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PubMed1978

Pituitary-adrenal response to separation in mother and infant squirrel monkeys.

Pituitary-adrenal response in mother and infant squirrel monkeys following brief separation was assessed. Each mother and infant pair was tested under each of 3 conditions: (1) Basal; (2) Separation-Reunion; and (3) Separation. Samples were obtained from mothers and infants in the Separation and Separation-Reunion conditions 30 min following the initial disturbance. A similar paradigm was used to assess the effects of separation in surrogate-reared animals. The results indicate that mothers, infants, and surrogate-reared infants respond to 30-min separation with a substantial increase in plasma cortisol. The values obtained in the Separation-Reunion condition did not differ significantly from Basal values in any of the 3 groups, suggesting that the effect of separation on the pituitary-adrenal system is not due to the disturbance involved in the separation procedure. The response of surrogate-reared infants suggests that these infants develop similar attachments to the surrogate as normal infants to their own mothers.

Animals↗
PubMed1993

Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale in early cognitive assessment.

Correlations between the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) and the Bayley Scales of Infant Development--Mental Scale (BSID) were examined in 61 infants and toddlers with suspected developmental delay. Highly significant correlations were found between the two instruments. Gender, race, and gestational age did not influence the relationship between CAT/CLAMS and BSID scores. The CAT/CLAMS was both sensitive (88%) and specific (67%) for mental retardation (BSID < 70). The CAT/CLAMS correlates with the BSID and can be used as an instrument for detecting cognitive delay.

Child, Preschool↗
PubMed1998

Adverse neurodevelopmental outcome after extracorporeal membrane oxygenation among neonates with bronchopulmonary dysplasia.

OBJECTIVE: The relationship between bronchopulmonary dysplasia (BPD) and neurodevelopmental outcome after extracorporeal membrane oxygenation (ECMO) has not been extensively reported. We compared the outcomes in a large series of infants with and without BPD after ECMO. STUDY DESIGN: Hospital charts and follow-up records of 145 infants treated with ECMO (1985 through 1990) were reviewed. Complete long-term respiratory and follow-up outcome data were available in 64 infants. BPD occurred in 17 survivors; the remaining 47 did not have BPD. RESULTS: Babies with BPD were more likely to have had respiratory distress syndrome. Mean (+/- SD) age at ECMO initiation was later for the BPD group (127+/-66 vs 53+/-39 hours, p < 0.001), and the duration of ECMO treatment was longer (192+/-68 vs 119+/-53 hours, p < 0.001). Bayley Scales of Infant Development scores at <30 months were lower in infants with BPD (p < 0.001), as were three of four Mullen Scales of Early Learning scores (> or = 30 months, p < 0.001 or p = 0.01). At 57+/-16 months 11 (64%) patients with BPD had mild neurologic disabilities, and 3 (18%) had severe disabilities. At a similar age (53+/-16 months, p = NS) 16 (34%) patients without BPD had mild disabilities, whereas 2 (4%) had severe disabilities (p < 0.01). CONCLUSIONS: The occurrence of BPD after ECMO is associated with adverse neurodevelopmental outcome. Patients with BPD after ECMO merit close long-term follow-up.

Bronchopulmonary Dysplasia↗
PubMed1997

Serratia marcescens infections in neonatal departments: description of an outbreak and review of the literature.

An outbreak of colonization and infection with Serratia marcescens occurred in a neonatal intensive care unit (NICU). S. marcescens was isolated from five preterm infants (gestational age 25-30 weeks). Two infants developed septicaemia, which were both fatal, and one infant (the presumed index case) had conjunctivitis due to S. marcescens. Two infants were colonized without clinical signs of infection. All infants were treated with antibiotic regimens including ciprofloxacin and gentamicin. The DNA fingerprints of isolates were determined by enterobacterial repetitive intergenic consensus primers by the polymerase chain reaction. This showed that a single strain had spread in the NICU. An extensive investigation pointed to an infant born from a mother with an intra-uterine infection after prolonged rupture of foetal membranes as a presumed source of the outbreak. A reservoir, other than the infected or colonized infants and their immediate vicinity, was not found, with the sole exception of the waste jar of a Na+/ K(+)-analysis apparatus. Containment of the outbreak was achieved by closure of the NICU for new admissions, strict hygienic measures and cohort nursing of the infected and colonized infants. It was considered especially important to handle the infants with gloves, since frequent hand carriage of staff with S. marcescens was found when gloves were not used.

Conjunctivitis, Bacterial↗
PubMed2000

Outcome of premature infants delivered after prolonged premature rupture of membranes before 25 weeks of gestation.

OBJECTIVE: To identify factors influencing the outcome of premature infants delivered after prolonged premature rupture of membranes before 25 weeks' gestation. DESIGN AND POPULATION: All premature infants with gestational age <34 weeks, either inborn or outborn, with history of rupture of membranes before 25 weeks' gestation, admitted to our NICU between January 1992 and July 1997, were eligible for this retrospective study. Collected information included birth weight, gestational age at rupture of membranes and at delivery, duration between rupture of membranes and delivery (latency period), severity of oligohydramnios, pre- and post-natal managements, and follow-up of survivors. RESULTS: A total of 28 neonates fulfilled the inclusion criteria. Despite new strategies of ventilation and optimal management, the overall mortality rate was 43% (12/28). Nonsurvivors were significantly less mature at rupture of membranes, and had severe oligohydramnios (anamnios). We also noted less antenatal corticosteroids and antibiotic therapy in this group. Nine of eleven infants (82%) following rupture of membranes before 22 weeks' gestation died shortly after birth. The two remaining infants developed severe bronchopulmonary dysplasia. Nine deaths occurred in thirteen cases (69%) of anamnios. The major death causes were refractory respiratory failure and neurologic complications. Half of all survivors (8/16) developed bronchopulmonary dysplasia. CONCLUSION: The outcome of premature infants following prolonged premature rupture of membranes before 25 weeks' gestation is influenced by gestational age at rupture, severity of oligohydramnios, and antenatal antibiotics and corticosteroids. Neonates with rupture of membranes before 22 weeks have a very low chance of survival at the present time.

Adrenal Cortex Hormones↗
PubMed2000

Living related liver transplantation in infants and children: report of anesthetic care and early postoperative morbidity and mortality.

STUDY OBJECTIVE: To determine those infants at high risk for perioperative complications and mortality following living, related liver transplantation. DESIGN: Retrospective chart review. SETTING: Large metropolitan teaching hospital. MEASUREMENTS AND MAIN RESULTS: The charts and anesthetic records of the 12 infants and children who received the left lateral hepatic segment from a living relative the past 2 years at our institution were reviewed. The records were examined to determine the causes of perioperative morbidity and to identify patients at high risk for serious complications and mortality. All infants and children (mean +/- SD age, 29+/-30 months; weight, 13.6 +/-6.8 kg) survived the operation (8.3+/-1.7 hours) without intraoperative complications. The average blood loss, including 500 mL of recipient blood used to flush the liver before reperfusion, was 1483 +/-873 mL (119+/-70 mL/kg). Three infants developed portal vein thrombosis, and one of these infants also had hepatic artery thrombosis. The risk of vessel thrombosis was significantly higher (3/3 vs. 0/9; p<0.0045) in infants less than 9 kg body weight, as was the risk of death (2/3 vs. 0/9; p<0.045). Both children who died had vascular thrombosis. Other serious complications were bleeding, 6; infection, 7; acute rejection, 3; and bile leak, 2. CONCLUSIONS: Infants and children can successfully undergo living, related liver transplantation. However, the risks of vascular complications and death are greater in infants less than 9 kg body weight.

Anesthesia↗
PubMed1999

An event-based analysis of the coordination of early infant vocalizations and facial actions.

This study used an event-based approach to provide empirical evidence regarding the nature of coordination in 3- and 6-month-old infants. Vocalizations and facial actions of 12 normally developing infants interacting with their caregivers were coded. Coded vocalizations and facial actions were considered coordinated when they temporally overlapped. Results indicate that infants coordinated their vocalizations and facial actions more than expected by chance. Coordinated events were governed by 2 sequence patterns. When 2 communicative events were temporally associated across modalities, 1 event tended to be completely embedded within the other, and vocalizations tended to end before facial actions. This study provides new information about how infant communication is structured, confirms results from other coordination studies, and describes a new method for analysis of event-based data.

Age Factors↗
PubMed1982

Standardization of the Denver developmental screening test on infants from Yucatan, Mexico.

The DDST was standardized on 288 babies ranging in age from 2 to 54 weeks from Yucatan, Mexico. They were divided equally by age, sex and socio-cultural group (as defined by the health care center attended). all were full-term according to gestational age and birthweight, if known. Prior to developmental assessment, each baby had been rated as normal after examination by a Yucatecan health center physician. Subtest scores increased with age. No sex differences were found. Significant differences among socio-cultural groups occurred only on the language subtest, with middle-to-upper class babies obtaining higher scores. With the variable of age controlled, intercorrelations among DDST subtests were fairly low, suggesting that these subtest measure different functions. Split-half reliability correlations were lower than other published infant tests. Compared with other cross-cultural studies using the DDST, Yucatecan infants were advanced in fine motor skills, but by the end of their first year showed delay in gross motor locomotion. The DDST failed to identify as "questionable" 16 of 17 babies whose Bayley Motor Scores were borderline (PDI less than or equal to 80), thus, the DDST may be of limited use in diagnosing developmental delay in Yucatecan infants. Cross-cultural differences in infant development reaffirm the need for continuing test standardization to aid clinicians, researchers, and, especially, the babies themselves.

Child Development↗
PubMed1985

The Landau reaction in fullterm and preterm infants at four months of age.

Twelve normal fullterm infants and 11 low-risk preterm infants were assessed at four months of age. Assessments included a Three-Component-Scale for the Landau reaction, the Touwen Scale for the Landau reaction, the Bayley Scales of Infant Development Motor Scale, and the Movement Assessment of Infants Muscle Tone Scale. A statistically significant relationship was found between gestational age (preterm vs. fullterm birth) and scores on the hip and kicking subcomponents on the Three-Component-Scale for the Landau reaction, and also between gestational age at birth and scores on the summary of tone-extremities and total risk score items on the Movement Assessment of Infants. Although preterm and fullterm infants may not show differences in scores on motor developmental level assessments, variations in postural reactions and muscle tone may be present at four months of age.

Female↗
PubMedDate not supplied

Early treatment of idiopathic respiratory distress syndrome using binasal continuous positive airway pressure.

During a 3-year period (1979-81) 85 premature infants with idiopathic respiratory distress (IRDS) were treated early with an easily applicable light-weight CPAP-system with a binasal tube and a gas jet. We used conservative criteria for ventilator treatment. The treatment proved sufficient in 18 out of 25 infants with a birth weight less than or equal to 1500 g and in 53 out of 60 infants with a birth weight greater than 1500 g. Seven infants developed pneumothorax during CPAP treatment. Seventy-four infants survived, all without bronchopulmonary dysplasia. At the age of 1.5-4.5 years the incidence of respiratory tract infections did not differ from that in a group of siblings; and the incidence of lower respiratory tract infections was low compared to previous studies. With the criteria used, early CPAP proved effective in the majority of infants with IRDS.

Birth Weight↗
PubMed1989

Limitations of patient triggered ventilation in neonates.

The practicality of long term patient triggered ventilation using airflow changes was assessed in 22 infants with a median gestational age of 29 weeks (range 25-33 weeks). Inflation time during patient triggered ventilation was limited to 0.4 seconds or less. Initially it was associated with improvements in oxygenation in most infants. Patient triggered ventilation was maintained till final extubation in 13 of the infants without complications. Only one infant developed a pneumothorax, but in the remaining eight infants (who tended to be less mature (p less than 0.01) it had to be discontinued after only a few hours. Predictors of failure of patient triggered ventilation at one hour were both a lack of improvement in oxygenation, and a relatively slow triggering rate that was related to gestational age. We conclude that long term patient triggered ventilation is practical for preterm neonates, but only for those more mature than 28 weeks' gestational age.

Evaluation Studies as Topic↗
PubMed2001

Cardiac troponin T in cord blood.

BACKGROUND: Perinatal asphyxia is associated with cardiac dysfunction. This may be secondary to myocardial ischaemia. Cardiac troponin T is the ideal marker for myocardial necrosis. Elevated levels in cord blood may be associated with intrauterine hypoxia and increased perinatal morbidity. AIMS: To establish an upper limit of normal for cardiac troponin T concentration in the cord blood of infants. Relations between cardiac troponin T levels and other variables were investigated. METHODS: Cord blood samples were collected from 242 infants and analysed. Data on gestation, birth weight, sex, Apgar scores, respiratory status, and mode of delivery were recorded. RESULTS: A total of 242 samples were collected, and 215 samples from infants without respiratory distress were used to establish the 95th percentile of 0.050 ng/ml. The gestation of these infants ranged from 31 to 42 weeks and birth weight ranged from 1.4 to 5 kg. There were no relations between cardiac troponin T levels and the other variables in these healthy infants. Twenty seven infants developed respiratory symptoms requiring oxygen and/or ventilation. These infants had significantly higher cord cardiac troponin T levels than their healthy counterparts (median (interquartile range) 0.031 (0.010-0.084) v 0.010 (0.010-0.014) ng/ml respectively; p < 0.001). CONCLUSIONS: Cardiac troponin T levels in the cord blood are unaffected by gestation, birth weight, sex, or mode of delivery. Infants with respiratory distress had significantly higher cord cardiac troponin T levels, suggesting that cardiac troponin T may be a useful marker for myocardial damage in neonates.

Biomarkers↗
PubMed1986

Absorption and oxidation of glucose polymers of different lengths in young infants.

Because mucosal glucoamylase is most active against glucose polymers less than 10 glucose units in length, longer chain polymers may not be completely absorbed by young infants. In order to investigate this possibility, the absorption and oxidation of 13C-rich glucose, short-chain (3 to 8 glucose units in length) and long-chain (average length 43 units) glucose polymers (GP) were compared in 12 healthy, 1-month-old infants. Recovery of the GP and glucose in stool was measured by determining the 13C enrichment of stool. The oxidation of the GP was measured by tracing the increase in breath 13CO2 after GP were fed. Carbohydrate malabsorbed in the small bowel was assessed by measurement of breath H2, a gas formed from the fermentation of carbohydrate in the colon. Analysis of the infants' stools revealed that one infant excreted 9.7% of the dose of glucose, another 6.7% of the dose of short-chain GP, and five infants excreted 2.6 to 18.5% (mean 8.4%) of the dose of long-chain GP. The percent of the administered dose recovered in breath was similar among substrates (mean = 28.7% of the dose fed). A rise in breath H2 greater than 20 ppm was found in four of the 12 infants after the feeding of glucose, in five of 12 after the short-chain GP, and in six of 12 after the long-chain GP. None of the infants developed diarrhea. The results suggest that healthy young infants do not absorb long-chain GP as completely as they absorb short-chain GP.(ABSTRACT TRUNCATED AT 250 WORDS)

Glucans↗
PubMed1989

The effects of a maternal preparation program on mother-infant pairs: a pilot study.

This quasi-experimental pilot study examined the association of a maternal preparation program with womens' competence in maternal care behaviors, self-perceived adaptation to the maternal role, and satisfaction with the maternal preparation received in conjunction with obstetric and delivery care. Sixteen subjects participated in the program. A cost-benefit questionnaire was completed by the program participants to examine whether the availability of such a maternal preparation program would influence future selections of a hospital for delivery. Our Occupational Therapy Maternal Role Preparation Program was provided to the subjects in four sessions. The program included material on physiological changes in the new mother, orchestration of activities of daily living, infant development and individual differences, and the mother-infant relationship. Results were statistically significant only for the factor of the mothers' satisfaction with their obstetric care and preparation for the maternal role, in favor of the treatment group. In addition, all 8 members of the treatment group reported that they thought the program was helpful and would recommend it to other mothers.

Adult↗
PubMed2002

Birthweight centiles in preterm infants. A new approach.

BACKGROUND: To analyze the birth weight of preterm infants developing a new methodology in order to efficiently collect data. METHODS: We have analyzed the birthweight of 2,482 preterm babies with a gestational age between 24 and 36 weeks admitted to a Neonatal Intensive Care Unit from 1991 to 1998. The gestational age was determined from obstetric data. No selections were performed at the earlier stages of the study by excluding newborns with congenital defects, sepsis, intrauterine growth retardation or obstetric pathologies. More selective criteria were applied at the final stage by using statistical tests. The anomalous and extreme weights for every gestational age were identified with Box and Whisker graphs. The clinical records of these cases were analyzed and their characteristics described but these weights were excluded from the calculation of the percentiles. For each gestational age we evaluated if the weight distribution was assimilable to normal distribution by calculating the kurtosis, asymmetry by applying the Kolmogorov-Smirnov and Shapiro test. RESULTS: In the majority of cases we found a normal weight distribution. CONCLUSIONS: The proposed methodology seems useful in making data collection for preterm centiles calculation simpler. A study of the clinical characteristics of the SGA and LGA identified with the normal procedure or with the proposed method might be useful in validating our approach to the definition of the percentiles.

Birth Weight↗
PubMed1992

Bilirubin encephalopathy in a term infant after planned home delivery.

A term infant was delivered at home by his father after a pregnancy which involved no organized medical care. By the third day of life the infant developed fever, poor feeding and severe jaundice. The infant was found to have a serum indirect bilirubin of 49 mg/dl secondary to isoimmune hemolytic anemia due to anti-c antibody. The infant survived but suffers from clinical manifestations of kernicterus.

Adult↗
PubMed1988

Temperament in infancy: stability, change, and correlates.

The present study investigated whether temperament categories and diagnoses of the Revised Infant Temperament Questionnaire (RITQ) remain stable during infancy. Additionally, the relationships between RITQ ratings and scores on the Brazelton Neonatal Behavioral Assessment Scale and the Bayley Scales of Infant Development were evaluated. The sample included 79 nonrisk infants. The results indicate that most categories of temperament, as well as diagnostic clusters, remain stable from 4 to 8 months of life. The majority of NBAS dimensions and Bayley mental scores were not significantly associated with temperament ratings. The antecedents of ratings of infants' difficultness were similarly unidentified by mothers' perceptions of their infant's behavior.

Adaptation, Psychological↗