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PubMed1985

Parents' beliefs about themselves as parents of a new infant: instrument development.

The instrument, What Being the Parent of a New Baby is Like (WPL), was designed to assess parental experiences and self-images which are likely to influence problem-solving concerning their infants. Forty-nine mothers responded to the questionnaire on three separate occasions during the infants' first 3 months. These data were the basis for a preliminary examination of the item characteristics, reliability (internal consistency), and validity. The pattern of responses to the WPL was in the expected direction for a sample of mothers who, on the whole, functioned well as parents. Principal components factor analysis with iteration and varimax orthogonal rotation identified two variables (centrality of the infant and success in parenting) that together accounted for 60.1% of the variance; adequate internal consistency for success and modest internal consistency for centrality were demonstrated. Use of the Neonatal Perception and Degree of Bother Inventories demonstrated divergent validity. Expected parity differences tested the known groups technique of construct validity. The significant relationship between success and a measure of parents' perceptions of their problem-solving skills demonstrated concurrent validity. Further testing of WPL with added items on larger and more heterogeneous samples is warranted.

Adolescent↗
PubMed1989

[Growth and development in infants with a birthweight of less than 1501 grams].

37 children with a birthweight below 1.501 grams were studied between the ages of one and two years. The children were all admitted to the neonatal intensive care unit at the Regional Hospital in Trondheim in 1985 or 1986. Morbidity, development, growth and major handicaps in the study group were registered and compared with a control group of children born at term during the same period. The preterm children showed a significantly higher incidence of lower respiratory tract infections and hospital readmissions than did the children in the control group. The incidence of cerebral palsy in the study group was 10.8% among the survivors (7.3% among live births). None of the children in the control group had a major handicap. Neurological development as judged by the Gesell scale was normal in the study group. However, the control group reached a higher score than expected for their age. A striking finding was the lack of catch-up growth in the prematurely born children. This finding should receive further attention in future.

Child↗
PubMed1992

Outcome after developmental intervention in the neonatal intensive care unit for mothers of preterm infants with low socioeconomic status.

The efficacy of developmental intervention in the neonatal intensive care unit for mothers of preterm infants with low socioeconomic status was evaluated. Mothers were assigned to an experimental group in which they met at least weekly with an infant-development specialist or to a control group in which they did not. During the sessions, they participated in a structured developmental and behavioral assessment of their infants, with the goal of enhancing their ability to provide appropriate interactions and environmental stimulation for their infants. When the infants were 4 and 8 months of age, follow-up home visits by a nurse who was unaware of group assignment showed that the experimental-group infants performed more optimally on the Bayley Mental scale (Bayley Scales of Infant Development) at 4 and 8 months of age and on the Bayley Motor scale at 4 months. In addition, the home environment was more developmentally appropriate at 4 months of age, and the mothers rated their babies as temperamentally less difficult at 4 and 8 months. We conclude that a mother-focused, neonatal intensive care unit-based program that utilizes the assessment process in a therapeutic way is an effective strategy in the initiation of interventions for families of low socioeconomic status whose infants were born prematurely.

Adult↗
PubMed1983

Developments in infants' search for displaced objects.

In an exploratory study of infants' search for displaced objects, 13-month-olds and 21-month-olds were tested on three kinds of displacement problems--visible displacements, invisible displacements, and transpositions--as well as single-hiding problems. Two aspects of performance on the displacement problems were distinguished: (1) searching within the locations involved in the displacement rather than at a control location, and (2) selecting between the displacement locations. Both the younger and the older infants were able to select the correct location on visible displacement problems and to search within the displacement locations on invisible problems. Neither age group was able to solve the transposition problems, but the older infants did at least search within the relevant locations on those problems. Age differences appeared to be due primarily to improved skill at identifying relevant locations rather than to improvements in selecting among those locations. Other factors contributing to the age differences in performance were a decrease in response biases and an increase in skills for coping with multiple possibilities.

Age Factors↗
PubMed1976

[The development of infants subjected to aided respiration in the newborn period (author's transl)].

22 children who required respiratory aid (LPPV, CPAP) in the newborn period were followed up to the age of 12 to 36 months. The birth weight ranged between 1050 and 4100 g and the duration of artificial ventilation ranged between 36 and 698 hours. Neurological development of 17 children was completely normal, whilst four showed noticeable hyperkinesis or slight dystonia and one child developed spastic diplegia of a moderate degree, which was almost completely overcome by physiotherapy. The mean developmental quotient (Eggers-Wagner) ranged between 76 and 127.

Apnea↗
PubMed1994

Incidence of apnoea and bradycardia in preterm infants following triple antigen immunization.

Ninety-seven preterm infants were immunized with diphtheria-tetanus-pertussis (DTP) prior to discharge from hospital. The mean gestational age at birth was 28.1 weeks (range 24-34) and the mean age at immunization was 80.6 days (range 44-257). Nineteen (20%) infants developed apnoea or bradycardia within 24 h of immunization. The infants who developed apnoea and/or bradycardia had a younger gestational age at birth than those who did not (P = 0.03), were artificially ventilated for longer (P = 0.01) and were more likely to have a diagnosis of chronic lung disease (P = 0.006). In the majority of infants these events were not clinically significant. Two infants who developed concurrent upper respiratory tract infections required additional oxygen and one of them was treated with oral theophylline. In general, it is safe practice to immunize preterm infants with DTP unless otherwise contraindicated. However, it is recommended that cardiorespiratory function is monitored after immunization in very preterm infants who had prolonged ventilatory support and/or chronic lung disease.

Analysis of Variance↗
PubMed1992

Infant Health and Development Program for low birth weight, premature infants: program elements, family participation, and child intelligence.

The Infant Health and Development Program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. The 377 intervention families received for the first 3 years of life: (1) pediatric follow-up, (2) home visits, (3) parent support groups, and (4) a systematic educational program provided in specialized child development centers. The control group (n = 608) received the same pediatric follow-up and referral services only. This paper describes the delivery of the intervention and its outcomes. A Family Participation Index that was the sum of participation frequencies in each of the program modalities unique to the intervention revealed that program implementation was not different across the eight sites. Index scores did not vary systematically with mother's ethnicity, age, or education or with child's birth weight, gender, or neonatal health status; but they were positively related to children's IQ scores at age 3. Only 1.9% of children of families in the highest tercile of participation scored in the mentally retarded range (IQ less than or equal to 70), whereas 3.5% and 13% of children in the middle and lowest participation terciles, respectively, scored in the retarded range. Similar findings were obtained for borderline intellectual functioning. These findings are consistent with previous research linking intensity of intervention services with degree of positive cognitive outcomes for high-risk infants. The determinants of variations in individual family participation remain unknown.

Child Day Care Centers↗
PubMed1998

Association of fungal colonization and invasive disease in very low birth weight infants.

BACKGROUND: Fungi are common pathogens of nosocomial infections in the very low birth weight (VLBW) infants. The purpose of this study was to investigate the fungal colonization rate in VLBW infants and the association between fungal colonization and systemic fungal diseases. MATERIALS: Between January 1, 1996, and December 31, 1996, 116 infants with birth weight < 1500 g admitted to the neonatal intensive care unit of Chang Gung Children's Hospital in the first day of life were included in this prospective study. METHODS: Cultures from oropharynx, rectum, skin (groin and axilla), bag urine and endotracheal aspirates were obtained in the first 24 h after birth and weekly thereafter throughout their neonatal intensive care unit stay. Medical records were reviewed weekly. RESULTS: Fungal colonization was detected in 25 infants, among whom 17 infants developed colonization by 2 weeks of life. Candida albicans (61%) and Candida parapsilosis (29%) were the 2 most common organisms. The rectum (76%) was the most frequent site of colonization. Factors significantly associated with colonization were prolonged administration of antibiotic therapy, parenteral nutrition and intralipid emulsion. Three of 116 infants developed fungemia. The association between colonization and subsequent fungemia was demonstrated in 1 infant, representing 4% of colonized infants. CONCLUSION: Fungal colonization was detected in one-fifth of VLBW infants and represents a risk factor for fungemia. Because disease occurred in the absence of apparent colonization, factors other than colonization may contribute to invasive candidiasis.

Candida↗
PubMed1985

The development of infant sensitivity to biomechanical motions.

3 experiments were conducted to examine infant sensitivity at 20, 30, and 36 weeks of age to the 3-dimensional structure of a human form specified through biomechanical motions. All 3 experiments manipulated occlusion information in computer-generated arrays of point-lights moving as if attached to the major joints and head of a person walking. These displays are readily recognized as persons by adults when occlusion information is present, but not when it is absent or inconsistent with the implicit structure of the human body. Converging findings from Experiments 1 and 2 suggested that 36-week-old infants were sensitive to the presence of occlusion information in point-light walker displays; neither 20- nor 30-week-old infants showed any sensitivity to this information. The results of Experiment 3 revealed further that 36-week-old infants were sensitive to whether or not the pattern of occlusion was consistent with the implicit form of the human body, but only when the displays were presented in an upright orientation. These findings are interpreted as suggesting that infants, by 36 weeks of age, are extracting fundamental properties necessary for interpreting a point-light display as a person.

Biomechanical Phenomena↗
PubMed1998

Recent developments in infant formulae: 1--The addition of LCPs.

Long chain polyunsaturated fats (LCPs) are important components of membranes in the human brain and retina. Preterm babies require a dietary source of LCPs, and all preterm formulae in the UK are currently supplemented with LCPs. Supplementation of term infant formulae with AA and DHA has resulted in apparent improvements to visual and cognitive functioning in bottle-fed babies. These improvements may be temporary and more research is needed to determine whether these differences remain in the longer term.

Bottle Feeding↗
PubMedDate not supplied

Outcome of extracorporeal membrane oxygenation survivors at age two years: relationship to status at one year.

The objective of this study was to assess the respiratory, neurologic, and developmental status at age 2 years of children treated with extracorporeal membrane oxygenation (ECMO) as neonates. The study population comprised patients treated at a tertiary care neonatal unit and included in a high-risk follow-up program. Eighty-five consecutive patients were treated with ECMO between June 1987 and October 1990, of which 64 (75%) survived. Forty-eight (73%) of the survivors underwent evaluation of growth and respiratory status, neurologic examination, and psychometric testing at ages 1 and 2 years. At age 2 years, 21% of study patients had at least one abnormal growth parameter (weight or length < 5%, head circumference < 2%). Twenty-one percent required respiratory medications and two children had tracheostomies. Six percent had significant abnormalities on neurologic examination. Twenty-five percent scored between 70 and 85 on the mental or psychomotor scales (or both) of the Bayley Scales of Infant Development or the Stanford-Binet, and 12% scored less than 70. Seventy-three percent of children who scored 70 to 85 on one or both subscales of the Bayley Scales of Infant Development or the Stanford-Binet at 2 years had normal scores at 1 year, as did 50% with scores less than 70. Spearman rank analysis suggested a relationship between congenital diaphragmatic hernia, neonatal electroencephalogram, and computed tomography of the head and developmental status at age 2 years (p < 0.05). We conclude that children treated with ECMO are at significant risk for abnormalities in growth and neurodevelopmental and respiratory status at age 2 years, which may not be evident at earlier assessments. This highlights the need for continued follow-up.

Central Nervous System↗
PubMedDate not supplied

Prenatal cocaine/polydrug exposure: effect of race on outcome.

OBJECTIVE: To determine the effect of prenatal exposure to cocaine on development. METHODS: We tested 106 infants in the range of 4 to 30 months adjusted age with the Bayley Scales of Infant Development. RESULTS: The 46 cocaine-exposed infants had similar mental scores to those of the 60 control infants. Among the 47 black infants, motor scores were 11.2 points higher in cocaine-exposed infants than in control infants (115.1 and 103.9, respectively, p = 0.023). Among the 59 white infants, motor scores were similar in cocaine-exposed infants (102.9) and control infants (100.6). CONCLUSION: Genetic differences may account for this variation in motor development of cocaine-exposed infants.

Child Development↗
PubMed1996

Altered platelet-activating factor levels and acetylhydrolase activities are associated with increasing severity of bronchopulmonary dysplasia.

Lipid inflammatory mediators are thought to play an important role in the pathogenesis of neonatal lung injury and bronchopulmonary dysplasia (BPD). Because preliminary studies from the intensive care nursery of the University of Tennessee Medical Center, Knoxville, revealed linear increased in blood platelet-activating factor (PAF) levels in very low birthweight infants developing chronic lung disease and lower cord blood PAF acetylhydrolase activities in premature infants, it was theorized that altered platelet-activating factor levels and PAF acetylhydrolase activities are associated with increasing severity of BPD. Platelet-activating factor levels (blood and tracheal lavage) and PAF acetylhydrolase activities (blood and tracheal lavage) were measured over days 1 to 2, 3 to 5 and 6 to 7 in 16 ventilated infants and weekly in 9 infants with bronchopulmonary dysplasia. Platelet-activating factor values were normalized per nanogram of lavage blood urea nitrogen. Severity of bronchopulmonary dysplasia was estimated using the scoring system developed by Toce. Mean blood and lavage PAF levels and PAF acetylhydrolase activities were compared in infants developing bronchopulmonary dysplasia with those without the disease over the first seven days of life. Infants developing chronic lung disease were significantly smaller and of younger gestational age. In infants with bronchopulmonary dysplasia, higher PAF levels in blood were seen on days 3 to 5, along with increased lavage acetylhydrolase activities on days 1 to 2. Increased levels of PAF in lavage on days 3 to 5 were associated with increasing severity of bronchopulmonary dysplasia. Altered blood and lavage platelet-activating factor levels and PAF acetylhydrolase activities appear to be associated with the pathogenesis and severity of bronchopulmonary dysplasia.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗