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Preterm Newborns (preterm + newborn)
Selected AbstractsOlfactory Familiarization and Discrimination in Preterm and Full-Term NewbornsINFANCY, Issue 1 2002Nathalie Goubet The purpose of this study was to observe olfactory detection and discrimination in preterm and full-term newborns. Infants were familiarized for 10 trials with either vanillin or anethole. On each trial, a cotton swab perfumed with one of the odors was slowly moved in front of the baby's nose for 10 sec. For half of the preterm and full-term infants, a new odor was presented after the last familiarization trial (experimental groups). For the other half, the same odor as during familiarization was presented (control groups). Facial and head movements for both populations and heart rates for preterm infants were recorded before, during, and after odor presentation. Preterm infants reacted to the scents by increasing facial actions and heart rate but not head movements. Full-term infants increased facial and head movements. Neither population showed a clear behavioral habituation pattern, but full-term newborns had a significantly reduced facial reactivity on the last familiarization trial compared to preterm infants. Preterm newborns did, however, show cardiac habituation on the last familiarization trial. Preterm and full-term infants presented with a new odor after familiarization increased responding compared to infants presented with the same odor, indicating their ability to discriminate between 2 odors. Infants' reactivity and discrimination to odors indicate preterm and full-term newborns' ability to be attuned to their olfactory environment. [source] Neonatal encephalopathy in the term infant: Neuroimaging and inflammatory cytokinesDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 1 2002Audrey Foster-Barber Abstract The interrelationship between inflammation and ischemia is complex and poorly understood in the developing nervous system. In the preterm newborn, maternal infection may predispose to white matter injury and may be associated with cytokine elevation. In the term infant, few studies exist linking elevation of cytokines with encephalopathy and poor neurodevelopmental outcome. This review discusses the interplay among inflammatory cytokines, neonatal encephalopathy, and neuroimaging parameters. MRDD Research Reviews 2002;8:20,24. © 2002 Wiley-Liss, Inc. [source] Determining the contribution of asphyxia to brain damage in the neonateJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2004James A. Low Abstract Studies in the research laboratory have demonstrated the complex relationship between fetal and newborn asphyxia and brain damage, a balance between the degree, duration and nature of the asphyxia and the quality of the cardiovascular compensatory response. Clinical studies would support the contention that the human fetus and newborn behave in a similar manner. An accurate diagnosis of asphyxia requires a blood gas and acid base assessment. The clinical classification of fetal asphyxia is based on a measure of metabolic acidosis to confirm that fetal asphyxia has occurred and the expression of neonatal encephalopathy and other organ system complications to express the severity of the asphyxia. The prevalence of fetal asphyxia at delivery is at term, 25 per 1000 live births of whom 15% are moderate or severe; and in the preterm, 73 per 1000 live births of whom 50% are moderate or severe. It remains to be determined how often the asphyxia recognized at delivery may have been present before the onset of labor. There is a growing body of indirect and direct evidence to support the contention that antepartum fetal asphyxia is important in the occurrence of brain damage. Although much of the brain damage observed in the newborn reflects events that occurred before delivery, newborn asphyxia and hypotension, particularly in the preterm newborn, may contribute to the brain damage accounting for deficits in surviving children [source] One-lung ventilation of a preterm newborn during esophageal atresia and tracheoesophageal fistula repairACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2002E. Tercan In this paper, we assessed the anesthesia management of a male, a 34-week gestation age newborn, weighing 1500 g, who has esophageal atresia and tracheoesophageal fistula localized just above the carina. Endotracheal intubation and intermittent positive pressure ventilation caused air leakage through the fistula into the stomach, causing abdominal distention. One-lung ventilation by left main bronchus intubation eliminated this problem. [source] COL4A1 mutation in two preterm siblings with antenatal onset of parenchymal hemorrhage,ANNALS OF NEUROLOGY, Issue 1 2009Linda S. de Vries MD Objective To report the presence of intracerebral hemorrhage and porencephaly, both present at birth, in two preterm infants with a mutation in the collagen 4 A1 gene. Methods Two preterm infants with antenatal intracerebral hemorrhage and established porencephaly, as well as their affected mother and grandfather, underwent neurological and ophthalmological examination and magnetic resonance imaging of the brain. Mutation analysis of the COL4A1 gene was performed in the infants and in their mother. Results Both infants had a novel G1580R mutation in the COL4A1 gene, encoding procollagen type IV ,1. A history of mild antenatal trauma was present in the first but not in the second infant. Both preterm infants were asymptomatic at birth. The intracerebral hemorrhage and porencephaly were diagnosed with cranial ultrasound examination and were subsequently confirmed with magnetic resonance imaging. Leukoencephalopathy was present in the mother and in her father. Interpretation Mutation of the COL4A1 gene appears to be a risk factor of antenatal intracerebral hemorrhage followed by porencephaly in the preterm newborn. Ann Neurol 2009;65:12,18 [source] Resuscitation at the limits of viability , an Irish perspectiveACTA PAEDIATRICA, Issue 9 2009RA Khan Abstract Background:, Advances in neonatal care continue to lower the limit of viability. Decision making in this grey zone remains a challenging process. Objective:, To explore the opinions of healthcare providers on resuscitation and outcome in the less than 28-week preterm newborn. Design/Methods:, An anonymous postal questionnaire was sent to health care providers working in maternity units in the Republic of Ireland. Questions related to neonatal management of the extreme preterm infant, and estimated survival and long-term outcome. Results:, The response rate was 55% (74% obstetricians and 70% neonatologists). Less than 1% would advocate resuscitation at 22 weeks, 10% of health care providers advocate resuscitation at 23 weeks gestation, 80% of all health care providers would resuscitate at 24 weeks gestation. 20% of all health care providers would advocate cessation of resuscitation efforts on 22,25 weeks gestation at 5 min of age. 65% of Neonatologists and 54% trainees in Paediatrics would cease resuscitation at 10 min of age. Obstetricians were more pessimistic about survival and long term outcome in newborns delivered between 23 and 27 weeks when compared with neonatologists. This difference was also observed in trainees in paediatrics and obstetrics. Conclusion:, Neonatologists, trainees in paediatrics and neonatal nurses are generally more optimistic about outcome than their counterparts in obstetrical care and this is reflected in a greater willingness to provide resuscitation efforts at the limits of viability. [source] Perceived Maternal Parenting Self-Efficacy (PMP S-E) tool: development and validation with mothers of hospitalized preterm neonatesJOURNAL OF ADVANCED NURSING, Issue 5 2007Christopher R. Barnes Abstract Title.,Perceived Maternal Parenting Self-Efficacy (PMP S-E) tool: development and validation with mothers of hospitalized preterm neonates Aim., This paper is a report of a study to develop and test the psychometric properties of the Perceived Maternal Parenting Self-Efficacy tool. Background., Mothers' perceptions of their ability to parent (maternal parenting self-efficacy) is a critical mechanism guiding their interactions with their preterm newborns. A robust measure is needed which can measure mothers' perceptions of their ability to understand and care for their hospitalized preterm neonates as well as being sensitive to the various levels and tasks in parenting. Methods., Using a mixed sampling methodology (convenience or randomized cluster control trial) 165 relatively healthy and hospitalized mother-preterm infant dyads were recruited in 2003,2005 from two intensive care neonatal units in the United Kingdom (UK). Mothers were recruited within the first 28 days after giving birth to a preterm baby. The Perceived Maternal Parenting Self-Efficacy tool, which is made up of 20 items representing four theorized subscales, was tested for reliability and validity. Results., Internal consistency reliability of the Perceived Maternal Parenting Self-Efficacy tool was 0·91, external/test-retest reliability was 0·96, P < 0·01. Divergent validity using the Maternal Self-Report Inventory was rs = 0·4, P < 0·05 and using the Maternal Postnatal Attachment Scale was rs = 0·31, P < 0·01. Conclusion., The Perceived Maternal Parenting Self-Efficacy tool is a psychometrically robust, reliable and valid measure of parenting self-efficacy in mothers of relatively healthy hospitalized preterm neonates. Although application outside the UK will require further cross-cultural validation, the tool has the potential to provide healthcare professionals with a reliable method of identifying mothers of preterm hospitalized babies who are in need of further support. [source] Measurement of pulmonary surfactant disaturated-phosphatidylcholine synthesis in human infants using deuterium incorporation from body waterJOURNAL OF MASS SPECTROMETRY (INCORP BIOLOGICAL MASS SPECTROMETRY), Issue 7 2005Paola E. Cogo Abstract The aim of the study was to determine surfactant palmitate disaturated-phosphatidylcholine (DSPC-PA) synthesis in vivo in humans by the incorporation of deuterium from total body water into DSPC-PA under steady state condition. We studied three newborns and one infant (body weight (BW) 4.6 ± 2.9 kg, gestational age 37.5 ± 2 weeks, age 9 ± 9 days) and four preterm newborns (BW 1.3 ± 0.6 kg, gestational age 30.3 ± 2.5 weeks, postnatal age 8.8 ± 9.2 h). All infants were mechanically ventilated during the study and the four preterm infants received exogenous surfactant at the start of the study. We administered 0.44 g 2H2O/kg BW as a bolus intravenously, followed by 0.0125 g 2H2O/kg BW every 6 h to maintain deuterium enrichment at plateau over 2 days. Urine samples and tracheal aspirates (TA) were obtained prior to dosing and every 6 h thereafter. Isotopic enrichment curves of DSPC-PA from sequential TA and urine deuterium enrichments were analyzed by Gas Chromatography-Isotope Ratio,Mass Spectrometry (GC-IRMS) and normalized for Vienna Standard Mean Ocean Water. Enrichment data were used to measure DSPC-PA fractional synthesis rate (FSR) from the linear portion of the DSPC-PA enrichment rise over time, relative to plateau enrichment of urine deuterium. Secretion time (ST) was defined as the time lag between the start of the study and the appearance of DSPC-PA deuterium enrichment in TA. Data were given as mean ± SD. All study infants reached deuterium-steady state in urine. DSPC-PA FSR was 6.5 ± 2.8%/day (range 2.6,10.2). FSR for infants who did not receive exogenous surfactant was 5.7 ± 3.5%/day (range 2.6,9.9%/day) and 7.3 ± 2.1%/day (range 5.1,10.2%/day) in the preterms, whereas DSPC-PA ST was 10 ± 10 h and 31 ± 10 h respectively. Surfactant DSPC-PA synthesis can be measured in humans by the incorporation of deuterium from body water. This study is a simpler and less invasive method compared to previously published methods on surfactant kinetics by means of stable isotopes. Copyright © 2005 John Wiley & Sons, Ltd. [source] Necrotizing enterocolitis in the full-term neonateJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2001SCY Ng Abstract: Necrotizing enterocolitis (NEC) is a relatively common disorder of multifactorial aetiology that primarily affects preterm newborns, but has been reported to occur in the full-term neonate as well. This review focuses on known and recent developments in the epidemiology, pathogenesis, diagnosis, management and prevention of NEC in the full-term neonate. [source] Serum pro-hepcidin levels in term and preterm newborns with sepsisPEDIATRICS INTERNATIONAL, Issue 2 2009Ece Yapakç Abstract Background:, An iron regulatory peptide hormone, hepcidin, is also part of the innate immune system and is strongly induced during infections and inflammation. The aim of the present study was to determine serum levels of the 60 aa pro-hormone form of hepcidin (pro-hepcidin) in full-term and preterm newborns with sepsis and to determine the possible relationships between pro-hepcidin levels and serum iron and complete blood count parameters. Methods:, Fifteen preterm newborns with sepsis, 17 healthy preterm, six full-term newborns with sepsis and 16 healthy full-term newborns were included the study. Blood samples were collected from patients with sepsis at the time of clinical diagnosis. Each blood sample was analyzed for complete blood count, serum iron and ferritin concentrations, iron-binding capacity, and pro-hepcidin level. Results:, The mean serum pro-hepcidin level (mean ± SD) in preterm neonates with sepsis and in healthy preterm newborns was 565.4 ± 519.5 ng/mL and 279.8 ± 227.6 ng/mL, respectively (P < 0.05). The mean serum pro-hepcidin level in full-term newborns with sepsis and in healthy full-term neonates was 981.4 ± 415.4 ng/mL and 482 ± 371.9 ng/mL, respectively (P < 0.05). Although the mean serum ferritin levels in the two groups with sepsis were higher when compared with the healthy groups, the difference was not statistically significant in full-term newborns. No statistically significant correlations were found between serum pro-hepcidin levels and any other parameters in each group. Conclusions:, Serum pro-hepcidin levels were higher in newborns with sepsis (either premature or full-term) than they were in healthy newborns at the time of clinical diagnosis. [source] Determination of total homocysteine in dried blood spots using high performance liquid chromatography for homocystinuria newborn screeningPEDIATRICS INTERNATIONAL, Issue 1 2004Andi Dwi Bahagia Febriani AbstractBackground: The most widely used method for newborn screening for homocystinuria (HCU) is a semiquantitative bacterial inhibition assay for measuring methionine concentration in dried blood spots (DBS). Because this method has resulted in a number of missed cases due to many factors, we developed a high performance liquid chromatography (HPLC) method with fluorescence detection to measure total homocysteine (tHcy) in DBS which might be useful for newborn screening for HCU. Methods: One disk of DBS 3 mm in diameter was sonicated in 10 min. The extract was reduced with dithioerythritol and was derivatized with 4-aminosulfonyl-7fluoro-2,1,3-benzoxadiazole before injection into HPLC. Results: This method showed good linearity (r = 0.996), precision (coefficient of variation range 2.7,5%), and excellent correlation coefficient between DBS and serum tHcy, both in control (r = 0.932) and patient samples (r = 0.952). By this method, the mean tHcy concentration in DBS of preterm newborns, full-term newborns, and adults was 1.4 ± 1.0, 2.5 ± 1.6, and 4.9 ± 1.5 µmol/L, respectively. The mean tHcy DBS concentration in two cases of cystathionine-,-synthase deficiency and one case of 5,10-methylentetrahydrofolate reductase deficiency was 22.7 ± 2.88, 29.3 ± 1.90, and 41.3 µmol/L, respectively. Conclusions: The present method, which is rapid, user friendly and reliable, seems applicable to newborn screening of HCU in place of methionine measurement. [source] Effect of chorioamnionitis on brain development and injury in premature newborns,ANNALS OF NEUROLOGY, Issue 2 2009Vann 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] Early iron supplementation for very low birth weight preterm newborns: statistical vs. clinical significance!!ACTA PAEDIATRICA, Issue 11 2009Bhavneet Bharti No abstract is available for this article. [source] Remifentanil analgosedation in preterm newborns during mechanical ventilationACTA PAEDIATRICA, Issue 7 2009Carmen Giannantonio Abstract Aim:, To assess efficacy of remifentanil in preterm newborns during mechanical ventilation. Methods:, Remifentanil was administered by continuous intravenous infusion to provide analgesia and sedation in 48 preterm infants who developed respiratory distress and required mechanical ventilation. We examined the doses needed to provide adequate analgesia, extubation time after the discontinuation of opioid infusion, the presence of side effects and safety of the use. Results:, Remifentanil provided adequate analgesia, with a significant reduction of NIPS and COMFORT score since 1 h after starting the infusion of remifentanil. The drug was initially administered at a dose of 0.075 ,g/kg/min, but in 73% of newborns the latter had to be increased; at a dose of 0.094 ± 0.03 (mean ± standard deviation) ,g/kg/min, 97% of the newborns received adequate analgesia and sedation. The time elapsed between the discontinuation of remifentanil infusion and extubation was 36 ± 12 min. Treatment was started between the 1st and the 17th day of life. The mean duration of therapy was 5.9 ± 5.7 days. No side effects on the respiratory or cardiovascular system were observed. Conclusion:, Remifentanil is a manageable and effective opioid in the newborn undergoing mechanical ventilation, though randomized controlled trials and information about long-term outcomes are necessary. [source] Plasma protein Z levels in healthy and high-risk newborn infantsACTA PAEDIATRICA, Issue 5 2004F Schettini Jr Aim: To evaluate plasma protein Z (PZ) levels in healthy and high-risk newborn infants. Methods: A longitudinal observational study was conducted. Inclusion criteria were: healthy term and pre-term newborns normal for gestational age and newborns belonging to one of the following groups: newborns small for gestational age (SGA), newborns affected by respiratory distress syndrome (RDS), newborns from mothers with pre-eclampsia. Newborns with sepsis, congenital malformation or haemorrhagic disorders were excluded. Plasma PZ levels, protein C (PC) concentration, PC activity and protein-induced vitamin K absence levels were measured. Results: 53 newborns were enrolled into the study. PZ and PC antigen levels varied significantly among analysed subgroups on day 1 (p < 0.01): lower levels of these inhibitors were found in RDS newborns (group C), newborns from mothers affected by pre-eclampsia (group D) and SGA newborns (group E) than in healthy term and preterm newborns (groups A and B). Conclusion: PZ deficiency occurs in newborns affected by severe RDS, in newborns from pre-eclamptic mothers and in SGA newborns, probably owing to activated coagulation in the first two conditions and to reduced PZ synthesis in the last condition. [source] Comparative outcome study between triplet and singleton preterm newbornsACTA PAEDIATRICA, Issue 11 2002A Maayan-Metzger Aim: To evaluate the outcome of triplet versus singleton preterm newborns. Methods: The study population included 64 sets of preterm triplet (gestational age 25-34 wk) and 64 singleton controls. Data on prenatal and perinatal findings, neonatal complications, duration of hospitalization, and neonatal mortality were collected by chart review. Results: Mothers of triplets were more likely to receive prenatal tocolytic treatment and more antenatal steroids for foetal lung maturation, and to be delivered by caesarean section. No differences were found between the groups in perinatal parameters (cord pH, Apgar score, respiratory support after birth), respiratory parameters (severity of acute and chronic lung disease, use and duration of oxygen treatment and assisted ventilation), or neonatal complications (patent ductus arteriosus, intraventricular haemorrhage, periventricular leukomalacia, necrotizing enterocolitis, retinopathy of prematurity, meningitis, sepsis and jaundice). This was also true for duration of hospitalization and neonatal mortality. No differences were recorded by birth order among the triplets for any of these parameters. Conclusion: The study indicates that good prenatal care can lead to a good outcome for preterm triplets, close to that of preterm singleton infants. Families and physicians should consider this information when foetal reduction is offered. [source] | |||||||||||||