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Low Birth Weight Infants (low + birth_weight_infant)
Kinds of Low Birth Weight Infants Selected AbstractsHow Do Mothers Feel About Their Very Low Birth Weight Infants?INFANT MENTAL HEALTH JOURNAL, Issue 2 2006Development of a New Measure The early relationship between a mother and her very low birth weight (VLBW; <1.5 kg) infant may be difficult to evaluate. Therefore, we aimed to develop a useful and practical method to describe a mother's early relationship with her VLBW infant. Mothers (mean age=27 years, 46% married) of 119 singleton VLBW infants (mean BW=1,056 g, mean GA=28 weeks) admitted to the neonatal ICU at Rainbow Babies and Children's Hospital completed a novel questionnaire regarding their feelings about their infant at 3 weeks' postnatal age, and at 35 weeks', 40 weeks' (term), and 4 months' postmenstrual ages. Factor analysis of initial interview data was used to construct subscales to measure unique domains hypothesized to underpin the beginning maternal,infant relationship. Three subscales were identified: (a) The Worry subscale focuses on the mother's concerns about her infant's current medical condition and future development, (b) the Enjoyment subscale examines the mother's positive feelings about and responsiveness to her infant, and (c) the Separation Anxiety subscale examines the mother's mental anxiety about being physically separated from her infant. Statistical and clinical validation of the subscales produced positive supporting evidence that the subscales are a meaningful measure of the mother,infant relationship. We have developed a unique and practical measure for describing the early mother,VLBW infant relationship. [source] Optimal Body Temperature in Transitional Extremely Low Birth Weight Infants Using Heart Rate and Temperature as IndicatorsJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2010Robin B. Knobel ABSTRACT Objective: To explore body temperature in relationship to heart rate in extremely low birth weight (ELBW) infants during their first 12 hours to help identify the ideal set point for incubator control of body temperature. Design: Within subject, multiple-case design. Setting: A tertiary neonatal intensive care unit (NICU) in North Carolina. Participants: Ten infants born at fewer than 29 weeks gestation and weighing 400 to 1,000 g. Methods: Heart rate and abdominal body temperature were measured at 1-minute intervals for 12 hours. Heart rates were considered normal if they were between the 25th and 75th percentile for each infant. Results: Abdominal temperatures were low throughout the 12-hour study period (mean 35.17-36.68 °C). Seven of 10 infants had significant correlations between abdominal temperature and heart rate. Heart rates above the 75th percentile were associated with low and high abdominal temperatures; heart rates less than the 25th percentile were associated with very low abdominal temperatures. The extent to which abdominal temperature was abnormally low was related to the extent to which the heart rate trended away from normal in 6 of the 10 infants. Optimal temperature control point that maximized normal heart rate observations for each infant was between 36.8 °C and 37 °C. Conclusions: Hypothermia was associated with abnormal heart rates in transitional ELBW infants. We suggest nurses set incubator servo between 36.8 °C and 36.9 °C to optimally control body temperature for ELBW infants. [source] Anxiety affects the relationship between parents and their very low birth weight infantsINFANT MENTAL HEALTH JOURNAL, Issue 3 2007Phyllis Zelkowitz The goal of this study was to examine the medical and sociodemographic factors associated with parental anxiety following the birth of a very low birth weight infant (VLBW, below 1500 g), and to determine the impact of anxiety on the behavior of parents with their VLBW infants in the Neonatal Intensive Care Unit (NICU). The parents of 88 VLBW infants were recruited through the NICU of a tertiary-care hospital, approximately 2 weeks following delivery. Parents completed self-report questionnaires measuring anxiety, marital quality, and social support. Prior to discharge, each parent was observed twice during a feeding interaction with the infant. Maternal anxiety was greater when their infants were smaller in terms of birth weight and younger in gestational age. Maternal education, marital status, and country of origin, as well as social support and marital quality, were also associated with anxiety. Paternal anxiety was not related to socioeconomic status or infant medical risk, but was associated with country of origin, social support, and marital quality. For both mothers and fathers, anxiety was a better predictor of parental behavior than was infant medical risk. These findings suggest the need to intervene with anxious parents in order to promote satisfactory parent-infant relationships. [source] Improved viability of the low birth weight infant and the increasing needs for anaesthesiaPEDIATRIC ANESTHESIA, Issue 2 2001Keiko Kinouchi No abstract is available for this article. [source] Solitary liver abscess caused by methicillin-resistant Staphylococcus aureus in a very low birth weight infantPEDIATRICS INTERNATIONAL, Issue 4 2000Kenichi Maruyama No abstract is available for this article. [source] Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infantACTA PAEDIATRICA, Issue 1 2009M Moran Abstract 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. [source] Heart rate variability in response to pain stimulus in VLBW infants followed longitudinally during NICU stayDEVELOPMENTAL PSYCHOBIOLOGY, Issue 8 2009Nikhil S. Padhye Abstract The objective of this longitudinal study, conducted in a neonatal intensive care unit, was to characterize the response to pain of high-risk very low birth weight infants (<1,500,g) from 23 to 38 weeks post-menstrual age (PMA) by measuring heart rate variability (HRV). Heart period data were recorded before, during, and after a heel lanced or wrist venipunctured blood draw for routine clinical evaluation. Pain response to the blood draw procedure and age-related changes of HRV in low-frequency and high-frequency bands were modeled with linear mixed-effects models. HRV in both bands decreased during pain, followed by a recovery to near-baseline levels. Venipuncture and mechanical ventilation were factors that attenuated the HRV response to pain. HRV at the baseline increased with post-menstrual age but the growth rate of high-frequency power was reduced in mechanically ventilated infants. There was some evidence that low-frequency HRV response to pain improved with advancing PMA. © 2009 Wiley Periodicals, Inc. Dev Psychobiol 51: 638,649, 2009 [source] Anxiety affects the relationship between parents and their very low birth weight infantsINFANT MENTAL HEALTH JOURNAL, Issue 3 2007Phyllis Zelkowitz The goal of this study was to examine the medical and sociodemographic factors associated with parental anxiety following the birth of a very low birth weight infant (VLBW, below 1500 g), and to determine the impact of anxiety on the behavior of parents with their VLBW infants in the Neonatal Intensive Care Unit (NICU). The parents of 88 VLBW infants were recruited through the NICU of a tertiary-care hospital, approximately 2 weeks following delivery. Parents completed self-report questionnaires measuring anxiety, marital quality, and social support. Prior to discharge, each parent was observed twice during a feeding interaction with the infant. Maternal anxiety was greater when their infants were smaller in terms of birth weight and younger in gestational age. Maternal education, marital status, and country of origin, as well as social support and marital quality, were also associated with anxiety. Paternal anxiety was not related to socioeconomic status or infant medical risk, but was associated with country of origin, social support, and marital quality. For both mothers and fathers, anxiety was a better predictor of parental behavior than was infant medical risk. These findings suggest the need to intervene with anxious parents in order to promote satisfactory parent-infant relationships. [source] Episodes of hypoxemia during synchronized intermittent mandatory ventilation in ventilator-dependent very low birth weight infantsPEDIATRIC PULMONOLOGY, Issue 1 2005Steve R.E. Firme MD Abstract Distinct patterns of asynchrony, and episodes of hypoxemia, may occur in a spontaneously breathing preterm infant during conventional intermittent mandatory ventilation (IMV) on traditional time-cycled, pressure-limited ventilators. Synchronized IMV (SIMV) and assist/control ventilation are frequent modes of patient-triggered ventilation used with infant ventilators. The objective of this study was to use computerized pulse oximetry to quantify the occurrence of episodes of hypoxemia (oxygen desaturation) during SIMV vs. IMV, in preterm infants ,1,250 g who required mechanical ventilation at ,14 days of age. We performed a randomized, crossover study with each infant being randomized to IMV or SIMV (Infant Star ventilator) for initial testing for a 1-hr period. Patients were subsequently tested on the alternate modality after a stabilization period of 10 min at the same ventilator and fractional inspired oxygen concentration (FiO2) settings. Pulse oximetry data were obtained with a Nellcor N-200 monitor, a microcomputer, and a software program (SatMaster). An investigator blinded to the randomized assignment evaluated all measurements. Eighteen very low birth weight (VLBW) infants with a birth weight of 777,±,39 g (mean,±,SEM) and gestational age 25.1,±,0.3 weeks were studied. The average pulse oximeter oxygen saturation (SaO2) was higher on SIMV than IMV (P,<,0.01). During SIMV, these infants had significantly fewer episodes of hypoxemia (duration of episodes of oxygen desaturation as a percentage of scorable recording time) to 86,90% SaO2 (P,<,0.01), 81,85% SaO2 (P,<,0.01), and 76,80% SaO2 (P,<,0.05) when compared to IMV. There was also a significant decrease in percentage of time of desaturation to SaO2,<,90% (P,=,0.002),,<,85% SaO2 (P,=,0.003), and <80% SaO2 (P,=,0.02) during SIMV vs. IMV. Our preliminary findings indicate that the use of SIMV in a population of VLBW ventilator-dependent infants (,14 days of age) results in better oxygenation and decreased episodes of hypoxemia as compared to IMV. © 2005 Wiley-Liss, Inc. [source] The temperament of pre-term, low birth weight infants and its potential biological substratesRESEARCH IN NURSING & HEALTH, Issue 6 2004Sandra J. Weiss Abstract Temperament profiles of pre-term, low birth weight (LBW) infants were assessed at 6 months of age using standardized norms from the Revised Infant Temperament Questionnaire (RITQ). The contributions of perinatal risk, ethnicity, and gender to various temperament dimensions were examined. The sample included 152 infants with a mean birth weight of 1687 g and a mean gestational age of 31 weeks. Eighty percent of the infants were classified as having temperaments that were difficult to manage. Irregularity of the infants' biorhythms, slowness in their ability to adapt to changes, and distractibility were the most problematic. Birth weight, gestational age, and gender were not associated with temperament. Perinatal morbidity was related to the temperament dimension of infant persistence, with implications for the infant's attention span and task performance. Euro American infants were rated as more persistent and less intense in emotional expression than were infants of other ethnic groups. Results suggest the need for a more direct assessment of the effects of neurobiological processes on development of temperament phenotypes and for measurement of temperament that is socioculturally appropriate. © 2004 Wiley Periodicals, Inc. Res Nurs Health 27:392,402, 2004 [source] Sodium intake and intraventricular hemorrhage in the preterm infantANNALS OF NEUROLOGY, Issue 6 2010Alan R. Barnette MD Objective Hypernatremia is associated with intracranial hemorrhage in term infants. The etiology of intraventricular hemorrhage in preterm infants is multifactorial. We aimed to characterize the associations between sodium intake, hypernatremia, and intraventricular hemorrhage in preterm infants. Methods The charts of 722 preterm infants with a birth weight ,1.5kg admitted to a tertiary care neonatal intensive care unit from 2002 to 2006 were retrospectively reviewed for daily sodium and fluid intake, weight loss, serum sodium concentrations, gender, gestational age, pneumothorax, hyper- or hypocarbia, severity of illness, and cranial imaging. A multivariate logistic model was used to adjust for risk factors and determine associations between sodium intake, hypernatremia, and intraventricular hemorrhage. Results Grade II to IV intraventricular hemorrhage was associated with increased sodium intake on each of the first 3 days following birth. The association remained after controlling for gestational age, severity of illness, respiratory factors, and gender. The association of high sodium intake with intraventricular hemorrhage was of similar magnitude to traditionally recognized risk factors such as pneumothorax. Interpretation Increasing intake of sodium appears to be a modifiable risk factor for intraventricular hemorrhage in very low birth weight infants. ANN NEUROL 2010;67:817,823 [source] Prolonged faecal excretion following a single dose of probiotic in low birth weight infantsACTA PAEDIATRICA, Issue 10 2010Richard Mc Gee No abstract is available for this article. [source] Oral D-penicillamine for the prevention of retinopathy of prematurity in very low birth weight infants: a randomized, placebo-controlled trialACTA PAEDIATRICA, Issue 9 2010Manjari Tandon Abstract Purpose:, To compare prophylactic enteral D-penicillamine (DPA) with placebo for prevention of ,retinopathy of prematurity (ROP) or death' among very low birth weight (VLBW) infants. Methods:, This was a double-blind, single-centre, randomized, placebo-controlled trial with stratification (for birth weight <1250 and ,1250 g) and blocking. Inborn neonates with birth weight 750,1500 g, gestation ,32 weeks, age ,5 days, who tolerated feeds were eligible. Neonates with gastro-intestinal malformations, life-threatening malformations and necrotizing enterocolitis were excluded. Enrolled subjects were randomly allocated to receive oral DPA suspension at 100 mg/kg/dose 8 h for 3 days, followed by 50 mg/kg/day for another 11 days or placebo. The primary outcome was ,any ROP or death'. Secondary outcomes included any ROP, treatable ROP, adverse effects and feed intolerance. Results:, A total of 88 subjects were enrolled. Baseline characteristics were similar with the exception of multiple gestation. There were no significant differences in primary and secondary outcomes, even after adjusting for multiple gestation and on sub-group analysis. No adverse reaction was noted. Conclusion:, Prophylactic enterally administered DPA suspension in a dose 100 mg/kg/dose 8 h for 3 days, followed by 50 mg/kg once per day for next 11 days, does not prevent ,any stage ROP or death' or ,ROP requiring treatment' in VLBW infants. DPA is well tolerated and does not have any major short-term adverse effects. [source] First year growth among very low birth weight infantsACTA PAEDIATRICA, Issue 4 2010Ane C. Westerberg Abstract Aim:, The aim of this study was to describe first-year growth among very low birth weight infants and the effect of growth restriction at hospital discharge on first year growth. Method:, Anthropometric measures and background information for 118 very low birth weight infants were collected from medical records. Z-scores were calculated based on recent Norwegian growth references. Results:, Significant catch-up growth for weight and length was observed during the first year with mean z-score change (SD) of 0.40 (1.05) and 1.01 (1.25) respectively. However, the very low birth weight infants remained lighter and shorter than full-term peers until 12 months corrected age with mean z-score of ,0.93 (1.09) and ,0.48 (1.06) respectively. Head circumference followed a normal growth pattern after 2 months. Infants discharged from hospital as growth restricted had increased catch-up in weight and length, but remained smaller than infants not subjected to early growth restriction and full-term peers. Multiple regression showed that weight below the 10th percentile at discharge is important for weight and length during the first year of life. Conclusion:, Very low birth weight infants showed catch-up growth during the first year, but their weight and length remained less than full-term peers. Growth deficiencies were more pronounced among infants subjected to early growth restriction, despite increased catch-up growth. [source] IGF-I, leptin and active ghrelin levels in very low birth weight infants during the first 8 weeks of lifeACTA PAEDIATRICA, Issue 1 2010N Ohkawa Abstract Aim:, We investigated the relationship between plasma insulin-like growth factor I (IGF-I), leptin, active ghrelin levels, and postnatal growth in very low birth weight (VLBW) infants. Method:, Plasma IGF-I, leptin, and active ghrelin levels were measured at birth and at 2, 4, 6 and 8 weeks after birth in 61 VLBW infants, including 31 appropriate-for-gestational-age (AGA) and 30 small-for-gestational-age (SGA) infants. Results:, Insulin-like growth factor I levels were the lowest at birth, but increased gradually over the first 8 weeks of life. IGF-I was positively correlated with body weight, body length and body mass index at all time points. Leptin levels did not change over the study period. Ghrelin levels were significantly lower at birth; however, there were no significant differences between the levels after 2 weeks of age. Leptin and ghrelin levels were not correlated with anthropometrical measures. IGF-I levels at birth were significantly lower in SGA than in AGA infants, but the leptin and ghrelin levels were not significantly different between the two groups. Conclusion:, Insulin-like growth factor I is related to length and weight gain in the prenatal and the early postnatal periods in VLBW infants, but this does not appear to be the case for leptin and ghrelin. [source] Interactions among peripheral perfusion, cardiac activity, oxygen saturation, thermal profile and body position in growing low birth weight infantsACTA PAEDIATRICA, Issue 1 2010R Sahni Abstract Aims:, To investigate the correlation between the ,perfusion index' (PI) and other commonly used estimates of cutaneous blood flow [heart rate (HR), surface temperatures (ST) and central-to-peripheral thermal gradients (C-P grad)] and to use this new non-invasive tool to compare differences between prone and supine sleep position in low birth weight (LBW) infants. Methods:, Six-hour continuous recordings of pulse oximetry, cardiac activity and absolute ST from three sites (flank, forearm and leg), along with minute-to-minute assessment of behavioural states were performed in 31 LBW infants. Infants were randomly assigned to the prone or supine position for the first 3 h and then reversed for the second 3 h. PI data were correlated with HR and C-P grad, and compared across sleep positions during quiet sleep (QS) and active sleep (AS). Results:, Perfusion index correlated significantly with HR (r2 = 0.40) and flank-to-forearm thermal gradient (r2 = 0.28). In the prone position during QS, infants exhibited higher PI (3.7 ± 0.9 vs. 3.1 ± 0.7), HR (158.4 ± 8.9 vs. 154.1 ± 8.8 bpm), SpO2 (95.8 ± 2.6 vs. 95.2 ± 2.6%), flank (36.7 ± 0.4 vs. 36.5 ± 0.4°C), forearm (36.1 ± 0.6 vs. 35.5 ± 0.4°C) and leg (35.4 ± 0.7 vs. 34.7 ± 0.7°C) temperatures and narrower flank-to-forearm (0.6 ± 0.4 vs. 0.9 ± 0.3°C) and flank-to-leg (1.3 ± 0.6 vs. 1.8 ± 0.7°C) gradients, compared to those of the supine position. Similar differences were observed during AS. Conclusion:, Perfusion index is a good non-invasive estimate of tissue perfusion. Prone sleeping position is associated with a higher PI, possibly reflecting thermoregulatory adjustments in cardiovascular control. The effects of these position-related changes may have important implications for the increased risk for sudden infant death syndrome in prone position. [source] Parents, siblings and grandparents in the Neonatal Intensive Care Unit A survey of policies in eight European countriesACTA PAEDIATRICA, Issue 11 2009Gorm Greisen Abstract Objective:, To describe policies towards family visiting in Neonatal Intensive Care Units (NICU) and compare findings with those of a survey carried out 10 years earlier. Methods:, A questionnaire on early developmental care practices was mailed to 362 units in eight European countries (Sweden, Denmark, the UK, the Netherlands, Belgium, France, Spain and Italy). Of them 78% responded, and among those responded, 175 reported caring for at least 50 very low birth weight infants every year and their responses were analysed further. Results:, A majority of all units allowed access at any time for both parents. This was almost universal in northern Europe and the UK, whereas it was the policy of less than one-third of NICU in Spain and Italy, with France in an intermediate position. Restrictions on visiting of grandparents, siblings and friends, as well as restricting parents' presence during medical rounds and procedures followed the same pattern. A composite visiting score was computed using all the variables related to family visiting. Lower median values and larger variability were obtained for the southern countries, indicating more restrictive attitudes and lack of national policy. Conclusions:, The presence of parents and other family members in European NICUs has improved over a 10-year period. Several barriers, however, are still in place, particularly in the South European countries. [source] Age of sitting unsupported and independent walking in very low birth weight preterm infants with normal motor development at 2 yearsACTA PAEDIATRICA, Issue 11 2009MA Marín Gabriel Abstract Aims:, 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. Methods:, 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. Results:, 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. Conclusion:, 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. [source] Variations of Apgar score of very low birth weight infants in different neonatal intensive care unitsACTA PAEDIATRICA, Issue 9 2009Mario Rüdiger Abstract Objective:, The Apgar score should be an objective method to assess the state of newborns; however, its applicability in preterm infants is hampered by large variations among different observers. The study tested whether physicians that give low scores to written case descriptions also apply lower scores to preterm infants. Patients and Methods:, Descriptions (BMJ 2004; 329: 143,4) were sent to 14 neonatal units. Physicians were asked to evaluate the Apgar (case score). From seven units Apgar scores of all very low birth weight infants (VLBW) born between January 2004 and December 2006 were obtained from charts (clinical score). Results:, In total, 121 physicians from 14 institutions (median 9, range 3,15) replied: 24 residents with <6-month and 28 with >6-month neonatal experience, and 69 consultants. The assessment of the case scores was very heterogeneous with large variations in respiration, muscle tone and reflexes. Clinical scores were obtained from 1000 VLBW infants. The score depended on the gestational age, with a median of 4 at 24 and 7 at 27 weeks. With one exception, centres that assigned low case scores had also low clinical scores. Conclusion:, There is considerable variation in assigning Apgar scores. Definitions are required to apply the Apgar score to infants under clinical conditions such as preterm delivery, resuscitation or artificial ventilation. [source] Early iron supplementation in very low birth weight infants , a randomized controlled trialACTA PAEDIATRICA, Issue 6 2009Mari Jeeva Sankar Abstract Aim: To evaluate if supplementing iron at 2 weeks of age improves serum ferritin and/or haematological parameters at 2 months of life in very low birth weight (VLBW) infants. Methods: Preterm VLBW infants who received at least 100 mL/kg/day of oral feeds by day 14 of life were randomized to either ,early iron' (3,4 mg/kg/day orally from 2 weeks) or ,control' (no iron until 60 days) groups. Infants were followed up fortnightly and all morbidities were prospectively recorded. Serum ferritin was measured at 60 days by enzyme immunoassay method. Results: Forty-six infants were included in the study; primary outcome was available for 42 infants. There was no difference in either serum ferritin (mean: 50.8 vs. 45.3 ,g/L; adjusted difference in means: 5.8, 95% CI: ,3.0, 14.6; p = 0.19) or haematocrit (32.5 ± 5.3 vs. 30.8 ± 6.3%; p = 0.35) at 60 days between the early iron and control groups. The magnitude of fall in serum ferritin from baseline to the end of study period was also not different between the groups (4.9 vs. 13.8 ,g/L; difference in means: 8.8; 95% CI: ,0.3, 17.9; p = 0.06). The requirement of blood transfusions (9.5 vs. 13%; p = 0.63) and a composite outcome of common neonatal morbidities (19% vs. 21.7%; p = 0.55) were also not different between the two groups. Conclusion: Supplementing iron at 2 weeks of age in preterm VLBW infants did not improve either serum ferritin or the haematological parameters at 2 months when compared to the standard practice of starting iron from 8 weeks of age. [source] Hospital volume and neonatal mortality among very low birth weight infantsACTA PAEDIATRICA, Issue 4 2009Helmut Hummler No abstract is available for this article. [source] Minimal enteral feeding reduces the risk of sepsis in feed-intolerant very low birth weight newbornsACTA PAEDIATRICA, Issue 1 2009Gianluca Terrin Abstract Aims: To evaluate the efficacy and safety of minimal enteral feeding (MEF) nutritional practice in feed-intolerant very low birth weight (VLBW) infants. Methods: A retrospective design using data reported in the clinical charts of VLBW newborns consecutively observed in neonatal intensive care units (NICU) that presents feed intolerance. During the study period, two feeding strategies were adopted: total parenteral nutrition (PN) (group 1) or PN plus MEF (group 2), for at least 24 h. Primary outcome was the time to reach full enteral feeding; secondary outcomes were the occurrence of sepsis, the time to regain birth weight, the length of hospitalization, the occurrence of necrotizing enterocolitis (NEC) Bell stage >II and death. Results: In total, 102 newborns were evaluated: 51 in group 1, and 51 in group 2. Neonates in group 2 achieved full enteral nutrition earlier (8 days, interquartile range [IQR] 5) compared with subjects receiving total PN (11 days, IQR 5, p < 0.001). A reduction of sepsis episodes was observed in group 2 (15.7%) compared with group 1 (33.3%, p = 0.038). Additionally, subjects in group 2 regained their birth weight and were discharged earlier. The occurrence of NEC and death were similar in the two groups. Conclusion: Minimal enteral feeding in very low birth weight infants presenting feed intolerance reduces the time to reach full enteral feeding and the risk of sepsis. This feeding practice does not increase the risk of necrotizing enterocolitis and death. [source] Nutrition and allergic diseaseCLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 5 2006S. Tricon Summary The prevalence of asthma and allergic diseases has increased dramatically over the past few decades with the highest incidence occurring in children. Most asthma and related atopic disorders have their origins in early life. Thus, it is imperative to understand the early life origins of the disease in order to identify targets for prevention and early intervention. Although atopic diseases have genetic determinants, the increased incidence of these diseases has occurred far too rapidly for genetic changes to explain the increase. This, most likely, results from changes in environmental influences acting on a pre-existent genetic susceptibility. One of the environmental changes over the last 20,40 years that could have contributed to the recent increase in atopic diseases is diet. Food allergy is often one of the earliest manifestations of atopy, and sensitization to food is a risk factor for the subsequent appearance of respiratory allergy and asthma. However, studies investigating the effects of dietary restrictions on the prevention of allergy have been disappointing. On the other hand, current data suggests that exclusive breastfeeding should be encouraged for at least 4,6 months in infants at both high and low risk of atopy. Increased risk of asthma has also been observed in low birth weight infants, suggesting that under-nutrition can detrimentally alter foetal development. Epidemiological and immunological studies also suggest that dietary modification or supplementation in the foetal and early life could reduce the development of atopic diseases. The current dietary hypotheses relate to antioxidants, lipids, electrolytes and probiotics. The aims of this report are: (i) to assess the best methods to analyse nutrient intake and nutrient status; (ii) to review the existing epidemiological evidence for an association between dietary intake (nutrients and food) and allergic diseases; and (iii) to define the windows of opportunity for nutritional supplementation to be used as a preventative strategy for asthma and allergy. [source] Growth and neurodevelopment outcome of very low birth weight infants delivered by preeclamptic mothersACTA PAEDIATRICA, Issue 12 2007Rita C Silveira Abstract Aim: To investigate growth and neurodevelopment outcome of very low birth weight (VLBW) infants delivered by preeclamptic mothers. Methods: A cohort including all VLBW infants delivered between December 2003 and May 2005 was followed up to 12 and 18 months corrected age (CA). Exclusion criteria: death before 1 year corrected age, major malformations, deafness and blindness. Weight, length and head circumference were plotted on NCHS curves. Bayley Scales were performed at 12 and 18 months CA. Results: 40 infants in preeclamptic and 46 in control groups were studied. Birth weight and gestational age were 1148 g ± 236 and 1195 g ± 240, and 31.3 weeks ± 1 and 30.6 weeks ± 2 for preeclamptic and control groups, respectively. At 12 and 18 months, CA, weight for age (Z score) was significantly higher in control than in preeclamptic. PDI scores were higher in preeclamptic than in controls at 18 months CA. Conclusions: Catch-up of body weight did not occur in the first 18 months CA in preeclamptic infants. Neurodevelopment outcome was better in infants delivered by preeclamptic mothers than in controls at 18 months CA. [source] Geographic variations in outcome of very low birth weight infants in ItalyACTA PAEDIATRICA, Issue 1 2007Carlo Corchia Abstract Aim: A number of social and health aspects in Italy show remarkable geographic dishomogeneity. We investigated if this phenomenon involves the outcome of very low birth-weight infants (VLBWI). Methods: This is a multi-centre nation-based survey among all Italian NICUs. The number of VLBWI admitted to each NICU in 2001 by birth-weight classes of 250 g, their inborn/outborn status and survival at discharge were registered through ad hoc questionnaires. The data were analysed for the whole country and for three geographic areas (North, Centre and South). Results: A total of 4679 VLBWI in 125 units were surveyed (0.88% of live births in Italy in 2001). The median number of infants admitted was 34 per NICU (interquartile range 16,52), without significant differences among the three geographic areas. The inborn rate was 80.7% (86.5% in the North, 83.7% in the Centre and 74.6% in the South). The mortality rate was 19.6% (15.6% in the North, 19.3% in the Centre and 23.4% in the South). Adjusted relative risk of death between Southern and Northern regions was 1.48 (95% CI 1.30,1.68), and that between outborn and inborn infants was 1.20 (95% CI 1.04,1.37). Conclusions: The differences in mortality among geographic areas suggest a state of socio-sanitary deprivation in the Southern regions, as well as different models of organisation and quality of perinatal care. [source] The association between maternal periodontitis and low birth weight infants among Malay womenCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 4 2008Norkhafizah Saddki Abstract,,, Objectives:, Maternal periodontitis has been suggested as one of the risk factors for low birth weight (LBW) infants. The objective of this study was to determine the association between maternal periodontitis and LBW infants among Malay women. Methods:, Screening periodontal examinations were carried out on all eligible Malay pregnant women in the second trimester of pregnancy attending two randomly selected community maternal and child health clinics in Kota Bharu, Kelantan. Patients with four or more sites with pocket depth 4 mm or higher, and clinical attachment loss 3 mm or higher at the same site with presence of bleeding on probing were diagnosed as having periodontitis in this study. Using this definition, systematic random sampling was utilized for selection of 250 subjects for each exposed and non-exposed group. Of 500 subjects enrolled in the study, 28 (5.6%) were either dropped or lost to follow-up. Of the remaining 472 subjects, 232 with periodontitis were in the exposed group and 240 with healthy periodontium were in the nonexposed group. Results:, The incidence of LBW was 14.2% (95% CI: 9.70,18.75) in women with periodontitis, and 3.3% (95% CI: 1.05,5.62) in women without periodontitis. The relative risk of having LBW infants was 4.27 times higher for women with periodontitis compared with those without periodontitis (95% CI: 2.01,9.04). After adjustment for potential confounders using multiple logistic regression analysis, significant association was found between maternal periodontitis and LBW (OR = 3.84; 95% CI: 1.34,11.05). Conclusion:, The results of this study provide additional evidence that pregnant women with periodontitis are at a significantly higher risk of delivering LBW infants. [source] | |||||||||||||