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Premature Birth (premature + birth)

Distribution by Scientific Domains

Medical Sciences	86%
Life Sciences	13%

Selected Abstracts

A comparison of mothers' and fathers' experiences of the attachment process in a neonatal intensive care unit

JOURNAL OF CLINICAL NURSING, Issue 6 2008
Liv Fegran RN
Aim., To compare mothers' and fathers' individual views and experiences of the attachment process in a neonatal intensive care unit within the first week after a premature birth. Background., The attachment between parents and children is a precursor to the consolidation of parenting skills, the growth and development of the infant and the establishment of a bond between parent and child. Premature birth and the resultant hospitalization disrupt the normal attachment process between parent and child. Most of the litteraure on attachment theory focuses on the mother,child connection and is being criticised for regarding the father's role as supportive and peripheral. Methods., The design of this study was descriptive with a hermeneutic approach. Twelve parents (six mothers and six fathers) in a 13-bed neonatal intensive care unit in a Norwegian regional hospital participated in a field study addressing the encounter between parents and nurses. This paper is based on the semi-structured interviews with the parents at discharge. Results., The interview analysis revealed two main categories. (a) Taken by surprise: For mothers, the premature birth created a feeling of powerlessness and they experienced the immediate postnatal period as surreal and strange. The fathers experienced the birth as a shock, but were ready to be involved immediately. (b) Building a relationship: Mothers experienced a need to regain the temporarily lost relationship with their child, whereas the fathers experienced the beginning of a new relationship. Conclusion., Comparing parents' experiences of the attachment process within the first days after a premature birth reveals a striking contrast between the mother's experience of surrealism and the father's ability to be involved immediately after birth. Relevance to clinical practice., Parents' of premature children's different starting points should be acknowledged as professionals encourage parents to have early skin-to-skin contact with their premature infant. [source]

Neuroimaging of cortical development and brain connectivity in human newborns and animal models

JOURNAL OF ANATOMY, Issue 4 2010
Gregory A. Lodygensky
Abstract Significant human brain growth occurs during the third trimester, with a doubling of whole brain volume and a fourfold increase of cortical gray matter volume. This is also the time period during which cortical folding and gyrification take place. Conditions such as intrauterine growth restriction, prematurity and cerebral white matter injury have been shown to affect brain growth including specific structures such as the hippocampus, with subsequent potentially permanent functional consequences. The use of 3D magnetic resonance imaging (MRI) and dedicated postprocessing tools to measure brain tissue volumes (cerebral cortical gray matter, white matter), surface and sulcation index can elucidate phenotypes associated with early behavior development. The use of diffusion tensor imaging can further help in assessing microstructural changes within the cerebral white matter and the establishment of brain connectivity. Finally, the use of functional MRI and resting-state functional MRI connectivity allows exploration of the impact of adverse conditions on functional brain connectivity in vivo. Results from studies using these methods have for the first time illustrated the structural impact of antenatal conditions and neonatal intensive care on the functional brain deficits observed after premature birth. In order to study the pathophysiology of these adverse conditions, MRI has also been used in conjunction with histology in animal models of injury in the immature brain. Understanding the histological substrate of brain injury seen on MRI provides new insights into the immature brain, mechanisms of injury and their imaging phenotype. [source]

A comparison of mothers' and fathers' experiences of the attachment process in a neonatal intensive care unit

Are Maternal Cortisol Levels Related to Preterm Birth?

JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2009
Carmen Giurgescu
ABSTRACT Objective: To examine the evidence related to the relationship between maternal cortisol levels and preterm birth. Data Sources: A search of Medline, PubMed, and Cumulative Index of Nursing and Allied Health Literature was conducted using the keywords preterm birth, preterm delivery, premature birth, and cortisol. Study Selection: Fifteen studies published in English were selected based on the inclusion criteria. There were no limitations on the dates of publication. Data Extraction: The data extracted were related to the gestational age at collection of biological samples, time of day at collection, and differences in cortisol levels between preterm and full-term groups. Data Synthesis: The majority of the studies suggested that maternal cortisol levels are related to preterm birth. Women with higher levels of cortisol had higher risk of having a preterm birth. Conclusions: Researchers can use the findings of this review to develop future studies that examine the relationship between cortisol levels and preterm birth. Health care providers need to assess pregnant women's stress levels more closely and provide appropriate referrals and treatment to ensure that any actions that may possibly lower stress are being taken to reduce the likelihood of preterm birth. [source]

Ventilatory strategies for the extremely premature infant

PEDIATRIC ANESTHESIA, Issue 5 2008
ANNE GREENOUGH
Summary Bronchopulmonary dysplasia (BPD), which has long-term adverse outcomes, is common following extremely premature birth. BPD has a multifactorial etiology, including a high level or prolonged use of mechanical ventilation. Numerous research studies, therefore, have attempted to identify ventilatory techniques which reduce the likelihood of baro/volutrauma and hence BPD; these have been critically examined in this review, particularly with regard to their relevance to the extremely prematurely born infant. This has highlighted that few randomized studies of ventilatory strategies have concentrated exclusively on those high-risk infants. Overall, in prematurely born infants, advantages have been suggested by the results of studies examining pressure support, proportional assist and volume-targeted ventilation. In addition, High-Frequency Oscillatory Ventilation (HFOV) may reduce the deterioration seen in lung function of prematurely born infants over the first year after birth. In conclusion, more randomized studies are required which concentrate exclusively on the extremely prematurely born population who are at highest risk of BPD. It is essential in such studies that long-term follow-up assessment is inbuilt so that the benefits/adverse effects can be appropriately identified. [source]

Neonatal clinical outcome after electivecesarean section before the onset of labor at the 37th and 38thweek of gestation

PEDIATRICS INTERNATIONAL, Issue 4 2003
Hajime Yamazaki
Abstract Background:,Although elective cesareansections are often performed after the 37th week of gestation withoutany complicating factor that may influence the timing of delivery,there is a possibility that infants born in the 37th week of gestation,especially early in the 37th week of gestation, do not obtain asatisfactory clinical outcome due to premature birth. Methods:,The authors analyzed the clinicalcourse during the neonatal period in 96 infants born in the 37th (n = 81)and 38th (n = 15) week of gestationby an elective cesarean section. Subjects were retrospectively dividedinto two groups: infants born in the first half of the 37th weekof gestation (37+0,37+3)(n = 48), and infants born fromthe latter half of the 37th week of gestation (37+4,37+6)through the 38th week of gestation (n = 48).Twin pregnancies, pregnancy with placenta previa, and pregnancyof women who had a diversity of medical complications were excludedfrom the present study, because of the possibility that these conditions mayhave affected the infants' status. The incidence of infantswho showed clinical symptoms during the neonatal period and whoneeded medical care was compared between the two groups. Results:,Of the 96 subjects, 25 infants(26.0%) had significant clinical symptoms. The incidenceof breathing difficulty was significantly higher in the infant groupborn in the first half of the 37th week of gestation than in thelatter group. Conclusions:,An elective cesarean sectionbefore the onset of labor early in the 37th week of gestation should notbe routinely undertaken. [source]

Effect of seasonal programming on fetal development and longevity: Links with environmental temperature

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2009
Andreas D. Flouris
This study examined the effect of birth season on fetal development and longevity using two independent databases of all Greek citizens that were born (total: 516,874) or died (total: 554,101) between 1999 and 2003. We found significantly increased birth weight, gestational age, and longevity in individuals born during the autumn and winter seasons of the year. These individuals also demonstrated statistically significantly lower prevalence rates for fetal growth restriction and premature birth. Furthermore, we found that increased temperature at birth was associated with adverse effects on fetal development and longevity. In conclusion, our results show strong effects of season of birth on fetal development and longevity mediated, at least in part, by environmental temperature at time of birth. Am. J. Hum. Biol., 2009. © 2008 Wiley-Liss, Inc. [source]

ORIGINAL ARTICLE: Soluble Human Leukocyte Antigen-G Isoforms in Maternal Plasma in Early and Late Pregnancy

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 5 2009
Roberta Rizzo
Problem Human Leukocyte Antigen (HLA)-G is a class Ib gene located in the human major histocompatibility complex (MHC). Several lines of investigation indicate that the HLA-G molecule is involved in the maternal acceptance of the semi-allogenic fetus during pregnancy and in the development of tolerance. Expression of soluble HLA-G (sHLA-G) is positively correlated with successful in vitro fertilization (IVF) treatments, and aberrant expression of HLA-G in certain complications of pregnancy, such as pre-eclampsia and spontaneous abortion, has been reported. The main purpose of this study was to investigate the levels of different soluble HLA-G isoforms in maternal plasma in early and late pregnancy. Method of study Soluble HLA-G (sHLA-G) can be detected in maternal blood, and in this study, two different isoforms of sHLA-G, namely sHLA-G1 generated by shedding of membrane-bound HLA-G1 and HLA-G generated by specific HLA-G transcripts, have been investigated early [median of 16.4 weeks of gestation (GW)] and late (median: 38.9 GW) in pregnancy in an original cohort of 580 pregnant Caucasian women. Results Lower concentrations of sHLA-G1 were found late in pregnancy (>32 GW) in a group of women with severe pre-eclampsia compared with controls with uncomplicated pregnancies (P = 0.029, PC = 0.09; Mann,Whitney; Logistic regression analysis: P = 0.024, OR = 0.920, 95% CI: 0.855,0.989). However, this was not the case with HLA-G5, and significantly more of the cases with severe pre-eclampsia had detectable plasma HLA-G5 compared with that of the control group (P = 0.013, PC = 0.04; Mann,Whitney). Similar findings were not observed in women with gestational hypertension or existing hypertension continuing into pregnancy. Furthermore, there was a trend toward lower maternal plasma sHLA-G1 in a group of women with premature birth (<37 GW) compared with that of the control group (P = 0.028, PC = 0.17; Mann,Whitney). On the contrary, HLA-G5 was lower in the control group compared with that in the premature group (P = 0.004, PC = 0.02; Mann,Whitney). Conclusion This study shows in line with other published studies that a high, detectable soluble HLA-G concentration in maternal plasma or serum is not mandatory for a successful pregnancy. However, complications during pregnancy, such as (severe) pre-eclampsia, spontaneous abortion, IUGR, and premature birth, are associated with a low or undetectable level of soluble HLA-G in the maternal blood circulation. Also, this study indicates that sHLA-G1 is the interesting soluble HLA-G isoform in pre-eclampsia, and that low or undetectable levels of HLA-G5 at the end of pregnancy seem to be associated with an uncomplicated normal pregnancy, whereas in severe pre-eclampsia and possibly other pregnancy complications, such as preterm birth and IUGR, the level of HLA-G5 is higher. [source]

Relationship between Cervical Mucus Interleukin-8 Concentrations and Vaginal Bacteria in Pregnancy

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2004
Masatoshi Sakai
Problem:, High interleukin (IL)-8 concentration in cervical mucus in the second trimester is a risk factor for premature birth. We investigated the relationship between vaginal pathogens and IL-8 in cervical mucus. Method of study:, In 501 women with single pregnancy, vaginal secretions were cultured for bacteria and cervical mucus IL-8 concentrations were measured between 20 and 24 gestational weeks. Results:,Lactobacillus species were detected in 56.0% of 84 subjects with high IL-8 (,377 ng/mL), significantly less often than in 417 subjects with IL-8 below 377 ng/mL (84.7%; P < 0.0001). Anaerobic pathogens were detected in 83.3% of high IL-8 subjects, significantly more often than in normal IL-8 subjects (43.9%; P < 0.0001). By multivariate analysis, cervical IL-8 was significantly high only in subjects without Lactobacillus species; they showed a significantly higher prematurity rate than Lactobacillus -positive subjects. Conclusions:, Absence of vaginal Lactobacilli was associated with increased cervical IL-8 and increased risk of premature delivery. [source]

Might Wasp Venom Desensitization Induced Th2 to Th1 Shift Cause Pregnancy Failure?

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 4 2002
UDO R. MARKERT
The case of a 28-year-old woman under wasp venom desensitization having a premature birth in her 24th week of pregnancy 16 days after the last injection is described. To test the hypothesis that a special profile of immune cells in the decidua may trigger abortions, placental and decidual tissue sections were stained with antibodies against T cells (CD3), cytotoxic cells (CD8), natural killer cells (CD56), and mast cells, and an in-situ-hybridization was performed for tumor necrosis factor-, (TNF-,). CD56+ Natural killer cells were the dominating population. In earlier analyses of healthy first trimester decidua the percentage of NK cells and T cells was in a similar range, but the CD8:CD3 ratio was only 2.2% in contrast to 27% in the present case. Mast cells, which are known to be able to secrete abortogenic TNF-,, were only detectable in the decidua (10 cells/mm2) and decidua sections were TNF-, positive. Since SIT induces a shift of the interleukin and functional profile from a Th2 type towards a Th1 type, and pregnancy is dependent on a Th2 pronounced profile, SIT may trigger abortions or immature births. This is supported by the present results and might have happened in this case. [source]

Selectin polymorphisms and perinatal morbidity in low-birthweight infants

ACTA PAEDIATRICA, Issue 10 2006
László Derzbach
Abstracts Background: Studies have shown an association between altered expression of selectins and premature birth, early sepsis and bronchopulmonary dysplasia. Aim: To investigate the possible link between functional polymorphisms of the E-, P- and L-selectin genes and perinatal morbidity. Methods: We compared the genotype distribution of the E-selectin Ser128Arg, P-selectin Thr715Pro and L-selectin Pro213Ser polymorphisms in 125 low-birthweight singleton infants with those of 156 healthy term neonates. We also analysed the association of genotype with risk of sepsis and bronchopulmonary dysplasia. Results: We found no association between E-selectin or P-selectin polymorphisms and premature birth, nor did we find any association between E-selectin or P-selectin and early postnatal sepsis or bronchopulmonary dysplasia. Carriers of the 213Ser L-selectin allele were found to be more prevalent in low-birthweight infants, particularly in those with bronchopulmonary dysplasia. We found no association between the L-selectin polymorphism and early postnatal sepsis. Conclusion: Our results underline the importance of L-selectin in perinatal pathology, but further studies are needed to evaluate the alteration of L-selectin levels in carriers of the 213Ser allele and their possible contribution to premature birth and bronchopulmonary dysplasia. [source]

Identification of risk factors associated with nosocomial infection by rotavirus P4G2, in a neonatal unit of a tertiary-care hospital

CLINICAL MICROBIOLOGY AND INFECTION, Issue 3 2009
R. Herruzo
Abstract A rotavirus outbreak in newborns admitted to the ,La Paz' University Hospital, Madrid was detected, followed up and controlled. Uninfected children were selected as control subjects. Samples of faeces were taken once or twice weekly from all the newborns, including those who were asymptomatic and who were admitted to the neonatal unit for early detection of rotavirus and the positive were separated from the rest of the neonates. Contact-related precautions were taken for all patients, and alcohol solutions were used for hand washing. During the months of the outbreak, 1773 children were admitted to the hospital, 131 of whom were affected by the rotavirus infection (7.4%). Of these, 72 (55%) had symptomatic infections. In the first month of the outbreak, nine cases of necrotizing enterocolitis were diagnosed (one patient developed massive intestinal necrosis). The infections (symptomatic and asymptomatic) presented a bimodal distribution caused by a new outbreak of rotavirus type P4G2 after two patients who had acquired the infection outside the hospital were admitted when the first outbreak was subsiding. The characteristics of cases and controls were analysed using bivariate and multivariate methods (non-conditional multivariate logistic regression) to identify four risk factors strongly associated with rotavirus infection: premature birth, infections other than rotavirus, malformation, and changes in glycaemia and/or presence of jaundice. [source]

Cushing's syndrome in pregnancy and neonatal hypertrophic obstructive cardiomyopathy

ACTA PAEDIATRICA, Issue 10 2004
L Fayol
Cushing's syndrome is rare in pregnancy but can cause spontaneous abortion, stillbirth or premature birth. We report a case of transient hypertrophic obstructive cardiomyopathy in a newborn whose mother had hypercortisolism due to a primary adrenal lesion. There was no family history of hypertrophic obstructive cardiomyopathy. Follow-up revealed complete resolution of the cardiac abnormalities in the infant. Cushing's syndrome in the mother resolved after delivery. Although maternal hypercortisolism seldom results in symptomatic hypercortisolism in the newborn, hypertrophic obstructive cardiomyopathy can occur. [source]

A parent as a vector of Salmonella brandenburg nosocomial infection in a neonatal intensive care unit

CLINICAL MICROBIOLOGY AND INFECTION, Issue 6 2003
G.-L. Cartolano
A newborn baby was admitted to the Neonatal Intensive Care Unit (NICU) of St Germain en Laye Hospital (France) because of premature birth. On day 12, he contracted gastroenteritis due to Salmonella brandenbourg. The salmonellosis led to a septic shock syndrome with a brief cardiopulmonary arrest. He was treated with intravenous ceftriaxone and gentamicin, and the evolution was favorable. Microbiological investigations revealed that the mother was the vector for this nosocomial infection. S. brandenbourg was isolated from the feces of the baby, despite recent recommendations on managing stool specimens from patients hospitalized for more than three days: according to these recommendations, these stools should be processed for viruses and Clostridium difficile toxin only. [source]

Antenatal corticosteroid therapy: benefits and risks

ACTA PAEDIATRICA, Issue 2004
O Baud
Antenatal glucocorticoid therapy remains one the most striking successes in perinatal management of complicated pregnancies leading to premature birth. All women at risk of preterm delivery before 34 weeks gestation should be treated, given the anti-inflammatory and maturative properties of fluorocorticoids. Betamethasone is preferred to dexamethasone and no more than two courses, two weeks apart, should be given, until the evidence from further controlled trials on repeated doses becomes available. [source]