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PubMed1990

[Intracranial hemorrhage in mature infants without predisposing factors].

Four mature infants developed intracranial haemorrhage at ages from ten hours to five weeks. No predisposing or provoking factors could be demonstrated. The symptoms were apnoea, vomiting, pyrexia, irritability, tremor, hypertonicity, seizures and tense fontanelle. The diagnosis was established by ultrasound scanning and confirmed by computed tomographic scanning. The infants developed hydrocephalus requiring treatment. During the period of observation, these infants showed normal psychomotor development and the neurological findings were normal.

Cerebral Hemorrhage↗
PubMed1994

Corpus callosum development in preterm and term infants.

The development of the corpus callosum was documented by magnetic resonance imaging in low-risk preterm infants and results were compared with those of term infants. Thirty-three magnetic resonance imaging studies were performed on 21 preterm infants whose corrected ages were 1-13 months. Twenty-one magnetic resonance imaging studies were performed on 17 term infants. All infants exhibited normal development. The thickness of the corpus callosum was measured at a point one-third of the length of the entire corpus callosum from the most anterior aspect of the genu. The thickening of the corpus callosum was related to age in the preterm group. The development of the corpus callosum in preterm infants was suggested to be the same as that of term infants matched by conceptional age.

Birth Weight↗
PubMed1997

Gravity constraints in infant motor development.

The effect of gravity in determining if and when during infancy movements eventuate and the rate at which they develop is unknown. In accordance with intersegmental relationships (Hof, 1992), a muscle moment during infancy would have to develop more rapidly than the gravitational moment before movement could occur. In this investigation, the effect of growth through the influence of gravity on the joint moments in the axial region when infants were in a prone or supine posture was examined. A mathematical model that considers the body to be composed of transverse elliptical cylinders, 1 cm deep and of known density, was used in estimating the mass of the 16 segments of the body. The gravitational moments about 3 joints within the axial region (C7-T1, T12-L1, and the hip) were determined by summation, using the radii from the joint transverse axis to the center of mass of the segments. Infants (N = 27) aged between 9 and 36 weeks at the beginning of the study were tested monthly 6 times, and the effect of growth on the gravitational moments was represented by first-order polynomials. Age x Joint analysis of variance (ANOVA) of the mean slopes of the regressions for the gravitational moments revealed significant main effects for age and joint. The means increased monotonically with the number of segments and decreased as infants aged. The mean slopes of the neck and trunk joints were significantly smaller than that of the hip joint. With increasing age, the gravitational slope was significantly smaller. The changes in the gravitational moments during infancy are seen as likely control parameters effecting phase shifts in motor patterns during development.

Aging↗
PubMed2007

A prospective case series of high-risk infants who developed autism.

The present paper documents the development of autism/autistic spectrum disorder in a consecutive series of nine high-risk infants followed prospectively from 6 months of age. Evidence is provided for two broadly defined subgroups: the first subgroup (n = 6) showed a decrease in IQ between 12 and 24 or 36 months (from average/near average to severe cognitive impairment), whereas the second subgroup (n = 3) continued to obtain average or near average IQs. Signs of autism emerged and/or were more striking earlier in the first subgroup. In all nine children, early impairment in social-communicative development coexisted with atypical sensory and/or motor behaviors, as did a temperamental profile marked by irritability/distress and dysregulated state. Discussion focuses on issues raised by the pattern of findings.

Autistic Disorder↗
PubMed2004

Low levels of tissue inhibitors of metalloproteinases with a high matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio are present in tracheal aspirate fluids of infants who develop chronic lung disease.

OBJECTIVE: The pathogenesis of chronic lung disease (CLD) involves inflammation with proteolytic damage to lung extracellular matrix. Matrix metalloproteinases (MMPs) are zinc-dependent endopeptidases that, acting in concert with their tissue inhibitors, tightly orchestrate extracellular matrix morphogenesis and repair after injury. Imbalances in their levels relative to that of their inhibitors have been implicated in diseases characterized by matrix disruption and remodeling. We investigated the possibility that imbalances in MMP-9 and MMP-2 relative to their tissue inhibitor of metalloproteinase-1 (TIMP-1) and TIMP-2, respectively, in tracheal aspirates of preterm infants may be involved in the development of CLD. METHODS: Serial tracheal aspirates collected from birth until extubation in 49 ventilated preterm infants (24-32 weeks' gestations) were analyzed for MMP-2, MMP-9, TIMP-1, and TIMP-2. Data normalized by TA values of free secretory component of immunoglobulin A were compared for CLD (n = 22) versus no CLD (n = 27). Also, known clinical predictors of CLD (gestational age, birth weight, and sex) were assessed for both groups. Association of predictors with the outcome CLD was assessed by logistic regression. RESULTS: Mean gestational age was lower in CLD infants, but birth weight and gender were comparable for both groups. CLD infants had significantly lower TIMP-1 level with higher MMP-9/TIMP-1 ratio during the first 2 weeks of life and low TIMP-2 and MMP-2 levels during the first 3 days of life compared with no-CLD infants. Logistic regression analysis indicated that the findings are predictive of CLD. CONCLUSIONS: We conclude that low tracheal aspirate levels of TIMPs, with a high MMP-9/TIMP-1 ratio early in life, are associated with subsequent development of CLD.

Bronchopulmonary Dysplasia↗
PubMed1989

[The physical development of infants and young children. 6. Skinfold thickness--a longitudinal study].

As a further result of a longitudinal study (conducted from 1979-1982) the somatic development figures for the skinfold thickness of 84 male and 91 female children from birth up to three years are presented. The Lange caliper was used to perform the measurements according to the recommendations of the International Biological Programme (8 sites of measurement on the right side of the body). The results for the development of skinfold thickness are similar to those of the Dortmund Study (1974), but in part quite different compared with earlier longitudinal studies (1956): our own investigations show a greater skinfold thickness during the first three months of life and thereafter lower figures up to the age of 18 months. The results are recommended by the authors as reference figures for the G.D.R.

Child Development↗
PubMed1999

Necrotizing enterocolitis in infants born to women with severe early preeclampsia and absent end-diastolic umbilical artery doppler flow velocity waveforms.

The aim of this study was to determine the prevalence of necrotizing enterocolitis (NEC) in infants born to a homogeneous group of women with severe preeclampsia before 34 weeks' gestation and who had absent end-diastolic umbilical artery Doppler flow (AEDF) or normal umbilical Doppler flow velocities (NUFV). A total of 242 infants were entered into the study. The mean birth weight was 1260.5 g (SD = 339) and the mean gestational age 30.5 weeks (SD = 2.0). Sixty-eight (28%) infants had AEDF, 43 (18%) had umbilical artery Doppler flow velocities between the 95th and 99th percentile, and 131 (54%) had NUFV. Forty-one (18%) infants developed NEC, of whom 20 (8%) developed definite and advanced NEC (grade 2 and 3). Of these, 16(80%) had grade 2 and 4(20%) had grade 3. Twenty-one (8%) infants developed suspected NEC (grade 1). The mean onset of grade 1 NEC (7.2 days) occurred significantly earlier than in those with grades 2 and 3 NEC (18.7 and 23.3 days, respectively). Of the 21 infants with grade 1 NEC, 10 (48%) had AEDF and 9 (43%) had NUFV. None of the infants with grades 2 or 3 NEC had AEDF. We conclude that although chronically hypoxemic fetuses born to women with severe early onset preeclampsia and AEDF respond by redistributing blood flow to vital organs and away from the gut; the intestinal compromise is of insufficient magnitude to induce intestinal necrosis or NEC. Enteral feeding, however, should be introduced cautiously in infants with AEDF, as so-called suspected NEC developed significantly more often in these infants.

Blood Flow Velocity↗
PubMed2002

Soy-based formulae and infant growth and development: a review.

Soy-based infant formulae, initially developed for infants who were lactose intolerant or allergic to cow's milk-based formulae, now account for >25% of the infant formulae sold in the United States. Formulations have changed over the years to improve digestibility, the stability and availability of minerals, and protein quality. Recent concerns have been raised regarding the phytoestrogenic isoflavone content of soy-based formulae. A systematic review of the literature was conducted to evaluate various measures of infant health and development in clinical studies comparing modern soy-based formulae with other diets and to document areas in which further research seems warranted. Results suggest that modern soy-based formulae support normal growth and nutritional status in healthy term infants in y 1 of life. However, there are very limited data on sexual and reproductive development or outcomes such as immune function, visual acuity/cognitive development and thyroid function. Available data do not provide evidence of meaningful differences in timing of maturation, sexual development or fertility in adolescents or adults. Nonetheless, given evidence suggesting that early exposure to soy and/or isoflavones might have long-term effects, further research following infants fed soy-based formulae into adulthood is warranted.

Clinical Trials as Topic↗
PubMed1980

The growth and development of infants weighing 1,000 to 2,000 grams at birth and delivered in a perinatal unit.

The neonatal outcome and follow-up over the first two years of life in a group of 124 infants with birth weights between 1,000 and 2,000 grams were studied. The overall neonatal mortality rate (first month of life) was 9% with a further five infants dying in the first year. Seventy-three infants have been seen for at least 1 year and three infants show evidence of neurological damage. Catch-up growth is slower in the 1,000 to 1,500 gram infant than in the 1,501 to 2,000 gram infant, the latter achieving normal head size at 2 years. However, mean Bayley Mental Development Scores are normal in both the 1,000 to 1,500 gram and 1,501 to 2,000 gram groups at both 1 and 2 years from expected date of confinement.

Female↗
PubMed1979

[Disturbances of mental development in infants and preschool children. Their recognition and treatment (author's transl)].

After a short introduction setting out the importance of development dimensions for the understanding of disturbances of development and some statistics on the frequency of peculiarities of behavior in the preschool age, some disorders of mental development of practical importance in the first years of life are dealt with. Psychomotor disturbances, disorders of speech and speaking and emotional and contact disturbances are emphasized.

Anxiety↗
PubMed2006

Sharing features of uncommon respiratory syncytial virus complications in infants.

We describe 4 nonconsecutive cases of infants admitted to Catholic University pediatric intensive care unit (PICU) because of complicated respiratory syncytial virus (RSV) infection during winter RSV outbreaks from the year 2000 to the year 2003. A hyponatremic epileptic status (as in the first case) has been reported by several authors as a rare RSV complication, potentially leading to death. The second infant developed a serious pulmonary edema after a subglottic obstruction (croup) associated with RSV infection. The remaining 2 infants developed a pneumothorax and subcutaneous emphysema while breathing spontaneously during an RSV bronchiolitis. In all infants, a full recovery and PICU discharge was achieved despite the need for mechanical ventilation in cases 1 and 2. Increased intrapleural negative pressure or its combination with hypoxia/hypercapnia has been suggested as the common factor possibly joining these different clinical pictures.

Female↗
PubMed1989

Increased compliance in response to salbutamol in premature infants with developing bronchopulmonary dysplasia.

We compared the effect of salbutamol and placebo in a double-blind study of preterm infants with bronchopulmonary dysplasia, using a randomized, crossover design with several replicates per subject. Sixty-two tests were performed on 20 ventilator-dependent infants weighing less than 1500 gm. Patients were entered as early as the first week of life and studied for at least 4 weeks or until extubation. Each subject was his own control subject and was randomly assigned to a placebo-salbutamol or salbutamol-placebo sequence administered on 2 consecutive days of each week. Static compliance, expiratory resistance of the respiratory system, and changes in transcutaneous oxygen and carbon dioxide tension were measured. Static compliance improved by 0.240 ml/cm H2O/kg (35.3%) after salbutamol and by 0.010 ml/cm H2O/kg (2.8%) after placebo (p less than 0.0001). The presence of a predetermined decrease in carbon dioxide tension correlated with large changes in static compliance per kilogram and with the need for a high level of fractional inspired oxygen. The magnitude of the clinical and physiologic improvement observed, and the early response suggest that long-term bronchodilator therapy starting as early as the second week of life may be beneficial for very low birth weight infants with early bronchopulmonary dysplasia.

Albuterol↗
PubMed2001

One-year outcome of auditory-tactile-visual-vestibular intervention in the neonatal intensive care unit: effects of severe prematurity and central nervous system injury.

Thirty-seven infants with severe central nervous system injury or extreme prematurity were randomly assigned to a multisensory (auditory-tactile-visual-vestibular) intervention or control group. Intervention began in the hospital at 33 weeks' postconceptional age and continued twice daily in the home until 2 months' corrected age. Mother-infant interactions during feedings were videotaped, and the Bayley Scales of Infant Development were administered. Control mothers stimulated their infants more during feeding, but these significant differences dissipated by 4 months. The presence of periventricular leukomalacia was associated with significantly poorer mental development, regardless of group assignment. Experimental infants tended to exhibit better motor and mental performance and had 23% fewer cerebral palsy diagnoses at 1 year, but these trends were not statistically significant. The type of brain injury was more important in determining 1-year developmental outcome than type of postnatal experience, suggesting that periventricular leukomalacia presents a major challenge for infant development.

Birth Injuries↗
PubMed1994

Interdisciplinary treatment of necrotizing enterocolitis and spontaneous intestinal perforations in preterm infants.

From January 1986 to December 1992, 13 patients with necrotizing enterocolitis (NEC) (Grade II-III; Bell) were treated. The incidence was highest in the very immature infants with birth weight < 1000 g: 6/148 (4%). From onset, NEC was associated with clinical symptoms such as abdominal distension, bloody stools, retained gastric contents and septicemia. Indications of inflammation were seen in only 6 out of 13 patients at the time of diagnosis. No complications were seen in 10 patients during the acute phase. Two infants developed a bowel perforation and another one a gangrene. Immediate surgery was performed. In three other infants, elective surgery was performed because of colonic strictures. Twelve (92%) patients survived NEC. Five other VLBW infants developed spontaneous perforations of the bowel. The clinical presentation, laboratory and radiological findings differed greatly from those with NEC. Four infants survived. A primarily conservative therapeutic regime with close cooperation between the surgeon and pediatrician may be an alternative to early surgical intervention in NEC.

Enterocolitis, Pseudomembranous↗
PubMed1978

Psychomotor development of infants and children after profound hypothermia during surgery for congenital heart disease.

We assessed neurological status and cognitive, verbal, social and motor skills of 17 children who had undergone cardiac surgery under profound hypothermia, and of seven siblings (controls). None of the subjects had significant neurological impairment. The mean development quotient (DQ) for the patients was 92.5 (in the low-average range) and for the controls was 103 (average). The DQ of one patient (71) was below the normal range. Development of the patients was comparable with that reported by other authors for children with cyanotic congenital heart-disease who have not undergone cardiac surgery. It correlated with the type of congenital heart-disease but not with the duration of hypoxic arrest. It is concluded that profound hypothermia can be used safely during the correction of cardiac defects in infants, without fear of retarding psychomotor development.

Cardiac Surgical Procedures↗