Twenty very premature babies, born at 24-29 weeks gestation, have been studied while they were maintained in intensive care with continuous intravenous feeding and constant ambient lighting and temperature. Hourly records of insulated skin temperature and heart rate were made for a continuous period of 6-17 weeks, always starting the recording within 24 h of birth. The development of rhythms within the ultradian, circadian and infradian domains was sought by methods including maximum entropy spectral analysis and autocorrelation. Circadian and ultradian rhythms were present, but not regularly so; rather they appeared and disappeared erratically in successive weeks. As a consequence, the group as a whole did not show an increasing rhythmicity with chronological age. In some cases, babies were later placed in a ward in which the lighting was dimmed at night, and feeding by mouth at regular intervals was instituted. There was some evidence for increases in circadian and ultradian rhythmicity after these changes. These results enable inferences to be drawn as to the origin of fetal rhythms in the third trimester of pregnancy, as well as speculation to be made on the ontogeny of ultradian and circadian rhythms in the neonate.

Age Factors↗

PubMed1991

Vitamin E supplementation and periventricular hemorrhage in the newborn.

In a randomized controlled trial preterm babies received 20 mg vitamin E/kg im soon after birth (day 0) and at 24 and 48 h. The mean +/- SD plasma vitamin E level on day 0 was identical in supplemented and control groups (9.98 +/- 4.88 mumol/L) and rose progressively only in supplemented babies reaching a peak of 69.2 +/- 21.36 mumol/L at 72 h. Supplemented babies had a lower incidence of intraventricular hemorrhage (IVH) diagnosed by ultrasound (9/102, 8.8%) than the control group (37/108, 34.3%; 95% CI for difference in incidence, 15-36%). In a subsequent uncontrolled study using the same vitamin E preparation, a single dose of 20 mg/kg was given soon after birth to preterm babies. The peak mean +/- SD plasma level was 32.97 +/- 13.47 mumol/L at 48 h. The incidence of IVH (16/121, 13.2%) was lower than in historical control from the randomized trial (95% CI for difference; 10.2-31.8%) in spite of the single-dose group having more clinical risk factors for IVH. We conclude that vitamin E protects against IVH in preterm babies.

Birth Weight↗

PubMed1989

Prophylaxis of periventricular hemorrhage in preterm babies by vitamin E supplementation.

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Cerebral Hemorrhage↗

PubMed1987

Vitamin E supplementation reduces frequency of periventricular haemorrhage in very preterm babies.

231 babies, born at less than or equal to 32 weeks' gestation were enrolled in a randomised, controlled trial to assess the efficacy of vitamin E (dl-alpha-tocopherol acetate) in the prevention of periventricular haemorrhage. Daily supplementation with 20 mg/kg vitamin E intramuscularly during the first 3 days of life was associated with a rise in plasma vitamin E concentration and a reduction in hydrogen peroxide haemolysis of red blood cells in vitro. Among babies without haemorrhage on entry to the trial (n = 210), supplemented babies had a lower frequency of intraventricular haemorrhage than controls (8.8% v 34.3%; p less than 0.005) and a lower combined frequency of intraventricular and parenchymal haemorrhage (10.8% v 40.7%; p less than 0.0001) on the final ultrasound brain scan. This protective effect was observed in both inborn and referred babies but was stronger in the former. Supplementation had no effect on mortality, but among survivors fewer supplemented babies than controls had intraventricular or parenchymal haemorrhage (10.7% v 32.6%; p less than 0.001). Possibly, vitamin E scavenges free radicals generated during ischaemic injury of the subependymal region and thereby limits tissue damage and the extent of periventricular haemorrhage on reperfusion.

Cerebral Hemorrhage↗

PubMedDate not supplied

Value of cranial ultrasound in newborn baby.

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Brain↗