used to detect risk factors.Results:A total of 258 ELBW infants were admitted to 26 NICUs,of whom the mean gestational age (GA) was 28.1 ± 2.2 weeks,and the mean BW was 868 ± 97 g.The overall survival rate at discharge was 50.0%.Despite aggressive treatment 60 infants (23.3%) died and another 69 infants (26.7%) died after medical care withdrawal.Furthermore,the survival rate was significantly higher in coastal areas than inland areas (53.6% vs.35.3%,P =0.019).BW <750 g and GA <28 weeks were the largest risk factors,and being small for gestational age was a protective factor related to mortality.Respiratory distress syndrome was the most common complication.The incidence of patent ductus arteriosus,intraventricular hemorrhage,periventricular leukomalacia,bronchopulmonary dysplasia,retinopathy of prematurity was 26.2%,33.7%,6.7%,48.1%,and 41.4%,respectively.Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization.Conclusions:Our study was the first survey that revealed the present status of ELBW infants in the mainland of China.The mortality and morbidity of ELBW infants remained high as compared to other developed countries.

  6. The outcome at 12 months of very-Iow-birth-weight infants ventilated ...

    African Journals Online (AJOL)

    1995-07-07

    Jul 7, 1995 ... referring hospital before cranial ultrasound studies could be ... complicated by an amorphous acardiac fetus. .... severity of the lung disease.'· ..... Finnstrom O. Studies on maturity in newborn infants: Further observations of.

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

    Directory of Open Access Journals (Sweden)

    Alan H. Jobe

    2010-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Hsin-Chung Huang

    Full Text Available Preeclampsia and retinopathy of prematurity (ROP are associated with impaired angiogenesis. Previous studies on the relationship between preeclampsia and ROP have produced conflicting results. The goal of this study was to evaluate the association between maternal preeclampsia and ROP using a large population-based cohort of very-low-birth-weight (VLBW infants from 21 neonatal departments registered in the database of the Premature Baby Foundation of Taiwan. Multivariable logistic regression analysis was used to estimate the adjusted odds ratios (OR and 95% confidence intervals (CI for preeclampsia with reference to ROP and severe ROP. A total of 5,718 VLBW infants (844 cases with maternal preeclampsia were included for analysis. The overall incidences of mild and severe ROP were 36.0% and 12.2%, respectively. Univariable analysis showed lower GA and lower birth weight, vaginal delivery, non-SGA, RDS, PDA, sepsis, transfusion, and absence of maternal preeclampsia to be associated with mild and severe ROP development. However, OR (95% CI adjusted for the variables that were significant according to univariable analysis showed the risks of developing any-stage ROP and severe ROP for maternal preeclampsia to be 1.00 (0.84-1.20 and 0.89 (0.63-1.25, respectively. The results remained unchanged in stratified analyses according to SGA status. Our data showed that maternal preeclampsia was not associated with the subsequent development of any stage or severe ROP in VLBW infants.

  9. A comparison of the efficacy of weight-shift vs. joystick control of a robotic mobility device by infants ages 5 to 10 months.

    Science.gov (United States)

    Stansfield, Sharon; Dennis, Carole; Altman, Rachel; Smith, Janelle; Larin, Hélène

    2017-02-02

    The onset of crawling in infants contributes to cognitive, perceptual, social, and emotional development. Conversely, infants with motor impairment that delays or prevents autonomous mobility often have associated developmental delays. Evidence suggests that providing mobility may have positive developmental outcomes, however powered wheelchairs may not be recommended for very young children, due to safety concerns and the child's level of cognitive maturity. The WeeBot is a mobility device controlled by infant weight shifting while seated; infants as young as 5 months have learned to use it. This study compares the efficacy of using the WeeBot vs. using the traditional manual joystick to control a robotic mobility device. Participants were 20 typically developing infants between 5 and 10 months who had not yet achieved independent mobility. A quasi-experimental two-group design was used: The first 10 participants recruited used the WeeBot (weight-shift); the next 10 used the joystick. Results showed that infants learned to use weight-shift control more easily and more skilfully than did infants using the joystick. The ability of infants to use the WeeBot suggests that an intuitive alternative control might allow very early powered mobility for children with disabilities, which might have implications for various aspects of their development.

  10. Role of the 145-kilodalton surface protein in virulence of the Brazilian purpuric fever clone of Haemophilus influenzae biogroup aegyptius for infant rats.

    Science.gov (United States)

    Rubin, L G

    1995-09-01

    Brazilian purpuric fever (BPF) is a fulminant infection associated with bacteremia with clonally related strains of Haemophilus influenzae biogroup aegyptius. Case-associated clone strains are more virulent for infant rats than are non-BPF case-associated H. influenzae biogroup aegyptius isolates. I sought to determine the possible role of P145, a 145-kDa surface protein of BPF case H. influenzae biogroup aegyptius clone isolates, in virulence. First, I compared the virulence of two case-associated clone isolates from the blood of children with BPF from Serrana, Brazil, which differed in P145 expression but were identical in all other phenotypic and genotypic characteristics studied. Twenty-four hours after intraperitoneal inoculation of infant rats, there was a significantly higher incidence (51 versus 26%; P = 0.035) and magnitude (2.9 +/- 5.8 versus 0.7 +/- 2.0 CFU/0.01 ml; P = 0.024) of bacteremia in rats inoculated with the P145-expressing strain. I next compared the virulence of a P145-expressing case-associated clone strain with two P145-nonexpressing phase variants of this strain. One variant exhibited a lower mean magnitude of bacteremia and one displayed a similar magnitude of bacteremia compared with that displayed the P145-expressing parental strain. P145-expressing revertants of the P145-nonexpressing strains exhibited the same virulence as the P145-negative variants from which they were derived. Colonies grown from blood cultures maintained the P145 phenotype of the inoculated strain. These results suggest that P145 expression does not contribute to the virulence of the BPF case clone strain for infant rats following intraperitoneal inoculation.

  11. Heterologous Immunological Effects of Early BCG Vaccination in Low-Birth-Weight Infants in Guinea-Bissau

    DEFF Research Database (Denmark)

    Jensen, Kristoffer Jarlov; Larsen, Nanna; Biering-Sørensen, Sofie

    2015-01-01

    -Bissau of early BCG vs the usual postponed BCG, a subgroup was bled 4 weeks after randomization. Levels of interleukin (IL)-1β, IL-5, IL-6, IL-10, IL-17, interferon (IFN)-γ and tumor necrosis factor (TNF)-α were measured from whole-blood assays stimulated with innate agonists to Toll-like receptor (TLR)-2, -4......BACKGROUND:  Bacillus Calmette-Guérin (BCG) seems to have beneficial nonspecific effects; early BCG vaccination of low-birth-weight (LBW) newborns reduces neonatal mortality by >40% due to prevention of primarily septicemia and pneumonia. METHODS:  Within a randomized trial in LBW infants in Guinea...... or -7/8, or purified protein derivative (PPD). RESULTS:  Among 467 infants, BCG significantly increased the in vitro cytokine responses to purified protein derivative of Mycobacterium tuberculosis (PPD), as expected. BCG was also associated with increased responses to heterologous innate stimulation...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  13. Environmental temperature control in very low birth weight infants (less than 1000 grams) cared for in double-walled incubators.

    Science.gov (United States)

    Chessex, P; Blouet, S; Vaucher, J

    1988-08-01

    To evaluate the effect of fluctuations in environment and body temperatures on preterm infants, we recorded these variables in very immature newborn infants (birth weight less than 1000 gm) cared for in double-walled incubators (Air-Shields model C-100 and Ohio model IC). Both incubators maintained environmental temperatures corresponding overall to the set point, despite incubator openings. Under skin temperature servocontrol, however, environmental temperature fluctuations were greater than 2 degrees C even in strictly controlled conditions. The pattern of incubator temperature fluctuations depended on the set point rather than on the type of incubator (conventionally heated or heated by warm air blown between the double walls). The long-term clinical significance of the incubator temperature variability remains to be determined; the choice between air and skin servocontrolling should depend in part on the need for environmental stability.

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

    Directory of Open Access Journals (Sweden)

    Kathrin Hanke

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

  15. A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon

    Science.gov (United States)

    Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Montresor, Antonio; Rahme, Elham; Fraser, William D.; Marquis, Grace S.; Vercruysse, Jozef; Allen, Lindsay H.; Blouin, Brittany; Razuri, Hugo; Pezo, Lidsky

    2017-01-01

    Background Nutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic. Methodology/Principal Findings From February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age. Conclusions/Significance In a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in

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

    Institute of Scientific and Technical Information of China (English)

    王恋; 李娟; 毛健; 张静; 陈丹

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sina Ahmadi

    2009-03-01

    Full Text Available Objective: Retinopathy of prematurity (ROP is a disease of the eye caused by disorganized growth of retinal blood vessels resulting in scarring and retinal detachment. All preterm babies are at high risk for ROP, and very low birth weight is an additional risk factor. An increased incidence of ROP is expected in Iran because of improved survival of low birth weight and premature babies, and it is obvious that pediatricians and ophthalmologists are concerned about prevention and timely treatment of ROP in these children. To asses the real situation of ROP in our NICU we studied its prevalence and risk factors. Methods: This was a retrospective analysis of premature infants with birth weight of ≤1500 grams or gestational age of ≤32 weeks, admitted April 1, 2005 to March 28, 2006, to the Neonatal Intensive Care Unit of Qaem Hospital, Mashhad, Iran. The collected data of 47 cases in this cross-sectional study are analyzed by SPSS (Mann_Whitney, t-Student. Findings: Forty five infants were included in the study. Out of these, 4 (8.5% developed ROP (inclusive all stages. Our analysis revealed that low gestational age, sepsis and respiratory distress syndrome were independent predictors for the development of ROP. Conclusion:The frequency of ROP in our hospital was lower than the range reported in developed countries, and our risk factors were a little different.

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

    Science.gov (United States)

    Almadhoob, Abdulraoof; Ohlsson, Arne

    2015-01-30

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

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

    LENUS (Irish Health Repository)

    Miletin, J

    2012-02-01

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

  20. Effect of glutamine with auxiliary enteral and parenteral nutrition on feeding intolerance of low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Cai; Chun-Hong Chen; Yan-Fang Li

    2016-01-01

    Objective:To analyze the clinical effects of glutamine assisted enteral nutrition and parenteral nutrition on improving the feeding intolerance of low birth weight infants.Methods: A total of 40 cases of low birth weight infants (LBW) in our hospital from May 2013 to June 2015 were selected, which were divided equally into the observation group and the control group according to the different nutritional intervention methods. Patients in the control group received routine enteral nutrition and parenteral nutrition while children of observed group received glutamine assisted enteral and parenteral nutrition. Differences of children’s growth and development indicators, nutritional status and levels of calcium and phosphorus, gastrin and motilin levels, mucosal barrier and immune function were compared between two groups. Results:After receiving nutritional intervention, children in the observation group had higher levels of serum leptin, GH, IGF-I and adiponectin than the control group patients, while Cor values were lower. The observation group patients who received nutritional intervention had higher TSF, AMC, TP, ALB, calcium and phosphorus levels than the control group, while the ALP values were lower; children of observation group who received nutrition intervention had higher GAS and MOT levels than the control group; children of observation group after intervention had higher peripheral blood CD3+T, CD4+T and CD4+/CD8+ levels than the control group children, while D-lactic acid and blood ammonia levels were lower.Conclusion:Glutamine assisted enteral nutrition and parenteral nutrition could improve the feeding intolerance of low birth weight infants, and it improved the nutritional status as well as growth and development of children as a whole, and thus had positive clinical significance.

  1. Early kangaroo mother care vs. conventional method in stabilizing low birth weight infant: physiologic parameters (preliminary report

    Directory of Open Access Journals (Sweden)

    Rulina Suradi

    2006-12-01

    Full Text Available Background Kangaroo mother care (KMC has been accepted as an effective method in nursing low birth weight infant (LBWI. However, the application of this method in the early life of infants has not been studied in Indonesia. Objective To evaluate some physiologic parameters of LBWI treated with early KMC compared to conventional method. Methods This was a randomized clinical-trial, which compared early KMC to conventional method in stabilizing LBWI in the first 4 hours of life. All LBWI (birth weight 1500-2499 g bom at Cipto Mangunkusumo Hospital and Budi Kemuliaan Matemity Hospital Jakarta were recruited consecutively in the period of November 2001 until March 2002. The inclusion criteria were spontaneous delivery, APGAR scores 13t and 5th minute 37, and parental consent. Results Sixty-four subjects distributed evenly into early KMC group and control group. One subject in the KMC group and three subjects in the control group were excluded due to respiratory distress. The mean birth weight was 2091 (SO 299.4 g in the KMC group and 2184 (SO 214.9 g inthe control group. The mean gestational-age in both groups was 35.6 (SO 3.0 weeks. There were no statistical differences in mean temperature (P=0.281, heart rate (P=0.956, and respiratory rate (P=0.898 between the two groups during the first 4 hours of life. We found a larger proportion of infants reaching the temperature of 36.5QC in the KMC group, especially at one hour (49% vs. 7%; the difference of proportion was 0.42 (95%CI 0.22 to 0.61. Conclusion Early KMC method is proved to be as safe as conventional method in stabilizing healthy LBWI.

  2. Stress and health-related well-being among mothers with a low birth weight infant: The role of sleep

    OpenAIRE

    Lee, Shih-Yu; Hsu, Hui-Chin

    2012-01-01

    This U.S.A.-based study examined the quantitative and qualitative characteristics of sleep, as well as the role of sleep, in the association of stress with depression, fatigue, and health-related quality of life (H-QOL) among mothers with a low-birth-weight, preterm infant in the neonatal intensive care unit at early postpartum. Fifty-five first-time mothers kept a sleep diary and filled out a battery of questionnaires. The wrist actigraphy method was also applied to collect information on ma...

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

    Science.gov (United States)

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

    2012-03-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ankana Daga

    2017-06-01

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

  6. Coagulation abnormalities and severe intraventricular hemorrhage in extremely low birth weight infants.

    Science.gov (United States)

    Piotrowski, Andrzej; Dabrowska-Wojciak, Iwona; Mikinka, Marek; Fendler, Wojciech; Walas, Wojciech; Sobala, Wojciech; Kuczkowski, Krzysztof Marek

    2010-07-01

    The association between intraventricular hemorrhage (IVH) and coagulation in infants has been a subject of controversy. Only few publications assessing risk factors for development of IVH reported results of coagulation studies. To evaluate the levels of coagulation and fibrinolysis systems in ELBW infants and determine their influence on IVH. Following IRB approval coagulation status of 38 ELBW infants was evaluated on first and second day of life. Severity of IVH assessed by cerebral ultrasonography was graded according to Papile classification. Newborns were assigned to either Group A--Grade III or IV, or Group B--Grade I-II, or no IVH. Neonates with Grade III/IV IVH had significantly lower plasma Factor VII (FVII) level on first day of life and FVII differed significantly between Groups A and B with sensitivity of 100%, specificity 41% for a cut-off value of< 7%. In Group A there was no improvement of prothrombin and activated partial thromboplastin times on Day 2. A significant decline of platelet count was also observed. High-grade IVH coincides with severe derangement of coagulation in ELBW infants with FVII level being the most sensitive, it is not clear what the reason for such low FVII concentration is. Further studies are indicated.

  7. Infant adiposity at birth and early postnatal weight gain predict increased aortic intima-media thickness at 6 weeks of age: a population-derived cohort study.

    Science.gov (United States)

    McCloskey, Kate; Burgner, David; Carlin, John B; Skilton, Michael R; Cheung, Michael; Dwyer, Terence; Vuillermin, Peter; Ponsonby, Anne-Louise

    2016-03-01

    Infant body composition and postnatal weight gain have been implicated in the development of adult obesity and cardiovascular disease, but there are limited prospective data regarding the association between infant adiposity, postnatal growth and early cardiovascular parameters. Increased aortic intima-media thickness (aortic IMT) is an intermediate phenotype of early atherosclerosis. The aim of the present study was to investigate the relationship between weight and adiposity at birth, postnatal growth and aortic IMT. The Barwon Infant Study (n=1074 mother-infant pairs) is a population-derived birth cohort. Infant weight and other anthropometry were measured at birth and 6 weeks of age. Aortic IMT was measured by trans-abdominal ultrasound at 6 weeks of age (n=835). After adjustment for aortic size and other factors, markers of adiposity including increased birth weight (β=19.9 μm/kg, 95%CI 11.1, 28.6; Pinfant weight and adiposity at birth, as well as increased early weight gain, were positively associated with aortic IMT. Excessive accumulation of adiposity during gestation and early infancy may have adverse effects on cardiovascular risk.

  8. Outcome of Very Lov Birth Weight Infants in Neonatal Care Unit of Dicle University Faculty of Medicine

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    Selahattin Katar

    2006-01-01

    Full Text Available Our purpose was to determine mortality and morbidity rates and selected outcome variables for infants weighing less than 1500 g, who were admitted to the neonatal care unit of our hospital from April 2005 to February 2006.The number of VLBW admissions to the our neonatal care unit was 91, fourty one percent female and %49 were male. The mean birth weight was 1191±261 g and gestational age was 29±2.4 weeks. The mortality rate was 37.3 %. Antenatal steroids had been given to only 8% of mothers. The most important maternal risk factors were preeclampsia/eclampsia 30%, premature rupture of membranes 13%, hemorhage 8%. Respiratory distress syndrome was diagnosed 47%, surfactant was given to 40% of these infants. The major causes of death were sepsis, respiratuar distres syndrome, and extreme prematurity.Compared with reports from other developed NICU, VLBW infants at our center had higher mortality rates. We conclude that, the major cause of high mortality rate depends on low-social –cultural –education conditions associated with insufficient prenatal care, neonatal care and inaccurate neonatal transport in our region.

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

    Science.gov (United States)

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

    2017-07-24

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

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

    OpenAIRE

    Wright, C.; Parkinson, K.

    2004-01-01

    Background: Although it is a well known phenomenon, limited normative data on neonatal weight loss and subsequent gain are available, making it hard to assess individual children with prolonged weight loss.

  11. Cross-sectional study on the weight and length of infants in the interior of the State of São Paulo, Brazil: associations with sociodemographic variables and breastfeeding

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    Julia Laura Delbue Bernardi

    Full Text Available CONTEXT AND OBJECTIVE: Increasing obesity is starting to occur among Brazilians. The aim of this study was to investigate the weight and length of children under two years of age in relation to sociodemographic variables and according to whether they were breastfed. DESIGN AND SETTING: Cross-sectional randomized study conducted in 2004-2005, based on the declaration of live births (SINASC in Campinas, Brazil. METHODS: 2,857 mothers of newborns were interviewed and answered a questionnaire seeking socioeconomic and breastfeeding information. The newborns' weights and lengths were measured at the end of the interviews and the body mass index was calculated. Percentiles ( 85 and Z-scores ( +1 were used for classification based on the new growth charts recommended by WHO (2006. The log-rank test, multiple linear regression and binomial test (Z were used. The statistical significance level used was 5%. RESULTS: The predominant social level was class C. The median for exclusive breastfeeding was 90 days; 61.25% of the children were between P15 and P85 for body mass index and 61.12% for length, respectively. Children whose mothers studied for nine to eleven years and children whose mothers were unemployed presented lower weight. Children whose mothers worked in health-related professions presented lower length when correlated with breastfeeding. CONCLUSION: The breastfeeding, maternal schooling and maternal occupation levels had an influence on nutrition status and indicated that obesity is occurring in early childhood among the infants living in the municipality.

  12. Concentração de fluoreto em arroz, feijão e alimentos infantis industrializados Fluoride concentrations in typical Brazilian foods and in infant foods

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    Renato C V Casarin

    2007-08-01

    Full Text Available OBJETIVO: Determinar a concentração de fluoreto na refeição brasileira típica (arroz e feijão e em alimentos infantis industrializados e estimar suas contribuições para fluorose dental. MÉTODOS: Os alimentos foram adquiridos de supermercados das cidades de Piracicaba e Campinas, SP, Brasil. Os alimentos infantis industrializados foram comprados em 2001 e o arroz e feijão em 2003, e imediatamente analisados. Foram analisadas três marcas de arroz, três de feijão e 36 amostras de alimentos infantis divididos em cinco grupos: prontos para o consumo; mingaus; alimentos formulados; leites em pó e outros alimentos. No arroz e feijão, foram determinadas as concentrações de fluoreto nas sementes "in natura" e após cozimento com água destilada ou fluoretada (0,7 ppm. Todas as análises de fluoreto foram feitas com eletrodo específico. Considerou-se 0,07 mg/kg/dia como a dose limite de exposição a fluoreto para risco de fluorose. RESULTADOS: A concentração de fluoreto encontrada nos grãos de arroz e feijão foi baixa. Porém, a concentração aumentou 100-200 vezes após cozimento em água fluoretada e mesmo assim, foi menor que a encontrada em alguns alimentos industrializados. Uma refeição com arroz e feijão preparada com água fluoretada seria responsável por 29% da dose limite de ingestão de fluoreto em termos de fluorose aceitável; a contribuição de alguns alimentos industrializados atingiria 45%. CONCLUSÕES: A alimentação típica brasileira, mesmo preparada com água fluoretada, é mais segura em termos de risco de fluorose dental que alguns alimentos infantis industrializados.OBJECTIVE: To determine fluoride concentrations in the typical Brazilian meal (rice with beans and in processed infant foods, and to estimate their contribution towards dental fluorosis. METHODS: The foods were purchased at supermarkets in the cities of Piracicaba and Campinas, Southeastern Brazil. The processed infant foods were bought in

  13. Sequential cranial ultrasound and cerebellar diffusion weighted imaging contribute to the early prognosis of neurodevelopmental outcome in preterm infants.

    Directory of Open Access Journals (Sweden)

    Margaretha J Brouwer

    Full Text Available OBJECTIVE: To evaluate the contribution of sequential cranial ultrasound (cUS and term-equivalent age magnetic resonance imaging (TEA-MRI including diffusion weighted imaging (DWI to the early prognosis of neurodevelopmental outcome in a cohort of very preterm infants (gestational age [GA] <31 weeks. STUDY DESIGN: In total, 93 preterm infants (median [range] GA in weeks: 28.3 [25.0-30.9] were enrolled in this prospective cohort study and underwent early and term cUS as well as TEA-MRI including DWI. Early cUS abnormalities were classified as normal, mild, moderate or severe. Term cUS was evaluated for ex-vacuo ventriculomegaly (VM and enlargement of the extracerebral cerebrospinal fluid (eCSF space. Abnormalities on T1- and T2-weighted TEA-MRI were scored according to Kidokoro et al. Using DWI at TEA, apparent diffusion coefficients (ADCs were measured in four white matter regions bilaterally and both cerebellar hemispheres. Neurodevelopmental outcome was assessed at two years' corrected age (CA using the Bayley Scales of Infant and Toddler Development, third edition. Linear regression analysis was conducted to explore the correlation between the different neuroimaging modalities and outcome. RESULTS: Moderate/severe abnormalities on early cUS, ex-vacuo VM and enlargement of the eCSF space on term cUS and increased cerebellar ADC values on term DWI were independently associated with worse motor outcome (p<.05. Ex-vacuo VM on term cUS was also related to worse cognitive performance at two years' CA (p<.01. CONCLUSION: These data support the clinical value of sequential cUS and recommend repeating cUS at TEA. In particular, assessment of moderate/severe early cUS abnormalities and ex-vacuo VM on term cUS provides important prognostic information. Cerebellar ADC values may further aid in the prognostication of gross motor function.

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

    Science.gov (United States)

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

    2009-05-01

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

  15. Prenatal and neonatal variables associated with enamel hypoplasia in deciduous teeth in low birth weight preterm infants

    Directory of Open Access Journals (Sweden)

    Kátia Maria Dmytraczenko Franco

    2007-12-01

    Full Text Available This study investigated possible prenatal and neonatal variables that may influence the prevalence of tooth enamel hypoplasia in preterm and low birth weight children (LBW and a matched control group of term children with normal birth weight (NBW. The study sample consisted of 61 children born preterm and with LBW examined at 18-34 months of age. The control group was formed by 61 infants born full term and with NBW examined at 31-35 months of age. All children were born at the Center of Integrated Attention of Women's Health (CAISM-UNICAMP. FDI criteria were followed for dental examination. Medical data was collected retrospectively from hospital records. Among preterms, 57.4% had some type of developmental defects of enamel (DDE, 52.5 % had opacities and 21.3 % presented hypoplasia. Among full-term children, 24.6% presented DDE, 24.6% had opacities and 3.3% had hypoplasia. LBW preterm infants presented a higher prevalence of hypoplasia than NBW controls. The deciduous teeth most affected by hypoplasia were maxillary incisors. There was no significant association with prenatal variables; among neonatal variables there was a significant association with respiratory distress syndrome and neurological examination at discharge with an altered result.

  16. Immunogenicity and safety of measles-mumps-rubella vaccine delivered by disposable-syringe jet injector in healthy Brazilian infants: a randomized non-inferiority study.

    Science.gov (United States)

    de Menezes Martins, Reinaldo; Curran, Birute; Maia, Maria de Lourdes Sousa; Ribeiro, Maria das Graças Tavares; Camacho, Luiz Antonio Bastos; da Silva Freire, Marcos; Yamamura, Anna Maya Yoshida; Siqueira, Marilda Mendonça; Lemos, Maria Cristina F; de Albuquerque, Elizabeth Maciel; von Doellinger, Vanessa dos Reis; Homma, Akira; Saganic, Laura; Jarrahian, Courtney; Royals, Michael; Zehrung, Darin

    2015-03-01

    This study aimed to determine if immunogenicity to measles-mumps-rubella vaccine delivered to infants via a disposable-syringe jet injector (DSJI) was non-inferior to that administered by needle and syringe (NS). Vaccination safety was evaluated, as were the use, performance, and acceptability of each delivery method. The DSJI was the PharmaJet 2009 generation-1 device (G1) and the vaccine was measles-mumps-rubella vaccine from Bio-Manguinhos. Five hundred eighty-two healthy Brazilian infants were randomized to receive vaccine via G1 or NS. Seroconversion rates against measles and mumps viruses in the G1 treatment group did not meet non-inferiority criteria when compared with the NS group; however, responses in the G1 group to rubella virus were non-inferior to those of NS vaccinees. Most adverse events were mild or moderate. Crying after injection was more frequent in the NS group, and local skin reactions were more common in the G1 group. Five serious adverse events were judged causally unrelated to treatment and all resolved. Parents/guardians expressed a strong preference for G1 over NS for their children. Vaccinators found the G1 easy to use but noted incomplete vaccine delivery in some cases. Although the G1 has been superseded by an updated device, our results are important for the continued improvement and evaluation of DSJIs, which have the potential to overcome many of the challenges and risks associated with needle-based injections worldwide. Recommendations for future DSJI clinical studies include rigorous training of vaccinators, quantitative measurement of wetness on the skin following injection, and regular monitoring of device and vaccinator performance.

  17. Factors associated with thymic size at birth among low and normal birth-weight infants

    DEFF Research Database (Denmark)

    Eriksen, Helle Brander; Biering-Sørensen, Sofie; Lund, Najaaraq

    2014-01-01

    treatment at the time of labor (0.84 [0.70-1.00]), number of pregnancy consultations (1.03 [1.00-1.05]), maternal age (0.91 [0.84-0.98]), Apgar score (1.06 [1.03-1.10]), and infant convulsions (0.44 [0.29-0.65]) were all independent determinants of thymic index but not all were determinants of thymus...

  18. Relationship between Matern al Nutritional Status and Infant Birth Weight of Vegetarians in DKI Jakarta

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    Sandra Fikawati

    2012-06-01

    Full Text Available Infant’s birth weight, especially low birth weight (LBW, areintergenerational issues that will affect the cycle of life.Vegetarian diets are at risk because limited food consumption could cause nutrient deficiencies. This retrospective studyaims to determine the relationship between maternal nutritional status (pre-pregnancy body mass index (BMI and weight gain during pregnancy and infant’s birth weight among vegetarians in Jakarta. The total sample of 85 children aged 1 month to 5 years was selected purposively. Results showed that the mean of pre-pregnancy BMI of vegetarian mothers is 20.2 kg/m2 (±2.2 kg/m2, pregnancy weight gain is 15.5 kg (±6.4 kg and infant’s birth weight is 3212 gs (±417.7 gs. Pre-pregnancy BMI and pregnancy weight gain were significantly associated with infant’s birth weight of vegetarians. There is no relationship between pre-pregnancy BMI and pregnancy weight gain. Multivariate analysis found that pre-pregnancy BMI, protein, vitamin B12, iron, and Zn intakes and sex has relationship with infant’s birthweight. It is recommended that vegetarian mothers should get information about the importance of pre-pregnancy nutrition, optimal pregnancy weight gain, and maintaining adequate intake of protein, vitamin B12, iron, and Zn during pregnancy

  19. Initial Nutritional Assessment of Infants With Cleft Lip and/or Palate: Interventions and Return to Birth Weight.

    Science.gov (United States)

    Kaye, Alison; Thaete, Kristi; Snell, Audrey; Chesser, Connie; Goldak, Claudia; Huff, Helen

    2017-03-01

      To assess and quantify cleft team practices with regard to nutritional support in the neonatal period Design :  Retrospective review.   Tertiary pediatric hospital.   One hundred consecutive newborn patients with a diagnosis of cleft lip and/or cleft palate between 2009 and 2012.   Birth weight, cleft type, initial cleft team weight measurements, initial feeding practices, recommended nutritional interventions, and follow-up nutritional assessments.   All patients in the study were evaluated by a registered dietitian and an occupational feeding therapist. Average birth weight and average age at the first cleft team visit were similar for each cleft type: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP). The calculated age (in days) for return to birth weight was significantly different between cleft types: CL = 13.58 days, CLP = 15.88 days, and CP = 21.93 days. Exclusive use of breast milk was 50% for patients with CL, 30.3% for patients with CLP, and 21.4% for patients with CP. Detailed nutritional interventions were made for 31 patients at the first visit: two with CL, 14 with CLP, and 15 with CP.   Distinct differences were seen in neonatal weight gain between cleft types. There was significantly greater total weight gain for patients with CL at their first visit and significantly slower return to birth weight for patients with isolated CP. Patients with CL required far fewer interventions at the initial assessment and were more likely to be provided breast milk exclusively or in combination with formula. Infants with CP were far less likely to receive any breast milk. Patients with CLP and CP required frequent nutritional interventions.

  20. Household tobacco smoke and admission weight predict severe bronchiolitis in infants independent of deprivation: prospective cohort study.

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    Malcolm G Semple

    Full Text Available OBJECTIVES: To examine demographic, environmental and clinical factors associated with severe bronchiolitis in infants admitted to hospital and quantify the independent effects of these factors. DESIGN: Prospective cohort study. SETTING: Alder Hey Children's Hospital, Liverpool, United Kingdom. PARTICIPANTS: 378 infants admitted to hospital with a diagnosis of bronchiolitis, of whom 299 (79% were antigen positive to respiratory syncytial virus (RSV. OUTCOME: Severity of disease during admission, defined as "no need for supplemental oxygen" (reference group, "any need for supplemental oxygen" and "any need for mechanical ventilation". RESULTS: Univariate analysis found male sex (p = 0.035 and tobacco smoking by a household member (p<0.001 were associated with need for both supplemental oxygen and mechanical ventilation. Premature birth, low gestation, low birth weight, low admission weight and low corrected age on admission were also associated with need for mechanical ventilation (all p≤0.002. Deprivation scores (IMD 2004 were significantly higher in households where a member smoked compared to non-smoking households (p<0.001. The odds of smoking predicted by deprivation were 7 times higher (95%CI (3.59, 14.03, when comparing the least and most deprived quintiles of the study population. Family history of atopic disease and deprivation score were not associated with severe disease. Multivariate multinomial logistic regression which initially included all covariates, found household tobacco smoking (adjusted OR = 2.45, 95%CI (1.60, 3.74 predicted need for oxygen supplementation. Household tobacco smoking (adjusted OR = 5.49, (2.78, 10.83 and weight (kg on admission (adjusted OR = 0.51, (0.40, 0.65 were both significant predictors in the final model for mechanical ventilation. The same associations and similar size of effects were found when only children with proven RSV infection were included in analysis. CONCLUSIONS: Low

  1. Physical Activity Pattern and Personal-Social Factors of Mothers During Pregnancy And Infant Birth Weight Based On MET Scale: A Case-Control Study.

    Science.gov (United States)

    Mahmoodi, Zohreh; Karimlou, Masoud; Sajjadi, Homeira; Dejman, Masoumeh; Vameghi, Meroe; Dolatian, Mahrokh; Baradarn Eftekhari, Monir

    2013-07-01

    Low birth weight is one of the most important public health issues in developing and developed countries and identifying its etiology is important for prevention. Considering the unknown impact of physical activity on low birth weight, this research was conducted to investigate the relationship between physical activity and low birth weight. This research was conducted using a case-control design. The control group was made of 500 women with normal birth weight infants and the case group included 250 women with low birth weight infants from the selected hospitals in city of Tehran. The information was gathered using a researcher-made questionnaire which was prepared for determining the relationship between mothers' lifestyle during pregnancy and infants' low birth weight using social determinants of health approach. In this questionnaire, scope of physical activity was investigated in three groups of athletic activities, activities at home and leisure activities. Activity intensity was determined using MET scale and the data were analyzed in SPSS software using independent t-test, Chi-square and logistic regression. In the present research, based on the results of multiple logistic regression test, an increase in the time spent on sport activities (OR = 2.20) and home activities (OR =1.44) (P = 0.003) was accompanied by increased chance of giving birth to low birth weight infants; in contrast, one hour increase of leisure activities decreased the probability of low birth weight infants by 0.32 (P = 0.008). An increase in the time spent on sport and home activities, even after considering other influential factors, was related to low birth weight.

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

    LENUS (Irish Health Repository)

    Moran, M

    2012-02-01

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

  3. [Prenatal care and risk factors associated with premature birth and low birth weight in the a capital in the Brazilian Northeast].

    Science.gov (United States)

    Gonzaga, Isabel Clarisse Albuquerque; Santos, Sheila Lima Diogenes; Silva, Ana Roberta Vilarouca da; Campelo, Viriato

    2016-06-01

    The main determinants of the risk of mortality in the neonatal period are low birth weight and premature birth. The study sought to analyze the adequacy of prenatal care and risk factors associated with premature birth and low birth weight in a northeastern Brazilian capital. This is a case-control study. A model for adequacy of prenatal conditions composed of four indicators was created. Descriptive statistics for univariate analysis were used; as well as Wald linear trend tests, Student's t and chi-square test for bivariate analysis and multiple logistic regression for multivariate analysis with p prenatal care, variable indicator III remained significant, showing that mothers who had inadequate prenatal care had an increased chance for the occurrence of the outcome, highlighting the need for adequate public health policies of care for pregnant women in the municipality under scrutiny.

  4. Weight growth of triplet infants from birth to twelve years of age.

    Science.gov (United States)

    Yokoyama, Yoshie; Pitkäniemi, Janne; Kaprio, Jaakko; Silventoinen, Karri

    2012-10-01

    We analyzed the characteristics associated with the growth in weight of Japanese triplets from birth to 12 years of age. The study included 376 mothers and their 1,128 triplet children, who were born between 1978 and 2006. Data were collected through a mailed questionnaire sent to the mothers asking for information recorded in medical records. For these births, data on triplets' weight growth, gestational age, sex, parity, maternal age at delivery, maternal height, and maternal body mass index were obtained from records in the Maternal and Child Health Handbooks and records in the school where children receive health check-ups. The weight deficit of the triplets compared to the general population of Japan remained between 10% and 17% until 12 years of age. Moreover, at 12 years of age, the differences of weight between the general population and triplets were approximately -4.75 kg for boys and -6.00 kg for girls. Very low birth weight had the strongest contribution to body weight until 8 years of age. After 8 years of age, maternal body mass index was a significant factor affecting the weight of triplets until 12 years of age.

  5. Exclusive Breastfeeding among Preterm Low Birth Weight Infants at One Month Follow-up after Hospital Discharge

    Directory of Open Access Journals (Sweden)

    Ishrat Jahan

    2011-01-01

    Full Text Available Background: Establishment and maintenance of breastfeeding in preterm low birth weight (PT LBW neonates after discharge from hospital is challenging and may be affected by multiple factors. We designed this study to find out the association of these factors with breastfeeding in our population. Objectives: To observe the rate of exclusive breasrfeeding (EBF among the PT LBW neonates at one month follow up and to identify the factors that are related with the maintenance of EBF. Materials and Methods: This observational study was conducted during the period from July 2009 to October 2011 in Enam Medical College Hospital (EMCH. Preterm infants ≤ 34 wks gestation, stayed in the NICU for >3 days and discharged home were eligible. Mothers were interviewed at one month follow-up after discharge. Infants who were given only breast milk up to 4 weeks were termed as “Exclusively breastfed (EBF” and who were given formula milk in addition were labeled as “Nonexclusively breastfed (NEBF”. Baseline information regarding maternal demography, delivery of the baby, feeding during discharge was taken from database of neonatal ward. Results: Among 89 infants, 37 (42% were female and 52 (58% were male, including 5 twins. Gestational age ranged from 29 to 34 weeks (mean 32±2, and birth weight ranged from 1100 to 2200 grams (mean 1763±20 g. At one month follow up visit 19% (17/89 were found to be NEBF and 81% were EBF. Factors significantly associated with EBF were shorter duration of hospital stay (p=0.001, method of feeding at discharge (p=0.001, mode of delivery (p=0.004, below average socio-economic status (p=0.03, maternal education (p=0.02, number of antenatal visits (p=0.02 and larger birth weight (p=0.038. Conclusion: A variety of factors may affect EBF in PT LBW babies. Extensive counseling of the mothers during antenatal visits, counseling of the family members regarding the advantages of exclusive breastfeeding is necessary. Support should be

  6. Effect of the INSIGHT Responsive Parenting Intervention on Rapid Infant Weight Gain and Overweight Status at Age 1 Year: A Randomized Clinical Trial.

    Science.gov (United States)

    Savage, Jennifer S; Birch, Leann L; Marini, Michele; Anzman-Frasca, Stephanie; Paul, Ian M

    2016-08-01

    Rapid infant weight gain is associated with later obesity, but interventions to prevent rapid infant growth and reduce risk for overweight status in infancy are lacking. To examine the effect of a responsive parenting (RP) intervention on infant weight gain between birth and 28 weeks and overweight status at age 1 year. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is an ongoing randomized clinical trial comparing an RP intervention designed to prevent childhood obesity with a safety control. The study includes primiparous mother-newborn dyads (n = 291) and was conducted at the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, in addition to home visits. Enrollment was initiated in January 2012, and evaluable population analyses for this study were conducted between April 2015 and November 2015. At 2 weeks post partum, initial intervention materials appropriate to the assigned treatment group were mailed to the participant's home. Research nurses conducted home visits at 3 weeks, 16 weeks, 28 weeks, and 40 weeks, and a research center visit occurred at 1 year. The Intervention Nurses Start Infants Growing on Healthy Trajectories curriculum included messages about infant feeding, sleep hygiene, active social play, emotion regulation, and growth record education. The control group received a developmentally appropriate home safety intervention also delivered by nurse home visitors. Conditional weight gain from birth to 28 weeks was calculated. General linear models examined intervention effect on conditional weight gain. The intervention's effect on infant weight-for-length percentiles was tested using analysis of variance. Logistic regression compared the odds of overweight status (weight for length ≥95th percentile) at 1 year as a function of conditional weight gain. Of the mothers included in the study, 246 were white (88%), 260 were non-Hispanic (93%), 210 were married (75%), and 201 were working full

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

    LENUS (Irish Health Repository)

    Hopewell, J

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Christoph Härtel

    2016-11-01

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

  9. Factors affecting prenatal sonographic estimation of weight in extremely low birthweight infants.

    Science.gov (United States)

    Townsend, R R; Filly, R A; Callen, P W; Laros, R K

    1988-04-01

    Because critical management decisions are based on sonographic estimation of fetal weight in fetuses less than 1000 g, we sought to evaluate the accuracy of birthweight prediction in this range and to identify factors affecting this accuracy. Fetal weight was estimated using several published methods in 53 fetuses with birthweights less than 1000 g. Standard deviations greater than 12.3% indicate more random error in the sonographic weight prediction than has been reported in higher weight groups. No statistically significant differences were found between patient groups with decreased, normal, or increased amniotic fluid volume or portable examination. There was a trend toward lower mean deviation (2.9 vs 6.0%) and standard deviation (8.9 vs. 15.0%) in studies with scan quality judged "good" compared with "poor" based on ability to visualize anatomic landmarks.

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

    Directory of Open Access Journals (Sweden)

    Ping Zhou

    2015-08-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

  12. Is there any role for terlipressin in the extremely low birth weight infant with refractory septic shock?

    Directory of Open Access Journals (Sweden)

    Francesca Bissolo

    2012-10-01

    Full Text Available Terlipressin, a synthetic long-acting analogue of vasopressin, has been investigated as a second line vasopressor in adults and children with refractory septic shock, i.e. not responding to fluid resuscitation and high-dose catecholamine administration. Little experience is available about the safety and efficacy of terlipressin in term and preterm newborns. We report the case of an extremely low birth weight infant with severe septic shock, unresponsive to fluids, noradrenalin and hydrocortisone, in whom terlipressin was attempted as a rescue drug. Despite three doses of terlipressin, administered 6-hourly, the patient remained profoundly hypotensive and eventually died. Further studies are required before any recommendation on the use of terlipressin in term or preterm newborns with septic shock can be made.

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

    Science.gov (United States)

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

    2009-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Regina Bentlin

    2015-04-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-08-15

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

  17. Biological risk versus socio-economic advantage: low birth-weight, multiple births and income variations among Irish infants born following fertility treatments.

    Science.gov (United States)

    Murray, Aisling

    2014-12-01

    The Growing Up in Ireland Infant Cohort dataset (n = 11,134) includes information on fertility treatments for over 400 infants. IVF (28.1 %) and IVF-related treatments (17.8 %) were the most frequent, but there was also a high percentage following clomiphene citrate alone (31.5 %). Infants born following fertility treatment were much more likely to be in higher income families, and this relationship was not accounted for by older mothers in wealthier families. Analysis of fertility-treatment pregnancies among Irish infants, controlling for income and maternal age, shows a greater risk of multiple birth and low birth-weight, although the latter appears to be largely related to the former especially for IVF-type treatments.

  18. Trends in survival among extremely-low-birth-weight infants (less than 1000 g without significant bronchopulmonary dysplasia

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    Botet Francesc

    2012-06-01

    Full Text Available Abstract Objective The aim of this study was to analyze the evolution from 1997 to 2009 of survival without significant (moderate and severe bronchopulmonary dysplasia (SWsBPD in extremely-low-birth-weight (ELBW infants and to determine the influence of changes in resuscitation, nutrition and mechanical ventilation on the survival rate. Study design In this study, 415 premature infants with birth weights below 1000 g (ELBW were divided into three chronological subgroups: 1997 to 2000 (n = 65, 2001 to 2005 (n = 178 and 2006 to 2009 (n = 172. Between 1997 and 2000, respiratory resuscitation in the delivery room was performed via a bag and mask (Ambu®, Ballerup, Sweden with 40-50% oxygen. If this procedure was not effective, oral endotracheal intubation was always performed. Pulse oximetry was never used. Starting on January 1, 2001, a change in the delivery room respiratory policy was established for ELBW infants. Oxygenation and heart rate were monitored using a pulse oximeter (Nellcor® attached to the newborn’s right hand. If resuscitation was required, ventilation was performed using a face mask, and intermittent positive pressure was controlled via a ventilator (Babylog2, Drägger. In 2001, a policy of aggressive nutrition was also initiated with the early provision of parenteral amino acids. We used standardized parenteral nutrition to feed ELBW infants during the first 12–24 hours of life. Lipids were given on the first day. The glucose concentration administered was increased by 1 mg/kg/minute each day until levels reached 8 mg/kg/minute. Enteral nutrition was started with trophic feeding of milk. In 2006, volume guarantee treatment was instituted and administered together with synchronized intermittent mandatory ventilation (SIMV + VG. The complications of prematurity were treated similarly throughout the study period. Patent ductus arteriosus was only treated when hemodynamically significant. Surgical closure of the

  19. Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study

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    Natália Maria da Silva Fernandes

    2013-01-01

    Full Text Available OBJECTIVES: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients. PATIENTS AND METHODS: Patients (n = 1911 older than 18 years of age recruited from 114 dialysis centers (Dec/ 2004-Oct/2007 and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died. RESULTS: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female. The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index 30 kg/m². Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: +7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles. CONCLUSION: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil.

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

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    Claudia Regina Hentges

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Introduction of percutaneous-tunneled transfontanellar external ventricular drainage in the management of hydrocephalus in extremely low-birth-weight infants.

    Science.gov (United States)

    Zucchelli, Mino; Lefosse, Mariella; Corvaglia, Luigi; Martini, Silvia; Sandri, Fabrizio; Soffritti, Silvia; Ancora, Gina; Mammoliti, Palma; Gargano, Giancarlo; Galassi, Ercole

    2016-07-01

    OBJECTIVE Hydrocephalus treatment in extremely low-birth-weight (ELBW) infants still represents a challenge for the pediatric neurosurgeon, particularly when the patient weighs far less than 1000 g. In such cases, the benefits in terms of neurological outcome following early treatment do not always outweigh the surgical risks, especially considering the great difference in the surgical risk before patient weight increases. To assess the efficacy and reliability of a percutaneous-tunneled, transfontanellar external ventricular drain (PTTEVD) in ELBW infants, the authors started a new protocol for the early surgical treatment of hydrocephalus. METHODS Ten cases of posthemorrhagic hydrocephalus (PHH) in ELBW infants (5 cases introduction of PTTEVD placement in our standard protocol for the management of PHH has proved to be a wise option for small patients.

  3. Survival rates of infants with birth weights between 501 and 1,000 g. Improvement by excluding certain categories of cases.

    Science.gov (United States)

    Kitchen, W H; Murton, L J

    1985-05-01

    Reported survival rates of infants with birth weights under 1,001 g vary greatly; by implication, high survival rates may be used as a measure of the standard of perinatal care. To illustrate the importance of precisely defining the population sample, we determined the survival rate to 2 years of 238 infants with birth weights of 501 to 1,000 g, born between 1977 and 1980. The rate was 33.6%; however, by excluding certain categories of patients, the survival rate was augmented to 46.9%. There were 36 infants who died in the delivery room and an additional 34 who died before the age of 3 hours in the intensive care unit; together they contributed 29.4% to the total mortality of 66.4%. This group is especially liable to influence reported survival rates. Although exclusion of patients is legitimate, the criteria need to be precisely defined if data between centers are to be compared.

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

    Science.gov (United States)

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

    2010-01-01

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

  5. Avanços na norma brasileira de comercialização de alimentos para idade infantil Advances in the Brazilian norm for commercialization of infant foods

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    Maria de Fátima Moura de Araújo

    2006-06-01

    Full Text Available OBJETIVO: Analisar os avanços na Norma Brasileira de Comercialização de Alimentos para Lactentes no período de 1988 a 2002, comparando seus diferentes textos entre si e com o Código Internacional de Comercialização de Substitutos do Leite Materno. MÉTODOS: Trata-se de um estudo descritivo, cujos dados foram obtidos em documentos, relatórios, portarias e resoluções do Ministério da Saúde. As versões utilizadas na comparação foram a de 1992 e a de 2002. RESULTADOS: A análise comparativa permitiu identificar importantes avanços na legislação. Em 1992, foram incluídos os leites fluídos, em pó, as chupetas e frases de advertência na propaganda e na rotulagem dos produtos. Em 2002, a regulamentação dos produtos foi publicada pela Agência Nacional de Vigilância Sanitária, fortalecendo a ação de fiscalização e incluindo a regulamentação dos alimentos para crianças de primeira infância, fórmulas de nutrientes indicadas para recém-nascido de alto risco e protetores de mamilo. As frases utilizadas na promoção comercial e na rotulagem dos produtos, inclusive de chupetas e mamadeiras, passaram a ser de advertência do Ministério da Saúde. A rotulagem foi definida para cada tipo de produto, baseada em regras mais restritas. CONCLUSÕES: Foram identificadas importantes modificações no controle do marketing dos produtos dirigidos à mãe no período de lactação. No entanto, ainda há questões legislativas que possibilitariam o aprimoramento da norma brasileira, visando à proteção do aleitamento materno. É necessário também que o governo implante rotinas de monitoramento sistemático de fiscalização dessa legislação.OBJECTIVE: To assess the advances in the Brazilian norm for commercialization of infant foods from 1988 to 2002, comparing the different texts with each other and with the International Code of Marketing of Breast-Milk Substitutes. METHODS: This was a descriptive study based on data collected

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

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    Mark F Cotton

    2015-12-01

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

  7. Relationship between gestational weight gain and birthweight among clients enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Hawaii, 2003-2005.

    Science.gov (United States)

    Chihara, Izumi; Hayes, Donald K; Chock, Linda R; Fuddy, Loretta J; Rosenberg, Deborah L; Handler, Arden S

    2014-07-01

    To investigate the relationship between gestational weight gain (GWG) and birthweight outcomes among a low-income population in Hawaii using GWG recommendations from the 2009 Institute of Medicine (IOM) guidelines. Data were analyzed for 19,130 mother-infant pairs who participated in Hawaii's Special Supplemental Nutrition Program for Women, Infants, and Children from 2003 through 2005. GWG was categorized as inadequate, adequate, or excessive on the basis of GWG charts in the guidelines. Generalized logit models assessed the relationship between mothers' GWG and their child's birthweight category (low birthweight [LBW: < 2,500 g], normal birthweight [2,500 g ≤ BW < 4,000 g], or high birthweight [HBW: ≥ 4,000 g]). Final models were stratified by prepregnancy body mass index (underweight, normal weight, overweight, or obese) and adjusted for maternal age, education, race/ethnicity, smoking status, parity, and marital status. Overall, 62% of the sample had excessive weight gain and 15% had inadequate weight gain. Women with excessive weight gain were more likely to deliver a HBW infant; this relationship was observed for women in all prepregnancy weight categories. Among women with underweight or normal weight prior to pregnancy, those with inadequate weight gain during pregnancy were more likely to deliver a LBW infant. Among the low-income population of Hawaii, women with GWG within the range recommended in the 2009 IOM guidelines had better birthweight outcomes than those with GWG outside the recommended range. Further study is needed to identify optimal GWG goals for women with an obese BMI prior to pregnancy.

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

    NARCIS (Netherlands)

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

    1994-01-01

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

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

    Directory of Open Access Journals (Sweden)

    İpek Güney Varal

    2014-05-01

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

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

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    Keshavarz M

    2009-08-01

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

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

    LENUS (Irish Health Repository)

    Miletin, J

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Jonathan Davis

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

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

    Science.gov (United States)

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

    2011-03-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Iijima, Shigeo; Uga, Naoki; Ohzeki, Takehiko

    2010-06-01

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

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

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    Christoph Czernik

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

  17. Small for Gestational Age and Higher Birth Weight Predict Childhood Obesity in Preterm Infants

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    Gaskins, Ronnesia B.; LaGasse, Linda L.; Liu, Jing; Shankaran, Seetha; Lester, Barry M.; Bada, Henrietta S.; Bauer, Charles R.; Das, Abhik; Higgins, Rosemary D.; Roberts, Mary

    2010-01-01

    We sought to determine the association between small for gestational age (SGA), birth weight, and childhood obesity within preterm polysubstance exposed children. We sampled 312 preterm children with 11-year body mass index (BMI; age- and sex-specific) data from the Maternal Lifestyle Study (51% girls, 21.5% SGA, 46% prenatal cocaine, and 55% tobacco exposed). Multinomial regression analyzed the association between 11-year obesity (OBE) and overweight (OW) and SGA, birth weight, first-year growth velocity, diet, and physical activity variables. Overall, 24% were OBE (BMI for age ≥95th percentile) and 16.7% were OW (BMI ≥85th and <95th percentiles). In adjusted analyses, SGA was associated with OW (odds ratio [OR]=3.4, confidence interval [CI] 1.5 to 7.5). Higher birth weight was associated with OBE (OR = 1.8, CI 1.3 to 2.4) and OW (OR=1.4, CI 1.1 to 2.0). Growth velocity was associated with OBE (OR=2.7, CI 1.8 to 4.0) and OW (OR=1.6, CI 1.1 to 2.4). Low exercise was associated with OBE (OR=2.1, CI 1.0 to 4.4) and OW (OR=2.1, CI 1.0 to 4.5). There was no effect of substance exposure on obesity outcomes. Many (41%) of these high-risk preterm 11-year-olds were obese/overweight. Multiple growth-related processes may be involved in obesity risk for preterm children, including fetal programming as indicated by the SGA effect. PMID:20408111

  18. Effects of high carnitine supplementation on substrate utilization in low-birth-weight infants receiving total parenteral nutrition.

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    Sulkers, E J; Lafeber, H N; Degenhart, H J; Przyrembel, H; Schlotzer, E; Sauer, P J

    1990-11-01

    Parenterally fed preterm neonates are known to be at risk for carnitine deficiency. We studied substrate utilization in low-birth-weight infants receiving total parenteral nutrition (TPN) with (A) and without (B) supplementation of 48 mg carnitine.kg-1.d-1 on days 4-7 (birth weights 1334 +/- 282 vs 1318 +/- 248 g, gestational age 32 +/- 2 vs 32 +/- 2 wk, A vs B, respectively). TPN consisted of 11 g glucose.kg-1.d-1 and 2.4 g.kg-1.d-1 of both protein and fat. Plasma carnitine concentrations at day 7 were for free carnitine 11.8 +/- 5.0 vs 164 +/- 56 mumol/L and for acyl carnitine 3.8 +/- 2.0 vs 33.9 +/- 15.4 mumol/L, respectively. Indirect calorimetry at day 7 showed a higher fat oxidation (0.21, -0.31 to +0.60 vs 1.18, 0.70 to 1.95 g. kg-1.d-1, respectively, P less than 0.02, median and interquartile range) in group B and a higher protein oxidation (0.37, 0.30-0.43 vs 0.63, 0.53-0.88 g.kg-1.d-1, P less than 0.001). The time to regain birth weight was also higher in group B (7, 5.5-9 vs 9, 7-14 d, P less than 0.05). Carnitine supplementation and calorie intake were the best explanatory variables for metabolic rate (R2 = 0.45, P less than 0.002). We conclude that carnitine supplementation of TPN in this dosage does not seem advisable.

  19. THE EFFECTIVENESS OF COMBINATION OF KANGAROO MOTHER CARE METHOD AND LULLABY MUSIC THERAPY ON VITAL SIGN CHANGE IN INFANTS WITH LOW BIRTH WEIGHT

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    Nuuva Yusuf

    2017-08-01

    Full Text Available Background: Kangaroo mother care (KMC and lullaby music methods have been considered as the alternative treatment for vital sign changes in low birth weight infants. However, little is known about the combination of the two methods. Objective: To identify effectiveness of combinations of Kangaroo mother care and Lullaby music methods on changes in vital signs in low birth weight infants. Methods: A quasi experiment with non-equivalent control group design. This study was conducted on October– December 2016 at the General Hospital of Ambarawa and General Hospital of Ungaran, Semarang. There were 36 samples selected using consecutive sampling divided into three groups, namely: 1 a group of LBW infants with the combination of KMC and lullaby music, 2 a LBW infant group with the lullaby music intervention, and 3 a control group given standard care in LBW infants by KMC method. Paired t-test and MANOVA test were used to analyzed the data. Results: Findings revealed that there were significant differences between the combination group, lullaby music group, and control group in temperature (p=0.003, pulse (p=0.001, respiration (p=0.001, and oxygen saturation (p=0.014 with significant value of <0.05, which indicated that there was a statistically significant difference in vital sign changes among the three groups. Conclusion: The combination of KMC method and Lullaby music intervention was effective on vital sign changes (temperature, pulse, respiration, and oxygen saturation compared with the lullaby music group alone and control group with KMC method in low birth weight infants. It is suggested that the combination of KMC and Lullaby music methods can be used as an alternative to improve LBW care for mothers in the NICU and at home and to reach the stability of the baby's vital signs.

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

    Science.gov (United States)

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

    2012-01-01

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

  1. Linking Early Adversity, Emotion Dysregulation, and Psychopathology: The Case of Extremely Low Birth Weight Infants

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    Lauren A. Drvaric

    2013-01-01

    Full Text Available The ability to regulate emotion is a crucial process that humans utilize in order to adapt to the demands of environmental constraints. Individuals exposed to early adverse life events such as being born at an extremely low birth weight (ELBW, 501–1000 g are known to have problems regulating emotion which have been linked to the development of psychopathology in this population. Recent studies have used psychophysiological measures, such as electroencephalogram (EEG and cardiac vagal tone, to index emotion regulatory processes. The purpose of this paper was three-fold: (1 to investigate the relation between ELBW and emotion regulation issues (pathway 1, (2 to review studies investigating the relation between early emotion regulation and later internalizing problems (pathway 2; and (3 to provide a model in which two psychophysiological measures (i.e., frontal EEG asymmetry and cardiac vagal tone are suggested to understand the proposed conceptual pathways in the relation between ELBW and psychopathology.

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

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    Abeer El Sakka

    2016-10-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  5. Risk and prognostic factors for diarrheal disease in Brazilian infants: a special case-control design application

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    Fuchs Sandra Costa

    2002-01-01

    Full Text Available The aim of this study was to examine the effect of demographic, socioeconomic, environmental, maternal reproductive, dietary, and nutritional variables on diarrhea risk and prognosis using a hierarchical framework. A case-control study of children aged 0-23 months in Greater Metropolitan Porto Alegre was conducted during the peak season for diarrhea in 1987-1988. Three groups were investigated, with 192 children each. The first group included hospitalized children with an episode of acute diarrhea complicated by moderate to severe dehydration. The second group included children with acute mild diarrhea without signs of dehydration who were identified in the same neighborhood as hospitalized cases. The third group consisted of controls without diarrhea. Mothers were interviewed by trained interviewers using a standardized questionnaire. Data analysis included a hierarchical approach to control for confounding, using conditional logistic regression. Comparison of the three groups aimed to identify risk factors for diarrhea complicated by dehydration, prognostic factors for dehydration, and risk factors for mild diarrhea. Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea.

  6. Risk and prognostic factors for diarrheal disease in Brazilian infants: a special case-control design application.

    Science.gov (United States)

    Fuchs, Sandra Costa; Victora, Cesar Gomes

    2002-01-01

    The aim of this study was to examine the effect of demographic, socioeconomic, environmental, maternal reproductive, dietary, and nutritional variables on diarrhea risk and prognosis using a hierarchical framework. A case-control study of children aged 0-23 months in Greater Metropolitan Porto Alegre was conducted during the peak season for diarrhea in 1987-1988. Three groups were investigated, with 192 children each. The first group included hospitalized children with an episode of acute diarrhea complicated by moderate to severe dehydration. The second group included children with acute mild diarrhea without signs of dehydration who were identified in the same neighborhood as hospitalized cases. The third group consisted of controls without diarrhea. Mothers were interviewed by trained interviewers using a standardized questionnaire. Data analysis included a hierarchical approach to control for confounding, using conditional logistic regression. Comparison of the three groups aimed to identify risk factors for diarrhea complicated by dehydration, prognostic factors for dehydration, and risk factors for mild diarrhea. Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea.

  7. Risk and prognostic factors for diarrheal disease in Brazilian infants: a special case-control design application

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    Sandra Costa Fuchs

    2002-06-01

    Full Text Available The aim of this study was to examine the effect of demographic, socioeconomic, environmental, maternal reproductive, dietary, and nutritional variables on diarrhea risk and prognosis using a hierarchical framework. A case-control study of children aged 0-23 months in Greater Metropolitan Porto Alegre was conducted during the peak season for diarrhea in 1987-1988. Three groups were investigated, with 192 children each. The first group included hospitalized children with an episode of acute diarrhea complicated by moderate to severe dehydration. The second group included children with acute mild diarrhea without signs of dehydration who were identified in the same neighborhood as hospitalized cases. The third group consisted of controls without diarrhea. Mothers were interviewed by trained interviewers using a standardized questionnaire. Data analysis included a hierarchical approach to control for confounding, using conditional logistic regression. Comparison of the three groups aimed to identify risk factors for diarrhea complicated by dehydration, prognostic factors for dehydration, and risk factors for mild diarrhea. Low birth weight, stunting, and lack or breastfeeding acted simultaneously as risk and prognostic factors for diarrhea.

  8. Associations of Infant Feeding and Timing of Weight Gain and Linear Growth during Early Life with Childhood Blood Pressure: Findings from a Prospective Population Based Cohort Study.

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    de Beer, Marieke; Vrijkotte, Tanja G M; Fall, Caroline H D; van Eijsden, Manon; Osmond, Clive; Gemke, Reinoud J B J

    2016-01-01

    Small birth size and rapid postnatal growth have been associated with higher future blood pressure. The timing of these effects, the relative importance of weight gain and linear growth and the role of infant feeding need to be clarified. We assessed how blood pressure relates to birth weight, infant and childhood growth and infant feeding (duration of exclusive breastfeeding and timing of introduction of complementary feeding) in 2227 children aged 5 years from a prospective cohort study (Amsterdam Born Children and their Development). Postnatal growth was represented by statistically independent measures of relative weight gain (weight gain independent of height) and linear growth in four age periods during infancy (0-1 month; 1-3 months; 3-6 months; 6-12 months) and from 12 months to 5 years. Lower birth weight was associated with higher childhood diastolic blood pressure (-0.38 mm Hg.SD-1; P = 0.007). Faster relative weight gain and linear growth after 1 month were positively associated with systolic and diastolic blood pressure. Associations of linear growth with systolic blood pressure ranged from 0.47 to 1.49 mm Hg.SD-1; Pgrowth. Compared to breastfeeding 1 month was associated with lower blood pressure (e.g. >6 months -1.56 mm Hg systolic blood pressure; P6 months, introduction of complementary feeding pressure (e.g. 4-6 months 0.91 mm Hg systolic blood pressure; P = 0.004). After the age of one month faster growth in either weight or height is associated with higher childhood blood pressure. It is unknown whether faster weight gain and linear growth carry the same risk for adult hypertension and cardiovascular morbidity. Longer breastfeeding and delayed introduction of complementary feeding may be associated with lower adult blood pressure.

  9. Bartter syndrome presenting as poor weight gain and abdominal mass in an infant.

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    Heffernan, Annie; Steffensen, Thora S; Gilbert-Barness, Enid; Perlman, Sharon

    2008-01-01

    Bartter syndrome, a group of disorders that encompasses multiple genetic defects with similar clinical presentation, has been divided into six different genotypes, according to different genetic defects, and into three main clinical variants (or phenotypes). Classic laboratory findings in all variants include hypochloremia, hypokalemia, and metabolic alkalosis with excessive excretion of chloride and potassium. Classic Bartter syndrome, neonatal Bartter syndrome, and Gitelman syndrome are the three main clinical variants. Classic Bartter syndrome and neonatal Bartter syndrome have defects in genes that affect transport channels in the ascending loop of Henle, where as in Gitleman syndrome the defect occurs in the transport channels of the distal convoluted tubule. Classic Bartter syndrome and neonatal Bartter syndrome have similar presenting symptoms, potential outcomes, and treatment, but different ages at presentation. Gitelman syndrome, a more benign condition than the other clinical variants, has the classic hallmark finding of hypomagnesemia and low to normal excretion of calcium. This differentiates it from the classic and neonatal variants of the disease. With early diagnosis and proper treatment, Bartter syndrome has a good prognosis. But failure to identify it can lead to tubulointerstitial nephritis and renal failure. We present a case of a 6-month-old boy with Bartter syndrome who presented with poor weight gain and an abdominal mass.

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

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

    2013-08-01

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

  11. Reduced Hospital Mortality With Surgical Ligation of Patent Ductus Arteriosus in Premature, Extremely Low Birth Weight Infants: A Propensity Score-matched Outcome Study.

    Science.gov (United States)

    Tashiro, Jun; Perez, Eduardo A; Sola, Juan E

    2016-03-01

    To evaluate outcomes after surgical ligation (SL) of patent ductus arteriosus (PDA) in premature, extremely low birth weight (ELBW) infants. Optimal management of PDA in this specialized population remains undefined. Currently, surgical therapy is largely reserved for infants failing medical management. To date, a large-scale, risk-matched population-based study has not been performed to evaluate differences in mortality and resource utilization. Data on identified premature (Propensity score-matched analysis of 1620 SL versus 1584 non-SL found reduced mortality (15% vs 26%) and more routine disposition (48% vs 41%) for SL (P Propensity score-matched analysis demonstrates reduced mortality in premature/ELBW infants with SL for PDA. NEC and sepsis are predictors of mortality and resource utilization.

  12. Prevalence of dental caries in obese and normal-weight Brazilian adolescents attending state and private schools.

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    Moreira, Patrícia Vasconcelos Leitão; Rosenblatt, Aronita; Severo, Aquilina Maria Ribeiro

    2006-12-01

    To measure the association between dental caries and obesity in adolescents aged 12 to 15 years attending state and private schools. Cross-sectional study. State and private schools in the state of Paraiba, Brazil. 1665 obese and 1665 normal-weight adolescents. These were chosen by means of an anthropometric study using height/age and weight/height indices, adopting as baseline the National Center for Health Statistics indices. The diagnostic criteria for caries were those of the World Health Organization (1997). The average DMFT for obese adolescents from state schools was 4.27 and for those of normal weight it was 4.25 (p = 0.7802). In private schools, the corresponding figures were 1.90 and 1.91, respectively (p = 0.1151). In state schools, the caries prevalence amongst the obese group was 50.9% and amongst those of normal weight, 52.4% (p = 0.5393). In private schools, it was 9.0% amongst the obese group and 9.6% amongst those of normal weight (p 0.6790). There was no statistically significant association between dental caries and obesity. Caries levels were higher amongst adolescents attending state schools.

  13. Stress and health-related well-being among mothers with a low birth weight infant: the role of sleep.

    Science.gov (United States)

    Lee, Shih-Yu; Hsu, Hui-Chin

    2012-04-01

    This U.S.A.-based study examined the quantitative and qualitative characteristics of sleep, as well as the role of sleep, in the association of stress with depression, fatigue, and health-related quality of life (H-QOL) among mothers with a low-birth-weight, preterm infant in the neonatal intensive care unit at early postpartum. Fifty-five first-time mothers kept a sleep diary and filled out a battery of questionnaires. The wrist actigraphy method was also applied to collect information on maternal sleep. We tested a path model, with sleep disturbance and depression mediating the effect of stress on health-related well-being. Results showed that the majority of the study participants were stressed, depressed, fatigued, and at risk for poor physical and mental health. Poor sleep quality as perceived by mothers was significantly associated with their stress, fatigue, and poor mental and physical H-QOL. A cascading effect was found in the path model where maternal stress contributed to poor sleep quality and depression, which in turn contributed to poor mental H-QOL. In addition, poor sleep quality was associated with fatigue, which in turn contributed to poor physical and mental H-QOL. The underlying neurobiological mechanisms through which sleep affects the stress-health relation are discussed. The implications of sleep for intervention and prevention are also addressed.

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

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    Sangtawesin, Varaporn; Singarj, Yupayao; Kanjanapattanakul, Wiboon

    2011-08-01

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

  15. Birth weight, infant growth, and adolescent blood pressure using twin status as an instrumental variable in a Chinese birth cohort: "Children of 1997".

    Science.gov (United States)

    Kwok, Man Ki; Au Yeung, Shiu Lun; Leung, Gabriel M; Schooling, C Mary

    2014-07-01

    To evaluate the credibility of twin status as an instrumental variable for birth weight and infant growth and to obtain less-confounded estimates of the associations of birth weight or infant growth with adolescent blood pressure (BP). Prospective population-based "Children of 1997" birth cohort of all surviving infants born in Hong Kong, China, from April to May 1997 with sex-, age-, and height-specific BP z-score at approximately 11 years (n = 6276) and approximately 13 years (n = 5305). In instrumental variable analyses, birth weight-for-gestational age z-score was not associated with z-score for systolic BP (0.01; 95% confidence interval [CI], -0.22 to 0.25) or diastolic BP (0.04; 95% CI, -0.09 to 0.18) at approximately 11 years adjusted for maternal age and migrant status (F = 38.6). Change in weight z-score at 0 to 12 months was not associated with z-score for systolic BP (-0.003; 95% CI, -0.15 to 0.15) or diastolic BP (-0.02; 95% CI, -0.10 to 0.07) at approximately 11 years (F = 54.4). Estimates were similar for BP at approximately 13 years, although the F-statistic was lower. Birth weight and infant growth may make little contribution to adolescent BP. Extending consideration of the effects of early life to other growth periods, such as puberty, on BP might yield public health benefits. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Association of fish and fish liver oil intake in pregnancy with infant size at birth among women of normal weight before pregnancy in a fishing community.

    Science.gov (United States)

    Thorsdottir, Inga; Birgisdottir, Bryndis E; Halldorsdottir, Sveinbjorg; Geirsson, Reynir T

    2004-09-01

    This 1998 study investigated the association between intake of fish and fish oil during pregnancy and full-term infants' size at birth in an Icelandic fishing community. Healthy women aged 20-40 years of normal weight before pregnancy (body mass index: 19.5-25.5 kg/m(2)) and at 38-43 weeks of gestation were selected randomly. Information on infant size at birth was collected from maternity records. Intake of fish and fish oil in pregnancy was ascertained (n = 491, 80.1%) by using a validated, focused, food frequency questionnaire. Infants of women in the lowest quartile of fish consumption weighed less (p = 0.036), were shorter (p fish. Infants of women in the highest quartile of fish oil intake (> or =1 tablespoon (11 ml)/day), consuming threefold the recommended dietary allowance of vitamin A and twofold that of vitamin D, were shorter (p = 0.036) and had a smaller head circumference (p = 0.003) than those of women consuming less. Infant size at birth increased with fish consumption, especially for women in the lower quartiles of consumption. Smaller birth size was linked to the highest levels of fish oil intake. Constituents of fish and fish oil might affect birth size differently depending on the amount consumed.

  17. A prospective cohort study of biomarkers of prenatal tobacco smoke exposure: the correlation between serum and meconium and their association with infant birth weight

    Directory of Open Access Journals (Sweden)

    Braun Joe M

    2010-08-01

    Full Text Available Abstract Background The evaluation of infant meconium as a cumulative matrix of prenatal toxicant exposure requires comparison to established biomarkers of prenatal exposure. Methods We calculated the frequency of detection and concentration of tobacco smoke metabolites measured in meconium (nicotine, cotinine, and trans-3'-hydroxycotinine concentrations and three serial serum cotinine concentrations taken during the latter two-thirds of pregnancy among 337 mother-infant dyads. We estimated the duration and intensity of prenatal tobacco smoke exposure using serial serum cotinine concentrations and calculated geometric mean meconium tobacco smoke metabolite concentrations according to prenatal exposure. We also compared the estimated associations between these prenatal biomarkers and infant birth weight using linear regression. Results We detected nicotine (80%, cotinine (69%, and trans-3'-hydroxycotinine (57% in most meconium samples. Meconium tobacco smoke metabolite concentrations were positively associated with serum cotinine concentrations and increased with the number of serum cotinine measurements consistent with secondhand or active tobacco smoke exposure. Like serum cotinine, meconium tobacco smoke metabolites were inversely associated with birth weight. Conclusions Meconium is a useful biological matrix for measuring prenatal tobacco smoke exposure and could be used in epidemiological studies that enroll women and infants at birth. Meconium holds promise as a biological matrix for measuring the intensity and duration of environmental toxicant exposure and future studies should validate the utility of meconium using other environmental toxicants.

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

    Science.gov (United States)

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

    2013-08-01

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

  19. A Qualitative Study to Examine Perceptions and Barriers to Appropriate Gestational Weight Gain among Participants in the Special Supplemental Nutrition Program for Women Infants and Children Program

    Directory of Open Access Journals (Sweden)

    Loan Pham Kim

    2016-01-01

    Full Text Available Women of reproductive age are particularly at risk of obesity because of excessive gestational weight gain (GWG and postpartum weight retention, resulting in poor health outcomes for both mothers and infants. The purpose of this qualitative study was to examine perceptions and barriers to GWG among low-income women in the WIC program to inform the development of an intervention study. Eleven focus groups were conducted and stratified by ethnicity, and each group included women of varying age, parity, and prepregnancy BMI ranges. Participants reported receiving pressure from spouse and family members to “eat for two” among multiple barriers to appropriate weight gain during pregnancy. Participants were concerned about gaining too much weight but had minimal knowledge of weight gain goals during pregnancy. Receiving regular weight monitoring was reported, but participants had inconsistent discussions about weight gain with healthcare providers. Most were not aware of the IOM guidelines nor the fact that gestational weight gain goals differed by prepregnancy weight status. Results of these focus groups analyses informed the design of a pregnancy weight tracker and accompanying educational handout for use in an intervention study. These findings suggest an important opportunity for GWG education in all settings where pregnant women are seen.

  20. Dietary exposure to persistent organochlorine compounds and health effects in women and their infants. Epidemiological studies on birth-weight, cancer incidence, and mortality

    Energy Technology Data Exchange (ETDEWEB)

    Rylander, L.

    1997-05-01

    In Sweden the main exposure route for both polychlorinated biphenyls (PCB) and other persistent organochlorine compounds is through consumption of fatty fish species from the Baltic Sea (the eastern coast of Sweden). Cohorts of fishermen`s wives from the Swedish east and west coasts were established. Interviewed east and west coast cohort women ate locally caught fish at least twice as often as women from the general population. The east coast cohort women displayed during the period 1968-1989 an increased breast cancer incidence and mortality in ischemic heart disease as compared with the west coast cohort. Due to lack of individual data on exposure and confounding factors, it is not possible to conclude that the differences were caused by fish intake. Infants from the east coast cohort had during the period 1973-1991 an increased risk for low birth weight, as compared with infants from the west coast cohort. A nested case-referent study within the east coast cohort indicated an increased risk of low birth weight among infants born to mothers who reported a relatively high current intake of fish from the Baltic Sea, as well as among mothers who had grown up in a fishing village. Moreover, maternal 2,2`,4,4`,5,5`-hexachlorobiphenyl (CB-153, which was showed to be a feasible biomarker for exposure to PCB) concentrations in plasma drawn in 1995 and the estimated concentrations during the year of childbirth showed effects on the risk for having an infant with low birth weight. Employing alternative plausible kinetic models, an increased risk for low birth weight was observed at a CB-153 concentration in plasma during year of childbirth around 300-400 ng/g lipid. 117 refs, 5 figs, 4 tabs

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

    Science.gov (United States)

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

    2014-12-01

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

  2. Obesogenic dietary intake in families with 1-year-old infants at high and low obesity risk based on parental weight status: baseline data from a longitudinal intervention (Early STOPP)

    OpenAIRE

    Svensson, Viktoria; Sobko, Tanja; Ek, Anna; Forssén, Michaela; Ekbom, Kerstin; Johansson, Elin; Nowicka, Paulina; Westerståhl, Maria; Riserus, Ulf; Marcus, Claude

    2015-01-01

    Purpose To compare dietary intake in 1-year-old infants and their parents between families with high and low obesity risk, and to explore associations between infant dietary intake and relative weight. Methods Baseline analyses of 1-year-old infants (n = 193) and their parents participating in a longitudinal obesity intervention (Early STOPP) were carried out. Dietary intake and diet quality indicators were compared between high- and low-risk families, where obesity risk was based on parental...

  3. 足月小样儿生长发育状况分析%A survey on growth development status of mature low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    林艳; 江雯; 何慧静

    2012-01-01

    目的 探讨低出生体重对儿童生长发育的影响.方法 采用1:1配对病例对照研究方法,测定6~12月龄的212名足月小样儿和212名正常婴儿身高、体重、头围,采用Bayley婴幼儿量表发展量表进行智能评估.结果 足月小样儿的身高、体重、头围均值低于正常对照组,分别相差2.70±0.39cm、0.81±0.39kg、0.95±0.14cm,差异均有统计学意义(t值分别为6.88、3.85、6.86,均P<0.05);足月小样儿智力发育指数低于对照组(t=3.53,P<0.05),足月小样儿运动发育指数低于对照组(t=4.33,P<0.05).结论 低出生体重对儿童的生长发育有明显的不利影响,应采取干预措施,减少低出生体重的发生.%Objective To investigate the influence of low birth weight ( LBW ) on children' s growth and development. Methods With 1:1 matched case-control study, the weight, height and head circumference of 212 mature LBW infants and 212 normal term infants ( control group ) aged 6-12 months were measured, and Bayley Scales of Infant Development was used to assess infants' intelligence development. Results Compared with normal term infants, the height, weight and head circumference of LBW infants were significantly lower, and the differences were 2.70 ±0.39cm, 0. 81 ± 0.39kg and 0. 95 ±0. 14cm, respectively. The differences were statistically significant ( t value was 6. 88, 3. 85 and 6. 86, respectively, all P < 0. 05 ). The mental development index ( MDI ) and psychomotor development index ( PDI ) of LBW infants were lower than those of control group ( t value was 3. 53 and 4. 33 , respectively, both P <0. 05 ). Conclusion LBW has obvious adverse impact on children' s growth and development, so intervention measures should be adopted to reduce the incidence of LBW.

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Lilian S.R. Sadeck

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Roehr CC

    2010-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    林素; 吴百威; 王能里; 刘花兰; 胡淑英; 林振浪

    2010-01-01

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

  8. Assessment of brain maturation in the preterm infants using diffusion tensor imaging (DTI) and enhanced T2 star weighted angiography (ESWAN)

    Energy Technology Data Exchange (ETDEWEB)

    Ling, Xueying, E-mail: lingxuey@163.com [Department of Medical Imaging Center, the First Affiliated Hospital, Jinan University, Guangzhou (China); Tang, Wen [Department of Medical Imaging Center, the First Affiliated Hospital, Jinan University, Guangzhou (China); Liu, Guosheng [Neonatal Intensive Care Unit, the First Affiliated Hospital, Jinan University, Guangzhou (China); Huang, Li [Department of Medical Imaging Center, the First Affiliated Hospital, Jinan University, Guangzhou (China); Li, Bingxiao [Neonatal Intensive Care Unit, the First Affiliated Hospital, Jinan University, Guangzhou (China); Li, Xiaofei; Liu, Sirun [Department of Medical Imaging Center, the First Affiliated Hospital, Jinan University, Guangzhou (China); Xu, Jing [Neonatal Intensive Care Unit, the First Affiliated Hospital, Jinan University, Guangzhou (China)

    2013-09-15

    Purpose: To assess the brain maturation of preterm infants using diffusion tensor imaging (DTI) and enhanced T2 star weighted angiography (ESWAN). Materials and methods: Conventional magnetic resonance imaging (MRI), DTI and ESWAN were performed in 60 preterm infants and 21 term controls. 60 preterm infants were subgrouped to two groups according to the age at imaging: before and at term-equivalent age (TEA). Fractional anisotropy (FA), apparent diffusion coefficient (ADC) map from DTI, T{sub 2}* and R{sub 2}* maps from ESWAN were post-processed at an off-line workstation. The values of FA, ADC, T{sub 2}* and R{sub 2}* from the posterior limb of internal capsule (PLIC), frontal white matter (FWM), occipital white matter (OWM) and lentiform nuclei (LN) were determined. These parameters were compared between preterm and term infants. Correlations of DTI and ESWAN parameters with the gestational age, postmenstrual age and postnatal age were analyzed. Results: ADCs of FWM, OWM and LN, and T{sub 2}* values of the PLIC and LN were higher in the preterm infants at TEA compared with the term controls. The correlations were existed between the postmenstrual age and the values of FA, ADC, T{sub 2}*, R{sub 2}* from the PLIC, values of ADC, T{sub 2}*, R{sub 2}* from the LN, T{sub 2}* value from the OWM. The correlations were also found between the postnatal age and the values of FA, ADC, T{sub 2}* from the PLIC, and T{sub 2}* value from the LN. Conclusion: The maturity of preterm brain around TEA was different from that of term controls and appeared to be independent of the prematurity at birth. T{sub 2}* was one of valuable indices to evaluate brain maturation in preterm infants.

  9. Combined effect of short stature and socioeconomic status on body mass index and weight gain during reproductive age in Brazilian women

    Directory of Open Access Journals (Sweden)

    Sichieri R.

    2003-01-01

    Full Text Available Short stature, a marker for undernutrition early in life, has been associated with obesity in Brazilian women, but not in men. We tested the hypothesis that weight gain during the reproductive years could explain this gender difference. A national two-stage household survey of mothers with one or more children under five years of age was conducted in Brazil in 1996. The subjects were women aged 20 to 45 years (N = 2297, with last delivery seven months or more prior to the interview. The regions of the country were divided into rural, North/Northeast (urban underdeveloped and South/Southeast/Midwest (urban developed. The dependent variables were current body mass index (BMI measured, BMI prior to childbearing (reported, and BMI change. Socioeconomic variables included mother's years of education and family purchasing power score. A secondary analysis was restricted to primiparous women. The prevalence of current overweight and overweight prior to childbearing (BMI > or = 25 kg/m² was higher among shorter women (<1.50 m compared to normal stature women only in the urban developed region (P < 0.05. After adjustment for socioeconomic variables, age, parity, BMI prior to childbearing, and age at first birth, current BMI was 2.39 units higher (P = 0.008 for short stature women living in the urban developed area compared with short stature women living in the urban underdeveloped area. For both multiparous and primiparous women, BMI gain compared to the value prior to childbearing was significantly higher among short stature women living in the urban developed region (P <= 0.04. These results provide clear evidence that short stature was associated with a higher BMI and with an increased risk of weight gain/retention with pregnancy in the developed areas of Brazil, but not in the underdeveloped ones.

  10. Liquid chromatographic determination of caffeine and adrenergic stimulants in food supplements sold in Brazilian e-commerce for weight loss and physical fitness.

    Science.gov (United States)

    Viana, Carine; Zemolin, Gabriela M; Müller, Larissa S; Dal Molin, Thaís R; Seiffert, Helena; de Carvalho, Leandro M

    2016-01-01

    Methyl-xanthines and adrenergic stimulants, such as caffeine and synephrine, are commonly added to food supplements due to their stimulating and thermogenic effects. In addition, the abusive consumption of food supplements with ergogenic and aesthetic purposes has been observed worldwide. This work describes the study of caffeine, p-synephrine, hordenine, octopamine, tyramine, ephedrine and salicin as stimulants in dietary supplements marketed in Brazil for weight loss and physical fitness claims. A total of 94 different products were acquired from 30 Brazilian websites. Thus, the sampling of marketed supplements was performed in virtual commerce (e-commerce) with claims of weight loss, appetite reduction, fat burning and metabolism acceleration. The developed analytical method involved the separation of the stimulants by HPLC with diode array detection (HPLC-DAD) by using a gradient elution of flow rate (0.7-2.5 ml min(-1)) and mobile phase composition (0.1% H3PO4/methanol). The validated method was applied to the study of 46 dietary supplements. Caffeine, p-synephrine and ephedrine were found to be present as stimulants in 52% of the studied samples marketed as encapsulated or bulk forms. Caffeine was found to be present in concentrations that represent doses from 25.0 to 1476.7 mg day(-1). Synephrine was found in concentrations that represent doses from 59.1 to 127.0 mg day(-1). Ephedrine was found to be associated with caffeine in one formulation at a concentration representing a 26.1 mg day(-1) dosage.

  11. Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study.

    Directory of Open Access Journals (Sweden)

    Camila Bôtto-Menezes

    Full Text Available Plasmodium vivax is the most prevalent malaria species in the American region. Brazil accounts for the higher number of the malaria cases reported in pregnant women in the Americas. This study aims to describe the characteristics of pregnant women with malaria in an endemic area of the Brazilian Amazon and the risk factors associated with prematurity and low birth weight (LBW.Between December 2005 and March 2008, 503 pregnant women with malaria that attended a tertiary health centre were enrolled and followed up until delivery and reported a total of 1016 malaria episodes. More than half of study women (54% were between 20-29 years old, and almost a third were adolescents. The prevalence of anaemia at enrolment was 59%. Most women (286/503 reported more than one malaria episode and most malaria episodes (84.5%, 846/1001 were due to P. vivax infection. Among women with only P. vivax malaria, the risk of preterm birth and low birth weight decreased in multigravidae (OR, 0.36 [95% CI, 0.16-0.82]; p = 0.015 and OR 0.24 [95% CI, 0.10-0.58]; p = 0.001, respectively. The risk of preterm birth decreased with higher maternal age (OR 0.43 [95% CI, 0.19-0.95]; p = 0.037 and among those women who reported higher antenatal care (ANC attendance (OR, 0.32 [95% CI, 0.15-0.70]; p = 0.005.This study shows that P. vivax is the prevailing species among pregnant women with malaria in the region and shows that vivax clinical malaria may represent harmful consequences for the health of the mother and their offsprings particularly on specific groups such as adolescents, primigravidae and those women with lower ANC attendance.

  12. birth-weight infants

    African Journals Online (AJOL)

    lowest oxygen requirement in the first 12 hours (which are two components of the CRIB score), and maximum partial arterial carbon dioxide pressure (PaCDJ in the first 72 hours. ..... This stUdy also brings into question the appropriateness.

  13. Transcatheter occlusion of patent ductus arteriosus in small weight infants%低体重婴儿动脉导管未闭介入治疗研究

    Institute of Scientific and Technical Information of China (English)

    肖云彬; 黄希勇; 陈智; 王祥; 王勋

    2013-01-01

    目的 评价国产封堵器治疗动脉导管未闭(patent ductus arteriosus,PDA)低体重婴儿的有效性和安全性.方法 2010年10月至2011年10月应用国产封堵器治疗30例体重低于8 kg 的PDA婴儿.术后24 h查血常规、尿常规,并于术后24 h、1、3和6个月行心脏彩色多普勒超声、胸部正位片、心电图检查.结果 1例患儿术后24 h彩色多普勒超声示残余分流,1个月随访时残余分流消失,其余29例术后及随访期间均未出现残余分流;未出现介入治疗的主要并发症,无一例死亡.结论 应用国产PDA封堵器介入治疗体重低于8 kg的PDA婴儿的近、中期疗效确切,安全.%Objective To evaluate the efficacy and safety of transcatheter occlusion of patent ductus arteriosus (PDA) by using domestic occluder in small weight infants. Methods During the period from Oct. 2010 to Oct. 2011 transcatheter occlusion of PDA by using domestic occluder was carried out in 30 PDA infants with body weight ≤ 8 kg. Two-dimensional and color Doppler echocardiography, chest radiograph, electrocardiogram, routine blood test and routine urine test were performed after the treatment in all infants. The results were analyzed. Results Colour Doppler echocardiography performed at 24 hours after the procedure showed that residual shunt was seen in one infant, which disappeared one month later. In the remaining 29 infants no residual shunt was detected during the follow-up period. Neither intervention-related complications nor death occurred. Conclusion For the treatment of PDA infants with body weight ≤ 8 kg, transcatheter occlusion of PDA by using domestic occluder is quite safe with reliable short-term and mid-term efficacy.

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

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    Twisk Jos WR

    2004-09-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  16. Infant feeding practices and weight gain for length of term normal birth weight infants in the first 6 months of life%喂养习惯与婴儿出生后前6个月按身长体质量增加的相关性

    Institute of Scientific and Technical Information of China (English)

    周丽莉; 孙倩倩; 胡燕琪; 刘金荣; 刘珊珊; 张杰; 盛晓阳

    2010-01-01

    Objective To explore the relationship between infant feeding practices and infants growth,especially the weight gain for length in the first 6 months of life. Methods Two-hundred healthy full-term singlet normal birth weight 5 - 6 months old infants and their main care givers were recruited in Kongjiang community health service center in Shanghai. The questionnaires included infants feeding pattern, feeding environment and care givers feeding behaviors, and were completed on-site by investigators. The birth weight was obtained. The weight and length of infants at 6 months were measured. Results There were 70/200 (35.0%) infants overweight (BMI for age Z score>+1) at 6 months. There were more overweight boys than girls (40.0% vs. 30.9%, x2 = 1.798, P = 0.180). Compared with normal weight infants, the overweight infants had same birth weight (3.30 ± 0.35 kg vs. 3.35 ± 0.32 kg, t =1.010, P = 0.314) and same length at 6 months (67.64 ± 2.10 cm vs. 67.91 ± 1.97 cm, t=- 0.896, P = 0.371). However, the overweight infants gained much more weight for length in the first six months of life. At 6 months, the weight and BMI of overweight infants was significantly higher than that of normal weight infants (9.16 ± 0.67 vs. 7.94 ±0.64, t = 12.324, P 0.05). The grandparents played an important role in infants feeding in Shanghai. There were 39.0% infants fed only by grandparents, and 23.0% infants fed jointly by grandparents and parents (x2 = 0.175, P > 0.05).The care givers' educational level and knowledge of feeding skill were similar in overweight and normal weight infants (x2 = 0.446, t = 0.949, P > 0.05). However, the overweight infants were fed more quickly than normal weight infants (Z = 2.753, P +1),占35%.男婴超重多于女婴(40.0%对30.9%,x2=1.798,P=0.180).超重婴儿和体质量正常婴儿的出生体质量一致(3.30±0.35 kg对3.35±0.32 kg,t=1.010,P=0.314),6月龄时两组婴儿的身长也一致(67.64±2.10 cm对67.91±1.97cm,t=0.896,P=0.371).

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  19. The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010

    Science.gov (United States)

    Sarton, Cheryl; Lichter, Erika

    2016-01-01

    The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000–2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes. PMID:27747104

  20. Como minimizar a lesão pulmonar no prematuro extremo: propostas Strategies to minimize lung injury in extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Cleide Suguihara

    2005-03-01

    Full Text Available OBJETIVO: Apresentar uma revisão das principais causas da nova displasia broncopulmonar e as estratégias utilizadas para diminuir sua incidência nos prematuros extremos. FONTES DOS DADOS: Para essa revisão, pesquisas foram feitas na MEDLINE (1996 a outubro de 2004, no Cochrane Database, em resumos da Society for Pediatric Research e recentes conferências sobre o tema. SÍNTESE DOS DADOS: A tecnologia e os novos conhecimentos científicos têm aumentado significantemente a sobrevida de prematuros extremos. Esse aumento da sobrevida resultou em aumento da incidência de displasia broncopulmonar. Atualmente, a displasia broncopulmonar é mais freqüentemente observada em recém-nascidos OBJECTIVE: To review the main causes of new bronchopulmonary dysplasia and the strategies utilized to decrease its incidence in extremely low birth weight infants. DATA SOURCES: For this review a MEDLINE search from 1966 to October 2004, the Cochrane Database, abstracts from the Society for Pediatric Research and recent meetings on the topic were used. SUMMARY OF FINDINGS: The survival of extremely low birth weight infants has increased significantly due to improvement in both scientific knowledge and technology. This improvement in survival has therefore resulted in an increased incidence of bronchopulmonary dysplasia. The characteristics of bronchopulmonary dysplasia in extremely low birth weight infants, the so called "new" bronchopulmonary dysplasia are quite different from the classic bronchopulmonary dysplasia described by Northway. This new bronchopulmonary dysplasia has a multifactorial etiology, which includes volutrauma, atelectrauma, oxygen toxicity and lung inflammation. Therapy such as prenatal corticosteroids, exogenous surfactant, nasal continuous positive airway pressure, new mechanical ventilation modalities and gentle ventilation have been used in attempts to decrease lung injury severity. CONCLUSIONS: In order to prevent lung injury in

  1. Parental perception of child weight in the first two years-of-life: a potential link between infant feeding and preschoolers' diet.

    Science.gov (United States)

    Musaad, Salma M A; Donovan, Sharon M; Fiese, Barbara H

    2015-08-01

    Approximately 23% of preschoolers are overweight or obese. Establishing a healthy dietary lifestyle at an early age can improve later child diet and body weight. This study examined the determinants of past infant feeding practices that do not follow standard feeding recommendations (breastfeeding for less than 6 months duration, cow's milk prior to the first year of age and solid foods at or before 4 months of age). It also examined the role of parental perception of child weight in the first 2 years-of-life on past infant feeding practices as well as current child diet and body weight. Families of 497 preschoolers aged 22-63 months (39.0 ± 8.2) were recruited from 30 child care centers in East-Central Illinois. Main findings indicate that past infant feeding practices were common and varied by socio-demographic factors including race/ethnicity, parental education and child gender. Children perceived as overweight in the first 2 years-of-life tended to breastfeed for lesser duration. Additionally, the majority (79.8%) of preschoolers who were classified as overweight using BMI percentile were perceived as non-overweight by the parent in the first 2 years-of-life. Mean daily total fatty/sugary food intake was higher among those perceived to be non-overweight in the first 2 years-of-life. These findings have identified parental perception of child weight in the first 2 years-of-life as a modifiable risk factor for unhealthy child diet and obesity among preschoolers.

  2. Obesogenic dietary intake in families with 1-year-old infants at high and low obesity risk based on parental weight status: baseline data from a longitudinal intervention (Early STOPP).

    Science.gov (United States)

    Svensson, Viktoria; Sobko, Tanja; Ek, Anna; Forssén, Michaela; Ekbom, Kerstin; Johansson, Elin; Nowicka, Paulina; Westerståhl, Maria; Riserus, Ulf; Marcus, Claude

    2016-03-01

    To compare dietary intake in 1-year-old infants and their parents between families with high and low obesity risk, and to explore associations between infant dietary intake and relative weight. Baseline analyses of 1-year-old infants (n = 193) and their parents participating in a longitudinal obesity intervention (Early STOPP) were carried out. Dietary intake and diet quality indicators were compared between high- and low-risk families, where obesity risk was based on parental weight status. The odds for high diet quality in relation to parental diet quality were determined. Associations between measured infant relative weight and dietary intake were examined adjusting for obesity risk, socio-demographics, and infant feeding. Infant dietary intake did not differ between high- and low-risk families. The parents in high-risk families consumed soft drinks, French fries, and low-fat spread more frequently, and fish and fruits less frequently (p intake of vegetables and fish increased the odds for children being consumers of vegetables (OR 1.7; 95 % CI 1.0-2.9) and fish, respectively (OR 2.5; 95 % CI 1.4-4.4). Infant relative weight was weakly associated with a high intake of milk cereal drink (r = 0.15; p intake, obesity risk, or early feeding patterns. At the age of one, dietary intake in infants is not associated with family obesity risk, nor with parental obesogenic food intake. Milk cereal drink consumption but no other infant dietary marker reflects relative weight at this young age.

  3. Crescimento de prematuros de extremo baixo peso nos primeiros dois anos de vida Growth of extremely low birth weight infants during the first two years of life

    Directory of Open Access Journals (Sweden)

    Ligia Maria S. S. Rugolo

    2007-06-01

    Full Text Available OBJETIVO: Analisar o padrão de crescimento de prematuros de extremo baixo peso (EBP até 24 meses de idade corrigida, a influência da displasia broncopulmonar (DBP e os fatores de risco para falha de crescimento. MÉTODOS: Coorte de prematuros OBJECTIVE: To evaluate the growth pattern of extremely low birth weight infants(ELBW from birth to 24 months of adjusted gestational age (AA, the influence of bronchopulmonary dysplasia (BPD and risk factors associated to growth failure. METHODS: This cohort study included all singleton inborn infants with birthweight <1,000g, admitted in the follow-up clinic of a level III Perinatal Center. Weight, length and head circumference were measured at birth, 40 weeks, and 3, 6, 9, 12, 18, 24 months AA, and Z-scores were calculated. Out of the 82 survivors, 70 were studied and classified in two groups: BPD (n=41 and no-BPD (n=29. Statistical analysis included t-test or Mann-Withney, chi-square or Fisher Exact test, and multivariate logistic regression. RESULTS: In both groups, weight z-score decreased significantly between birth and 40 weeks AA. A peak incremental change in weight, length and head circumference z-scores occurred between 40 weeks and three months. Z-scores for the no-BPD group were close to the expected values by the age of six months and remained at these levels at 24 months AA. Children with BPD had lower z-scores for weight and head circumference in the first year of life, but no difference was found between BPD and no-BPD children in the second year of life. Regression analysis showed that catch-down in weight z-score at 40 weeks was a risk factor for failure to thrive. CONCLUSIONS: ELBW infants experienced early catch-up growth during the first two years of life. ELBW with BPD had poor weight gain. Post-natal growth restriction predicts failure to thrive in infancy.

  4. Maternal Concentrations of Perfluoroalkyl Substances and Fetal Markers of Metabolic Function and Birth Weight: The Maternal-Infant Research on Environmental Chemicals (MIREC) Study.

    Science.gov (United States)

    Ashley-Martin, Jillian; Dodds, Linda; Arbuckle, Tye E; Bouchard, Maryse F; Fisher, Mandy; Morriset, Anne-Sophie; Monnier, Patricia; Shapiro, Gabriel D; Ettinger, Adrienne S; Dallaire, Renee; Taback, Shayne; Fraser, William; Platt, Robert W

    2017-01-09

    Perfluoroalkyl substances (PFAS) are ubiquitous, persistent chemicals that have been widely used in the production of common household and consumer goods for their nonflammable, lipophobic, and hydrophobic properties. Inverse associations between maternal or umbilical cord blood concentrations of perfluorooctanoic acid and perfluorooctanesulfonate and birth weight have been identified. This literature has primarily examined each PFAS individually without consideration of the potential influence of correlated exposures. Further, the association between PFAS exposures and indicators of metabolic function (i.e., leptin and adiponectin) has received limited attention. We examined associations between first-trimester maternal plasma PFAS concentrations and birth weight and cord blood concentrations of leptin and adiponectin using data on 1,705 mother-infant pairs from the Maternal Infant Research on Environmental Chemicals (MIREC) Study, a trans-Canada birth cohort study that recruited women between 2008 and 2011. Bayesian hierarchical models were used to quantify associations and calculate credible intervals. Maternal perfluorooctanoic acid concentrations were inversely associated with birth weight z score, though the null value was included in all credible intervals (log10 β = -0.10, 95% credible interval: -0.34, 0.13). All associations between maternal PFAS concentrations and cord blood adipocytokine concentrations were of small magnitude and centered around the null value. Follow-up in a cohort of children is required to determine how the observed associations manifest in childhood.

  5. The use of Perioscan as a potential screening test for mothers at risk for delivery of pre-term and low birth-weight infants.

    Science.gov (United States)

    Africa, Charlene W J; Bayingana, Claude; Yasin-Harnekar, Soraya

    2009-04-01

    Increased levels of oestrogen and progesterone during pregnancy may lead to periodontal disease. The anaerobic Gram-negative bacteria classified as the "red complex" (Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola) are frequently associated with periodontal disease. Periodontopathogens produce toxins and enzymes that can enter the bloodstream and cross the placenta to harm the foetus. The response of the mother's immune system to infection by these periodontopathogens brings about the release of inflammatory mediators which may trigger preterm labour or result in low birth-weight infants. The purpose of this study was to examine the use of Perioscan as a potential screening test for mothers at risk for pre-term delivery of low birth weight infants due to periodontal disease. Subgingival plaque samples were obtained from pregnant women between the ages of 17 to 45 years attending an ante-natal clinic in the Western Cape in South Africa. Plaque samples were analyzed by the enzymatic Perioscan test for detection of the red complex in 372 sites from 66 women. Results were confirmed by polymerase chain reaction (PCR) detection of the three species of the red complex. Seventeen (25.75%) of the population group tested positive with Perioscan but only 27 (7.25%) of the 372 sites were positive. Of the 66 mothers examined, we managed to retrieve 29 records post-delivery. In all the mothers examined, Perioscan results showed an association with the indices used to diagnose periodontal disease, and could also be associated with preterm delivery of low birth-weight infants in two of the 29 maternal records recovered.

  6. Age and weight at final discharge from an early discharge programme for stable but tube-fed preterm infants

    DEFF Research Database (Denmark)

    Ahnfeldt, A M; Stanchev, H.; Jørgensen, Henrik Løvendahl

    2015-01-01

    AIM: Preterm birth is often associated with prolonged hospitalisation, complicating the parent-child relationship and breastfeeding rates. As a result, an early discharge programme was implemented in the department of neonatology at Rigshospitalet. The infants were stable, but required tube feeding...

  7. Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years

    Directory of Open Access Journals (Sweden)

    Rüegger Christoph

    2012-02-01

    Full Text Available Abstract Background Over the last two decades, improvements in medical care have been associated with a significant increase and better outcome of very preterm (VP, Methods Our population-based observational cohort study used the Minimal Neonatal Data Set, a database maintained by the Swiss Society of Neonatology including information of all VP- and VLBW infants. Perinatal characteristics, mortality and morbidity rates and the survival free of major complications were analysed and their temporal trends evaluated. Results In 1996, 2000, 2004, and 2008, a total number of 3090 infants were enrolled in the Network Database. At the same time the rate of VP- and VLBW neonates increased significantly from 0.87% in 1996 to 1.10% in 2008 (p Conclusions Over the 12-year observation period, the number of VP- and VLBW infants increased significantly. An unchanged overall mortality rate and an increase of survivors free of major complication resulted in a considerable net gain in infants with potentially good outcome.

  8. Effect of Blood Transfusions on the Outcome of Very Low Body Weight Preterm Infants under Two Different Transfusion Criteria

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    Hsiu-Lin Chen

    2009-06-01

    Conclusion: Both criteria of PRBC transfusion had similar clinical outcomes, although liberal transfusion resulted in a greater amount of blood transfused and a low reticulocyte count at 30 days of age. We suggest restrictive criteria for minimizing the overall amount of transfusion to less than 30 mL may be a better way of preventing CLD in VLBW infants.

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

    Science.gov (United States)

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

    2017-08-01

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

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

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    Baier R John

    2004-12-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

  12. Bifidobacterium bifidum OLB6378 Simultaneously Enhances Systemic and Mucosal Humoral Immunity in Low Birth Weight Infants: A Non-Randomized Study

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    Katsunori Tanaka

    2017-02-01

    Full Text Available Probiotic supplementation has been part of the discussion on methods to enhance humoral immunity. Administration of Bifidobacterium bifidum OLB6378 (OLB6378 reduced the incidence of late-onset sepsis in infants. In this non-randomized study, we aimed to determine the effect of administration of live OLB6378 on infants’ humoral immunity. Secondly, we tried to elucidate whether similar effects would be observed with administration of non-live OLB6378. Low birth weight (LBW infants weighing 1500–2500 g were divided into three groups: Group N (no intervention, Group L (administered live OLB6378 concentrate, and Group H (administered non-live OLB6378 concentrate. The interventions were started within 48 h after birth and continued until six months of age. Serum immunoglobulin G (IgG levels (IgG at one month/IgG at birth were significantly higher in Group L than in Group N (p < 0.01. Group H exhibited significantly higher serum IgG levels (p < 0.01 at one month of age and significantly higher intestinal secretory immunoglobulin A (SIgA levels (p < 0.05 at one and two months of age than Group N. No difference was observed in the mortality or morbidity between groups. Thus, OLB6378 administration in LBW infants enhanced humoral immunity, and non-live OLB6378, which is more useful as a food ingredient, showed a more marked effect than the viable bacteria.

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

    Directory of Open Access Journals (Sweden)

    Sarah A Coggins

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-05-01

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

  15. Trial gain of weight and hospital length stay of the low birth weight preterm infant in assistance for kangaroo mother care

    OpenAIRE

    Márcia Aparecida Giacomini Rodrigues; Maria Aparecida Tedeschi Cano

    2006-01-01

    The aim of this study was to evaluate if the Kangaroo Mother Care (KMC) interferes in the gain of weight and in the hospital length stay of the low birth weight preterm newborn (LWBPTN). For this, it was realized an analytic retrospective study, through the evaluation of the medical records of 60 LWBPTN with born weight less than 2000 g that received assistance by KMC, for a period of 2 hours per day and, 60 LWBPTN that received assistance by the Traditional Method of Care (TMC), admitted in ...

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

    Institute of Scientific and Technical Information of China (English)

    曾嵘; 庄建; 陈寄梅; 岑坚正; 丁以群; 王晟

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

  18. Usefulness of extracorporeal membrane oxygenation using double roller pumps in a low body weight newborn: A novel strategy for mechanical circulatory support in an infant

    Directory of Open Access Journals (Sweden)

    Keisuke Nakanishi

    2016-01-01

    Full Text Available Extracorporeal membrane oxygenation (ECMO with a centrifugal pump requires a certain flow rate; therefore, its application for low body weight infants is frequently accompanied by oxygenator membrane malfunction and/or inadequate perfusion. To prevent low-flow associated complications, we report a case in which a novel system of dual roller pumps was used. A baby girl with a body mass index 0.25 m 2 , who experienced difficulty weaning from cardiopulmonary bypass after a Norwood-like operation, required an ECMO. Concerns for the tube lifespan reduction due to roller pump friction led to the use of a double roller pump circulation. The termination of ECMO during tube exchange is not needed, because circulation is maintained by another roller pump. The novel strategy of ECMO with double roller pumps will allow low perfusion rate to provide adequate circulatory support for low body weight patients.

  19. Trial gain of weight and hospital length stay of the low birth weight preterm infant in assistance for kangaroo mother care

    Directory of Open Access Journals (Sweden)

    Márcia Aparecida Giacomini Rodrigues

    2006-08-01

    Full Text Available The aim of this study was to evaluate if the Kangaroo Mother Care (KMC interferes in the gain of weight and in the hospital length stay of the low birth weight preterm newborn (LWBPTN. For this, it was realized an analytic retrospective study, through the evaluation of the medical records of 60 LWBPTN with born weight less than 2000 g that received assistance by KMC, for a period of 2 hours per day and, 60 LWBPTN that received assistance by the Traditional Method of Care (TMC, admitted in the unity of neonatal intensive care and unity of premature of a private maternity in the city of Ribeirão Preto-SP, Brazil, comparing the gain of weight and the hospital length stay. We did not find differences statistically significant in relation to the gain of weight of the LWBPTN assisted by KMC, in relation to LWBPTN assisted by the TMC, 15,8 and 14,9 g/per day, respectively. In relation to the time of admission, we also did not find differences statistically significant, 27,3 and 26,2 days, for the LWBPTN in the KMC and TMC, respectively, although in the stratification of the sample, the LBWPTN with pregnancy age < 30 weeks or birth weight < 1500 g left the hospital 3 days earlier in the KMC. It was concluded that the KMC, in the conditions of this study, it seems not to interfere significatively in the gain of weight and in the time of admission of LWBPTN. We emphasize that the utilization of KMC in the assistance to the LWBPTN of low weight is a viable model, even for the private health institution.

  20. Analysis of Weight Development of Low Birth Weight Infants and Its Influence Factors%低出生体质量儿体质量发育及其影响因素

    Institute of Scientific and Technical Information of China (English)

    胡素君; 李智瑞; 苏元元; 徐发林; 程秀永; 王玲

    2012-01-01

    目的 探讨低出生体质量儿(LBWI)出生12个月时体质量发育情况及影响因素.方法 以2010年2月-2011年2月在本院出生后转入NICU的41例LBWI作为观察组,选择同期在本院产科出生的健康足月新生儿(NBWI)50例作为健康对照组.2组新生儿均于12个月时进行体质量发育评估,比较体质量发育情况;分析影响体质量发育的相关因素,调查内容包括姓名、性别、胎龄、日龄、出生体质量、娩出方式、家庭经济收入、父母文化程度、喂养方式、早期大小便训练等项目.结果 LBWI组在12个月时体质量显著低于NBWI组,差异有统计学意义(t=4.268,P<0.01).回归分析显示,与体质量发育呈正相关的因素有孕周、出生体质量、娩出方式、喂养方式、母亲文化程度、早期大小便训练(Pa<0.05),其中孕周影响最大(OR=0.465).结论 LBWI 12个月时体质量发育仍落后于NBWI,体质量发育受多种因素的影响,其中孕周影响最大.%Objective To investigate the weight development and the influence factors for low birth weight infant(LBW1) in 12 months after birth. Methods Forty - one LBW1 delivered from Feb. 2010 to Feb. 2011 were enrolled in NICU ,the Third Affiliated Hospital of Zhengzhou University, were selected as observation group. Fifty full term normal birth weight infant (NBWI) ,bom in the Third Affiliated Hospital of Zhengzhou University in the same period,were selected as healthy control group. Infants in the 2 groups all received weight development assessment in 12 months. The weight development between 2 groups was compared and the influence factors in weight gain were analyzed. The survey included name, sex, gestational age, day age, birth weight, style of childbirth, income of family, cultural background of the parents, way of feeding,early urine training,et al. Results There was statistically significant difference between LBWI group and NBWI group in weight development in 12 months

  1. SPACIAL DISTRIBUTION AND ASSOCIATION BETWEEN INFANT MORTALITY AND LOW BIRTH WEIGHT WITH SOCIOECONOMIC FACTORS AND HEALTH SERVICES IN THE SOUTHERN REGION OF BRAZIL.

    Directory of Open Access Journals (Sweden)

    Antonio Fernando Boing, Fernando Kel e Alexandra Crispim Boing

    2006-12-01

    Full Text Available This research aimed to realize the spacial distribution of the infant mortality rates and of the proportion of low weight newborns in the southern area of Brazil and to test the association of those indicators with socioeconomic factors and health services. It is an ecological study put together from data collected from the 1,159 municipalities comprising the southern area of Brazil in the year 2000. The independent variables were the Municipal Human Development Rate, the illiteracy rate, the Gini coefficient, the proportion of poor people and people in homes with indoor plumbing and bathrooms, the annual average of medical visits for basic medical specialties, the monthly average of home visits per family and the number of medical clinics per 10,000 inhabitants. Kolmogorov-Smirnov, ANOVA and Kruskall-Wallis tests were performed and the Spearman coefficient of correlation was calculated. A significant statistical association was established between infant mortality and all the socioeconomic indicators. As for the proportion of low birth weight, it was associated with the proportion of people in homes with indoor plumbing and bathrooms, the annual average of medical visits for basic medical specialties, the Gini coefficient, poverty levels and monthly average of home visits per family. The spacial distribution of the diseases investigated allowed the identification of areas with the worst indicators investigated and which need greater government investment and attention. The public policies in infant health care should consider the need to improve the socioeconomic conditions and accessible health services in order to reduce the inequalities in health and the magnitude of the disease.

  2. Frequent Use of Fresh Frozen Plasma Is a Risk Factor for Venous Thrombosis in Extremely Low Birth Weight Infants: A Matched Case-control Study

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    Maruyama,Hidehiko

    2012-02-01

    Full Text Available Percutaneously inserted central catheters (PICCs are often used in neonatal medicine. Venous thrombosis (VT is one of the complications associated with PICC use. According to some reports, fresh frozen plasma (FFP may be a risk factor for VT. The purpose of this study was to determine whether FFP use is associated with VT in extremely low birth weight infants (ELBWIs. We performed a matched case-control study on risk factors for VT in ELBWIs born over a period of 5 years in the neonatal intensive care unit of a tertiary hospital. Controls were infants from the unit matched for gestational age and birth weight. We performed univariate analyses and created receiver operating characteristic (ROC curves for the cut-off values of continuous parameters such as FFP. We also conducted multivariate conditional logistic regression analysis and calculated adjusted odds ratios and their 95% confidence intervals. Thirteen VT cases and 34 matched controls were examined. Using an ROC curve, FFP by day 5>50mL/kg was selected as the cut-off value. In multivariate conditional logistic regression analysis, FFP by day 5>50mL/kg exhibited an adjusted odds ratio of 5.88 (95% confidence interval:1.12-41.81, p=0.036. FFP by day 5>50mL/kg may be a risk factor for VT in ELBWIs.

  3. Salivary Cortisol as a Biomarker of Stress in Mothers and their Low Birth Weight Infants and Sample Collecting Challenges

    Directory of Open Access Journals (Sweden)

    Janevski Milica Ranković

    2016-04-01

    Full Text Available Background: Salivary cortisol measurement is a non-invasive method suitable for use in neonatal research. Mother-infant separation after birth represents stress and skin-to-skin contact (SSC has numerous benefits. The aim of the study was to measure salivary cortisol in mothers and newborns before and after SSC in order to assess the effect of SSC on mothers’ and infants’ stress and to estimate the efficacy of collecting small saliva samples in newborns.

  4. Urinary metabolomics (GC-MS) reveals that low and high birth weight infants share elevated inositol concentrations at birth.

    Science.gov (United States)

    Barberini, Luigi; Noto, Antonio; Fattuoni, Claudia; Grapov, Dmitry; Casanova, Andrea; Fenu, Gianni; Gaviano, Mauro; Carboni, Roberta; Ottonello, Giovanni; Crisafulli, Maurizio; Fanos, Vassilios; Dessì, Angelica

    2014-10-01

    Metabolomics is a new "omics" platform aimed at high-throughput identification, quantification and characterization of small-molecule metabolites. The metabolomics approach has been successfully applied to the classification different physiological states and identification of perturbed biochemical pathways. The purpose of the current investigation is the application of metabolomics to explore biological mechanisms which may lead to the onset of metabolic syndrome in adulthood. We evaluated differences in metabolites in the urine collected within 12 h from 23 infants with IUGR (IntraUterine Growth Restriction), or LGA (Large for Gestational Age), compared to control infants (10 patients defined AGA: Appropriate for Gestational Age). Urinary metabolites were quantified by GC-MS and used to highlight similarities between the two metabolic diseases and identify metabolic markers for their predisposition. Quantified metabolites were analyzed using a multivariate statistics coupled with receiver operator characteristic curve (ROC) analysis of identified biomarkers. Urinary myo-inositol was the most important discriminant between LGA + IUGR and control infants, and displayed an area under the ROC curve = 1. We postulate that the increase in plasma and consequently urinary inositol may constitute a marker of altered glucose metabolism during fetal development in both IUGR and LGA newborns.

  5. Associations of consumption of fruits and vegetables during pregnancy with infant birth weight or small for gestational age births: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Murphy MM

    2014-10-01

    Full Text Available Mary M Murphy,1 Nicolas Stettler,1,2 Kimberly M Smith,1 Richard Reiss3 1Exponent, Inc., Center for Chemical Regulation and Food Safety, Washington, DC, USA; 2The Lewin Group, Falls Church, VA, USA; 3Exponent, Inc., Center for Chemical Regulation and Food Safety, Alexandria, VA, USA Abstract: Maternal nutrition is recognized as one of the determinants of fetal growth. Consumption of fruits and vegetables is promoted as part of a healthful diet; however, intakes are typically lower than recommended levels. The purpose of this study was to systematically review results from studies examining the relationship between maternal consumption of fruits and vegetables during pregnancy with infant birth weight or risk for delivering a small for gestational age baby. A comprehensive search of PubMed and EMBASE was conducted and abstracts were screened using predefined criteria. Eleven relevant studies were identified and systematically reviewed, including six prospective cohort studies, three retrospective cohort studies, and two case–control studies. Seven studies were conducted in cohorts from highly developed countries. One prospective study from a highly developed area reported increased risk for small for gestational age birth by women with low vegetable intakes (odds ratio 3.1; 95% confidence interval 1.4–6.9; P=0.01; another large prospective study reported a 10.4 g increase in birth weight per quintile increase in fruit intake (95% confidence interval 6.9–3.9; P<0.0001 and increases of 8.4 or 7.7 g per quintile intake of fruits and vegetables (combined or fruits, vegetables, and juice (combined, respectively. One retrospective study reported an association between low fruit intake and birth weight. In less developed countries, increased vegetable or fruit intake was associated with increased birth weight in two prospective studies. Overall, limited inconclusive evidence of a protective effect of increased consumption of vegetables and risk for

  6. Secular trends in the rate of low birth weight in Brazilian State Capitals in the period 1996 to 2010 Tendencia secular de la tasa de bajo peso al nacer en las capitales brasileñas de 1996 a 2010 Tendência secular da taxa de baixo peso ao nascer nas capitais brasileiras de 1996 a 2010

    Directory of Open Access Journals (Sweden)

    Helma Jane Ferreira Veloso

    2013-01-01

    Full Text Available Secular trends in rates of low birth weight in Brazilian state capital cities were evaluated for the period 1996 to 2010 using joinpoint regression models. The rates were calculated using data from the Live Births Information System. Newborns weighing less than 500g were excluded. Only data for capital cities was included since under-registration of births in these cities is lower and new trends can be detected earlier. There was a significant increase in the rate of low birth weight in the Brazilian capitals of the North Region, Northeast Region, South Region and Southeast Region up to 2003/2004, stabilizing thereafter. In the capitals of the Center-west Region the rate increased throughout the whole study period. The rate of low birth weight was higher in the capitals of the more developed regions. The rate of multiple births increased significantly in all Brazilian capitals, while the stillbirth rate decreased and showed a negative correlation with the rate of low birth weight. The increase in the rate of low birth weight may be partially explained by the increase in multiple births, an increase in the birth of infants weighing 500 to 999g and by the reduction in the stillbirth rate.La tendencia secular de la tasa de bajo peso al nacer de 1996 a 2010 en las capitales brasileñas se evaluó utilizando modelos de regresión joinpoint. Las tasas se calcularon a partir del Sistema de Información sobre Nacidos Vivos, excluyéndose recién nacidos con un peso A tendência secular da taxa de baixo peso ao nascer de 1996 a 2010 nas capitais brasileiras foi avaliada utilizando-se modelos de regressão joinpoint. As taxas foram calculadas a partir do Sistema de Informações sobre Nascidos Vivos, excluindo-se recém-nascido com peso < 500g. Foram incluídos apenas dados das capitais, onde o sub-registro é menor e novas tendências podem ser detectadas mais precocemente. A taxa de baixo peso ao nascer aumentou significantemente nas capitais

  7. Speciation of zinc in low molecular weight proteins of breast milk and infant formulas by size exclusion chromatography/flame atomic absorption spectroscopy.

    Science.gov (United States)

    Bermejo, P; Peña, E M; Fompedriña, D; Domínguez, R; Bermejo, A; Cocho, J A; Fernández, J R; Fraga, J M

    2001-01-01

    Size exclusion chromatography (SEC) and flame atomic absorption spectroscopy (FAAS) were used for the separation of metal-containing species in milk whey. After milk ultracentrifugation, the sample was injected into a TSK-Gel G2000 glass column and eluted with 0.2M NH4NO3-NH3, pH 6.7. Low molecular weight proteins were fractionated, and the fractions were characterized by molecular weight. Zinc distributions were obtained by FAAS using a high performance nebulizer. The method was very sensitive (limit of detection = 2.6 x 10(-3) microg/mL; limit of quantitation = 8.9 x 10(-3) microg/mL) and precise (RSDs < or =10%). This method was applied to the determination of Zn in binding compounds in breast milk whey and in commercial cow's milk-based formulas. Distribution patterns were different. The presence of Zn in most fractions in breast milk was most significant, whereas in infant formulas Zn was detected only in fractions of molecular weight <5 kDa and in the highest molecular weight peak.

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

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    Christoph Härtel

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

  9. Effects of fine particulate matter and its constituents on low birth weight among full-term infants in California

    Energy Technology Data Exchange (ETDEWEB)

    Basu, Rupa, E-mail: Rupa.Basu@oehha.ca.gov [California Office of Environmental Health Hazard Assessment, Air Pollution Epidemiology Section, Oakland, CA (United States); Harris, Maria [School of Public Health, Boston University, Boston, MA (United States); Sie, Lillian [School of Public Health, University of California, Berkeley, CA (United States); Malig, Brian; Broadwin, Rachel; Green, Rochelle [California Office of Environmental Health Hazard Assessment, Air Pollution Epidemiology Section, Oakland, CA (United States)

    2014-01-15

    Relationships between prenatal exposure to fine particles (PM{sub 2.5}) and birth weight have been observed previously. Few studies have investigated specific constituents of PM{sub 2.5}, which may identify sources and major contributors of risk. We examined the effects of trimester and full gestational prenatal exposures to PM{sub 2.5} mass and 23 PM{sub 2.5} constituents on birth weight among 646,296 term births in California between 2000 and 2006. We used linear and logistic regression models to assess associations between exposures and birth weight and risk of low birth weight (LBW; <2500 g), respectively. Models were adjusted for individual demographic characteristics, apparent temperature, month and year of birth, region, and socioeconomic indicators. Higher full gestational exposures to PM{sub 2.5} mass and several PM{sub 2.5} constituents were significantly associated with reductions in term birth weight. The largest reductions in birth weight were associated with exposure to vanadium, sulfur, sulfate, iron, elemental carbon, titanium, manganese, bromine, ammonium, zinc, and copper. Several of these PM{sub 2.5} constituents were associated with increased risk of term LBW. Reductions in birth weight were generally larger among younger mothers and varied by race/ethnicity. Exposure to specific constituents of PM{sub 2.5}, especially traffic-related particles, sulfur constituents, and metals, were associated with decreased birth weight in California. -- Highlights: • Examine full gestational and trimester fine particle and its constituents on term birth weight. • Fine particles and several of its constituents associated with birth weight reductions. • Largest reductions for traffic-related particles, sulfur constituents, and metals. • Greater birth weight reductions for younger mothers, and varied by race/ethnicity.

  10. [The use of caspofungin in extremely low birth weight preterm infants based on clinical trials and reports considering the own experience (case report)].

    Science.gov (United States)

    Stempniewicz, Krzysztof; Walas, Wojciech; Gregorek-Pełka, Edyta; Kamińska, Ewa

    2014-01-01

    In recent years, despite of significant progress in the treatment of premature infants with extremely low body weight, still a significant problem remains severe, treatment-resistant generalized infections among which the percentage of fungal infections is increasing. The invasive candidiasis, especially caused by non-albicans species of Candida, are of particular importance. In the case of resistance on fluconazole and amphotericin B the use of echinocandin drug may be a useful choice. This paper reviews the pharmacokinetics of caspofungin in neonates and children, as well as the case reports and clinical trials on the use of caspofungin in neonates, including the premature infants. We describe also the premature neonate with low birth weight and a generalized infection caused by Candida glabrata, where, despite of the treatment based on the sensitivity of the fungus it did not achieve clinical improvement and sterilization of cultures. It was not until the lead-in of caspofungin in dose 2 mg/kg/day allowed to cure the patient. There was a transient increase in the activity of aminotransferases and level of bilirubin as a complication of treatment. At the end of application of caspofungin the liver functions have been slowly normalized. Caspofungin appeared to be effective in the treatment of systemic fungal C. glabrata in premature neonate with extremely low birth weight. Echinocandins, including caspofungin, appear to be a promising alternative to previously used agents in the treatment of invasive Candida infections in newborns. However, the further randomized trials on the use of caspofungin in preterm neonates, regarding long term follow-up, should be undertaken.

  11. Infant weight gain, duration of exclusive breast-feeding and childhood BMI - two similar follow-up cohorts

    DEFF Research Database (Denmark)

    Gunnarsdottir, Ingibjorg; Schack-Nielsen, Lene; Michaelsen, Kim F.

    2010-01-01

    To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF.......To describe the association between duration of exclusive breast-feeding (EBF), weight gain in infancy and childhood BMI in two populations with a long duration of EBF....

  12. Salivary Cortisol as a Biomarker of Stress in Mothers and their Low Birth Weight Infants and Sample Collecting Challenges

    Science.gov (United States)

    Vujičić, Ana Đorđević; Đukić, Svjetlana Maglajić

    2016-01-01

    Summary Background Salivary cortisol measurement is a non-invasive method suitable for use in neonatal research. Mother-infant separation after birth represents stress and skin-to-skin contact (SSC) has numerous benefits. The aim of the study was to measure salivary cortisol in mothers and newborns before and after SSC in order to assess the effect of SSC on mothers’ and infants’ stress and to estimate the efficacy of collecting small saliva samples in newborns. Methods Salivary cortisol was measured in 35 mother-infant pairs before and after the first and the fifth SSC in small saliva samples (50 μL) using the high sensitivity Quantitative ELISA-Kit (0.0828 nmol/L) for low cortisol levels detection. Samples were collected with eye sponge during 3 to 5 minutes. Results Cortisol level in mothers decreased after SSC: the highest levels were measured before and the lowest after SSC and the differences in values were significant during both the first (pcortisol level decrease was detected in 14 (40%) and an increase in 21 (60%) newborns, and during the fifth SSC a decrease was detected in 16 (45.7%) and an increase in 19 (54.3%) newborns, without confirmed significance of the difference. Saliva sampling efficacy using eye sponge was 75%. Conclusions Cortisol level decrease in mothers proves the stress reduction during SSC, while variable cortisol levels in infants do not indicate stress reduction and imply the need for further research. The used sampling method appeared to be one of the most optimal considering the sample volume, sampling time and efficacy.

  13. Weight Loss Instead of Weight Gain within the Guidelines in Obese Women during Pregnancy: A Systematic Review and Meta-Analyses of Maternal and Infant Outcomes.

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    Mufiza Zia Kapadia

    Full Text Available Controversy exists about how much, if any, weight obese pregnant women should gain. While the revised Institute of Medicine guidelines on gestational weight gain (GWG in 2009 recommended a weight gain of 5-9 kg for obese pregnant women, many studies suggested even gestational weight loss (GWL for obese women.A systematic review was conducted to summarize pregnancy outcomes in obese women with GWL compared to GWG within the 2009 Institute of Medicine guidelines (5-9 kg.Five databases were searched from 1 January 2009 to 31 July 2014. The Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement were followed. A modified version of the Newcastle-Ottawa scale was used to assess individual study quality. Small for gestational age (SGA, large for gestational age (LGA and preterm birth were our primary outcomes.Six cohort studies were included, none of which assessed preterm birth. Compared to GWG within the guidelines, women with GWL had higher odds of SGA 90th percentile (AOR 0.57; 95% CI 0.52-0.62. There was a trend towards a graded relationship between SGA <10th percentile and each of three obesity classes (I: AOR 1.73; 95% CI 1.53-1.97; II: AOR 1.63; 95% CI 1.44-1.85 and III: AOR 1.39; 95% CI 1.17-1.66, respectively.Despite decreased odds of LGA, increased odds of SGA and a lack of information on preterm birth indicate that GWL should not be advocated in general for obese women.

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

    Institute of Scientific and Technical Information of China (English)

    宋文萍; 晋芙莉

    2013-01-01

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

  15. Pattern of functional antibody activity against Haemophilus influenzae type b (Hib in infants immunized with diphtheria-tetanus-pertussis/Hib Brazilian combination vaccine

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    D.C.S. Matos

    2009-12-01

    Full Text Available We evaluated the functional activity of Haemophilus influenzae B (Hib antibodies elicited in a group of infants immunized with the diphtheria-tetanus-pertussis vaccine combined with an Hib vaccine produced totally in Brazil after technological transfer of Hib vaccine production from Glaxo SmithKline, Belgium. Blood samples from immunized infants (N = 985 were collected for the determination of Hib antibodies. Total Ig and IgM and IgG subclasses of antibodies against polyribosyl ribitol phosphate (PRP were analyzed by ELISA. Almost all vaccinees (97.56%, 961/985 developed a strong anti-PRP IgG antibody response (≥1.0 μg/mL, while an anti-PRP IgM response was observed in 64.24% (634/985 of them (≥0.15 μg/mL. Only 18.88% (186/985 of the infants in the group with high PRP antibody IgG concentrations (≥1.0 μg/mL developed a high IgM antibody response. Anti-PRP IgG antibody levels were significantly higher than anti-PRP IgM. These results demonstrate the predominance of IgG antibodies over IgM antibodies in response to PRP, with a ratio of 17:1. IgG antibodies were predominantly of the IgG1 subclass. An increase in IgG avidity was also observed during the course of immunization.

  16. Pattern of functional antibody activity against Haemophilus influenzae type B (Hib) in infants immunized with diphtheria-tetanus-pertussis/Hib Brazilian combination vaccine.

    Science.gov (United States)

    Matos, D C S; Silva, A M V; Neves, P C C; Martins, R M; Homma, A; Marcovistz, R

    2009-12-01

    We evaluated the functional activity of Haemophilus influenzae B (Hib) antibodies elicited in a group of infants immunized with the diphtheria-tetanus-pertussis vaccine combined with an Hib vaccine produced totally in Brazil after technological transfer of Hib vaccine production from Glaxo SmithKline, Belgium. Blood samples from immunized infants (N = 985) were collected for the determination of Hib antibodies. Total Ig and IgM and IgG subclasses of antibodies against polyribosyl ribitol phosphate (PRP) were analyzed by ELISA. Almost all vaccinees (97.56%, 961/985) developed a strong anti-PRP IgG antibody response (>or=1.0 microg/mL), while an anti-PRP IgM response was observed in 64.24% (634/985) of them (>or=0.15 microg/mL). Only 18.88% (186/985) of the infants in the group with high PRP antibody IgG concentrations (>or=1.0 microg/mL) developed a high IgM antibody response. Anti-PRP IgG antibody levels were significantly higher than anti-PRP IgM. These results demonstrate the predominance of IgG antibodies over IgM antibodies in response to PRP, with a ratio of 17:1. IgG antibodies were predominantly of the IgG1 subclass. An increase in IgG avidity was also observed during the course of immunization.

  17. Brazilian Congress structural balance analysis

    OpenAIRE

    Levorato, Mario; Frota, Yuri

    2016-01-01

    In this work, we study the behavior of Brazilian politicians and political parties with the help of clustering algorithms for signed social networks. For this purpose, we extract and analyze a collection of signed networks representing voting sessions of the lower house of Brazilian National Congress. We process all available voting data for the period between 2011 and 2016, by considering voting similarities between members of the Congress to define weighted signed links. The solutions obtai...

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

    Science.gov (United States)

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

    2012-05-01

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

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

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    Silvana Darcie

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

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

    Science.gov (United States)

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

    2017-01-01

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

  1. Exposure Assessment of Infants to Aflatoxin M1 through Consumption of Breast Milk and Infant Powdered Milk in Brazil

    Science.gov (United States)

    Ishikawa, Angélica T.; Takabayashi-Yamashita, Cássia R.; Ono, Elisabete Y. S.; Bagatin, Artur K.; Rigobello, Fabiana F.; Kawamura, Osamu; Hirooka, Elisa Y.; Itano, Eiko N.

    2016-01-01

    Aflatoxin M1 (AFM1) is an important biomarker that can be used to evaluate aflatoxin exposure in both humans and animals. The aim of this study was to evaluate the exposure degree of infants to AFM1 through consumption of breast milk and infant powdered milk in Brazil. For this purpose, the estimated daily intake (EDI) for infants was calculated based on the AFM1 levels analyzed in 94 breast milk (BM) samples collected in Southern Brazil, and 16 infant powdered milk (IPM) samples commonly commercialized in Brazil. AFM1 was detected in 5.3% (n = 5) and 43.8% (n = 7) of BM and IPM samples, with mean levels of 0.003 ng/g and 0.011 ng/g, respectively. All the IPM samples showed AFM1 levels lower than those established by the Brazilian guidelines (5 ng/g), and in most of the samples (81.25%) levels were below the maximum limit tolerated by the European Commission (0.025 ng/g). The EDI of AFM1 for infants aged zero to 12 months old showed values from 0.018 to 0.069 ng/kg body weight/day for BM, and 0.078 to 0.306 ng/kg body weight/day for IPM. Hazard index (HI) values for BM and IPM were less than one, except for IPM intended for infants up to one month. In conclusion, the exposure of infants to AFM1 was low, but continuous monitoring of mycotoxin levels is essential to minimize infant health risk. PMID:27589799

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

    Science.gov (United States)

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

    2016-10-01

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

  3. Bifidobacterium bifidum OLB6378 Simultaneously Enhances Systemic and Mucosal Humoral Immunity in Low Birth Weight Infants: A Non-Randomized Study

    Science.gov (United States)

    Tanaka, Katsunori; Tsukahara, Takamitsu; Yanagi, Takahide; Nakahara, Sayuri; Furukawa, Ouki; Tsutsui, Hidemi; Koshida, Shigeki

    2017-01-01

    Probiotic supplementation has been part of the discussion on methods to enhance humoral immunity. Administration of Bifidobacterium bifidum OLB6378 (OLB6378) reduced the incidence of late-onset sepsis in infants. In this non-randomized study, we aimed to determine the effect of administration of live OLB6378 on infants’ humoral immunity. Secondly, we tried to elucidate whether similar effects would be observed with administration of non-live OLB6378. Low birth weight (LBW) infants weighing 1500–2500 g were divided into three groups: Group N (no intervention), Group L (administered live OLB6378 concentrate), and Group H (administered non-live OLB6378 concentrate). The interventions were started within 48 h after birth and continued until six months of age. Serum immunoglobulin G (IgG) levels (IgG at one month/IgG at birth) were significantly higher in Group L than in Group N (p food ingredient, showed a more marked effect than the viable bacteria. PMID:28245626

  4. The impact of the method Kangaroo Mother Care in the learning process of low-birth-weight preterm infants: A literature review

    Directory of Open Access Journals (Sweden)

    Mariana de Paiva Franco

    2014-04-01

    Full Text Available Technology advances and scientific studies in Neonatal Intensive Care Units (NICU have contributed significantly to reduce mortality and morbidity of at-risk newborns (NB. However, they are more likely to present neurological and/or developmental psychomotor delay with neurological and sensory alterations. Therefore, proposals for neonatal intervention were developed with the aim of protecting the baby and offering appropriate incentives to minimize the effects of hospital intervention. To this end, programs of protective measures such as the Kangaroo Mother Care (KMC were developed. Given the relevance of the issue described, this systematic review critically appraises articles from the national and international literature, published in recent years (from 2000 to 2011, that describe whether the KMC can be a protective factor for the development of writing in premature infants. The textual search was conducted using the Virtual Health Library (VHL, a website that covers publications worldwide, allowing access to articles from health science, including LILACS, IBECS, MEDLINE, Cochrane Library and SciELO, as database. The findings revealed that infants who participated in the KMC program showed improvements in their development and that factors such as low-birth-weight prematurity and learning disorders have close relationship with the onset of motor impairments and changes in psychomotor development. The findings showed no articles describing the KMC as a protective factor for the incidence of dysgraphia. Thus, we emphasize the importance of conducting further studies on these topics.

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

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    Cornette Luc

    2007-08-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  7. Use and Cutaneous Side Effects of Skin Antiseptics in Extremely Low Birth Weight Infants - A Retrospective Survey of the German NICUs.

    Science.gov (United States)

    Biermann, C D; Kribs, A; Roth, B; Tantcheva-Poor, I

    2016-07-01

    Background Nosocomial infections are a serious problem in the treatment of extremely low birth weight infants (ELBW, Octenidine without phenoxyethanol (OwPh) and Octenisept(®) were the predominantly used skin antiseptics for intensive-care procedures. At least one skin complication was reported by 27% (n=17) of the NICUs. In 9 cases Octenisept(®) was used, and in 6 cases octenidine was used. According to our knowledge, this is the first study surveying practices and safety of skin antisepsis in ELBWs in the German NICUs. Most German NICUs use octenidine, however, in different preparations. Skin complications including blistering, necrosis and scarring were seen with all octenidine products, a fact which has not been previously reported. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Fluconazole prophylaxis in extremely low birth weight infants and neurodevelopmental outcomes and quality of life at 8 to 10 years of age.

    Science.gov (United States)

    Kaufman, David A; Cuff, Amy L; Wamstad, Julia B; Boyle, Robert; Gurka, Matthew J; Grossman, Leigh B; Patrick, Peter

    2011-05-01

    To examine the long-term effects of fluconazole prophylaxis in extremely low birth weight infants. Neurodevelopmental status and quality of life of survivors from a randomized, placebo-controlled trial of fluconazole prophylaxis were evaluated at 8 to 10 years of life using the Vineland Adaptive Behavior Scales-II (VABS-II) and the Child Health Questionnaire Parent-Completed Form 28 (CHQ-PF28), respectively. VABS-II Domain Scores for the fluconazole-treated (n = 21; 9.1 ± 0.7 years) compared with the placebo group (n = 17; 9.3 ± 0.8 years) were similar for communication [94.6 (±14.8) versus 92.6 (±12.6), P = .65], daily living skills [87.9 (±10.6) versus 87.4 (±9.3), P = .89], socialization [97.2 (±9.2) versus 94.4 (±7.9), P = .31], and motor skills [92.1 (±17.8) versus 95.1 (±14.6), P = .57]. Internalizing and externalizing behaviors and maladaptive behavior index were also similar. The CHQ-PF28 revealed no differences between the two groups regarding quality of life. Survivors were also happy or satisfied with school (90% versus 100%, P = .49), friendships (90% versus 88%, P = 1.00), and life (95% versus 100%, P = 1.00). Self esteem scores were 87.3 ± 15.7 versus 89.7 ± 10.4 (P = .59). There were also no differences between groups regarding emotional difficulties or behavior problems. Fluconazole prophylaxis for the prevention of invasive Candida infections is safe in extremely low birth weight infants and does not appear to be associated with any long-term adverse effects on neurodevelopment and quality of life at 8 to 10 years of life. Copyright © 2011 Mosby, Inc. All rights reserved.

  9. Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood Relações problemáticas entre pais e criança em famílias com pai e mãe: prevalência e fatores de risco em um bairro brasileiro

    Directory of Open Access Journals (Sweden)

    Olga Garcia Falceto

    2012-09-01

    Full Text Available Introduction: Although the quality of parent-child relationships is known to be associated with the offspring's mental health, little is known about the prevalence of problematic relationships in this scenario. This cross-sectional study aims to investigate the prevalence and risk factors of different types of early parent-infant relationships in a Brazilian population group. Methods: During 1 year, all families (n = 230 from an urban community of Porto Alegre, southern Brazil, with 4-month-old infants born in public hospitals were identified, and 148 were fully investigated by two family therapists. This study describes data on the 116 infants with two-parent families. Demographic, obstetric, and relational variables were collected through questionnaires and scales (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning, and Self-Report Questionnaire. Prevalence ratios were calculated, and Poisson regression with robust variance was performed to adjust for covariates. Results: Almost 10% of mothers and 12% of fathers showed at least a significantly perturbed relationship with their 4-month-old infants. Inadequate mother-infant bonding coincided with evidence of paternal mental disorder, poor maternal social network, and discontinuation of breastfeeding at 4 months. A problematic father-infant relationship was associated with a dysfunctional couple relationship and with low infant birth weight. Conclusions: There is a high prevalence of early parent-child relationship problems, suggesting a need for health system interventions. Parent-infant relational problems are prevalent very early in life and more associated with other relational problems than with socioeconomic burden.Introdução: Embora seja consenso que a qualidade das relações pais-filho influencie a saúde mental da prole, pouco se sabe sobre a prevalência de relações problemáticas nessa esfera. Este estudo transversal teve como objetivo

  10. Bioethics, culture and infanticide in Brazilian indigenous communities: the Zuruahá case Bioética, cultura e infanticídio em comunidades indígenas brasileiras: o caso Zuruahá

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    Saulo Ferreira Feitosa

    2010-05-01

    Full Text Available This article analyzes the practice of infanticide in indigenous communities in Brazil. Taking as a reference point a specific case involving two children of the Zuruahá people, it takes a broader look at the issue and discusses how infanticide is understood among other indigenous peoples. A debate focusing specifically on this topic that took place during a public hearing held in the Brazilian National Congress in December 2005 has also been taken into consideration in this discussion. In view of the positions adopted as a result of the hearing, this paper seeks to identify the ethical problems and moral dilemmas relating to the subject, by putting them into context and analyzing them in the light of respect for cultural pluralism. Seeking to contribute to the debate, the authors analyze the possibilities for intervention in the traditional practices of infanticide, while rejecting those positions that are not anchored in an attitude of profound respect for other people's cultures or that do not create conditions for dialogue between individuals or groups with different moralities.O artigo analisa a prática do infanticídio em comunidades indígenas brasileiras. Tomando como referência um caso específico envolvendo duas crianças do povo Zuruahá, focaliza o tema sob uma abordagem mais abrangente e discute como o infanticídio é interpretado em outros povos indígenas. Foram considerados, na discussão, os debates ocorridos durante a Audiência Pública realizada no Congresso Nacional Brasileiro, em dezembro de 2005, que analisou o tema, além de revisão bibliográfica. Diante dos posicionamentos assumidos naquela audiência, procurou-se identificar os problemas éticos e os dilemas morais, contextualizando-os e analisando-os à luz do respeito ao pluralismo cultural. A fim de contribuir com o debate, os autores analisam as possibilidades de intervenção nas práticas tradicionais de infanticídio, recusando qualquer opção que n

  11. RED BLOOD CELL TRANSFUSION IN VERY LOW BIRTH WEIGHT INFANTS AND/OR INFANTS LESS THAN 32 WEEKS OF GESTATIONAL AGE – 4 YEARS EXPERIENCE IN A NEONATAL INTENSIVE CARE UNIT

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    Cátia Rodrigues Correia

    2016-06-01

    Discussion and Conclusion: RBC transfusions were more frequently used in preterm infants with lower GA and BW. Transfusion criteria applied were consistent with National Neonatal Guidelines in 2004. The transfused preterm infants had higher morbidity.

  12. Analysis on Influencing Factors of Premature and Low Birth Weight Infants%早产低体重儿相关影响因素分析

    Institute of Scientific and Technical Information of China (English)

    曹蓓; 黄广文; 龚瑾; 彭湘莲; 冯彬彬

    2011-01-01

    目的 探讨早产低出生体重儿发生的相关影响因素.方法 分析398例早产低出生体重儿的一般情况、产科及母孕期情况.采用多元逐步回归分析对398例早产低出生体重儿母亲年龄、多胎妊娠、孕周、胎盘早剥、胎膜早破、妊娠高血压综合征、母亲贫血、羊水异常、母亲心血管疾病等与早产低出生体重的关系进行分析.结果 孕周≤32周16.3%;胎盘早剥12.8%;胎膜早破48.2%;多胎妊娠35.9%;妊娠高血压综合征21.9%;母亲贫血27.9%;羊水异常11.1%;母亲心血管疾病2.5%.孕周、妊娠高血压综合征、胎盘早剥是早产低出生体重发生的重要影响因素.结论 加强孕期保健,早期诊断及防治妊娠期合并症及并发症有利于预防和减少早产低出生体重儿的发生.%Objective To explore the influencing factors of premature and low birth weight infants.Methods Cornmon complexion, tocology and gestation complexion of 398 premature and low birth weight neonates and mother were examined.The correlation between premature and low birth weight neonates with age of mother, twin gestation, gestation week, placenta peeling early, caul breakage early, pregnancy induced hypertension, anemia of mother, abnormity of amniocentesis, disease of heart and vas of mother were analyzed by multiple regression analysis.Results Gestation week ≤32 weeks was 16.3%, placenta peeling early was 12.8%, caul breakage early was 48.2%, twin gestation was 35.9%, pregnancy induced hypertension was 21.9%, anemia of mother was 27.9%, abnormity of amniotic water was 11.1%, disease of heart and vas of mother was 2.5%.Gestation week, pregnancy induced hypertension, end placenta peeling early were the important influencing factors of occurring premature and low birth weight infant.Conclusions Intensifying health care of gestation, diagnosing early, and preventing and curing syndrome of gestation would be benefit to prevent and reduce the

  13. Low Income, Mexican Mothers' Perception of Their Infants' Weight Status and Beliefs about Their Foods and Physical Activity

    Science.gov (United States)

    Jimenez-Cruz, Arturo; Bacardi-Gascon, Montserrat; Castillo-Ruiz, Octelina; Mandujano-Trujillo, Zally; Pichardo-Osuna, Alexandra

    2010-01-01

    Childhood obesity is being considered a global health epidemic, and one of the countries mostly affected by it is Mexico. The aim of this study was to assess the perceptions of low-income mothers with regard to their child's weight status and physical activity and their beliefs about healthy and high-density foods. A total of 813 mothers attending…

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  15. Low Income, Mexican Mothers' Perception of Their Infants' Weight Status and Beliefs about Their Foods and Physical Activity

    Science.gov (United States)

    Jimenez-Cruz, Arturo; Bacardi-Gascon, Montserrat; Castillo-Ruiz, Octelina; Mandujano-Trujillo, Zally; Pichardo-Osuna, Alexandra

    2010-01-01

    Childhood obesity is being considered a global health epidemic, and one of the countries mostly affected by it is Mexico. The aim of this study was to assess the perceptions of low-income mothers with regard to their child's weight status and physical activity and their beliefs about healthy and high-density foods. A total of 813 mothers attending…

  16. Short-term growth and substrate use in very-low-birth-weight infants fed formulas with different energy contents

    NARCIS (Netherlands)

    J.B. van Goudoever (Hans); E.J. Sulkers; H.N. Lafeber (Harrie); P.J.J. Sauer (Pieter)

    2000-01-01

    textabstractBACKGROUND: Currently available preterm formulas with energy contents of 3350 kJ (800 kcal)/L promote weight and length gain at rates at or above intrauterine growth rates but disproportionately increase total body fat. OBJECTIVE: The objective of this

  17. [Strategies for integration of health care practices and sanitary surveillance in the context of the implementation of Rede Cegonha - a Brazilian mother and infant health care network].

    Science.gov (United States)

    Fernandes, Roberta Zanelli Sartori; Vilela, Maria Filomena de Gouveia

    2014-11-01

    Mother and infant mortality has been the scope of analysis throughout the history of public health in Brazil and various strategies to tackle the issue have been proposed to date. The Ministry of Health has been working on this and the Rede Cegonha strategy is the most recent policy in this context. Given the principle of comprehensive health care and the structure of the Unified Health System in care networks, it is necessary to ensure the integration of health care practices, among which are the sanitary surveillance actions (SSA). Considering that the integration of health care practices and SSA can contribute to reduce mother and infant mortality rates, this article is a result of qualitative research that analyzed the integration of these actions in four cities in the State of São Paulo/Brazil: Campinas, Indaiatuba, Jaguariúna and Santa Bárbara D'Oeste. The research was conducted through interviews with SSA and maternal health managers, and the data were evaluated using thematic analysis. The results converge with other studies, identifying the isolation of health care practices and SSA. The insertion of SSA in collectively-managed areas appears to be a potential strategy for health planning and implementation of actions in the context under scrutiny.

  18. Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population1-2

    Science.gov (United States)

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

    2013-01-01

    Background Stunting is prevalent by the age of 6 mo in the indigenous population of the Western Highlands of Guatemala. Aim The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy. Study Design and Subjects One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 mo. Maternal measurements were also obtained. Results 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 mo respectively. Stunting rates for newborn, 3 and 6 mo were 47%, 53% and 56% respectively. A multiple regression model (R2 = 0.64) demonstrated that the major predictor of LAZ at 3 mo 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 mo. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ. Conclusion 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. PMID:24083893

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

    Institute of Scientific and Technical Information of China (English)

    赵建华

    2011-01-01

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

  20. Incidence of intracranial haemorrhage in low-birth weight infants and its outcome: a hospital based prospective study

    Directory of Open Access Journals (Sweden)

    Rajesh Debbarma

    2016-10-01

    Conclusions: Low gestational age, specially <34 weeks, very low birth weight, male gender, difficult vaginal delivery, birth asphyxia, and hypothermia are risk factors for intracranial hemorrhage, specially intra-ventricular hemorrhage. For better evaluation of risk factors for ICH and its outcome, multicentric study should be performed with large number of simple and longer time period of follow up with the help of newer modalities of investigation. [Int J Res Med Sci 2016; 4(10.000: 4279-4285

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

    Directory of Open Access Journals (Sweden)

    Eveline Campos Monteiro de Castro

    2016-03-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Early Vocalization of Preterm Infants with Extremely Low Birth Weight (ELBW), Part II: From Canonical Babbling up to the Appearance of the First Word

    Science.gov (United States)

    Torola, Helena; Lehtihalmes, Matti; Heikkinen, Hanna; Olsen, Paivi; Yliherva, Anneli

    2012-01-01

    The aim of this study was to systematically describe the preverbal development of preterm infants from canonical babbling up to the first word and to compare it with that of healthy full-term infants. In addition, the amount of vocalization between the preterm and full-term groups was compared. The sample consisted of 18 preterm infants with…

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Dino Gibertoni

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

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

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    Maria Lúcia Silveira Ferlin

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

  8. Infant mortality rates according to socioeconomic status in a Brazilian city Mortalidade infantil e nível socioeconômico em uma cidade brasileira

    Directory of Open Access Journals (Sweden)

    Marcelo Zubaran Goldani

    2001-06-01

    Full Text Available OBJECTIVE: Data from municipal databases can be used to plan interventions aimed at reducing inequities in health care. The objective of the study was to determine the distribution of infant mortality according to an urban geoeconomic classification using routinely collected municipal data. METHODS: All live births (total of 42,381 and infant deaths (total of 731 that occurred between 1994 and 1998 in Ribeirão Preto, Brazil, were considered. Four different geoeconomic areas were defined according to the family head's income in each administrative urban zone. RESULTS: The trends for infant mortality rate and its different components, neonatal mortality rate and post-neonatal mortality rate, decreased in Ribeirão Preto from 1994 to 1998 (chi-square for trend, pOBJETIVO: Informações de bancos de dados municipais podem ser usadas para o planejamento de investigações que visem reduzir as desigualdades no cuidado à saúde. O objetivo do estudo foi determinar a distribuição da mortalidade infantil, segundo uma classificação geoeconômica urbana, usando dados coletados rotineiramente em nível municipal. MÉTODOS: Todos os nascidos vivos (42.381 crianças e todos os óbitos de menores de um ano de idade (731 casos, ocorridos no período entre 1994 e 1998 em Ribeirão Preto, SP, foram considerados para este estudo. Quatro diferentes áreas geoeconômicas foram definidas de acordo com a renda do chefe de família em cada zona administrativa urbana. RESULTADOS: As taxas de mortalidade infantil e de seus componentes neonatal e pós-neonatal, entre 1994 e 1998, apresentaram queda em Ribeirão Preto (chi² para tendência, p<0,05. Essas taxas relacionaram-se inversamente à distribuição de baixos salários (menor do que cinco salários-mínimos por chefe de família nas diversas regiões urbanas (chi² para tendência, p<0,05. A área mais pobre da cidade apresentou contínuo acréscimo de excesso de mortalidade infantil nesse período. CONCLUS

  9. Determinants of Survival in Low Birth Weight Infants at a Tertiary Healthcare Facility in the South Eastern Nigeria

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    Ekwochi U

    2017-06-01

    Full Text Available Low birth weight (LBW babies account for a large number of neonatal deaths globally, with over 90% of these occurring in developing countries with low resources. Identifying factors that determine survival in these sub-groups of babies in such a low-resource setting will help clinicians prioritize care and improve outcomes. This study aims to bridge some knowledge gaps in this regard. This was a 45-month prospective study carried out at the Enugu State University Teaching Hospital (ESUTH, Enugu, Nigeria. All eligible newborns weighing between 500g and and lt;2500g that were seen in this period were enrolled and monitored. Data collected were analysed with SPSS Version 24, and significant associations identified using logistic regression models. A total of 166 LBW neonates were enrolled, and 68.2% of them survived. Asphyxia and episodes recurrent apnoea were recorded at least once in 78.8% and 68.4% of the babies respectively, with about two-thirds requiring respiratory support at one time or the other. Survival in these LBW newborns was negatively associated with gestational age at birth of less than 32 weeks (OR 0.17; CI 0.03-0.50; P and lt;0.01 as well as with episodes of recurrent apnoea (OR 0.07; CI 0.02-0.34; P and lt;0.01. However, intra-uterine exposure to malaria was associated with a 15 times higher likelihood of survival (OR 15.41; CI 2.22-106.91; P=0.01. No significant associations was found between survival and attendances to antenatal care, mode of delivery, birth weight and a number of neonatal morbidities like necrotizing enterocolitis, hypothermia, hypoglycaemia, septicaemia, anaemia and neonatal jaundice. Survival rate among low birth weight neonates in a low resource setting is decreased with delivery at less than 32 weeks completed gestation as well as recurrent episodes of apnoea, but is increased with in-utero exposure to malaria.

  10. Weight and weight gain during early infancy predict childhood obesity

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Holst, Claus; Michaelsen, Kim F.

    2012-01-01

    Infant weight and weight gain are positively associated with later obesity, but whether there is a particular critical time during infancy remains uncertain.......Infant weight and weight gain are positively associated with later obesity, but whether there is a particular critical time during infancy remains uncertain....

  11. Effects of poverty on home environment: an analysis of three-year outcome data for low birth weight premature infants.

    Science.gov (United States)

    Watson, J E; Kirby, R S; Kelleher, K J; Bradley, R H

    1996-06-01

    Investigated the relationship between poverty and parenting in a sample of low birth weight (poverty levels, poor families scored lower on the HOME inventory (used to measure the caregiving environment) than nonpoor families. A regression model including poverty, race, site, and representative environmental, maternal, and child variables accounted for 60% of variance in total HOME scores. Poverty and maternal IQ had significant and independent effects on HOME scores, whereas maternal distress accounted for little of the variance. In a LBWPT sample, our results find a strong relationship between parenting and poverty, suggest a modest role for maternal psychological distress in this relationship, and indicate that the influence of poverty likely extends beyond commonly measured environmental, maternal, and child factors.

  12. 低出生体质量儿呼吸暂停护理干预效果观察%The effect observation of nursing intervention in low birth weight infants with apnea

    Institute of Scientific and Technical Information of China (English)

    朱丽波; 袁明泽; 陈丽君

    2015-01-01

    目的:观察新生儿监护病房( NICU)中低出生体质量儿呼吸暂停的临床护理效果。方法回顾性分析低出生体质量儿呼吸暂停180例临床护理干预及治疗效果。结果呼吸暂停多发生于胎龄28~34周,出生体质量1500~1800g的早产儿;胎龄<28周,出生体质量<1500g的早产儿呼吸暂停的发生率可高达89.92%;胎龄>34周,出生体质量在1800~2500g的低出生体质量儿呼吸暂停发生率明显降低,对于有呼吸暂停的低出生体质量儿均应予心率,呼吸及血氧饱和度的监测。结论对于低出生体质量儿尤其是胎龄<28周及出生体质量<1500g的患儿发生呼吸暂停应给予密切监测、认真评估及早期及时干预。%Objective To observe the effect of nursing care for low birth weight infants with apnea in NICU. Methods Retrospectively analysed the treatment and nursing effects for 180 low birth weight infants with apnea. Results The apnea occurred in the gestational age in 28~34 weeks,which were born in 1500~1800g. The premature whose gestational age less than 28 weeks and birth weight less than 1500g,apnea occurrence rate is 89. 92%. For the infants with gestational age more than 34 weeks and birth weight in 1800~2500g,the incidence of apnea was significantly decreased. For the low birth weight infants with apnea should be given the monitoring for heart rate,respiration and blood oxygen saturation. Conclusion For low birth weight infants with apnea,especially for the infants whose gestational age less than 28weeks and birth weight of less than 1500g,should be given close monitoring,careful evaluation and timely intervention.

  13. CPR - infant

    Science.gov (United States)

    ... breathing and chest compressions - infant; Resuscitation - cardiopulmonary - infant; Cardiopulmonary resuscitation - infant ... CPR is best done by someone trained in an accredited CPR course. The newest techniques emphasize compression ...

  14. Desenvolvimento de prematuros com baixo peso ao nascer nos primeiros dois anos de vida Development of low birth weight preterm infants during the first two years of life

    Directory of Open Access Journals (Sweden)

    Cristiane Alves da Silva

    2011-09-01

    Full Text Available OBJETIVO: Analisar e descrever o desenvolvimento neuropsicomotor de prematuros com baixo peso ao nascer nos dois primeiros anos de vida. MÉTODOS: Estudo transversal realizado com prematuros entre quatro e 24 meses, no Ambulatório de Alto Risco Neonatal do Hospital Universitário da Universidade Federal de Santa Catarina, avaliados em três momentos: 8, 11 e 14 meses de idade cronológica. A amostra, composta inicialmente por 69 indivíduos, teve caráter intencional, segundo os critérios de inclusão e exclusão estabelecidos. A Escala de Brunet e Lèzine foi usada para avaliar o desenvolvimento nas seguintes áreas: coordenação óculo-motriz, linguagem, postura e sociabilidade. Os dados foram analisados por meio de estatística descritiva e inferencial. RESULTADOS: A idade gestacional média foi de 31 semanas e o peso ao nascer foi de 1236g. O quociente de desenvolvimento global apresentou melhora da primeira para a última avaliação, alcançando 85% de escores dentro da normalidade na terceira avaliação. As áreas específicas da coordenação óculo-motriz e da linguagem tiveram os piores resultados iniciais, contrapondo-se à postural, que apresentou os melhores escores. Foi encontrada correlação entre o peso ao nascer e as áreas da postura, linguagem e sociabilidade na primeira avaliação e sociabilidade e coordenação óculo-motriz na terceira avaliação. CONCLUSÕES: O desenvolvimento neuropsicomotor desta população apresentou déficits mais evidentes nos primeiros meses de vida. Embora o seguimento não tenha mostrado diferenças estatísticas entre a primeira e a última avaliação, houve melhora em todas as áreas do desenvolvimento.OBJECTIVE: To analyze and describe the neuropsychomotor development of low birth weight preterm infants in the first two years of life. METHODS: This cross-sectional study enrolled preterm infants between 4 and 24 months old at the follow up clinic of Universidade Federal de Santa Catarina

  15. Brazilian Green Propolis Promotes Weight Loss and Reduces Fat Accumulation in C57BL/6 Mice Fed A High-Fat Diet.

    Science.gov (United States)

    Sakai, Tohru; Ohhata, Miyuki; Fujii, Misaki; Oda, Sayaka; Kusaka, Yasuna; Matsumoto, Miki; Nakamoto, Akiko; Taki, Tomoyo; Nakamoto, Mariko; Shuto, Emi

    2017-01-01

    Propolis is a bee product with various biological properties. C57BL/6 mice were fed a high-fat diet and treated with propolis for 14 weeks. Body weight in mice treated with 2% propolis was less than that in control mice from 3 weeks after the start of treatment until 14 weeks except for the 7th week. Mice treated with propolis showed significantly lower epididymal fat weight and subcutaneous fat weight. Infiltration of epididymal fat by macrophages and T cells was reduced in the propolis group. Supplementation of propolis increased feces weight and fat content in feces, suggesting that mechanisms of weight reduction by propolis partly include a laxative effect and inhibition of fat absorption.

  16. Neurobehavioral conditions and effects of gender, weight and severity in preterm infants according to the Neonatal Behavioral Assessment Scale

    Directory of Open Access Journals (Sweden)

    Alicia Álvarez-García

    2015-10-01

    Full Text Available The increasing number of preterm babies in recent years has raised interest in studying the consequences of prematurity as a risk factor. In the present paper, 30 preterm babies (at 40 weeks of gestational age were assessed using the Neonatal Behavioral Assessment Scale and the results were compared with those of a control group of 28 full term babies. Moreover, the influence of weight, sex and gestational age was analyzed considering the Brazelton results in the preterm group. The preterm group showed significantly lower scores than the control group for 9 of the 28 behavioral items in the Scale and for 2 of the 5 clusters. However, preterm babies performed better in habituation to disturbing stimuli (light and noise during sleep. In relation to the influence of sex, premature girls performed better in the Social-Interactive cluster. The preterm group has lower neurobehavioral conditions than the full term group, probably due to the abrupt interruption of their intrauterine maturation. In contrast, they showed a better ability of habituation, maybe as a consequence of a learning effect due to earlier additional extrauterine exposition.

  17. 超低出生体重儿呼吸管理的研究进展%Advance in the respiratory management of extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    黄文娣

    2014-01-01

    随着辅助生育技术及新生儿重症监护室的发展,超低出生体重儿存活率逐渐增加.由于超低出生体重儿肺发育不成熟,一些产前干预、复苏策略及产后的呼吸管理对于该类患儿长期存活及远期预后具有重要意义.无创性呼吸支持策略可以减少机械通气产生的气压伤、容量伤及氧化应激损伤.吸入性NO、体外膜肺等呼吸支持策略还有待深入研究.%With the improvement of assisted reproductive technology and neonatal intensive care unit,the extremely low birth weight infants have increasingly survived.Since the immature pulmonary,antenatal interventions,resuscitation techniques and postnatal respiratory management attribute to their survival and long term outcomes.Non-invasive ventilation minimize barotrauma,volutrauma and oxygen toxicity induced by mechanical ventilation.Other new strategy such asinhaled NO,extracorporeal membrane oxygenation will be explored.