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Biomedical subjects

F Botet Mussons

Publications and source records attributed to F Botet Mussons.

11 recordsLinked to original sources
PubMed2002

[Neonatal morbidity and mortality in very low birth weight infants according to exposure to chorioamnionitis].

OBJECTIVES: To study differences in the incidence of neonatal morbidity and mortality among newborns weighing less than 1,500 g according to exposure to chorioamnionitis (CA). PATIENTS AND METHODS: A case-control study of 135 newborns weighing less than 1,500 g at birth and born between 1988 and 1998 was performed. The case group was composed of 45 newborns exposed to clinical or subclinical levels of maternal CA. Each newborn in the case group was matched with two controls, both weighing less than 1,500 g, one of them born immediately before and the other one immediately after. Perinatal records, neonatal morbidity and mortality were analyzed. RESULTS: The mean gestational age was 28.5 weeks (range: 24-38 weeks) with a mean weight of 1,131 g (range: 520-1,500 g). The time of membrane rupture was significantly greater in the case group (176 h vs 57 h; p < 0.001). Forty percent of the cases presented sepsis in the first 72 h of life compared with 10 % of the controls (p < 0.0001). No significant differences in morbidity or mortality were found between the groups, although chronic lung disease (20 % vs 13 %) and intraventricular hemorrhage (24 % vs 17 %) were more frequent in infants exposed to CA. Resuscitation (77.8 % vs 45.6 %; p 0.001) and mechanical ventilation (73 % vs 50 %; p 0.016) were required by a great number of cases than controls. CONCLUSIONS: The presence of CA was associated with a higher risk of early onset infection and the need for neonatal resuscitation and mechanical ventilation. No significant differences were found in morbidity or mortality.

Case-Control Studies↗
PubMed1999

[Hyperbilirubinemia in full-term newborns. Predictive factors].

OBJECTIVE: Nowadays economical criteria lead to early maternal hospital discharge, even before 48 hours after labor, producing an increase in neonatal readmissions for hyperbilirubinemia. We tried to predict the healthy term newborns that may develop a significant hyperbilirubinemia (> or = 17 mg/dl in the first 4 days of life). METHODS: Bilirubin in umbilical cord blood, transcutaneous measurements of bilirubin at 24, 48 and between 60 and 96 hours of life and bilirubin in blood obtained from heel-sticks at 96 hours was analyzed in 610 newborns. Moreover, serum bilirubin was determined at the same time-points in 169 newborns submitted to blood extractions for different reasons. The transcutaneous bilirubinometer used was a Minolta/Air-Shields JM-102. RESULTS: A significant hyperbilirubinemia was present in 2.95% of the newborns. The correlation between serum and transcutaneous bilirubin was high (r = 0.92; p < 0.0001). Umbilical cord blood bilirubin with a cut-off point of 2.2 mg/dl was not an useful predictor of neonatal jaundice. At 24 and 48 hours of life serum bilirubin levels > or = 6 mg/dl and > or = 9 mg/dl, respectively, predicted a subsequent hyperbilirubinemia with a sensitivity of 100% at both time-points, specificity of 47.5% and 64.3%, positive predictive value of 7.3% and 16.4%, respectively, and a negative predictive value of 100% for both. Transcutaneous measurement at 48 hours with a cut-off point of 13 (equivalent to a bilirubinemia of 9 mg/dl) predicts hyperbilirubinemia with a sensitivity of 94.4%, specificity of 51.7%, positive predictive value of 6.0% and negative predictive value of 99.6%. CONCLUSIONS: If the newborn presents a bilirubinemia > or = 6 mg/dl at 24 hours and > or = 9 mg/dl or a transcutaneous measurement > or = 13 at 48 hours a new bilirubin measurement must be performed between 48 and 72 hours of life.

Bilirubin↗
PubMed1998

[The effects of acute fetal distress on neonatal behavior measured by the Brazelton scale].

OBJECTIVE: The purpose of this study was to evaluate the effects of fetal distress associated with metabolic acidosis (pH < 7.15 and BE < -8 in blood samples from umbilical artery) in neonatal behavior. PATIENTS AND METHODS: Infants were evaluated with the Brazelton Neonatal Behavioral Assessment Scale (NBAS) on the third day of life (60-84 hours) in the Clinic Hospital of Barcelona, Spain. Fifteen anoxic neonates (experimental group) were compared to a sample of eight-seven newborns (control group) with the same characteristics, but with normal pH and BE levels (pH > 7.25 and BE > -5). RESULTS: Statistically significant differences were found between the two groups. The control group performed much better than the experimental group in almost all of the NBAS clusters: habituation, orientation, autonomic, regulation of states and motor functioning. There were no differences between the groups in the cluster range of states. The anoxic newborns of this study showed more irritation, stress, hypersensibility and difficulties to modulate states than the neonates without this problem. CONCLUSIONS: The NBAS is a useful evaluation technique as a complement to the physical examination because it gives a detailed description of the newborn behavior and competence. Habituation (p = 0.002), orientation (p = 0.000) and autonomic (p = 0.000) are the clusters who discriminate best between the groups.

Acute Disease↗
PubMed1997

[Alcoholic embryofetopathy. Neonatal case reports for the past twelve years].

OBJECTIVE: Alcohol embryopathy represents an important pediatric and obstetric problem, not only for the high risk of adverse effects on the neurodevelopment of the fetus and child, but for the imperative need for detecting and preventing alcohol consumption during pregnancy. In this study the clinical manifestations of newborns with maternal antecedents of alcohol consumption are reviewed. PATIENTS AND METHODS: Our experience from 1985 to 1996 with all newborns diagnosed as "children of an alcoholic mother, without associated clinical findings or partial forms (fetal alcohol effect) or as "alcohol embryofetopathy (complete forms) is reviewed. In this study we have reviewed the obstetric and neonatal records of 33 newborns born to 33 alcohol abusers, collecting both maternal (serological tests, alcohol and other substances consumed during pregnancy) and neonatal (gestational age, birth weight, birth length, head circumference, pathology, physical anomalies, cardiovascular defects and acute withdrawal symptoms) data. RESULTS: Our findings are similar to those described in other reports as regards to the incidence (1.9/1,000 newborns) and clinical manifestations, with the exception only in the low proportion of microcephalia. In our experience, alcohol consumption in pregnancy is associated with a high risk of low birth weight (39%) and intrauterine growth retardation (21%), malformations (42%, 9% cardiopathies), prematurity (54%) and maternal drug addiction (24%, with HIV serology positive in 18%). Acute withdrawal symptoms were detected in 24% of these newborns.

Alcoholism↗
PubMed1993

[Neurologic evolution of premature infants following assisted ventilation, with and without bronchopulmonary dysplasia].

The aim of this work was to evaluate the influence of bronchopulmonary dysplasia on the neurological outcome of the preterm infant requiring assisted ventilation. Thirty-nine preterm infants requiring ventilation support during 72 hours or more were classified into two groups according to the presence or absence of bronchopulmonary dysplasia (BPD). In the BPD group (n = 11), only the incidence of mild cognitive deficits was significantly higher (36.4 % vs 0 %). Our results suggest that the neurological outcome of the infants with BPD is more closely associated with other neonatal events (intraventricular hemorrhage, periventricular leukomalacia, neonatal seizures, longer ventilation support, maximum serum bilirubin levels, low Apgar score at 10 minutes and poor intake of amino acids) than with the presence of BPD. The data of this study suggest that indomethacin reduces the risk of neurological deficits.

Bronchopulmonary Dysplasia↗
PubMed1990

[Pattern of survival and sequelae in very low birth weight infants].

The survival and sequelae of the very low birth weight (VLBW) newborns are reported. Two time-periods have been compared (1980-84 vs 1985-88) as well as two weight groups. (Lower than 1,000 vs 1,000-1,499). A total number of 205 VLBW were admitted, and 74 died. Only 72 were used to study morbidity and sequelae with a minimum follow-up of 12 months after correcting age. Those with a weight lower than 1,000 g have a greater motor impairment, (45.5 vs 16.4%), cognitive deficiency (55.5 vs 14.8%), myopia (27.3 vs 3.3%), neurosensorial deafness (27.3 vs 0%), and overall sequelae. During the period 1985-88, survival was 77.9% of the VLBW have any sequelae (12.5% major sequelae and 15.3% minor sequelae). A 36.4% of the newborns with a weight under 1,000 g have major sequelae comparing with the 8.2% in the others. Growth delay is closely related to neurologic sequelae.

Birth Weight↗
PubMed1990

[Prognostic factors of neurosensory sequelae in extremely premature infants].

Modern neonatal intensive care has led to a rise in the survival rate of very low birthweight infants (VLBW), but at the same time is a greater number of neurosensorial sequelae. In this study, 50 VLBW (weight less than 1,500 g) babies followed up for at least 12 months are analysed. 18% showed major sequelae (40% of those weighing less than 1,000 g, 12.5% of those weighing 1,000 g or more). The prognostic factors which were most important in the prediction of sequelae were: low birthweight, major irregularities in the EEG, the presence of sepsis, and prolonged ventilotherapy or antibiotherapy.

Brain Diseases↗
PubMed1989

[Prognosis factors in hypoxico-ischemic encephalopathy in full term infants].

This study analyzes 61 full-term neonates affected by hypoxic-ischemic encephalopathy, who were followed for a minimum of 15 months to determine the factors related to the later appearance of neurological sequels. No severe sequels have been detected, while 8.2% showed moderate sequels and 4.9% slight sequels. The degree of cerebral suffering and the intensity of convulsions influence both the appearance of sequels and their severity, contrary to the scores of the Apgar tests after one minute or 5 minutes and the birth weight. By applying the formula (Sequel Rate = 0.2143* Cerebral suffering + 0.3228* Convulsions - 0.2276* EEG RN - 0.0851), if the "sequel rate" is equal to or lower than 0.55, the probability of later sequels is null, whereas a value in excess of this figure indicates a 57.1% probability of their arising.

Brain Diseases↗
PubMed1988

[Etiopathogenic factors in neonatal necrotizing enterocolitis].

Necrotizing enterocolitis is the most common digestive emergency in neonatal units. Several factors are involved in their pathogenesis: intestinal ischemia, bacterial colonization and feeding. To analyse these factors, 25 cases of NEC are compared to a control group of 48 newborns. Results showed an incidence of NEC about 1.6 0/00 live newborns, without a greater mortality in respect to other pathologic newborns. Ischemic factors influence significatively in appearance of ECN (p less than 0.001). None of them received maternal feeding. By this reason it seems to be a protective factor against bottle feeding (p less than 0.05). Enteral feeding its main influence upon mature newborns. No common bacterial findings have been found, but 68% of children developed clinical findings compatible with sepsis. Severity of abdominal sings in clinical examination in the acute phase of NEC is positively correlated with the presence of complications. Individual considerations are needed in sight to the different severity and prognosis of NEC.

Breast Feeding↗