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Term Neonates (term + neonate)
Kinds of Term Neonates Selected AbstractsSignificant differences between capillary and venous complete blood counts in the neonatal periodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2003S.M. Kayiran Summary The normal capillary and venous hematologic values for neonates have not been defined clearly. It is well known that capillary blood has higher hemoglobin (Hb) and hematocrit (Hct) values than venous blood. In a recent study, we reported differences between capillary and venous complete blood counts (CBC) in healthy term neonates on day 1 of life. The aim of this study was to extend our previous investigation. Term neonates (n=141) were stratified into four groups by days of postnatal age: group 2 (day 7, n=38), group 3 (day 14, n=35), group 4 (day 21, n=32) and, group 5 (day 28, n=36). Data from our previous study were included in the statistical analysis as group 1 (day 1, n=95). A CBC and differential count were carried out on each capillary and venous sample drawn simultaneously. Within each group, the mean and standard deviation for each parameter in capillary and venous blood were calculated and then compared using the paired sample t -test. In all groups, the capillary blood samples had higher Hb, Hct, red blood cell (RBC), white blood cell (WBC), and lymphocyte counts. In each group, venous platelet counts were significantly higher than the corresponding capillary values. There was also a trend toward higher venous mean corpuscular volume, higher capillary polymorphonuclear leukocyte (PML) count and mean platelet volume in all groups. In both capillary and venous blood, Hb, Hct, RBC, MCV values and WBC, lymphocyte, PML counts decreased and platelet counts increased steadily during neonatal period. This study reveals that CBC parameters and differential counts may differ depending on the blood sampling used. The findings underline the importance of considering the sample source when using hematologic reference ranges for healthy or septic neonates. When interpreting results, the term ,peripheral blood' should be replaced with ,capillary blood' or ,venous blood' so that an accurate assessment can be made. [source] A randomized, controlled trial of aprotinin in neonates undergoing open-heart surgeryPEDIATRIC ANESTHESIA, Issue 9 2008GLYN D. WILLIAMS MBChB Summary Background:, Neonates undergoing open-heart surgery are especially at risk for massive bleeding and pronounced inflammation. The efficacy of aprotinin, a serine protease inhibitor, at ameliorating these adverse effects of cardiopulmonary bypass has not been clearly demonstrated in neonates. Methods:, Term neonates were enrolled and randomly assigned in a blinded fashion to receive saline (group P, placebo) or high-dose aprotinin (group A). Intraoperative management was standardized: surgeon, anesthesia, cardiopulmonary bypass and hemostasis therapy. Patients were admitted postoperatively to a pediatric cardiac intensive care unit. Primary outcome measure of efficacy was duration of the postoperative mechanical ventilation. Secondary outcome measures were total volume and units of blood products transfused intraoperatively and for 24 h after surgery, duration of chest tube in situ, and intensive care and hospital stays after surgery. Results:, Twenty-six neonates were enrolled; 13 received aprotinin and 13 received placebo. The study was halted prematurely because of US Food and Drug Administation's concerns about aprotinin's safety. Baseline patient, surgery and cardiopulmonary bypass characteristics were similar between groups. No outcome variables differed between groups (P > 0.05). Duration of postoperative ventilation was 115 ± 139 h (group A); 126 ± 82 h (group P); P = 0.29, and total blood product exposure was 8.2 ± 2.6 U (group A); 8.8 ± 1.4 U (group P); P = 0.1. Postoperative blood creatinine values did not differ between groups. In-hospital mortality rate was 4%. Conclusions:, Aprotinin was not shown to be efficacious in neonates undergoing open-heart surgery. It is unclear whether adult aprotinin safety data are relevant to neonates undergoing open-heart surgery. [source] Early severe weight loss in newborns after discharge from regular nurseriesACTA PAEDIATRICA, Issue 5 2010E Tjora Abstract Aims:, To study incidence and risk factors of early neonatal dehydration in a Norwegian population based cohort. Methods:, Term neonates admitted to a paediatric department during 2002,2008 with a weight loss , 12% within three weeks of age were identified retrospectively through review of medical records. For each patient a sex-matched control group of two full-term infants was selected to assess risk factors for dehydration. Results:, A total of 38 of 37 321 infants (1.0,) were admitted at a median age of 6 (interquartile range 5,12) days, and the admission rate increased during the study period (p for trend = 0.008). Simultaneously, mean nursery stay decreased from 3.5 to 2.7 days (p = 0.022). Mean weight loss was 15.0% of birth weight and 17 of 29 (58.6%) had serum sodium above 145 mmol/L. The only significant difference between patients and controls was that mothers of patients were older (32.3 ± 5.0 vs. 29.4 ± 5.4 years, p = 0.005). Conclusion:, Short nursery stay may be a risk factor for dehydration in newborn infants. [source] Neonatal ascites and hyponatraemia following umbilical venous catheterizationJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2002MS Mohan Abstract: The complications associated with umbilical venous catheterization in neonates range from pericardial effusion, portal hypertension, and peritoneal perforation with ascites, to Wharton's jelly embolism. The case of a term neonate who developed ascites and severe hyponatraemia (serum sodium 119 mmol/L) most probably following peritoneal perforation by an umbilical venous catheter is reported. The presenting feature was convulsions associated with dilutional hyponatraemia, probably following absorption of a large quantity of ascitic fluid across the peritoneum. Conservative management was associated with gradual recovery over 24 h. The case highlights that, irrespective of the route, excessive administration of salt-free fluids can lead to dilutional hyponatraemia with adverse consequences. The present case illustrates the importance of confirming intravascular positioning of umbilical catheters by ensuring free flow of blood on aspiration, to prevent/detect inadvertent peritoneal perforation. Ideally, echocardiographic confirmation of optimal intravascular placement of such catheters is preferred as radiographic confirmation is reported to be unreliable. [source] Resistance to vecuronium in a term neonateACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2002A. Sarti We report a case of resistance to curarization in a term neonate undergoing surgery. The dosage of vecuronium required to obtain satisfactory muscular blockade and cessation of spontaneous breathing efforts was more than 10-fold the normal one. The operation was delayed for 90 min The mechanism of this marked resistance is unknown, but some possible hypotheses are presented, focusing on the neonate's poor intrauterine growth and an abnormality in pharmacodynamics. [source] Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birthAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2009Michelle Lampl The variability in fetal growth rates and gestation duration in humans is not well understood. Of interest are women presenting with an episode of preterm labor and subsequently delivering a term neonate, who is small relative to peers of similar gestational age. To further understand these relationships, fetal growth patterns predating an episode of preterm labor were investigated. Retrospective analysis of fetal biometry assessed by serial ultrasound in a prospectively studied sample of pregnancies in Santiago, Chile, tested the hypothesis that fetal growth patterns among uncomplicated pregnancies (n = 3,706) and those with an episode of preterm labor followed by term delivery (n = 184) were identical across the time intervals 16,22 weeks, 22,28 weeks, and 28,34 weeks in a multilevel mixed-effects regression. The hypothesis was not supported. Fetal weight growth rate was faster from 16 weeks among pregnancies with an episode of preterm labor (P < 0.05), declined across midgestation (22,28 weeks, P < 0.05), and rebounded between 28 and 34 weeks (P = 0.06). This was associated with perturbations in abdominal circumference growth and proportionately larger biparietal diameter from 22 gestational weeks (P = 0.03), greater femur (P = 0.01), biparietal diameter (P = 0.001) and head circumference (P = 0.02) dimensions relative to abdominal circumference across midgestation (22,28 weeks), followed by proportionately smaller femur diaphyseal length (P = 0.02) and biparietal diameter (P = 0.03) subsequently. A distinctive rapid growth phenotype characterized fetal growth preceding an episode of preterm labor among this sample of term-delivered neonates. Perturbations in abdominal circumference growth and patterns of proportionality suggest an altered growth strategy pre-dating the preterm labor episode. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Nursing and midwifery management of hypoglycaemia in healthy term neonatesINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 7 2005Vivien Hewitt BSc(Hons) GradDipLib Executive summary Objectives The primary objective of this review was to determine the best available evidence for maintenance of euglycaemia, in healthy term neonates, and the management of asymptomatic hypoglycaemia in otherwise healthy term neonates. Inclusion criteria Types of studies The review included any relevant published or unpublished studies undertaken between 1995 and 2004. Studies that focus on the diagnostic accuracy of point-of-care devices for blood glucose screening and/or monitoring in the neonate were initially included as a subgroup of this review. However, the technical nature and complexity of the statistical information published in diagnostic studies retrieved during the literature search stage, as well as the considerable volume of published research in this area, suggested that it would be more feasible to analyse diagnostic studies in a separate systematic review. Types of participants The review focused on studies that included healthy term (37- to 42-week gestation) appropriate size for gestational age neonates in the first 72 h after birth. Exclusions ,,preterm or small for gestational age newborns; ,,term neonates with a diagnosed medical or surgical condition, congenital or otherwise; ,,babies of diabetic mothers; ,,neonates with symptomatic hypoglycaemia; ,,large for gestational age neonates (as significant proportion are of diabetic mothers). Types of intervention All interventions that fell within the scope of practice of a midwife/nurse were included: ,,type (breast or breast milk substitutes), amount and/or timing of feeds, for example, initiation of feeding, and frequency; ,,regulation of body temperature; ,,monitoring (including screening) of neonates, including blood or plasma glucose levels and signs and symptoms of hypoglycaemia. Interventions that required initiation by a medical practitioner were excluded from the review. Types of outcome measures Outcomes that were of interest included: ,,occurrence of hypoglycaemia; ,,re-establishment and maintenance of blood or plasma glucose levels at or above set threshold (as defined by the particular study); ,,successful breast-feeding; ,,developmental outcomes. Types of research designs The review initially focused on randomised controlled trials reported from 1995 to 2004. Insufficient randomised controlled trials were identified and the review was expanded to include additional cohort and cross-sectional studies for possible inclusion in a narrative summary. Search strategy The major electronic databases, including MEDLINE/PubMed, CINAHL, EMBASE, LILACS, Cochrane Library, etc., were searched using accepted search techniques to identify relevant published and unpublished studies undertaken between 1995 and 2004. Efforts were made to locate any relevant unpublished materials, such as conference papers, research reports and dissertations. Printed journals were hand-searched and reference lists checked for potentially useful research. The year 1995 was selected as the starting point in order to identify any research that had not been included in the World Health Organisation review, which covered literature published up to 1996. The search was not limited to English language studies. Assessment of quality Three primary reviewers conducted the review assisted by a review panel. The review panel was comprised of nine nurses with expertise in neonatal care drawn from senior staff in several metropolitan neonatal units and education programs. Authorship of journal articles was not concealed from the reviewers. Methodological quality of each study that met the inclusion criteria was assessed by two reviewers, using a quality assessment checklist developed for the review. Disagreements between reviewers were resolved through discussion or with the assistance of a third reviewer. Data extraction and analysis Two reviewers used a data extraction form to independently extract data relating to the study design, setting and participants; study focus and intervention(s); and measurements and outcomes. As only one relevant randomised controlled trial was found, a meta-analysis could not be conducted nor tables constructed to illustrate comparisons between studies. Instead, the findings were summarised by a narrative identifying any relevant findings that emerged from the data. Results Seven studies met the inclusion criteria for the objective of this systematic review. The review provided information on the effectiveness of three categories of intervention , type of feeds, timing of feeds and thermoregulation on two of the outcome measures identified in the review protocol , prevention of hypoglycaemia, and re-establishment and maintenance of blood or plasma glucose levels above the set threshold (as determined by the particular study). There was no evidence available on which to base conclusions for effectiveness of monitoring or developmental outcomes, and insufficient evidence for breast-feeding success. Given that only a narrative review was possible, the findings of this review should be interpreted with caution. The findings suggest that the incidence of hypoglycaemia in healthy, breast-fed term infants of appropriate size for gestational age is uncommon and routine screening of these infants is not indicated. The method and timing of early feeding has little or no influence on the neonatal blood glucose measurement at 1 h in normal term babies. In healthy, breast-fed term infants the initiation and timing of feeds in the first 6 h of life has no significant influence on plasma glucose levels. The colostrum of primiparous mothers provides sufficient nutrition for the infant in the first 24 h after birth, and supplemental feeds or extra water is unnecessary. Skin-to-skin contact appears to provide an optimal environment for fetal to neonatal adaptation after birth and can help to maintain body temperature and adequate blood glucose levels in healthy term newborn infants, as well as providing an ideal opportunity to establish early bonding behaviours. Implications for practice The seven studies analysed in this review confirm the World Health Organisation's first three recommendations for prevention and management of asymptomatic hypoglycaemia, namely: 1Early and exclusive breast-feeding is safe to meet the nutritional needs of healthy term newborns worldwide. 2Healthy term newborns that are breast-fed on demand need not have their blood glucose routinely checked and need no supplementary foods or fluids. 3Healthy term newborns do not develop ,symptomatic' hypoglycaemia as a result of simple underfeeding. If an infant develops signs suggesting hypoglycaemia, look for an underlying condition. Detection and treatment of the cause are as important as correction of the blood glucose level. If there are any concerns that the newborn infant might be hypoglycaemic it should be given another feed. Given the importance of thermoregulation, skin-to-skin contact should be promoted and ,kangaroo care' encouraged in the first 24 h after birth. While it is important to main the infant's body temperature care should be taken to ensure that the child does not become overheated. [source] Significant differences between capillary and venous complete blood counts in the neonatal periodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2003S.M. Kayiran Summary The normal capillary and venous hematologic values for neonates have not been defined clearly. It is well known that capillary blood has higher hemoglobin (Hb) and hematocrit (Hct) values than venous blood. In a recent study, we reported differences between capillary and venous complete blood counts (CBC) in healthy term neonates on day 1 of life. The aim of this study was to extend our previous investigation. Term neonates (n=141) were stratified into four groups by days of postnatal age: group 2 (day 7, n=38), group 3 (day 14, n=35), group 4 (day 21, n=32) and, group 5 (day 28, n=36). Data from our previous study were included in the statistical analysis as group 1 (day 1, n=95). A CBC and differential count were carried out on each capillary and venous sample drawn simultaneously. Within each group, the mean and standard deviation for each parameter in capillary and venous blood were calculated and then compared using the paired sample t -test. In all groups, the capillary blood samples had higher Hb, Hct, red blood cell (RBC), white blood cell (WBC), and lymphocyte counts. In each group, venous platelet counts were significantly higher than the corresponding capillary values. There was also a trend toward higher venous mean corpuscular volume, higher capillary polymorphonuclear leukocyte (PML) count and mean platelet volume in all groups. In both capillary and venous blood, Hb, Hct, RBC, MCV values and WBC, lymphocyte, PML counts decreased and platelet counts increased steadily during neonatal period. This study reveals that CBC parameters and differential counts may differ depending on the blood sampling used. The findings underline the importance of considering the sample source when using hematologic reference ranges for healthy or septic neonates. When interpreting results, the term ,peripheral blood' should be replaced with ,capillary blood' or ,venous blood' so that an accurate assessment can be made. [source] Childbearing Women's Perceptions of Nursing Care That Promotes DignityJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2004Rachel Matthews RN Objective: To gain an understanding of the perceptions of childbearing women about the maintenance of dignity while laboring and giving birth. Design: Descriptive qualitative study. Setting: A university community in the western United States. Patients/Participants: Twenty low-risk primiparous women who had recently given birth to healthy term neonates. Main Outcome Measures: Semistructured audio-taped interviews were conducted in the homes of participants using an interview guide. Results: The following themes were identified: (a) nurses played a pivotal role in preserving dignity during childbirth, (b) women appreciated feeling valued and respected, and (c) dignity was enhanced by nursing care that gave women their preferred level of control. Conclusion: Nursing behaviors that demonstrate valuing and respect of childbearing women are essential in preserving the quality of the birth experience. [source] Use of nonsteroidal anti inflammatory drugs in preterm, term neonates and infants: analgesia by consensus?PEDIATRIC ANESTHESIA, Issue 10 2007JULIA C. FINKEL MDArticle first published online: 28 AUG 200 No abstract is available for this article. [source] Airway function in infants treated with inhaled nitric oxide for persistent pulmonary hypertensionPEDIATRIC PULMONOLOGY, Issue 3 2008Aparna U. Hoskote MD Abstract Rationale Inhaled nitric oxide (iNO), used for treatment of persistent pulmonary hypertension of newborn (PPHN), is an oxygen free radical with potential for lung injury. Deferring ECMO with iNO in these neonates could potentially have long-term detrimental effects on lung function. We studied respiratory morbidity (defined as occurrence of respiratory infections requiring treatment, episodes of wheezing, and/or need for ongoing medications following discharge) and airway function at 1 year postnatal age in term neonates treated with iNO but not ECMO for PPHN, and compared data from similar infants recruited to the UK ECMO Trial randomized to receive ECMO or conventional management (CM). Methods Maximal expiratory flow at FRC (V'maxFRC) was measured in infants treated with iNO for PPHN (oxygenation index ,25) at birth. Results V'maxFRC was measured in 23 infants and expressed as z -scores, to adjust for sex and body size and compared to data from 71 (46 ECMO, 25 CM) infants studied at a similar age in the ECMO Trial. Respiratory morbidity was low in iNO group. V'maxFRCz -score was lower than predicted in all groups (P,<,0.001), with no significant difference between those treated with iNO [mean (SD) z -score: ,1.65 (1.2)] and those treated with ECMO [,1.59 (1.2)] or CM [,2.1(1.0)]. Within iNO, ECMO and CM groups; 26%, 37% and 56%, respectively, had V'maxFRCz -scores below normal. Conclusions Respiratory outcome at 1 year in iNO treated neonates with moderately severe PPHN is encouraging, with no apparent increase in respiratory morbidity when compared to the general population. Sub-clinical reductions in airway function are evident at 1 year, suggesting that continuing efforts to minimize lung injury in the neonatal period are warranted to maximize lung health in later life. Pediatr Pulmonol. 2008; 43:224,235. © 2008 Wiley-Liss, Inc. [source] Comparison of two doses of breast milk and sucrose during neonatal heel prickPEDIATRICS INTERNATIONAL, Issue 2 2010Tutku Ozdogan Abstract Background:, The aim of the present study was to test analgesic effects of double- versus single-dose breast milk and compare this effect with efficacy of double- versus single-dose sucrose in a group of healthy term newborns during heel prick blood sampling. Methods:, Healthy newborns (n= 142) were consecutively allocated to one of the six groups: group 1, single-dose breast milk; group 2, single-dose sterile water; group 3, single-dose 12.5% sucrose; group 4, two doses breast milk; group 5, two doses sterile water; and group 6, two doses 12.5% sucrose before the heel prick. The medians for crying time and the pain scores according to the neonatal facial coding system were recorded. Results:, Crying times were 117 s, 126 s, 82 s, 128 s, 117 s, and 95 s in groups 1,6, respectively (P= 0.053). The mean pain scores were 4.60, 5.82, 3.91, 4.94, 5, and 4.05 in groups 1,6, respectively (P= 0.068). There was a significant difference between the groups for mean pain scores at 1 min and 3 min. There was a significant difference between the single-dose sucrose group and single-dose sterile water group at 1 min (P= 0.002). The babies in the sucrose group were active awake, whereas the ones in the breast milk group were asleep before heel prick. Conclusion:, Two doses of sucrose solution were not superior to single-dose sucrose. Neither single nor double doses of breast milk were effective in relieving pain in neonates. Two milliliters breast milk does not reduce response to pain during minor painful procedures in term neonates even when two doses have been given. Further studies are needed. [source] Umbilical serum concentrations of chemokines (RANTES and MGSA/GRO-,) in preterm and term neonatesPEDIATRICS INTERNATIONAL, Issue 6 2006BARBARA KRÓLAK-OLEJNIK Abstract Background: The objective of this study was to explore the relationship between labor (preterm and term) and umbilical blood serum regulated on activation, normal T cell expressed and secreted (RANTES) and melanoma growth stimulatory activity/growth-related oncogene-a (MSGA/GRO-,) concentration, and to determine whether early sepsis and pneumonia are associated with changes in concentrations of the chemokines (RANTES and MSGA/GRO-,) in umbilical blood serum. Methods: Umbilical blood was obtained from 67 neonates in the following groups: (i) preterm neonates with early sepsis; (ii) preterm neonates with pneumonia; (iii) non-infected preterm neonates; and (iv) full-term healthy neonates. RANTES and MGSA/GRO-, concentrations were determined by use of a commercially available immunoassay kit. Results: Non-infected preterm neonates had lower RANTES concentrations than healthy term neonates. Preterm infected neonates (pneumonia or sepsis) did not have higher RANTES concentrations than non-infected preterm neonates. In contrast, non-infected preterm neonates had higher MSGA/GRO-, concentrations than full-term healthy neonates. And preterm neonates with sepsis had higher MGSA/GRO-, concentrations than preterm ones with pneumonia and non-infected preterm ones. Conclusions: Preterm neonates had constitutively lower RANTES concentrations than term ones and it seems that during infection RANTES concentrations did not increase. MGSA/GRO-a concentrations were constitutively higher in preterm than term neonates, and septic events further increased its concentrations in preterm neonates. [source] Nitric oxide inhalation therapy in very low-birthweight infants with hypoplastic lung due to oligohydramniosPEDIATRICS INTERNATIONAL, Issue 1 2004Naoki Uga AbstractBackground: Although nitric oxide inhalation (iNO) therapy improves arterial oxygenation and reduces the rate of extracorporeal membrane oxygenation in term neonates, the efficacy of this therapy in premature infants is controversial. The objective of the present study was to determine whether iNO therapy improves the survival of very low-birthweight infants with pulmonary hypoplasia due to prolonged rupture of membrane. Methods: A retrospective comparative study of very low-birthweight infants with pulmonary hypoplasia due to oligohydramnios who had or had not been treated with iNO therapy, was performed (iNO-treated group, eight infants; control group, 10 infants). A neonate was considered to have pulmonary hypoplasia due to oligohydramnios if the following conditions were satisfied: (i) artificial surfactant treatment did not improve the respiratory distress; (ii) prolonged rupture of membrane (PROM) continued for more than 5 days with oligohydramnios; and (iii) sufficient arterial oxygenation did not occur even after giving 100% oxygen, and more than 8 cm H2O of mean airway pressure was needed to maintain arterial oxygenation. Results: Nitric oxide inhalation improved arterial oxygenation rapidly and consistently in all eight infants with pulmonary hypoplasia. All eight iNO-treated infants survived longer than 28 days, while five of the 10 control infants died within 24 h of birth (P < 0.05). Before starting iNO, seven of the eight treated infants had shown persistent pulmonary hypertension, which was confirmed by echocardiography. No iNO-treated infant had IVH greater than grade 1, while one control infant had grade 2 IVH. All six long-term survivors in the iNO-treated group are developing normally, while only two of the control infants are developing normally as of February 2002. Conclusions: The majority of the infants with pulmonary hypoplasia due to oligohydramnios had persistent pulmonary hypertension. iNO improved the arterial oxygenation and significantly improved the survival rate. A controlled study to determine whether iNO therapy improves the survival rate of preterm infants with pulmonary hypoplasia due to oligohydramnios is necessary. [source] Fetal distress increases interleukin-6 and interleukin-8 and decreases tumour necrosis factor-, cord blood levels in noninfected full-term neonatesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2000Mickael Jokic MD Objective To assess the influence of fetal distress on interleukin-1,, interleukin-6, interleukin-8 and on tumour necrosis factor-, blood levels in noninfected full-term neonates. Study design In a multicentre prospective study, cord blood samples were obtained at time of delivery from 234 noninfected full-term neonates for the purposes of measuring serum levels of interleukin-1,, interleukin-6, interleukin-8 and tumour necrosis factor-, using immunoassays. Women were classified into four groups according to the mode of delivery (vaginal delivery or caesarean section) and the presence or absence of fetal distress. The role of labour was also investigated. Results No significant relationship was found between cytokine cord blood levels and the mode of delivery. Fetal distress was associated with an increase in interleukin-6 (P= 0.01) and interleukin-8 (P < 0.001) levels, and a decrease in tumour necrosis factor-, (P < 0.001). Labour was also associated with a significant increase in interleukin-6 and interleukin-8 cord blood levels (P= 0.01 and P < 0.001, respectively). Conclusion Fetal distress and labour were each associated with elevated interleukin-6 and interleukin-8 cord blood levels in noninfected full term neonates while only fetal distress was associated with decreased tumour necrosis factor-, levels. [source] Once daily dose gentamicin in neonates , is our dosing correct?ACTA PAEDIATRICA, Issue 7 2009Tiroumourougane V Serane Abstract Aim:, The aim of this paper is to study the safety and efficacy (measured by therapeutic level) of once daily gentamicin in neonates ,32 weeks of gestation and ,7 days of age. Setting:, Level II neonatal intensive care unit. Subjects:, Neonates ,32 weeks of gestation and ,7 days of age treated with gentamicin for presumed sepsis. Methods:, Gentamicin was administered by intravenous injection at 4 mg/kg/day once daily. Peak and trough gentamicin levels were measured at the third dose. Results:, In neonates with gestational age between 32 and 36 weeks, 14 out of 65 (22%) had trough serum concentration >2 mg/L. Only 39 (60%) had peak and trough levels within the therapeutic range. All babies who had audiometric evaluation (62 out of 65) had normal hearing. Out of the 65 babies, 60 had paired serum creatinine levels estimated and none had evidence of renal dysfunction. Among term neonates, only 2 out of 50 had the trough serum concentration of >2 mg/L. In 38 (76%) of the 50 neonates, the trough serum gentamicin concentration was <2.0 mg/L and the peak level was <10 mg/L. Forty-eight babies had audiometric evaluation which was normal. Conclusion:, A dose of 4 mg/kg/day produces serum gentamicin levels outside the therapeutic range in two-fifths of neonates between 32 and 36 ± 6 weeks. A single dose of 4 mg/kg/day of gentamicin is appropriate for term babies and probably excessive for 32,36 weeks' neonates. [source] Physiological skin conditions of preterm and term neonatesCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2010F. S. Afsar Summary Skin problems in children during the first few weeks of life can raise concern, even for experienced neonatologists and paediatric dermatologists. The skin of preterm and term newborn babies has distinct differences from juvenile and adult skin. An understanding of the nature of neonatal skin, the physiological and nonphysiological skin conditions of preterm and term neonates, and skin care are essential in paediatric practice. This article discusses the nature of the neonatal skin and its physiological phenomena. [source] Skin care for preterm and term neonatesCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 8 2009F. S. Afsar Summary Neonatal skin experiences a progressive adaptation to the extrauterine environment during which special care is needed. The immaturity of the epidermal barrier in the neonatal period may cause dry skin, vulnerability to trauma, rapid onset of microbial colonization and percutaneous drug toxicity. This article reviews the practical implications for hygiene, bathing practices, skin integrity, emollient use, infection control and exposure to percutaneous toxic agents in preterm and term infants. [source] Selectin polymorphisms and perinatal morbidity in low-birthweight infantsACTA PAEDIATRICA, Issue 10 2006László 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] Cord plasma concentrations of adiponectin and leptin in healthy term neonates: positive correlation with birthweight and neonatal adiposityCLINICAL ENDOCRINOLOGY, Issue 1 2004Po-Jung Tsai Summary objective, Adiponectin is negatively associated with leptin, insulin and obesity in children and adults. Whereas increases in fetal insulin and leptin are associated with increased weight and adiposity at birth, the role of adiponectin in fetal growth has not yet been determined. The aims of this study were to examine the relationships between adiponectin and insulin, leptin, weight and adiposity at birth in healthy term infants. design and methods, Anthropometric parameters including weight, length, circumferences and skinfold thickness were measured, and plasma lipid profiles, insulin, leptin and adiponectin concentrations in cord blood samples from 226 singleton infants born at term after uncomplicated pregnancies were assayed. results, Cord plasma adiponectin, leptin and insulin levels correlated significantly and positively with birthweight (P = 0·001, P < 0·001, P < 0·001, respectively) and the sum of skinfold thicknesses (P < 0·001, P < 0·001, P < 0·001, respectively). Mean cord plasma adiponectin and leptin levels, but not insulin level, were significantly higher in large-for-gestational-age (LGA) infants compared with appropriate-for-gestational-age (AGA) infants. Cord plasma leptin concentration, but not adiponectin concentration, was significantly higher in female infants than in male infants (P = 0·003 and P = 0·94, respectively). Cord plasma adiponectin concentration correlated positively with leptin level (P = 0·007) but not with insulin level (P = 0·78). conclusions, High adiponectin levels are present in the cord blood. Cord plasma adiponectin and leptin levels are positively correlated with birthweight and adiposity. This suggests that adiponectin may be involved in regulating fetal growth. [source] Oral hypertonic glucose spray: a practical alternative for analgesia in the newbornACTA PAEDIATRICA, Issue 10 2004M Akçam Aim: Pain and stress have been shown to induce significant physiological and behavioural reactions in newborn infants. Pharmacological agents are not recommended in neonates for pain relief in minor procedures. Since different sweet solutions given orally by syringe have been shown to relieve pain in neonates, we decided to compare the analgesic effects of a small dose of glucose solution given orally by spray and by syringe during heel lancing in term neonates, using a validated behavioural acute pain rating scale. Methods: Sixty hyperbilirubinaemic full-term neonates were studied. We used a randomized, masked, placebo-controlled, crossover trial. Each infant was assessed three times receiving 0.5 ml 30% glucose in spray form, 0.5 ml 30% glucose by syringe or 0.5 ml sterile water by syringe in random order, 2 min before heel lancing. Results: Pain scores were significantly lower in the 30% glucose given either spray or syringe groups compared with the placebo group. No statistically significant difference in pain scores was found between the 30% glucose spray group and 30% glucose syringe group. Conclusions: A small dose of 0.5 ml 30% glucose spray has an equal analgesic effect to the same dose given by syringe. The spray form has the advantage of being easy to use and is well accepted by newborn babies. [source] Effects of magnesium sulphate on amplitude-integrated continuous EEG in asphyxiated term neonatesACTA PAEDIATRICA, Issue 10 2002F Groenendaal In this study it is hypothesized that magnesium sulphate in asphyxiated full-term neonates could lead to a gradual improvement in background pattern of the amplitude integrated EEG (aEEG), an early marker of hypoxic-ischaemic brain injury. In a double-blind, randomized, controlled pilot study of 22 asphyxiated full-term neonates 8 received magnesium sulphate, reaching serum Mg2+ levels of 2.5 mmol/L. Magnesium sulphate had no immediate effect on aEEG-patterns. At 12 h of age, aEEG was more depressed compared with aEEG at 3 h in 6 of the 8 magnesium-treated neonates, and in 3 of the 14 placebo-treated neonates (Mg2+ vs placebo: p < 0.05, Mann-Whitney). No further significant changes in aEEG were seen between 12 and 24 h. Outcome was unfavourable in 4 of the 8 magnesium-treated neonates, and in 8 of the 14 placebo-treated neonates. Conclusion: Magnesium sulphate did not have a positive effect on aEEG patterns in this small group of asphyxiated term neonates. [source] Comparison of brainstem auditory evoked responses recorded at different presentation rates of clicks in term neonates after asphyxiaACTA PAEDIATRICA, Issue 12 2001ZD Jiang This study examined whether high presentation rates of clicks while recording brainstem auditory evoked responses (BAER) can improve the detection of central auditory impairment in asphyxiated neonates using the BAER. The BAER was analysed at different presentation rates of clicks within the first week after birth in 38 term neonates who suffered perinatal asphyxia. At the routinely used 21 s,1 clicks all BAER wave latencies increased significantly (ANOVA, p < 0.05-0.01). After excluding five neonates who had a significantly elevated BAER threshold, only wave V latency increased slightly (p < 0.05). The interpeak intervals of I,V and III,V also increased slightly (both p < 0.05). Similar results were found at 51 s,1 clicks. As the clicks were increased to 91 s,1, the III,V interval increased more significantly (p < 0.01) and the III,V/I,III interval ratio also increased significantly (p < 0.01). In particular, wave V amplitude reduced more significantly than that in normal term controls (p < 0.01). Compared with values in the controls, wave V amplitude reduced by 4.5%, 12.2% and 24.7% at 21, 51 and 91 s,1 clicks, respectively. Conclusion: Although a moderate increase in the rate (e.g. 51 s,1) while recording the BAER did not improve the detection of hypoxic-ischaemic auditory impairment, a significant increase (e.g. 91 s,1) did, which mainly indicates an abnormal reduction in wave V amplitude. [source] Cholesterol dynamics in the foetal and neonatal brain as reflected by circulatory levels of 24S-hydroxycholesterolACTA PAEDIATRICA, Issue 6 2001D Lütjohann Oxysterols, particularly those hydroxylated in the steroid side-chain, are formed from cholesterol by specific cytochrome P450 enzymes and may facilitate elimination of cholesterol from extrahepatic sources. In humans, the greatest portion of circulating 24S-hydroxycholesterol (24S-OH-Chol) is derived from the brain and the absolute concentration depends on age. In the present study, concentrations of 24S-OH-Chol and for comparison 27-OH-Chol were determined by a highly sensitive isotope dilution method using gas chromatography-mass spectrometry in serum samples from normal preterm and term neonates and those with Rhesus haemolytic disease, taken serially for diagnostic purposes. Serum concentrations of cholesterol, 24S-OH-Chol and 27-OH-Chol were similar in venous versus arterial cord blood of 6 term neonates. Serum concentrations of 24S-OH-Chol and 27-OH-Chol in 12 small for gestational age (SGA) preterm neonates were significantly lower than those in 12 appropriate for gestational age (AGA) preterm neonates (p < 0.001), and also lower than those in 12 SGA (p < 0.001) and 12 AGA term neonates (p < 0.05). Serum cholesterol was significantly higher in preterm than in term neonates (p < 0.001). 24S-OH-Chol serially determined in 8 infants with Rhesus haemolytic disease increased 5-6-fold during the first 3 mo after birth (from 42 ± 20 ng ml,1 to 227 ± 71 ng ml,1). 27-OH-Chol increased simultaneously from 30 ± 14 ng m ml,1 to 100 ± 39 ng m ml,1. Conclusion: Serum concentrations of 24S-OH-Chol increased 5-6-fold after birth. This could be an indication of normal cholesterol metabolism in the developing neonatal brain. [source] | |||||||||||||||||||||||||