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PubMed1991

[A study mother-infant interaction and maternal identity in mother-infant dyads of premature and full-term infants].

The study was conducted to examine Mother-Infant interaction and Maternal identity in two groups, that is, premature infant and its mother and full-term infant and its mother. For this purpose, the data were collected from 24 sample groups (12 for premature dyads and the remaining 12 for full-term dyads) by using observation method and questionnaires during July 20 through September 30, 1987. The results are summarized as follows: 1. In terms of Mother-Infant Interaction, full-term dyads considerably stood out compared to that of premature dyads (u = 21, p less than 0.01). 2. In terms of Maternal Identity, though full-term dyads showed somewhat high results, there was not a significant difference between two groups. 3. There was not a significant correlation between Mother-Infant Interaction and Maternal Identity.

Female↗
PubMed1984

Cardiac rhythm, rate and ventricular repolarization properties in infants at risk for sudden infant death syndrome: comparison with age- and sex-matched control infants.

Using 24-hour ambulatory electrocardiographic recordings and 120-lead body surface potential maps, prevailing cardiac rate and rhythm, incidence and frequency of dysrhythm and rate and pattern of ventricular repolarization at the body surface were compared in 17 infants at risk for sudden infant death syndrome (SIDS) and 17 age- and sex-matched control subjects. Sinus rhythm was the prevailing rhythm in both study groups and there were no intergroup differences in average overall awake or asleep sinus rates, nor in temporal variability of sinus rate. Atrial and ventricular ectopic activity were equally uncommon in both study groups. Although there were smooth and bipolar body surface distributions of ST-T and QRST time integrals in both study groups, the average rate of ventricular repolarization (QTc), measured from the 12-lead electrocardiogram, 120-lead body surface potential maps and 24-hour electrocardiography, was consistently shorter in the at-risk group than in the control group. However, temporal variability of QTc was not different between the 2 groups. Thus, significant cardiac dysrhythm and QT prolongation are not found in infants at increased risk for SIDS. Rather, there is an abbreviated ventricular repolarization interval in at-risk infants. In combination with the findings of intergroup similarity of average sinus rate and temporal variability of sinus rate and ventricular repolarization rate, the data suggest a subtle, constant difference in cardiac autonomic activity, most likely an increase in sympathetic tone, in at-risk subjects. The role of this altered cardiac autonomic activity in the causation of SIDS remains undetermined.

Electrocardiography↗
PubMed2002

Temperament ratings do not predict arousability in normal infants and infants at increased risk of sudden infant death syndrome.

This study sought to determine whether temperament was an indicator of arousability from sleep in infants. We hypothesized that the "threshold" dimension would be the most predictive characteristic because it measures the stimulus intensity required to evoke a discernible response. Healthy term, healthy preterm, and preterm infants with a neonatal history of apnea underwent polysomnography at 2 to 3 months. Arousal was induced using air-jet stimulation of the nostrils in active (AS) and quiet sleep (QS). Temperament was assessed using the Early Infancy Temperament Questionnaire. Arousal thresholds were elevated in QS compared with AS in each group ( <.001), and preterm infants with a neonatal history of apnea were less arousable than healthy preterm infants ( <.05). Temperament was not a predictor of arousability in AS. "Adaptability" was the only significant predictor of arousability in QS. This study demonstrates that temperament characteristics as measured by questionnaire may not be reliable indicators of arousability from sleep.

Arousal↗
PubMed2003

Longitudinal performance of infants with cerebral palsy on the Test of Infant Motor Performance and on the Alberta Infant Motor Scale.

Understanding the natural history of development in children with cerebral palsy (CP) is important for studying the consequences of early intervention. The purpose of this paper is to present results on the Test of Infant Motor Performance (TIMP) from 0-4 months of age and on the Alberta Infant Motor Scale (AIMS) from 3 to 12 months of age in a group of infants later diagnosed as having CP. Ages at which infants with CP were first recognized as having delayed motor performance on each instrument and the stability of performance over time are presented. Clinical implications for using both instruments are discussed.

Age Distribution↗
PubMed1992

Evaluation of care for the preterm infant: review of literature on follow-up of preterm and low birthweight infants. Report from the collaborative Project on Preterm and Small for Gestational Age Infants (POPS) in The Netherlands.

Since the introduction of neonatal intensive care in the 1960s, mortality in very preterm and very low birthweight infants has been decreasing steadily. Consequently, interest in the outcome of surviving infants is growing. Restriction of health care resources has stressed the need for information concerning the effect of individual treatment components on mortality and morbidity. Concern about the quality in apparently normal survivors has been increasing as well. The current flood of papers on these subjects illustrates the interest in these issues. The first part of this paper reviews the methodology used in follow-up studies in the past decades. It aims at methodological problems that hamper comparison between studies and preclude unequivocal conclusions. New treatment techniques seldom were but should be evaluated by randomised trials. To monitor the combined effects of changing obstetric and neonatal techniques on perinatal outcome, studies in geographically defined populations are recommended using data from early pregnancy until at least preschool age. Comparability of outcomes could be enhanced by international agreement on standardisation of assessment methods and outcome measures. In the second part the results concerning gestational age- and birthweight-specific mortality, impairments and disabilities and the risk factors for such disorders are discussed. Increased survival of even the tiniest infants is clearly established. This increase in survival has not yet been accompanied by an apparent increase in major morbidity. However, many minor impairments are reported, occurring often in combination and predisposing these children to deviations of normal development. Important changes in the manifestation of brain damage appear to occur during development. These findings stress the importance of long-term follow-up studies.

Follow-Up Studies↗
PubMed1995

Comparison of [125I]iodomelatonin binding sites in infant cerebellum of sudden infant death syndrome and non-sudden infant death syndrome.

[125I]Iodomelatonin bindings sites in human infant cerebellum were studied by radioligand receptor binding assay and in vitro quantitative autoradiography. The binding sites characterized in membrane preparations revealed saturable, reversible and highly specific binding sites with a Kd value of 21.2 +/- 8.33 pM and a Bmax value of 2.02 +/- 0.52 fmol/mg protein. 10 microM of GTP gamma S significantly reduced the binding capacity, suggesting the possible G-protein coupling of the binding sites. Autoradiographic study showed that the labelling was mainly located in the cerebellar cortex. On comparison of the binding parameters from cerebellum of sudden infant death syndrome (SIDS) and non-SIDS infants, no significant change in binding capacity and binding affinity was detected. These findings suggest that the binding sites in cerebellum may not be related to the etiology of SIDS.

Analysis of Variance↗
PubMed1988

[Doppler sonographic measurement of normal values of flow velocities in the internal carotid artery of premature infants, newborn infants and infants].

In 121 healthy premature born infants, full-term newborns and older infants (gestational age: 29 to 45 weeks; weight at investigation: 1070 g to 3750 g), the flow velocities in the internal carotid arteries were measured by pulsed doppler sonography. All infants were investigated by computer sonography (Acuson 128) with a 5 MHz transducer. The following parameters were measured: The maximal systolic velocity, the end-systolic and end-diastolic velocity as well as the mean flow velocities, the pulsatility-index and the resistance-index. For all parameters the relationship to the gestational age and weight were analysed. All flow velocities increased linearly with increasing gestational age and weight. In contrast to the flow velocities neither the pulsatility-index nor the resistance-index changed with increasing gestational age and weight. As flow velocities in the internal carotid arteries increase with increasing gestational age and weight these parameters must be taken into consideration when pathologic flow velocities are analysed.

Birth Weight↗
PubMed1982

Developmental patterns of heart rate and heart rate variability during sleep and waking in normal infants and infants at risk for the sudden infant death syndrome.

The developmental sequence of heart rate and heart rate variability was examined during sleep and waking states in 22 normal infants, and 22 siblings of sudden infant death syndrome (SIDS) victims, using 12-h polygraphic recordings at 1 week and at 1, 2, 3, 4, and 6 months of age. Heart rate was higher in siblings of SIDS victims than in normal infants during quiet sleep over the first 6 months of life and was higher in the waking state at 3 months of age. The sibling group also had lower variability at 1 week during quiet sleep. Gender contributed no significant differences to heart rate, but females at risk for SIDS had lower waking cardiac variability than males.

Child Development↗
PubMed1984

The Pennsylvania Infant and Family Development Project, I: Stability and change in mother-infant and father-infant interaction in a family setting at one, three, and nine months.

In order to further understanding of the development of the father-infant relationship, patterns of mothering and fathering in 72 families were observed longitudinally (at 1, 3, and 9 months) and from the perspective of the family system. Analyses of variance revealed comparable developmental change in maternal and paternal behaviors, but striking differences between parents, with mothers engaging in far more interaction at all ages studied. Analyses of individual differences in maternal and paternal behavior revealed consistent stability over time, especially from 3 to 9 months, thereby highlighting points of similarity in mothering and fathering. Within-age correlational analyses revealed consistent positive associations between measures of father-infant and husband-wife interaction, yet little relationship between measures of mother-infant and spousal interaction. These findings and others are discussed in terms of similarities and differences in mothering and fathering.

Adult↗
PubMed1984

[Histologic thyroid gland findings in the newborn infant and infant, with special reference to sudden infant death].

The morphological picture of the thyroid gland, the only endocrine organ with a follicle structure, allows a limited conclusion to be drawn with respect to the functional state in spite of any physiological variability. The thyroid of the newborn shows total colloid release and collapse of the follicles. The regular structure of the thyroid will be rebuilt within several weeks after birth. Total colloid absorption can be found in cases of stress-activated thyroids as well as in cases of death due to freezing. A histological examination was done on 88 thyroids of fetuses, newborns and infants. About 70% of the results on 27 cases of sudden infant death syndrome (SIDS) may be interpreted as a morphological correlate of a premortal chronic or recurrent stress reaction. The value of these results is discussed.

Child, Preschool↗
PubMed1990

[A new amino acid solution for parenteral nutrition of premature infants, newborn infants and infants].

A new amino acid solution (Aminopäd 5% and Aminopäd 10%) was used for intravenous feeding of 240 preterm and term newborn infants in 4 hospitals. Indications, dosages and infusion sites were up to the policies of the 4 hospitals. Plasma amino acid concentrations were measured in 491 samples which were obtained during steady 24 h infusions of the daily doses. Results were analyzed in four subgroups formed according to the postmenstrual ages of the patients at the time of blood withdrawal and showed good agreement with the reference values. Acute cholestasis was observed in 22 infants which could be explained by bacterial infection alone in 18 patients.

Amino Acids↗
PubMed1981

[12-hour pattern of the waking state in the normal infant and in the infant who has survived the 'syndrome of sudden infant death' (author's transl)].

The authors report the results of 16 sleep EEGs carried out on 5 infants said to have survived the syndrome of sudden infant death (near-miss group) and 5 controls. The recordings were performed at 1.5 months, 3 months and 4.5 months, times when the risk of sudden death is maximum. The EEG appearance and the organization of sleep patterns have been studied in both groups. The various states of wakefulness, and the modalities of sleep and waking were subjected to statistical analysis with respect to age. The study showed no significant difference between the percentages of different states of wakefulness in the control and 'near-miss' group, but there were more sleep onsets in active sleep (REM) in this group compared with the controls and there were fewer waking periods, although when they occurred these were more prolonged.

Circadian Rhythm↗
PubMed1997

Influence on the selenium concentration and selenium intake of infants of infants of ingredients in Spanish homogenised infant beikosts.

Selenium (Se) concentration in 13 homogenised beikosts ("any additional food used in infant nutrition different from human milk and formulas") was investigated, as well as the influence of ingredients on Se concentration in three beikost types (meat, vegetables and fish). Levels of Se varied widely, ranging from 20 micrograms/kg d.w. for mixed vegetables to 258 micrograms/kg d.w. for hake with rice. These values increased as high-protein ingredients (meat or fish) were included. Fish-based beikosts showed the highest contribution of Se, covering more than 50% of the RDA in the USA for infants from 6 to 12 months old. The best Se sources were meat and fish, and their contributions to Se concentrations in the final products were 85.3% for chicken with rice and 75% for hake and vegetables.

Animals↗
PubMed2000

HIV-1 genotypic zidovudine drug resistance and the risk of maternal--infant transmission in the women and infants transmission study. The Women and Infants Transmission Study Group.

OBJECTIVES: Although the treatment of pregnant women and their infants with zidovudine (ZDV) has been remarkably effective in preventing the perinatal transmission of human HIV-1, many potentially preventable infections still occur. To examine whether the risk of perinatal infection is increased among women who carry ZDV-resistant HIV-1, the role of genotypic ZDV resistance in perinatal transmission was evaluated. METHODS: The reverse transcriptase (RT) region of clinical isolates from culture supernatants of 142 HIV-1-infected women enrolled in the Women and Infants Transmission Study (WITS), who had been treated with ZDV during pregnancy was sequenced. Results from genotypic sequencing were linked to demographic, laboratory, and obstetrical databases, and the magnitude of association of having consensus drug-resistant HIV-1 RT mutations with transmission was estimated. RESULTS: Twenty-five per cent (34/142) of maternal isolates had at least one ZDV-associated resistance mutation. A lower CD4 cell percentage and count (P= 0.0001) and higher plasma HIV-1 RNA (P=0.006) were associated with having any ZDV resistance mutation at delivery. Having any RT resistance mutation [odds ratio (OR): 5.16; 95% confidence interval (CI): 1.40, 18.97; P=0 0.01], duration of ruptured membranes [OR: 1.13 (1.02, 1.26) per 4 h duration; P= 0.02], and total lymphocyte count [OR: 1.06 (1.01, 1.10) per 50 cells higher level; P=0.009] were independently associated with transmission in multivariate analysis. CONCLUSION: Maternal ZDV resistant virus was predictive of transmission, independent of viral load, in these mothers with moderately advanced HIV-1 disease, many of whom had been treated with ZDV before pregnancy.

Anti-HIV Agents↗
PubMed2001

Early volume expansion for prevention of morbidity and mortality in very preterm infants.

BACKGROUND: Reduced perfusion of organs such as the brain, heart, kidneys and the gastrointestinal tract may lead to acute dysfunction and be associated with permanent injury. Various strategies have been used to provide cardiovascular support to preterm infants including inotropes, corticosteroids and volume expansion. OBJECTIVES: In very preterm infants, does early volume expansion reduce morbidity and mortality. If volume expansion is effective, what type of volume expansion is most effective. SEARCH STRATEGY: The standard search strategy of the Neonatal Review Group was used. Searches were conducted of the Oxford Database of Perinatal Trials, Cochrane Controlled Trials Register, MEDLINE, previous reviews including cross references, abstracts and conference proceedings. SELECTION CRITERIA: Randomised trials of early volume expansion with normal saline, fresh frozen plasma, albumin, plasma substitutes or blood compared to no treatment or another form of volume expansion in preterm infants < 32 weeks gestation or < 1500g were included. Volume expansion was defined as at least 10 mls/kg given in the first 72 hours of life. DATA COLLECTION AND ANALYSIS: Standard methods of the Neonatal Review Group with use of relative risk (RR), risk difference (RD) and weighted mean difference (WMD). The fixed effects model using RevMan 4.1 was used for meta-analysis. Data from individual studies were only eligible for inclusion if a least 80% of infants were reported for that outcome. MAIN RESULTS: Seven studies were included. Five studies, four with data for mortality, compared volume to no treatment. Most studies enrolled very preterm infants on the basis of gestation or birthweight. Two studies comparing different types of volume expansion enrolled very preterm infants with hypotension. No study enrolled infants on the basis of low blood flow. One study examined the effect of volume expansion on blood flow but in normotensive very preterm infants. Comparing volume and no treatment, 4 studies with a total of 940 very preterm infants reported no significant difference in mortality (RR 1.11, 95% CI 0.88, 1.40). The large NNNI 1996 study reported no significant difference in severe disability (RR 0.80, 95% CI 0.52, 1.23), cerebral palsy (RR 0.76, 95% CI 0.48, 1.20) and combined death or severe disability (RR 1.00, 95% CI 0.80, 1.24). Although one small study (Beverley 1985) reported reduced P/IVH with volume expansion, this was not supported by any other study. No significant difference was reported in grade 3-4 P/IVH and combined death or grade 3-4 P/IVH. One study (NNNI 1996) reported no significant difference in the incidence of hypotension. The finding of decreased necrotising enterocolitis and increased sepsis in infants who received fresh frozen plasma compared to a gelatin-based plasma substitute or no treatment in one study should be treated with caution. No significant differences in mortality or disability were found in this study. In one small study, there were no significant differences in outcomes between hypotensive infants who received colloid (albumin) or crystalloid (saline). REVIEWER'S CONCLUSIONS: There is no evidence from randomised trials to support the routine use of early volume expansion in very preterm infants without cardiovascular compromise. There is insufficient evidence to determine whether infants with cardiovascular compromise would benefit from volume expansion. There is insufficient evidence to determine what type of volume expansion should be used in preterm infants (if at all) or for the use of early red cell transfusions. The trial comparing colloid (albumin) and crystalloid (saline) in hypotensive preterm infants found no benefit in using a more expensive blood product compared to saline, but is insufficiently powered to detect an important clinical difference.

Blood Volume↗
PubMed2000

Thyroid hormone for preventing of neurodevelopmental impairment in preterm infants.

BACKGROUND: Observational studies have shown an association between transiently low thyroid hormone levels in preterm infants in the first weeks of life (transient hypothyroxemia) and an abnormal neurodevelopmental outcome. Thyroid hormone therapy might prevent this morbidity. OBJECTIVES: To assess whether thyroid hormone therapy in preterm infants without congenital hypothyroidism results in clinically important changes in neonatal and long term outcomes in terms of both benefits and harms. SEARCH STRATEGY: The standard search strategy of the Neonatal Review Group was used. This included searches of the Oxford Database of Perinatal Trials, Cochrane Controlled Trials Register, MEDLINE, previous reviews including cross references, abstracts, conferences, symposia proceedings, expert informants and journal handsearching in the English language. SELECTION CRITERIA: All trials using random or quasi-random patient allocation, in which thyroid hormone therapy (either treatment or prophylaxis) was compared to a control in premature infants. DATA COLLECTION AND ANALYSIS: Primary clinical outcomes included measures of neurodevelopmental outcome and mortality. Assessment of trial quality, data extraction and synthesis of data, using relative risk (RR) and weighted mean difference (WMD), were performed using standard methods of the Cochrane Collaboration and its Neonatal Review Group. MAIN RESULTS: Eight studies were identified that compared thyroid hormone treatment to control. Four randomized or quasi-randomized studies met inclusion criteria (Chowdhry 1984, Amato 1989, van Wassenaer 1997 and Vanhole 1997). All studies enrolled preterm infants < 32 weeks gestation, but used different timing, dose and duration of treatment with thyroid hormones. Three studies used thyroxine, whereas Amato 1989 used triiodothyronine. Only two studies with neurodevelopmental follow-up were of good methodology (van Wassenaer 1997 and Vanhole 1997). All studies were of small size with the largest, van Wassenaer 1997, enrolling 200 infants. A lack of comparability of data (neurodevelopmental test or timing of follow-up) prevented meta-analytic pooling of the studies for neurodevelopmental outcomes. There was no significant difference in mortality to discharge (typical relative risk 0.74, 95% CI 0.44, 1.26) in infants who received thyroid hormone treatment compared to controls. In individual studies, no significant differences were found in neurodevelopmental outcomes including risk of abnormal neurological outcome, and Bayley Mental or Psychomotor Development Indices. No data were available for the incidences of cerebral palsy or sensorineural impairment. Fraction of inspired oxygen was lower in infants receiving triiodothyronine in one small quasi-randomized study (Amato 1989), but not in infants receiving thyroxine in a randomized study (Vanhole 1997). No other differences were found to suggest a reduced severity of respiratory distress syndrome in infants receiving early thyroid hormone therapy. REVIEWER'S CONCLUSIONS: This review does not support the use of thyroid hormones in preterm infants to reduce neonatal mortality, improve neurodevelopmental outcome or to reduce the severity of respiratory distress syndrome. The a posteriori subgroup analyses of data from one study (van Wassenaer 1997) which showed benefits in infants 24-25 weeks gestation should be treated with caution. The small number of infants included in trials incorporated in this review limits the power of the meta-analysis to detect clinically important differences in neonatal outcomes. Future trials should be of sufficient size to detect clinically important differences in neurodevelopmental outcomes. They should consider enrolling those infants most likely to benefit from thyroid hormone treatment such as infants born at less than 27 weeks gestation and use thyroid hormones as treatment instead of prophylaxis.

Developmental Disabilities↗