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Gestational Age Range (gestational + age_range)
Selected AbstractsRetinopathy of prematurity in a Copenhagen high-risk sample 1997,98ACTA OPHTHALMOLOGICA, Issue 3 2000The allover surveillance for ROP appears more, more complete ABSTRACT. Purpose: From two recent materials to describe the present clinical status regarding retinopathy of prematurity in Denmark, and to outline trends over time. Methods: A) Results of regular ophthalmic surveillance of 201 clinically selected (higher risk of ROP than average) pre-term infants of birth year 1997,98 taken care of in the two greater Copenhagen tertiary neonatal units, in an intended prospective design. Gestational age range was 24,32 weeks at delivery; birth weights 490,2200 g. Median values 28 weeks and 1090 g. B) A brief account of the latest ROP-associated registrations of visual impairment in Danish children aged 0,17 years (n=138). Results: A) ROP was observed in 31.3% (n=201). Retinal cryotherapy was given to eleven ,own' cases and to two from elsewhere (n=13, gestational age at delivery 25,31 weeks). Five had cryotherapy twice. Four of the 13 were later registered for visual impairment. B) Comparing the first and the latest third of the registrations, visual impairment has dropped in frequency and severity over the period from 1981 till now. Conclusions: Compared to previous data the present clinical profile of ROP in Denmark indicates a relatively lower overall frequency of ROP and a decrease in eventual severe visual impairment. Undoubtedly, the continued refinement of neonatal care has been of relevance, but the definite decline in visual impairment further reflects a more complete ophthalmic surveillance, on a national basis. The advanced cases are generally detected in time and retinal ablation therapy offered. [source] Plasma anhydro- d -glucitol (1,5-AG) as an indicator of hyperglycaemic excursions in pregnant women with diabetesDIABETIC MEDICINE, Issue 2 2006M. Dworacka Abstract Aims To evaluate the use of the plasma 1,5-anhydro- d -glucitol (1,5-AG) level as a possible marker for glucose excursions in pregnant women with diabetes. Methods The study group consisted of 55 pregnant women with diabetes (gestational diabetes mellitus,GDM, n = 28 or pre-gestational diabetes mellitus ,PGDM, n = 27), without hepatic or renal insufficiency, gestational age range 5,38 weeks. In each patient, 24-h glucose profile, glycated haemoglobin and 1,5-AG plasma levels were measured. Mean blood glucose (MBG) and M-value (by Schlichtkrull) were calculated. MBG, M-value and maximal daily glycaemia (MxG) were used as indexes of daily glycaemic excursions. Results A significant correlation was found between the 1,5-AG plasma level and MxG [r = (,0.3)] and between the 1,5-AG level and M-value [r = (,0.36)]. There was no association between the 1,5-AG level and gestational age. Multivariate regression analysis, with 24-h glucose profile, gestational age and MxG as independent variables, showed that MxG was the main parameter determining the 1,5-AG plasma level [, = (,0.68)]. The M-value, the coefficient of glucose fluctuations, also determined the 1,5-AG level but with lower statistical power [, = (0.41)]. No statistical differences were found in the group with HbA1c < 6% or > 6% for 1,5-AG and M-value, while MBG was higher in poorly controlled patients (HbA1c > 6%). Conclusions The plasma 1,5-AG level may be a useful marker of daily glucose excursion in pregnant women with diabetes, as an adjunct to HbA1c monitoring. [source] Gestational age- and birthweight-specific declines in infant mortality in Canada, 1985,94PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2000K.S. Joseph We studied infant mortality rates in Canada within specific gestational age and birthweight categories after using probabilistic techniques to link information in Statistics Canada's live births data base (1985,94) with that in the death data base (1985,95). Gestational age- and birthweight-specific mortality rates in 1992,94 were contrasted with those in 1985,87 with changes expressed in terms of relative risks with 95% confidence intervals [CI]. Statistically significant reductions in infant mortality were observed beginning at 24,25 weeks of gestation and extended across the gestational age range to post-term births. Crude infant mortality rates, infant mortality rates among those 500 g and among those 1000 g decreased by 22%, 25% and 26%, respectively, from 1985,87 to 1992,94. The magnitude of the reductions in infant mortality rates ranged from 14%[95% CI 7, 21%] at 24,25 weeks of gestation to 40%[95% CI 31, 47%] at 28,31 weeks. Almost all reductions in gestational age- and birthweight-specific infant mortality between 1985,87 and 1992,94 were due to approximately equal reductions in neonatal and post-neonatal mortality. Live births 42 weeks of gestation did not follow this rule; post-neonatal mortality rates among such live births decreased significantly by 51%[95% CI 26, 68%], although neonatal mortality rates showed no significant change. The mortality reductions observed across the gestational age and birthweight range are probably a consequence of specific clinical interventions complementing improvements in fetal growth. Temporal changes in the outcome of post-term pregnancies need to be carefully examined, especially in relation to recent changes in the obstetric management of such pregnancies. [source] ORIGINAL ARTICLE: Activation of the Alternative Pathway of Complement is a Feature of Pre-Term Parturition but not of Spontaneous Labor at TermAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 4 2010Edi Vaisbuch Citation Vaisbuch E, Romero R, Erez O, Mazaki-Tovi S, Kusanovic JP, Soto E, Dong Z, Chaiworapongsa T, Kim SK, Ogge G, Pacora P, Yeo L, Hassan SS. Activation of the alternative pathway of complement is a feature of pre-term parturition but not of spontaneous labor at term. Am J Reprod Immunol 2010; 63: 318,330 Problem, Plasma concentrations of fragment Bb (FBb) are a marker for activation of the alternative pathway of the complement system. High concentrations of FBb in maternal blood, as early as the first trimester, are associated with subsequent spontaneous pre-term delivery <34 weeks of gestation. The aim of this study was to determine whether spontaneous pre-term labor (PTL) with intact membranes, intra-amniotic infection/inflammation (IAI) or labor at term are associated with alterations in circulating maternal FBb concentrations. Method of study, This cross-sectional study included women in the following groups: (i) non-pregnant (n = 40); (ii) normal pregnancy (gestational age range 20,36, 6/7 weeks, n = 63); (iii) women at term not in labor (n = 70); (iv) women at term in spontaneous labor (n = 59); (v) patients with an episode of PTL who delivered at term (n = 62); (vi) PTL without IAI who delivered pre-term (n = 30); and (vii) PTL with IAI who delivered pre-term (n = 67). Maternal plasma FBb concentrations were determined by ELISA. Results, (i) Among patients with PTL, those who had a pre-term delivery either with IAI (1.21 ,g/mL, IQR 0.77,2.16) or without IAI (1.13 ,g/mL, IQR 0.92,2.08) had a higher median maternal plasma FBb concentration than those who delivered at term (0.86 ,g/mL, IQR 0.64,1.57; P = 0.007 and P = 0.026, respectively); (ii) there was no difference in the median plasma FBb concentration between patients with and without IAI who delivered pre-term (P = 0.9); (iii) in contrast, spontaneous labor at term was not associated with a significant change in the maternal plasma FBb concentration (P = 0.8); (iv) maternal plasma concentration of FBb did not differ significantly between normal pregnant women and the non-pregnant controls (P = 0.8) and were not correlated with advancing gestational age (r = ,0.28, P = 0.8). Conclusion, (i) Pre-term parturition is associated with activation of the alternative complement pathway in maternal circulation; (ii) such activation is not detectable in spontaneous labor at term; (iii) IAI does not explain the activation of the alternative pathway of complement in PTL. Collectively, these observations suggest that pre-term and term labors have fundamental differences in the regulation of innate immunity. [source] Developmental disorders of glucose metabolism in infantsCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2002R. Hume Abstract Background Developmental failures to adequately control postnatal blood glucose levels are common in the transition from fetal to infant life and can persist for many months. The standard method of functionally measuring hepatic glucose production and/or disordered glucose production is the response to a glucagon tolerance test. Method We adapted the standard glucagon tolerance test used for children and adults for use in preterm infants. 79 consecutive preterm infants gestational age range 25,36 weeks (mean 32.2 weeks), mean birth weight 1.66 kg admitted to the Neonatal Intensive Care Unit, Ninewells Hospital, Dundee and who survived to discharge home were recruited into the study. At the time of discharge home the characteristics of the group were as follows: adjusted mean gestational age 36.7 weeks, mean discharge weight 2.23 kg. Results In this study of preterm infants the maximal increase in plasma glucose following administration of a glucagon tolerance test is 1.39 ± 07 mmol/L, n = 78 (range 0,3.98 mmol/L). Conclusions An increase in plasma glucose of less than 4 mmol/L is considered abnormal in adults following administration of a fasting glucagon tolerance test. The responses of preterm infants and adults to glucagon are clearly different. The attenuated response to glucagon in the preterm infants is consistent with the low levels of hepatic glucose-6-phosphatase activity in premature infants as glucose-6-phosphatase is the terminal step of the two main pathways of liver glucose production. [source] Survival and neurodevelopmental morbidity at 1 year of age following extremely preterm delivery over a 20-year period: a single centre cohort studyACTA PAEDIATRICA, Issue 2 2008K Riley Abstract Aim: To assess survival and neurodevelopmental outcome of extremely preterm infants over a 20-year period at a single tertiary neonatal centre. Methods: All infants between 22 and 25+6 weeks of gestation admitted to a single UK neonatal centre between 1981 and 2000 were enrolled prospectively. Infants in the same gestational age range who were born alive at the hospital but not admitted to the neonatal unit were also identified over the period 1991,2000. All surviving infants received neurological and developmental assessment at a corrected age of 1 year. Results: There was a progressive increase in survival at all gestational ages over the 20-year period. Overall survival rose from 32% to 71% as a proportion of all admissions. The proportion of survivors with adverse neurodevelopmental outcome at 1 year of age showed no consistent change over the same period. Conclusion: In this single centre cohort study, marked improvements in survival over a 20-year period were not accompanied by a significant increase in neurodevelopmental morbidity. [source] | ||||||||||