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Frequent Use of Fresh Frozen Plasma Is a Risk Factor for Venous Thrombosis in Extremely Low Birth Weight Infants: A Matched Case-control Study
Acta Medica Okayama , 2012,
Abstract: Percutaneously inserted central catheters (PICCs) are often used in neonatal medicine. Venous thrombosis (VT) is one of the complications associated with PICC use. According to some reports, fresh frozen plasma (FFP) may be a risk factor for VT. The purpose of this study was to determine whether FFP use is associated with VT in extremely low birth weight infants (ELBWIs). We performed a matched case-control study on risk factors for VT in ELBWIs born over a period of 5 years in the neonatal intensive care unit of a tertiary hospital. Controls were infants from the unit matched for gestational age and birth weight. We performed univariate analyses and created receiver operating characteristic (ROC) curves for the cut-off values of continuous parameters such as FFP. We also conducted multivariate conditional logistic regression analysis and calculated adjusted odds ratios and their 95% confidence intervals. Thirteen VT cases and 34 matched controls were examined. Using an ROC curve, FFP by day 5>50mL/kg was selected as the cut-off value. In multivariate conditional logistic regression analysis, FFP by day 5>50mL/kg exhibited an adjusted odds ratio of 5.88 (95% confidence interval:1.12-41.81, p=0.036). FFP by day 5>50mL/kg may be a risk factor for VT in ELBWIs.
Lower Transplacental Antibody Transport for Measles, Mumps, Rubella and Varicella Zoster in Very Preterm Infants  [PDF]
Jolice P. van den Berg, Elisabeth A. M. Westerbeek, Gaby P. Smits, Fiona R. M. van der Klis, Guy A. M. Berbers, Ruurd M. van Elburg
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0094714
Abstract: Background Maternal antibodies, transported over the placenta during pregnancy, contribute to the protection of infants from infectious diseases during the first months of life. In term infants, this protection does not last until the first recommended measles-mumps-rubella vaccination at 14 months in the Netherlands, while these viruses still circulate. The aim of the study was to investigate the antibody concentration against measles, mumps, rubella and varicella (MMRV) in mothers and preterm infants or healthy term infants at birth. Methods Antibody concentrations specific for MMRV were measured in cord blood samples from preterm (gestational age <32 weeks and/or birth weight <1500 g) and term infants, and matched maternal serum samples, using a fluorescent bead-based multiplex immune-assay. Results Due to lower placental transfer ratios of antibodies against MMRV in 96 preterm infants (range 0.75–0.87) compared to 42 term infants (range 1.39–1.65), the preterm infants showed 1.7–2.5 times lower geometric mean concentrations at birth compared to term infants. Maternal antibody concentration is the most important determinant of infant antibody concentration against MMRV. Conclusions Preterm infants benefit to a lesser extent from maternal antibodies against measles, mumps, rubella and varicella than term infants, posing them even earlier at risk for infectious diseases caused by these still circulating viruses.
The effect of maternal anthropometric characteristics and social factors on gestational age and birth weight in Sudanese newborn infants
Eltahir M Elshibly, Gerd Schmalisch
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-244
Abstract: In 1000 Sudanese mothers with singleton births, anthropometric measurements (weight, height, mid-arm circumference) and newborn birth weight were taken within 24 hours of delivery. Furthermore, maternal education and socio-economic status were recorded. The effect of these maternal variables on gestational age and birth weight was investigated by receiver operating characteristic (ROC) curves and by multivariate logistic regression analysis.Although maternal height was significantly correlated (p = 0.002) with gestational age, we did not find maternal characteristics of value in determining the risk for preterm birth. Birth order was the strongest determinant of birth weight compared to other maternal characteristics. The LBW rate of first born babies of 12.2% was nearly twice that of infants of multiparous mothers. Maternal age and all maternal anthropometric measurements were positively correlated (p < 0.001) with birth weight. A maternal height of <156 cm, a maternal weight of <66 kg, a maternal mid arm circumference of <27 cm and years of education of ≤ 8 years were found to increase the relative risk of LBW but this was statistically significant only in the case of maternal height. Maternal age and BMI had no statistically significant effect on determining the risk for LBW. The social class did not affect the birth weight, while the number of years of education was positively correlated with birth weight (p = 0.01). The LBW rate decreased from 9.2% for ≤ 8 years of education to 6.0% for >12 years of education.Birth order and maternal height were found to be the most important maternal parameters which influences birth weight and the risk for LBW. The duration of maternal education and not social class was found to significantly affect the risk for LBW.There is a large body of literature showing that the world wide problem of low birth weight (LBW), i.e. infants weighing <2500 g, is among the strongest determinants of infant mortality and morbidity. While in ind
Guidelines for Feeding Very Low Birth Weight Infants  [PDF]
Sourabh Dutta,Balpreet Singh,Lorraine Chessell,Jennifer Wilson,Marianne Janes,Kimberley McDonald,Shaneela Shahid,Victoria A. Gardner,Aune Hjartarson,Margaret Purcha,Jennifer Watson,Chris de Boer,Barbara Gaal,Christoph Fusch
Nutrients , 2015, DOI: 10.3390/nu7010423
Abstract: Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas.
Nephrocalcinosis in very low birth weight infants  [cached]
Nasseri Fatemeh,Azhir Afshin,Rahmanian Shiva,Iranpour Ramin
Saudi Journal of Kidney Diseases and Transplantation , 2010,
Abstract: To determine the incidence and risk factors of nephrocalcinosis in preterm infants, we studied in a prospectively 64 preterm infants of birth weight :5 1500 g from February 2006 to November 2007. Data were collected on gestation, birth weight, gender and family history of renal calculi, respiratory support, and use of nephrotoxic drugs. The parameters of mineral meta-bolism were assessed in blood and spot urine samples at the end of 2 nd and 4 th weeks of age. Forty-nine babies completed the study, and nephrocalcinosis was observed in 13 (26.5%) babies and was bilateral in 7 (14.3%) infants. The mean age of diagnosis of nephrocalcinosis was 52.58 days (range 30-123 days). Gestational age, birth weight, and sex were not significantly associated with increased risk of nephrocalcinosis. The mean duration of ventilation was significantly less in babies with than without nephrocalcinosis (P= 0.020), and the mean levels of urine calcium and phosphate at 4 weeks of age, respectively (P= 0.013, P= 0.048). There were also significant diffe-rences in urine calcium/creatinine ratio (P= 0.001), mean plasma levels of calcium at 2 weeks of age (P= 0.047) and plasma levels of phosphate at 4 weeks of age (P= 0.016) between babies with and without nephrocalcinosis. Using logistic regression analysis, family history of renal stone (P= 0.002) and urine calcium/creatinine ratio (P= 0.011) were significant predictors of nephrocalci-nosis. However, there were no significant differences in the length of stay in the intensive care unit, duration of total parenteral nutrition, and duration and cumulative doses of nephrotoxic drugs between these two groups. We conclude that the incidence of nephrocalcinosis was similar in our population to the previous studies. Family history of renal stone and urine calcium/ creatinine ratio are the major risk factors of nephrocalcinosis in very low birth weight neonates.
Weight Gain in Pregnancy and its Correlation with Birth Weight of Infants  [PDF]
Masoume Delaram,Nasrin Akbari
Knowledge & Health Journal , 2008,
Abstract: Introduction: Birth weight is one of the main determinations for somatic and mental growth in infants and it is an important symptom of intrauterine growth. This study has been designed to detect the weight gain in pregnancy and its correlation with birth weight of infants. Methods: Six hundred pregnant women were selected from those referred to delivery room in Hajar hospital. Data was collected by a questionnaire using conversation with mothers, prenatal, natal and infant,s records. We used similar scale balance to measure the mothers and infants weight. Age of mother less than 18 and more than 35, gestational age less than 37 weeks, twin,s pregnancy, history of abortion and intrauterine fetal death, smoking drinking of alcohol and medical history of diseases in mother, were excluded. Results: The mean of weight gain in pregnancy was 11.50 ± 3.6 kg. It was increased with the increase of parity (P=0.015) and level of education in mother (P=0.018). Also it was greater in cesarean section versus the vaginal delivery (P=0.006). The mean of birth weight was 3179.1±433.1 gr. It was greater in multifarious than the nulliparous women (P=0.003), in male infants than the female infants (P=0.013) and in educated than the uneducated women. The mean of birth weight was increased by increased of mother,s weight in the beginning and along of pregnancy. Conclusion: Results of this study showed the importance of mother,s weight at the first and along of pregnancy. Following to recognize of mothers who are at risk for delivery of low birth weight we are able to care them carefully and educate them in different fields
Language and cognition in very low birth weight preterm infants with PELCDO application
Bühler, Karina Elena Bernardis;Limongi, Suelly Cecília Olivan;Diniz, Edna Maria de Albuquerque;
Arquivos de Neuro-Psiquiatria , 2009, DOI: 10.1590/S0004-282X2009000200013
Abstract: the performance of very low birth weight preterm infants, in terms of cognition and expressive language, was analyzed and compared with that of term infants with the protocol for expressive language and cognition development observation (pelcdo). the study involved 12 very low birth weight preterm infants and 20 term infants, all of whom were evaluated monthly. sessions were videotaped, and data were analyzed according to this specific protocol. our results suggest that cognition and expressive language develop significantly later in very low birth weight preterm infants than in the term. we found positive correlations for cognitive and expressive language development, the delay becoming more evident after 6 months of age, persisting through the sensorimotor period, and continuing into the beginning of preoperational period, indicating the importance of follow-up evaluation, defining the true needs of such infants and identifying the ideal moment for speech-language intervention.
The Relationship Between the Primary Tooth Eruption and Low Birth Weight Infants
H Shajary,PS Akhavan,A Ahmadiah,N Valaey
Iranian Journal of Pediatrics , 2003,
Abstract: The tooth eruption is clearly quite complex, and many different mechanisms are undoubtedly involved. Low birth weight (LBW) infants (birth weight 2500g or less) are prone to many serious medical problems during the neonatal period which may affect the development of oral tissues. This cohort study evaluated the eruption pattern of primary teeth in 26 LBW infants and 26 normal birth weight infants. Wilcoxon rank sum test and student t-tests were used for comparison of two groups. Initial eruption sequence in both groups was the same, with the two lower central incisors erupting first.
Postpartum Depression in Mothers of Infants with Very Low Birth Weight  [cached]
Sabri HERGüNER,Ali ANNAGüR,Erdin? ???EK,Hüseyin ALTUNHAN
N?ropsikiyatri Ar?ivi , 2013,
Abstract: Background: Giving birth to an infant with very low birth weight (VLBW) is a major life event for a mother. Several studies have shown that mothers of these infants are at greater risk of psychological distress. The aim of this study was to investigate the level of depressive symptoms and to determine the associated factors among mothers who have infants with VLBW.Methods: The sample consisted of 105 subjects: 35 mothers of VLBW infants (<1500 g), 35 mothers of low birth weight (LBW) infants (1500-2500 g), and 35 mothers of healthy term infants (>2500 g). The Edinburgh Postpartum Depression Scale (EPDS) was used to detect maternal depressive symptoms. Maternal social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Results: The mean EPDS score and the number of mothers with high depressive scores (EPDS>12) were significantly higher in mothers of infants with VLBW than in mothers of LBW and term infants. EPDS score was negatively correlated with birth weight, gestational age, and perceived social support and positively correlated with duration of hospital stay in mothers of infants with VLBW. Low birth weight and long hospital stay were found as predictors of postpartum depression in mothers of infants with VLBW. Conclusion: The birth and subsequent hospitalization of an infant with very low birth weight evoke psychological distress in mothers. Pediatricians should be more careful about depressive symptoms of mothers of infants with VLBW and should refer for counseling when it is necessary. (Arc-hi-ves of Neu-ropsy-chi-atry 2012; 50: 30-33)
Prenatal and neonatal variables associated with enamel hypoplasia in deciduous teeth in low birth weight preterm infants
Franco, Kátia Maria Dmytraczenko;Line, Sérgio Roberto Peres;Moura-Ribeiro, Maria Valeriana Leme de;
Journal of Applied Oral Science , 2007, DOI: 10.1590/S1678-77572007000600012
Abstract: this study investigated possible prenatal and neonatal variables that may influence the prevalence of tooth enamel hypoplasia in preterm and low birth weight children (lbw) and a matched control group of term children with normal birth weight (nbw). the study sample consisted of 61 children born preterm and with lbw examined at 18-34 months of age. the control group was formed by 61 infants born full term and with nbw examined at 31-35 months of age. all children were born at the center of integrated attention of women's health (caism-unicamp). fdi criteria were followed for dental examination. medical data was collected retrospectively from hospital records. among preterms, 57.4% had some type of developmental defects of enamel (dde), 52.5 % had opacities and 21.3 % presented hypoplasia. among full-term children, 24.6% presented dde, 24.6% had opacities and 3.3% had hypoplasia. lbw preterm infants presented a higher prevalence of hypoplasia than nbw controls. the deciduous teeth most affected by hypoplasia were maxillary incisors. there was no significant association with prenatal variables; among neonatal variables there was a significant association with respiratory distress syndrome and neurological examination at discharge with an altered result.
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