Assessment of Anthropometric Measurements as Predictors of Car Seat Screening Failure

2017 ◽  
Vol 34 (13) ◽  
pp. 1318-1325
Author(s):  
Elena Donald ◽  
Maura Heffernan ◽  
Brian Corwell ◽  
Natalie Davis
Keyword(s):  
Preterm Infants ◽  
Anthropometric Measurements ◽  
Multiple Gestation ◽  
Term Infants ◽  
Car Seat ◽  
Increased Risk ◽  
Absolute Measurements ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Record Review

Objective The objective of this study was to determine whether anthropometric measurements such as head circumference (HC), body mass index (BMI), and body surface area (BSA) can predict car seat tolerance screen (CSTS) failure. We hypothesized that subjects with larger HC and lower BMI/BSA would have increased risk of failure. Study Design We performed retrospective medical record review of infants born in 2013 who qualified for CSTS due to being born preterm (< 37 weeks) or low birth weight (LBW). We performed bivariate analyses of clinical and demographic risk factors including anthropometrics to identify predictors of CSTS failure. Results In this study, 19 of 366 subjects failed their CSTS (5.3%). There were no significant differences in HC, length, BSA, BMI, or ratio of HC to length, BMI, or BSA between those who passed versus failed. On subgroup analysis of preterm infants, the significant predictor of failure was multiple gestation (p = 0.024). In the term LBW cohort, requiring nasal canula (NC) (p = 0.03) and having limited or no prenatal care (PNC) (p = 0.0006) were both significant predictors of failure. Conclusion Neither absolute measurements nor the ratios of HC to body measurements predicted CSTS outcome. Multiple gestation was a significant predictor of failure in preterm infants, while NC requirement and poor PNC were predictors in LBW term infants.

Vaccinations in Infants Born Preterm: An Update

2020 ◽  
Vol 16 (2) ◽  
pp. 148-155
Author(s):  
Areti Aphrodite Sioriki ◽  
Despoina Gkentzi ◽  
Evangelia Papadimitriou ◽  
Gabriel Dimitriou ◽  
Ageliki Karatza
Keyword(s):  
Preterm Infants ◽  
Vaccine Safety ◽  
Full Term ◽  
Morbidity And Mortality ◽  
Term Infants ◽  
Safety And Efficacy ◽  
Vaccine Preventable Diseases ◽  
Increased Risk ◽  
Protective Antibodies

Infants born prematurely (before completion of 37 weeks of gestation) are at increased risk of morbidity and mortality due to vaccine preventable diseases, mostly because of their immunological immaturity and failure of transfer of maternal protective antibodies. Despite their great need of being vaccinated, concerns on vaccine safety and efficacy, constitute the main reasons for which vaccinations are often delayed in this group. In this review we summarize the latest evidence on vaccine safety, efficacy and immunogenicity in preterm infants which is similar to full-term infants. Therefore there is no reason for delaying vaccination in this population.

scholarly journals Metastatic Bladder Cancer Presenting with Persistent Hematuria in Young Man with Cystic Fibrosis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Premal Patel ◽  
Harvey R. Rabin ◽  
Michael M. Vickers ◽  
Michael D. Parkins
Keyword(s):  
Risk Factors ◽  
Cystic Fibrosis ◽  
Bladder Cancer ◽  
Renal Colic ◽  
Atypical Symptoms ◽  
Metastatic Bladder Cancer ◽  
Increased Risk ◽  
Demographic Risk ◽  
Demographic Risk Factors ◽  
Rule Out

We report a case of metastatic bladder cancer developing in a young man with cystic fibrosis (CF) that was initially diagnosed as ureterolithiasis and managed as renal colic. With the improved survival of patients with CF, an increasing burden of extrapulmonary disease manifestations is apparent. Renal colic is observed at an increased frequency in patients with CF relative to the general population and is a commonly recognized cause of hematuria. However, CF patients harboring a malignancy are recognized to be at increased risk of delayed identification owing to atypical symptoms and lack of demographic risk factors. This case illustrates how investigations to rule out malignancy are warranted in those CF patients not responding to therapies directed towards presumptive diagnoses.

scholarly journals Neurodevelopmental Outcome Among Multiples and Singletons: A Regional Neonatal Intensive Care Unit's Experience in Turkey

2013 ◽  
Vol 16 (2) ◽  
pp. 614-618 ◽  
Author(s):  
Zeynep Eras ◽  
Banu Mutlu Ozyurt ◽  
Gozde Kanmaz ◽  
Omer Erdeve ◽  
Evrim Durgut Sakrucu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neurodevelopmental Outcome ◽  
Index Score ◽  
Multiple Gestation ◽  
Increased Risk ◽  
Developmental Index ◽  
Neurodevelopmental Impairment ◽  
A Prospective Study

Objective: The aim of this study was to compare the neurodevelopmental outcome at 12–18 months’ corrected age between multiples and singleton preterm infants. Methods: We designed a prospective study of preterm infants (≤32 weeks gestation) born and hospitalized in the neonatal intensive care unit between November 2008 and November 2009, whose assessments were performed at 12–18 months’ corrected age. Neurodevelopmental impairment was defined as the presence of any one of the following: moderate or severe cerebral palsy, severe bilateral hearing loss or bilateral blindness, mental developmental index score, or psychomotor developmental index score less than 70. Results were compared for both multiples and singleton infants. Results: One hundred and fifty-nine multiples and 211 singleton infants were assessed at 12–18 months’ corrected age. The neurodevelopmental outcome including all parameters at 12–18 months’ corrected age in multiples was not significantly different from singleton preterm infants. Conclusions: Multiple gestation in preterm infants is not associated with an increased risk of neurodevelopmental impairment at 12–18 months’ corrected age compared with singleton preterm infants. For further information, long term and high participation in neurodevelopmental follow-up and evaluation at pre-school age will be needed.

scholarly journals Responses to a Conjugate Pneumococcal Vaccine in Preterm Infants Immunized at 2, 3, and 4 Months of Age

2010 ◽  
Vol 17 (11) ◽  
pp. 1810-1816 ◽  
Author(s):  
S. J. Moss ◽  
A. C. Fenton ◽  
J. A. Toomey ◽  
A. J. Grainger ◽  
J. Smith ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Pneumococcal Disease ◽  
Geometric Mean ◽  
Enzyme Linked Immunosorbent Assay ◽  
Type B ◽  
Term Infants ◽  
Increased Risk ◽  
Pneumococcal Serotype ◽  
Specific Igg ◽  
Second Year

ABSTRACT Preterm infants are at an increased risk of invasive pneumococcal disease infection and, additionally, have a diminished response to Haemophilus influenzae type b (Hib) conjugate vaccines. There are little data examining the response of preterm infants to a seven-valent pneumococcal conjugate vaccine (PCV7). We examined the responses of preterm infants immunized at 2, 3, and 4 months of age to PCV7. A total of 133 preterm and 54 term infants were immunized with PCV7 and the Neisseria meningitidis group C (MCC), diphtheria, tetanus, pertussis, polio, and Hib vaccines. Pneumococcal serotype-specific IgG was measured by enzyme-linked immunosorbent assay (ELISA) pre- and postimmunization and at 12 months or following a booster of PCV7. Term and preterm responses were compared using linear and logistic regression analyses. Term infants had higher preimmunization geometric mean concentrations (GMCs) for all serotypes. Preterm infants had lower postimmunization GMCs for serotype 23F. Gestational age affected postimmunization GMCs for serotypes 4, 6B, and 23F. Preterm infants were as likely to have levels of ≥0.35 μg/ml as term infants for all serotypes except 23F. The proportions of infants with titers of ≥0.35 μg/ml for all 7 serotypes were comparable between groups. A total of 28 of 29 term infants who received a booster had levels of ≥0.35 μg/ml for all serotypes. One infant had undetectable levels for serotype 6B. Of the 32 preterm infants boosted, 9 had levels of <0.35 μg/ml for 1 serotype, and 1 had levels of <0.35 μg/ml for 2 serotypes. In nonboosted infants, GMCs for all serotypes except 6B had fallen by 12 months of age. These results support the need for a booster dose in the second year of life.

scholarly journals Analysis of clinico-demographic risk factors for postoperative pulmonary complications following gastrointestinal surgery

2019 ◽  
Vol 7 (1) ◽  
pp. 93
Author(s):  
Vijay Sinouvassan ◽  
Hemalatha Dayalane ◽  
Subalakshmi Balagurunathan ◽  
Ashok Kumar Sahoo ◽  
Vishnu Kanth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Gastrointestinal Surgery ◽  
Pulmonary Complications ◽  
Lung Pathology ◽  
Postoperative Pulmonary Complications ◽  
Increased Risk ◽  
Education Status ◽  
Demographic Risk ◽  
Demographic Risk Factors

Background: Postoperative pulmonary complications (PPC) are one of the commonest complications following gastrointestinal surgery. They lead to increased mortality, increased length of intensive care unit (ICU) stay, and higher cost of treatment. Identifying the risk factors of PPC helps in predicting its occurrence and to develop preventive measures. The objectives of the present study were to study the clinical and demographic risk factors for PPC following gastrointestinal surgery.Methods: The study was designed as an observational descriptive analytic study. All the patients ≥18 years of age undergoing gastrointestinal surgery were included. The patients with preoperative lung pathology requiring ICU care or ventilatory support and patients with lung metastasis were excluded. The demographic and clinical parameters at admission were recorded. The details of pulmonary complications like the time of occurrence after surgery and the mode of treatment for pulmonary complications were noted. The risk association was assessed for statistical significance.Results: A total of 100 patients were underwent various gastrointestinal surgeries during the study period. The incidence of PPC was 34% in our study. Age, education status, smoking, and presence of comorbidities were found to be positively associated with an increased incidence of PPCs. The serum albumin of less than 3.5gm and the haemoglobin of less than 8 gm were also associated with an increased incidence of PPC. Pleural effusion was the commonest PPC seen in 15 (44.1%) patients followed by pneumonia in 9 (26.5%).Conclusions: Age, smoking, education status, serum albumin, haemoglobin, emergency surgery, elective postoperative ventilation, nasogastric intubation and blood loss in the intraoperative period were found to associated with increased risk of PPCs. 

scholarly journals Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
E. Chiappini ◽  
C. Petrolini ◽  
C. Caffarelli ◽  
M. Calvani ◽  
F. Cardinale ◽  
...  
Keyword(s):  
Adverse Events ◽  
Preterm Infants ◽  
Gestational Age ◽  
Standard Of Care ◽  
Vaccination Schedule ◽  
Italian Society ◽  
System Response ◽  
Term Infants ◽  
Hexavalent Vaccine ◽  
Increased Risk

AbstractHexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.

Respiratory Syncytial Virus in Otherwise Healthy Prematurely Born Infants: A Forgotten Majority

2018 ◽  
Vol 35 (06) ◽  
pp. 541-544 ◽  
Author(s):  
Bosco Paes
Keyword(s):  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Burden Of Illness ◽  
Hospital Costs ◽  
Chronic Obstructive ◽  
Term Infants ◽  
Increased Risk ◽  
Syncytial Virus

AbstractHealthy, premature infants ≤35 weeks' gestational age (wGA) are universally recognized to be at an increased risk of perinatal morbidity and mortality. Serious respiratory syncytial virus (RSV) lower respiratory tract infection imposes an additional burden of illness on these infants following hospitalization. Incurred morbidities relative to term infants include longer lengths of hospital stay, admission to intensive care, and need for oxygen and mechanical ventilation, all of which are associated with increased hospital costs. The highest morbidities are experienced by premature infants who are youngest (<3 months' chronological age) and are of lower gestational age. Short- and long-term follow-up indicates that healthy preterm infants both of lower gestational age and who are late preterm have obstructive lung function at baseline, which is further compromised by RSV-related infection during infancy. There is increasing evidence that childhood exposure to an episode of RSV infection may set the stage for an abnormal respiratory function trajectory, which, in adulthood, leads to chronic obstructive pulmonary disease. Healthy premature infants <32 wGA merit RSV prophylaxis based on existing data, whereas moderate- and high-risk preterm infants 32 to 35 wGA should be selectively and cost-effectively targeted for prophylaxis using validated risk scoring tools and country-specific thresholds for funding.

Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation: a systematic review and meta-analysis

2019 ◽  
Vol 105 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Abdul Razak ◽  
Maher Faden
Keyword(s):  
Mechanical Ventilation ◽  
Diagnostic Accuracy ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Late Preterm ◽  
Lung Ultrasonography ◽  
Term Infants ◽  
Surfactant Treatment ◽  
Increased Risk

ContextLung ultrasonography (LUS) is increasingly used to identify various neonatal respiratory disorders. There is emerging evidence that it can identify infants with significant lung disease who need surfactant treatment or mechanical ventilation.ObjectiveTo systematically review the accuracy of LUS in determining the need for surfactant treatment or mechanical ventilation in infants with respiratory distress treated with nasal continuous positive airway pressure (NCPAP).MethodsDatabase search include EMBASE, Medline, CINAHL and Cochrane central from inception until 17 October 2018. Included is diagnostic accuracy studies reporting LUS evaluating surfactant therapy/mechanical ventilation. Two authors extracted data independently and assessed quality. Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to determine the methodological quality.ResultsSix studies involving 485 infants included in the review. Three studies used LUS score, two used type 1 lung profile, and one used high-risk LUS to evaluate the outcome. The pooled sensitivity and specificity at LUS score cut-off >5–6 was 88% (95% CI 80% to 93%) and 82% (95% CI 74% to 89%), respectively. Infants with LUS score >5–6 were at significantly increased risk of surfactant treatment compared with infants with LUS score <5–6 (relative risk=7.51; 95% CI 4.16 to 13.58; two studies; participants=189; I2=0%). The diagnostic accuracy of type 1 lung profile was better in younger preterm infants (sensitivity 88.9%, specificity 100%) compared with late preterm and term infants (sensitivity 100%, specificity 28%).ConclusionsLUS, particularly LUS score, can be used accurately to determine the need for surfactant replacement treatment or mechanical ventilation in infants with respiratory distress treated with NCPAP support. The accuracy is better in younger preterm infants compared with late preterm and term infants.PROSPERO registration numberCRD42018115135.

scholarly journals Early neonatal morbidities in late preterm compared to term neonates born in a tertiary care private hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 565
Author(s):  
Yogesh P. Mehta ◽  
Manjusha Bhicurao Naik ◽  
Kinnera Putrevu
Keyword(s):  
Preterm Infants ◽  
Tertiary Care ◽  
Full Term ◽  
Late Preterm ◽  
Term Infants ◽  
Term Neonates ◽  
Late Preterm Infants ◽  
Increased Risk ◽  
Preterm Babies ◽  
Term Newborns

Background: Late preterm babies, born between 34 completed weeks of gestation through 36 weeks 6/7 gestation, tend to be physiologically less mature than term infants, subjecting them to an increased risk of developing various morbidities. Limited information is available regarding the current scenario in India. Therefore, the objective of this study was to understand and compare the early morbidities in late preterm newborns with those in full term babies in a tertiary hospital in India.Methods: The current prospective, observational study consisted of total 150 babies divided into two groups equally; late preterm neonates born between 34 and 36 weeks of gestation and full-term neonates. Weight (at birth, at 72 hours), heart rate, temperature and respiratory parameters were noted of all babies. The newborns were examined for respiratory morbidities, ability to breastfeed, hypoglycemia, hypothermia, neonatal jaundice and signs of sepsis. The need for resuscitation, admission to neonatal intensive care unit (NICU) and parenteral nutrition was also assessed. Data was expressed as mean±SD and was analyzed using the Student ‘t’ and Mann Whitney U tests.Results: The mean length and weight at birth in late preterm babies was significantly lesser than term newborns. Late preterm babies were found to have significantly higher incidence of complications like hyperbilirubinemia (62.7% vs 13.3%), respiratory morbidities (16% vs 4%), poor feeding, hypothermia, hypoglycemia, and sepsis compared to term newborns (p<0.01).Conclusions: Late preterm infants are at a higher risk than term infants for a number of neonatal complications. Initiatives imparting special care to late preterm infants are required in order to lower the morbidities endured by this population.

scholarly journals A comparative study of morbidity pattern among term and late preterm infants in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 593
Author(s):  
Kiran Haridas ◽  
Rajendra Shinde ◽  
Pritesh Nagar ◽  
Hemant Parakh
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Neonatal Period ◽  
Tertiary Care ◽  
Late Preterm ◽  
Care Hospital ◽  
Term Infants ◽  
Late Preterm Infants ◽  
Early Neonatal Period ◽  
Increased Risk

Background: The incidence of preterm birth, defined as delivery before the end of the 37th week of pregnancy from the first day of the last menstrual period, is increasing. India accounts for the 40% of the global burden of low birth weight babies with 7.5million babies born with a birth weight of <2500g. The objective of the study is to compare the morbidity suffered by the late preterm infants with that of term infants.Methods: This was a retrospective study and the data for this study came from the medical records of maternal and neonatal case sheets and discharge summaries. The data was collected for the period between January 2014 and December 2014. All the late preterm infants born and admitted during early neonatal period were compared with term infants who were born and admitted during early neonatal period to the Aditya Hospital on the basis of maternal, infant and clinical characteristics.Results: A total 292 infants including LPTI and term infant records were obtained. LPTI group had significant problems compared to term infants. The predominant clinical problems at birth and during the early neonatal period are neonatal jaundice, transient tachypnea of newborn, feeding difficulty and probable sepsis.Conclusions: LPTI are at increased risk of morbidity compared to term infants and hence require special attention and care for possible complication during their early neonatal period.

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