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Premature Newborns (premature + newborn)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Delay of liver maturation as a cause of transient neonatal galactosemia

PEDIATRICS INTERNATIONAL, Issue 1 2000
Hiroaki Ono
Abstract Background: Because a large amount of serum ,-fetoprotein (,-FP) is synthesized in the liver of the fetus or premature newborn, high concentrations or delayed degradation of serum ,-FP during the neonatal period may reflect hepatic immaturity. Methods: In order to evaluate the relationship between transient neonatal galactosemia and delay of liver maturation, the concentration and half-life of serum ,-FP during the neonatal period were measured in patients with transient galactosemia and in normal neonates. Results: No significant differences were observed in the serum concentration of ,-FP between normal and galactosemic patients less than 1 month of age. However, the half-life of serum ,-FP was significantly longer in galactosemic patients between 15 and 60 days of age compared with age-matched normal neonates. Conclusion: Based on these results, we hypothesize that delay of liver maturation during the neonatal period, especially during the first 2 months after birth, can be a cause of transient neonatal galactosemia. [source]

Effect of chorioamnionitis on brain development and injury in premature newborns,

ANNALS OF NEUROLOGY, Issue 2 2009
Vann Chau MD
Objective The association of chorioamnionitis and noncystic white matter injury, a common brain injury in premature newborns, remains controversial. Our objectives were to determine the association of chorioamnionitis and postnatal risk factors with white matter injury, and the effects of chorioamnionitis on early brain development, using advanced magnetic resonance imaging. Methods Ninety-two preterm newborns (24,32 weeks gestation) were studied at a median age of 31.9 weeks and again at 40.3 weeks gestation. Histopathological chorioamnionitis and white matter injury were scored using validated systems. Measures of brain metabolism (N-acetylaspartate/choline and lactate/choline) on magnetic resonance spectroscopy, and microstructure (average diffusivity and fractional anisotropy) on diffusion tensor imaging were calculated from predefined brain regions. Results Thirty-one (34%) newborns were exposed to histopathological chorioamnionitis, and 26 (28%) had white matter injury. Histopathological chorioamnionitis was not associated with an increased risk of white matter injury (relative risk: 1.2; p = 0.6). Newborns with postnatal infections and hypotension requiring therapy were at higher risk of white matter injury (p < 0.03). Adjusting for gestational age at scan and regions of interest, histopathological chorioamnionitis did not significantly affect brain metabolic and microstructural development (p > 0.1). In contrast, white matter injury was associated with lower N-acetylaspartate/choline (,8.9%; p = 0.009) and lower white matter fractional anisotropy (,11.9%; p = 0.01). Interpretation Histopathological chorioamnionitis does not appear to be associated with an increased risk of white matter injury on magnetic resonance imaging or with abnormalities of brain development. In contrast, postnatal infections and hypotension are associated with an increased risk of white matter injury in the premature newborn. Ann Neurol 2009;66:155,164 [source]

Retinopathy of prematurity: Mutations in the Norrie disease gene and the risk of progression to advanced stages

PEDIATRICS INTERNATIONAL, Issue 2 2001
Mohammad Z Haider
AbstractBackground: Retinopathy of prematurity (ROP) is a retinal vascular disease that occurs in infants with short gestational age and low birth weight and may lead to retinal detachment and blindness. Missense mutations in the Norrie disease (ND) gene have been associated with the risk of progression to advanced stages in cases of ROP from the US and also in clinically similar ND and familial exudative vitreoretinopathy. Methods: We have screened two ND gene mutations, namely A105T and Val60Glu, by polymerase chain reaction,restriction fragment length polymorphism (PCR-RFLP) and allele-specific PCR methods, respectively, in 210 Kuwaiti premature newborns to replicate these findings in a different ethnic group. Results: In the Kuwaiti premature newborn cohort, 115 of 210 babies had no eye problems and served as controls, while 95 were cases of ROP. In 71 of 95 ROP cases, the disease regressed spontaneously on or before stage 3, while in 24 of 95 ROP cases the disease progressed to advanced stages 4 and 5. In case of missense mutation (A105T), the AA genotype was detected in 96% of controls compared with 87% of ROP cases (NS); similarly no significant difference was found between spontaneously regressed ROP cases and those who progressed to advanced stages. For the Val60Glu mutation, no significant association was detected between the genotype and progression of ROP to advanced stages. Conclusions: Unlike data from the US, our findings from a Kuwaiti cohort of ROP cases and controls suggest a lack of association between the two ND gene mutations (A105T and Val60Glu) and ROP and the risk of progression of the disease to advanced stages. [source]

Effect of chorioamnionitis on brain development and injury in premature newborns,

ANNALS OF NEUROLOGY, Issue 2 2009
Linda S. de Vries MD
No abstract is available for this article. [source]

Effect of chorioamnionitis on brain development and injury in premature newborns,

ANNALS OF NEUROLOGY, Issue 2 2009
Vann Chau MD
Objective The association of chorioamnionitis and noncystic white matter injury, a common brain injury in premature newborns, remains controversial. Our objectives were to determine the association of chorioamnionitis and postnatal risk factors with white matter injury, and the effects of chorioamnionitis on early brain development, using advanced magnetic resonance imaging. Methods Ninety-two preterm newborns (24,32 weeks gestation) were studied at a median age of 31.9 weeks and again at 40.3 weeks gestation. Histopathological chorioamnionitis and white matter injury were scored using validated systems. Measures of brain metabolism (N-acetylaspartate/choline and lactate/choline) on magnetic resonance spectroscopy, and microstructure (average diffusivity and fractional anisotropy) on diffusion tensor imaging were calculated from predefined brain regions. Results Thirty-one (34%) newborns were exposed to histopathological chorioamnionitis, and 26 (28%) had white matter injury. Histopathological chorioamnionitis was not associated with an increased risk of white matter injury (relative risk: 1.2; p = 0.6). Newborns with postnatal infections and hypotension requiring therapy were at higher risk of white matter injury (p < 0.03). Adjusting for gestational age at scan and regions of interest, histopathological chorioamnionitis did not significantly affect brain metabolic and microstructural development (p > 0.1). In contrast, white matter injury was associated with lower N-acetylaspartate/choline (,8.9%; p = 0.009) and lower white matter fractional anisotropy (,11.9%; p = 0.01). Interpretation Histopathological chorioamnionitis does not appear to be associated with an increased risk of white matter injury on magnetic resonance imaging or with abnormalities of brain development. In contrast, postnatal infections and hypotension are associated with an increased risk of white matter injury in the premature newborn. Ann Neurol 2009;66:155,164 [source]

Remifentanil in neonatal intensive care and anaesthesia practice

ACTA PAEDIATRICA, Issue 10 2010
Márcia Gomes Penido
Abstract Remifentanil is a relatively new ultrashort action synthetic opioid. Studies on the use of remifentanil in neonatology have emerged demonstrating its effectiveness and safety in neonates. The present study describes the use of remifentanil in both full-term and premature newborns, highlighting the theoretical benefits for this population in terms of both neonatal intensive care and anaesthesia. A Medline search was undertaken of all reviews and reports about the use of remifentanil in neonates published between 1996 and 2009 using MeSH search terms ,remifentanil', ,analgesia', ,anaesthesia', ,newborn' and ,neonate'. The review points that remifentanil has been used with advantages in newborns including preterm neonates and even for foetal anaesthesia. It proved to be a good option to attenuate the hemodynamic/endocrine markers of stress related to surgery. Owing to its unique pharmacokinetic profile, shorter extubation times can be achieved what makes the drug also a good option for short duration invasive procedures in NICUs (InSurE). A concern on its use is that the hemodynamic response (hypotension) may become significant when the drug is associated to other drugs like sevoflurane. Conclusion:, Remifentanil seems to be an effective and safely used opioid for neonatal intensive care and anaesthesia practice. [source]

In-hospital mortality of newborn infants born before 33 weeks of gestation depends on the initial level of neonatal care: the EPIPAGE study

ACTA PAEDIATRICA, Issue 3 2003
JP Empana
Aim: To determine the relation between the level of initial neonatal care and in-hospital mortality of infants born before 33 wk of gestation in the era of surfactant therapy. Methods: A 1 y prospective population-based survey was conducted in the north of France, as part of the EPIPAGE (Epidemiologie des Petits Ages Gestationnels) survey. Perinatal data were recorded for 585 very premature newborns transferred to a neonatal intensive care unit in 1997. The relation between the level of the neonatal unit that provided care for the first consecutive 48 h and in-hospital mortality was assessed by multivariate logistic regression, and adjusted for perinatal data and initial disease severity, estimated by the Clinical Risk Index for Babies (CRIB). Results: The average gestational age (mean ± SD) was 31.6 ± 0.62 wk in level I, 30.7 ± 0.21 in level II, 29.9 ± 0.13 in non-teaching level III, and 29.0 ± 0.15 in the level III teaching unit (p < 0.0001). The mean in-hospital mortality rate was 8.4% and did not differ by level of care (ptrend= 0.17). After adjustment for perinatal data and CRIB, however, with the teaching unit as the reference, the risk of death was significantly higher in level I,II units [adjusted odds ratio (ORa) = 7.9, 95% confidence interval (95% CI) 2.2,29.1], but not in the non-teaching level III units (ORa = 0.8, 95% CI 0.3,2.1). Conclusion: In-hospital mortality in non-teaching level III units was similar to that in a teaching unit, but significantly higher in level I-level II units. Neonatal care of newborns delivered before 33 wk of gestation should initially occur in level III units. [source]