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At least 19 recordsLinked to original sources
PubMed1979

Folic acid supplementation in low birth weight infants.

Low birth weight infants (246) entered a trial to folic acid supplementation from 3 weeks to 12 months of age. The folic acid group had significantly higher mean hemoglobin levels at 6 and 9 months of age but the differences were only about 0.5 gm/dl, there was no significant difference in hematocrit, and in both groups of infants the mean hemoglobin levels were higher than those of normal birth weight infants. The differences in hemoglobin, although statistically significant, are of uncertain clinical significance. Median red cell folate levels remained within the normal adult range in both groups of infants. A minority of infants in the untreated group had low red cell folate levels but this was usually temporary, corrected by dietary folate, and not associated with low hemoglobin. Weight gain was not affected by folic acid supplementation. The infants in this trial were fed with a milk preparation containing 3.5 microgram/100 ml of folic acid which is a similar concentration to that of human milk and we recommend that the folate content of milks fed to low birth weight infants should not fall below this level. We do not have sufficient grounds to recommend routine folic acid supplements for all low birth weight infants throughout the first year of life but there is a possibility that their folate intake may sometimes be suboptimal.

Anemia, Macrocytic↗
PubMed1998

Behavioral outcomes in low birth weight infants.

Low birth weight infants are at increased risk for behavioral and emotional problems. The Infant Health and Development Program was designed to evaluate the efficacy of intense pediatric and family support on reducing developmental and behavioral problems in low birth weight, premature infants. The major findings of this and other studies are presented in this article.

Child Behavior Disorders↗
PubMedDate not supplied

Maternal exposure to neighborhood carbon monoxide and risk of low infant birth weight.

This case-control study investigated the potential association between ambient levels of carbon monoxide in a pregnant woman's neighborhood of residence and her chance of delivering a low birth weight infant. Low birth weight infants and normal birth weight infants were contrasted with respect to ambient levels of CO during the 3 months prior to delivery in the neighborhoods where their mothers lived at birth. After adjustment for the confounding effects of maternal race and education, there was no association between higher CO exposure and higher odds of low birth weight. These data do not support a strong association between maternal exposure to neighborhood CO during pregnancy and odds of delivering a low birth weight infant. Further investigation of the effects of CO exposure on birth weight, with direct measurement of total CO exposure, is needed.

Air Pollutants↗
PubMed2004

The changes in the mortality rates of low birth weight infant and very low birth weight infant in Korea over the past 40 years.

Total 36 reports on the mortality rates (MRs) of low birth weight infants (LBWI) and very LBWI (VLBWI) in Korea from the 1967 through 2001 were analyzed. We compared the changes in the MR by 5 and 10-yr interval. The MRs observed by 5-yr intervals from the early 1960s through the 1990s have drastically decreased. The MRs of LBWI are as follows: 23.1% and 23.6% in the 1960s, 17.3% and 16.8% in the 1970s, 14.1% and 14.4% in the 1980s, and 8.1% in the early 1990s. The MRs of VLBWI have also fallen and were reported as follows: 68.2% and 63.7% in the 1960s, 55.8% and 57.6% in the 1970s, 56.2% and 48.1% in the 1980s, 33.5% and 24.5% in the 1990s, and 11.7% in the early 2000s. In every 10-yr period, the MRs of LBWI have decreased from 23.4% in 1960, to 17.0% in 1970, to 14.2% in 1980, and to 8.1% in 1990. The MRs of VLBWI also have decreased from 66.2% in 1960, to 56.7% in 1970, to 50.8% in 1980, to 32.9% in 1990, and to 11.7% in 2000. The MR of LBWI and VLBWI has gone down remarkably due to improvements in neonatology in Korea as shown above.

Humans↗
PubMed1991

Effect of blood transfusion on plasma selenium, glutathione peroxidase and manganese levels in very low birth weight infants.

Very low birth weight infants often receive multiple blood transfusions. We measured the plasma levels of the trace elements selenium, manganese, and glutathione peroxidase in 20 very low birth weight infants prior to blood transfusion and then at 24, 48 and 72 h after transfusion. There was no detectable change in mean selenium or glutathione peroxidase concentrations after transfusion, but the mean (SD) plasma manganese increased from 3.8 (1.5) to 6.0 (2.3) micrograms/l at 72 h.

Blood Transfusion↗
PubMed1979

Increased incidence of lactobezoars in low birth weight infants.

Fifteen low birth weight infants had their conditions complicated by the formation of a lactobezoar. The mean gestational age was 30.3 weeks; mean birth weight was 1,184 g, and the mean age at the time of diagnosis was 11.8 days. Twelve of the infants were receiving an 80 kcal/dL-formula and one infant, a 40 kcal/dL-formula designed for the premature infant. Symptoms included abdominal distension, emesis or increased gastric residual, diarrhea, hematest-positive stools, abdominal mass, and gastric perforation.

Bezoars↗
PubMed1993

The effects of a pressure relief mattress on postnatal head molding in very low birth weight infants.

Very low birth weight (VLBW) infants often develop postnatal head molding (PHM)--an elongation of the skull--when a standard, firm mattress is used. This study was undertaken to determine if a pressure relief mattress (PRM) might reduce the severity of PHM. One hundred twenty-eight infants (birth weight range 567-1,490 gm, mean 1,084; gestational age range 24-36 weeks, mean 28.5) with no congenital or acquired anomalies affecting head growth were randomly assigned to a control group (standard, firm mattress) or a study group (PRM). Study infants were placed on the PRM within 72 hours of birth. Occipitofrontal circumference (OFC) and anterior-posterior (AP) and biparietal (BP) diameters were measured at day four, seven, and then at one week intervals of life until the infant reached 2,000 gm or was discharged. An electronic digital caliper with an accuracy of 0.025 mm was used to obtain the AP and BP measurements. T-tests revealed no significant differences in head shape between the two groups. In conclusion, the pressure relief mattress did not reduce PHM in VLBW infants.

Bedding and Linens↗
PubMed1996

Severity of medical and neurologic complications as a determinant of neurodevelopmental outcome at 6 and 12 months in very low birth weight infants.

Very low birth weight (n = 154) and term infants (n = 119) had neurologic and developmental assessment at 6 and 12 months of age. Preterm infants with severe neonatal complications were considered to be at high risk, and those with milder complications were considered to be at low risk, for neurodevelopmental abnormality. Compared to term infants, high- and low-risk infants had abnormalities at 6 months in total neurologic score, cranial nerves, motor tone, motor coordination, and reflexes (P < .001). At 12 months, all groups had improved. However, high-risk infants had persistent abnormalities in the same subcategories (P < .001), whereas low-risk infants differed from term infants only in motor tone (P < .001). Bayley developmental scores were different for all groups at 6 months (P < .001), but at 12 months only high-risk infants differed from term infants (P < .01). These results demonstrate improvement in neurologic and developmental scores over time in very low birth weight infants. The degree of neurodevelopmental abnormality and improvement over time is related to severity of neonatal complications in preterm infants.

Age Factors↗
PubMed1982

Fluid, electrolyte, and glucose maintenance in the very low birth weight infant.

The low birth weight premature newborn, less than 1000 gm, represents a difficult problem in the management of parenteral fluid, electrolyte, and glucose maintenance. To assess this problem, six infants (mean weight 720 gm, range 575-835 gm; mean gestation 26.5 +/- 0.4 SEM wk) nursed under radiant warmers were evaluated during the first three days of life to determine volume of fluid intake, sodium and dextrose intakes, and urine output. Insensible water loss (IWL) was measured on a metabolic scale. In accordance with current recommendations, infant received fluid volumes of 111 +/- 10, 152 +/- 16, and 191 +/- 27 ml/kg/day on days 1, 2, and 3, respectively. Sodium intake (usually as 0.2% saline) ranges 0-8.5 mEq/kg/day. Dextrose infusions (as 10% solution) ran from 3.3 to 13.7 mg/kg/min. Insensible water loss measured 159 +/- 15 ml/kg/day. Despite increasing fluid intake, serum sodium concentration increased from 141 +/- 3 mEq/l on day 1 to 155 +/- 7 mEq/l on day 3 (p less than 0.05). None of the infants became oliguric and only two urine specimens had specific gravity greater than 1.015. These data demonstrate a larger insensible water loss than reported previously in small infants, but increasing the administration of standard 10% dextrose and 0.2% saline solution to balance insensible losses may result in sodium and glucose overload. Recommendations are made for adjusting parenteral fluid therapy for birth weight groups 600-800, 801-1000, 1001-1500, and 1501-2000 grams and for environmental conditions or radiant warmer or incubator, with or without plastic shielding or phototherapy.

Fluid Therapy↗
PubMed1997

Characteristic neuropathology of leukomalacia in extremely low birth weight infants.

Extremely low birth weight (ELBW) infants with periventricular leukomalacia (PVL) were examined by neuropathological and immunohistochemical methods. Thirteen ELBW infants of 85 infants with PVL, born at 23 to 27 weeks of gestation, showed a widespread type of distribution of PVL from the deep to intermediate white matter. Immunohistochemistry demonstrated glial fibrillary acidic protein (GFAP)-positive astrocytes to be increased in the deep white matter, often spreading to the intermediate white matter, in all cases of PVL. Tumor necrosis factor-alpha (TNF-alpha)-positive cells were found in the deep to intermediate white matter in 69% of PVL cases and appeared earlier, from 23 weeks of gestation, than in controls. beta-Amyloid precursor protein (beta APP)-positive axons were found around PVL in the deep to intermediate white matter in 85% of the cases. In age-matched control ELBW infants, GFAP-, TNF-alpha-, or beta APP-positive cells were never found. Therefore, in ELBW infants, widespread axonal damage and glial activation with cytokine production occur in the progression in characteristic PVL lesions.

Amyloid beta-Protein Precursor↗
PubMed2002

Effects of parenteral lipid infusion on DNA damage in very low birth weight infants.

Very low birth weight (VLBW) infants are known to have poorly developed antioxidant system and may be at increased risk for radical damage. Previous studies have reported higher levels of lipid peroxide products in lipid emulsion used for parenteral nutrition. To examine the direct effects of parenteral lipid infusion on DNA damage in VLBW infants, we measured urinary 8-hydroxydeoxyguanosine (8-OHdG) levels in VLBW infants before, during, and after the parenteral lipid infusion. In both the lipid-infused and lipid-free groups, urinary 8-OHdG excretion levels at 14 days old were significantly (p < 0.01) lower than those at 2 and 7 days old. However, there were no significant differences in urinary 8-OHdG excretion levels between the lipid-infused and lipid-free groups at 2, 7, and 14 days old. Our results suggest that parenteral lipid infusion does not cause oxidative DNA damage, but irrespective of the infusion DNA damage during the first week of life is enhanced when compared with 14 days after birth in VLBW infants.

8-Hydroxy-2'-Deoxyguanosine↗
PubMedDate not supplied

Outcome and cost of intensive care for very low birth weight infants.

Very low birth weights (VLBW) remain the major factor contributing to neonatal mortality and morbidity. The development of Neonatal Intensive Care Units (NICU) has improved the outcome for the VLBW infants. However, outborn VLBW infants may have different outcomes, and different medical costs than those born intramurally. This study compared the mortality, morbidity and costs of inborn and outborn VLBW infants cared in the NICU of a tertiary care center. A total of 176 VLBW infants (inborn 83, outborn 93) were examined over the three years period June 1990 to May 1993. The birth weights (1131 +/- 244 g vs 1133 +/- 255 g) and gestational ages (29.0 +/- 4.0 wk vs 28.9 +/- 3.0 wk) were not different between the two groups. However, the age of admission to our wards was significantly different between the inborn infants (5.0 +/- 3.2 hr.) and outborn infants (53.6 +/- 26.8 hr.). There was no difference in mortality rates between the outborn infants (35.7%) and the inborn infants (32.9%), nor in the incidence of intraventricular hemorrhage, respiratory distress syndrome, sepsis, necrotizing enterocolitis, retinopathy of prematurity or abnormal auditory brainstem response. However the incidence of patent ductus arteriosus and chronic lung disease of the outborn infants was higher than those of the inborn (47% vs 32%, 51% vs 29% respectively). The mean duration of hospitalization and cost seemed to be longer and higher in the outborn VLBW infants. It was concluded that outborn VLBW infants have higher rates of morbidity, longer hospitalization and cost more than inborn infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Care Costs↗
PubMed1993

Breast-feeding of very low birth weight infants.

Twenty very low birth weight infants (birth weight < 1500 gm) were assessed to compare the clinical effects of breast and bottle feedings. The infants started breast-feeding during the same week that they started bottle feedings. Five breast-feedings and five bottle feedings for each infant were observed. Axillary temperature and weight before and after feedings were measured, and oxygen saturation, respiratory rate, and heart rate were monitored and recorded every 2 minutes during the feeding periods. The results showed no difference in oxygen saturation during breast-feeding (p = 0.056) but a lower incidence of oxygen desaturation (< 90%) (21% vs 38% in breast-feeding vs bottle feeding, respectively; p < 0.025). Infants with bronchopulmonary dysplasia had higher oxygen saturation during breast-feeding than during bottle feeding (p < 0.025), but weight gain during breast-feeding sessions was less (median, no gain vs 31 gm, p < 0.001). We conclude that (1) very low birth weight infants can tolerate both breast and bottle feedings at the same postnatal age; (2) very low birth weight infants are less likely to have oxygen desaturation to less than 90% during breast-feeding; and (3) weight gain is less during breast-feeding, probably because of lower intake, and may require more lactation counseling or supplementation of the feedings.

Body Weight↗
PubMed1977

Unconjugated hyperbilirubinemia in very low birth weight infants.

In very low birth weight infants, the occurrence of bilirubin-related brain damage has been repeatedly observed at low serum bilirubin concentrations in close association with altered pathophysiologic status (hypoxia, acidosis, hypothermia, and so on). This increased susceptibility is accompanied by increased severity and duration of unconjugated hyperbilirubinemia as compared with more mature infants. Clinical manifestations of kernicterus in very low birth weight infants are almost always nonspecific. No single biochemical or physiologic measurement is sufficient to predict the risk for development of the bilirubin-related brain damage in this group. Prevention of bilirubin-related brain damage in very low birth weight infants requires not only the maintenance of physiologic and biochemical milieu within normal limits, but also specific therapy to alleviate unconjugated hyperbilirubinemia. Although exchange transfusion has been the mainstay of therapy for unconjugated hyperbilirubinemia, the increased morbidity and mortality associated with exchange transfusion in these immature infants and the need to maintain very low serum bilirubin concentrations suggest that prophylactic phototherapy may be more beneficial for this group.

Bilirubin↗
PubMed1981

Effect on serum calcium of a alpha-hydroxy-vitamin D3 supplementation in infants of low birth weight, infants with perinatal asphyxia, and infants of diabetic mothers.

Thirty infants of low birth weight, 35 infants with perinatal asphyxia, and 16 infants of diabetic mothers were investigated for early neonatal hypocalcaemia. The infants were randomized into a group prophylactically given 1 alpha-hydroxy-vitamin D3, 0.05 or 0.10 micrograms/kg i.v. on the first 3 days of life, and an untreated control group. In infants of low birth weight and infants of diabetic mothers there were no differences in serum ion-Ca concentrations on days 2, 3, 5, and 7 between the treated and untreated groups. In infants with perinatal asphyxia, however, serum ion-Ca concentrations on days 5 and 7 were significantly higher in the treated than in the untreated group, while on days 2 and 3 the differences were not statistically significant. The hypocalcaemia in asphyctic infants was not correlated to bicarbonate treatment, but infants with severe signs of asphyxia had lower serum ion-Ca concentrations than infants with only mild or no signs. Hypocalcaemia in asphyctic infants might be explained by a decreased concentration of 1 alpha, 25-dihydroxy-vitamin D3 following reduced 1 alpha-hydroxylation in the kidney as a consequence of anoxia during perinatal asphyxia.

Asphyxia Neonatorum↗
PubMed2001

Thyroxine and illness severity in very low-birth-weight infants.

The objective of this study was to determine the relationship between thyroxine (T4) and illness severity in a population of preterm infants. We investigated a cohort of infants with birth weights 1,500 g or less from a single level III neonatal intensive care unit who received a minimum of one cranial sonogram to screen for intraventricular hemorrhage (IVH) and one newborn screen for T4 during a 2-year period, (n = 284). The Score for Neonatal Acute Physiology (SNAP) was used to measure illness severity. T4 and SNAP were investigated in relationship to mortality, IVH, and severe IVH. T4 correlated inversely with SNAP (R = -0.46, p < 0.01). Infants with severe IVH and mortality had lower T4 and higher SNAP scores when compared to infants without these conditions. These differences persisted after controlling for the confounding effect of gestational age. Analysis of receiver operator curves indicated that high SNAP and low T4 were equivalently associated with IVH, severe IVH, and mortality. Our data indicate that T4 is associated with illness severity in very low-birth-weight infants. Low T4 levels and high SNAP scores are both associated with the outcomes of IVH and mortality in very low-birth-weight infants.

Cerebral Hemorrhage↗
PubMed1992

Low renal net acid excretion, high calciuria and biochemical signs of sodium deficiency in low-birth-weight infants fed a new low-phosphorus formula.

In 11 infants (birth weight greater than 1800 g) fed a new type of humanized formula with a low phosphorus (P) content (calcium (Ca) 11 mmol/l, P 7.2 mmol/l, sodium (Na) 8.3 mmol/l) biochemical parameters of blood, serum and urine were determined. In nine boys Ca and P balances were evaluated also. Renal net acid excretion was low (0.85 mmol/kg/day). Mean concentrations of P and Ca in urine were 0.34 mmol/kg/day (10.5 mg/kg/day) and 0.1 mmol/kg/day (4 mg/kg/day), respectively. In four infants, Ca concentration in urine was, however, greater than 0.15 mmol/kg/day) (6 mg/kg/day). In infants with birth weights greater than 1800 g fed the new, low-P formula, the low renal net acid excretion, the normal P and the high Ca concentrations in urine were comparable to term infants fed human milk. The high calciuria in several infants may be normal physiologic values. However, it remains to be established that the urinary solubility product of infants fed the new, low-P formula is in the same range as those for infants fed human milk. Unexpectedly, low urinary Na excretion (0.26 mmol/kg/day) and increased urinary excretion of aldosterone-18-glucuronide indicated biochemical evidence of Na deficiency secondary to low Na intake and a high weight gain. If the new, low-P formula is to be fed to infants with a birth weight as low as 1800 g. Na content should be higher than in mature human milk because of the often relatively higher weight gain.

Acid-Base Equilibrium↗