Plasma leptin, insulin, and neuropeptide Y response to feeding in newborn infants.
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Breast Feeding↗
Biomedical subjects
C Mamì
Publications and source records attributed to C Mamì.
Plasma leptin, insulin, and neuropeptide Y concentrations in infants.
Changes in plasma leptin, insulin, and neuropeptide Y (NPY) concentrations were determined by radioimmunological methods in healthy infants. Compared with umbilical concentrations, on the 4th day of life plasma leptin and insulin were significantly decreased, and NPY was significantly increased. No correlation was observed between leptin, insulin, and NPY.
Fetal Blood↗
Incidence of dehydration and hypernatremia in exclusively breast-fed infants.
OBJECTIVES: To verify in exclusively breast-fed, term infants the incidence of hypernatremic dehydration and identify possible maternal and/or infant factors that interfere with successful breast-feeding. STUDY DESIGN: We prospectively included all healthy breast-fed neonates referred to our Neonatology Unit between October 1999 and March 2000. All neonates with a weight loss > or = 10% of birth weight had a breast-feeding test and a determination of serum sodium, urea, and base excess. Student t test and chi-square test were used for statistical analysis of the data. RESULTS: Of 686 neonates, 53 (7.7%) had a weight loss > or = 10% of the birth weight, and 19 also had hypernatremia. These 53 neonates had a significantly higher incidence of caesarean delivery and lower maternal education than neonates with a weight loss < 10%. CONCLUSION: Our prospective study demonstrates that a weight loss > or = 10% during the first days of life is frequent. Daily weight evaluation, careful breast-feeding assessment, and early routine postpartum follow-up are effective methods to prevent hypernatremic dehydration and promote breast-feeding.
Body Weight↗
Incidence of meconium aspiration syndrome in term meconium-stained babies managed at birth with selective tracheal intubation.
The delivery room management of infants born through meconium stained amniotic fluid (MSAF) remains controversial. The aim of this prospective study was to evaluate maternal and neonatal characteristics of MSAF infants and the incidence of meconium aspiration syndrome (MAS) in routine delivery room management which reserved selective intubation for depressed/asphyxiated babies. Between October 1993 and September 1997, a consecutive sample of 3745 full-term infants was analyzed. Of these, 361 were MSAF infants. No significant difference in maternal age, parity, gestational age, sex, low 1 and 5 minute Apgar scores, metabolic acidemia, or need for endotracheal intubation was found between MSAF and non-MSAF infants. Only one of the MSAF infants (0.28%), who needed intubation, developed MAS. Identification of postterm pregnancy and prenatal asphyxia is the best prevention of MAS.
Adult↗
[Diabetes and pregnancy. Maternal risk factors and neonatal morbidity].
BACKGROUND: To verify in our population the incidence of infants of mother with insulin dependent diabetes mellitus (IDDM) or gestational diabetes (GD) and to evaluate the maternal characteristics influencing neonatal outcome. METHODS: The study was retrospectively performed on 6179 infants born between 1995 and 1998 at the Obstetric Clinic of the University of Messina and referred the Division of Neonatology. The following groups have been selected: group A (offsprings of IDDM mothers), group B (offsprings of DG mothers), group C and group D, controls, (2 infants of the same sex and gestational age born before and after the infants of group A and group B, respectively). The parameters analyzed were: diabetic familiarity, age, weight and body mass index (BMI) of the mothers, delivery, gestational age, weight at birth, neonatal outcome. RESULTS: The infants of IDDM mothers were 3% and the infants of GD mothers were 0.8%. Group A and group B present a significantly higher incidence of: diabetic familiarity, cesarean section, macrosomia, hypoglycemia, hypocalcemia, hyperbilirubinemia. The GD mothers had weight and BMI higher than IDDM mothers. The infant weight did not correlate with maternal weight and BMI. CONCLUSIONS: These data suggest that in our population GD is underestimated, metabolic control in pregnancy is insufficient, obstetric practices are too invasive, neonatal outcome is verosimely correlated only to metabolic control.
Adult↗
[Brachial plexus paralysis: its incidence, predisposing factors and outcome].
METHODS: We have studies, retrospectively, the risk factors, incidence and outcome of obstetric palsy in all infants delivered between January 1990 and December 1994 at the Obstetric and Gynecological Department and afferent to the Neonatological Division of the University of Messina. Twenty-eight of the 5556 live born full term infants (5/1000) were at birth diagnosed as having a brachial plexus paresis. Of these eight (1.6/1000) had persistent palsy. RESULTS: In about 40-50% of the infants with brachial plexus palsy the obstetric history was characterized by high birthweight, shoulder dystocia, and parity 1. The infants who recovered totally did so during the first 12 months of life. All infants had upper brachial plexus, or Erb's palsy, which is more favorable than entire brachial plexus palsy. At follow-up (15 months-5 years), all infants with persistent palsy were afflicted by varying degrees of arm function compromise. CONCLUSIONS: We stress that, in several cases, obstetric brachial plexus palsy results in life-long handicap, and that prevention, early diagnosis and therapy need to be the goals of the obstetrical and pediatric management.
Brachial Plexus↗
[Infants born to hypertensive mothers: a clinical-epidemiological study].
The aim of this prospective study was to evaluate the frequency of the hypertensive disorders of pregnancy and their effects on the newborn infants. The study was performed between January 1992 and December 1994 on the 4793 infants born at the Obstetric Divisions of the University of Messina. These 123 infants were born of hypertensive women and 4670 were control infants. Between the two groups of infants there were significant differences with regard to the incidence of nulliparity, prematurity, low Apgar scores at birth and low birth weight. The blood pressure and the haematic parameters were not different between the two groups of infants. Five of the infants born to hypertensive women were referred to the Division of Neonatal Pathology. The low frequency of infants born to hypertensive women observed by us suggests that in our population the hypertensive disorders of pregnancy are understimated. Moreover, the high incidence of preterm and LBW infants confirms that in infants born to hypertensive women the neonatal risks are consequent to fetal growth retardation.
Apgar Score↗
The validity of the Apgar scores in the assessment of asphyxia at birth.
A prospective study was performed in 613 consecutively live born infants to investigate the validity of 1- and 5-min Apgar scores as an index for asphyxial assessment at birth. The independent and combined relationship between Apgar scores, metabolic acidemia, pulse oximeter (SaPO2) measurements and neonatal outcome were determined. In the term infants 1-min Apgar score was more influenced by the mode of delivery and by gestational age than by asphyxia. Instead, 5-min Apgar score had a high concordance with metabolic acidemia. Infants with low Apgar scores, metabolic acidemia and arterial desaturation have the highest incidence of neonatal intensive care unit admission and poor neonatal outcome. The study suggests that the 5-min Apgar score is useful for immediate clinical assessment and care of the neonate.
Acidosis↗
Effects of the mode of delivery on ANP and renin-aldosterone system in the fetus and the neonate.
Plasma ANP and aldosterone levels, plasma renin activity (PRA), haematocrit, systolic and diastolic blood pressure (BP), were evaluated in 15 full-term infants delivered by elective Caesarean section (CS group) and in 15 full-term infants delivered vaginally (vaginal group). The mode of delivery did not influence the cord blood levels of ANP and their increase at the 24th hour of life. Instead, PRA was lower and plasma aldosterone levels were higher in the CS group than in the vaginal group. Also haematocrit and BP were influenced by mode of delivery. The haematocrit values were lower in the CS group than in the vaginal group at birth as well at the 24th hour of life. The values of systolic and diastolic BP were the same in both groups, at birth, but at the 24th hour of life increases were observed only in the vaginal group. On the fourth day of life weight loss was the same in both groups. Our findings suggest that the mode of delivery has more influence on neonatal BP adaptation than on neonatal volume homeostasis.
Aldosterone↗
The effect of feeding on plasma immunoreactive ACTH and beta-endorphin levels in newborn infant.
In order to clarify whether an interaction between endogenous opioids and feeding occurs at birth, we studied Beta-endorphin (beta-EP) and ACTH plasma levels in response to a feed of 10% glucose, or formula, in 120 healthy full-term infants. Neither postprandial beta-EP nor ACTH increases were found at the 24th hour or on the fourth day of life. beta-EP physiology in newborn infants seems to be different from adults.
Adrenocorticotropic Hormone↗
Atrial natriuretic peptide and renin-aldosterone relationship in healthy newborn infants.
Plasma atrial natriuretic peptide (ANP) and aldosterone concentrations, and plasma renin activity (PRA) were measured by radioimmunoassay concurrently in 20 healthy full term infants, in cord blood, at 24 hours after birth and on the 4th day of life. ANP and aldosterone increased significantly at 24 hours and was persistently elevated on the 4th day of life. PRA remained unchanged during the first four days of life. In cord blood, ANP concentrations were correlated with aldosterone concentrations (r = 0.49, p less than 0.05) and hematocrit (r = 0.58, p less than 0.02). At the 24 hours of life, plasma ANP concentrations were correlated with weight loss observed on the 4th day of life (r = -0.70, p less than 0.005), while the percentage changes in plasma aldosterone concentrations were correlated with percentage changes in systolic blood pressure (BP) (r = 0.49, p less than 0.05). These findings suggest that during the early newborn period ANP and aldosterone act as an integrated system which has a role in regulation blood pressure and intravascular volume homeostasis.
Age Factors↗
[Analysis of factors associated with very low birth weight (less than or equal to 1500 g)].
In 7675 deliveries performed at the University of Messina between November 1, 1983 and October 31, 1988 we determined the incidence and obstetric factors specifically associated with the birth of very low weight infants (less than or equal to 1500 gm) (VLBW). Our purpose was to characterize these factors in order to determine what may be done to limit delivery rate of VLBW. Information obtained concerning the mothers' included socioeconomic status, age, parity, previous obstetric history, any maternal conditions affecting the pregnancy, route of delivery (vaginal or operative). The incidence of infants under 1500 gm was 1.1 per cent of live births. The etiologic analysis showed that preterm labor is more frequent cause of VLBW. In women under 17 years of age the incidence of VLBW was 5.2 per cent as opposed to 1.1 per cent in the total population. Absence of prenatal care was shown in 40.8 per cent of VLBW. The previous obstetric history reported 1 or more abortions in the 53 per cent and 1 or more perinatal deaths in 17 per cent of VLBW. The clinical implications of these results are discussed.
Humans↗
[Immunoprophylaxis in the prevention of perinatal transmission of hepatitis virus B. Analysis of limiting factors].
The significance of obstetric anamnesis in neonatal risk identification and efficiency of a vaccinal schedule were investigated in order to verify the condition which limited the efficiency of immunoprophylaxis in the prevention of perinatal hepatitis B virus transmission. The data suggested that the lack of obstetric screening is the highest limitative factors in the realization of hepatitis B neonatal prevention. The immunoprophylaxis is surely a substantial method in the prevention of hepatitis B virus perinatal transmission, but the vaccinal schedule and follow-up should be improved.
Female↗
Longitudinal study of blood pressure during the 1st year of life.
Systolic and diastolic blood pressure (BP), heart rate and weight were measured in 260 boys and 254 girls, from birth to 12 months of age. Mean +/- SD values of parameters studied and percentile curves are reported. Systolic and diastolic BP increase significantly during the first 6 months of life and are poorly correlated with weight. In the 1st month of life the diastolic BP values are lower than those reported by others.
Blood Pressure↗
[Development of percentile curves of arterial pressure of a school population of children aged 6-11 years].
This study describes the blood pressure (BP), heart rate and weight distribution of 1214 school-age children (6-11 years old) in Messina. The systolic BP is significantly correlated with weight in every age and in both sexes. The incidence of BP values equal or above the 95 degrees percentile are significantly higher in obese children. The distribution of BP in our population is the same as that reported by other Italian reports, but different from Task Force report. These data suggest the use of Italian blood pressure centiles in the valuation of our childhood population.
Blood Pressure↗
Correlation between plasma levels of ACTH and beta-endorphin in the first seven days of postnatal life.
Plasma adrenocorticotropic hormone (ACTH) and beta-endorphin (beta-EP) concentrations were measured by radioimmunoassay in 122 newborns, born vaginally after spontaneous labor between the 38th and the 41st week of pregnancy. Blood samples were taken from umbilical cord in 10 newborns and from antecubital vein in the remaining 112 newborns, divided into 8 groups aged from 12 h to 7 days. The mean (+/- SE) ACTH concentrations in cord plasma were 81.87 +/- 10.16 pg/ml and decreased significantly (p less than 0.01) at the 24th h of life (49.09 +/- 6.93 pg/ml). Afterwards mean ACTH plasma concentrations fluctuated around the latter values. The mean (+/- SE) B-EP concentrations in cord plasma were 21.96 +/- 3.12 pmol/l and decreased significantly at the 24th h of life (13.43 +/- 2.08 pmol/l; p less than 0.01). From the 24th h to the 7th day the mean plasma concentrations of beta-EP were not significantly different. ACTH and beta-EP plasma levels were positively correlated (p less than 0.001) at delivery and during the first seven days of life.
Adrenocorticotropic Hormone↗
[Pelvic echography in the differential diagnosis of isolated precocious thelarche and true precocious puberty].
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Age Factors↗
Changes in LH and FSH serum pattern following L-T4 withdrawal in L-T4 substituted hypothyroids.
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Adolescent↗