THE POSTNATAL DEVELOPMENT OF THE COAGULATION SYSTEM IN THE PREMATURE INFANT

1987 ◽  
Author(s):  
M Andrew ◽  
B A Paes ◽  
R A Milner ◽  
P J Powers ◽  
M Johnston ◽  
...  
Keyword(s):  
Premature Infant ◽  
Postnatal Development ◽  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Term Infant ◽  
Full Term ◽  
Screening Tests ◽  
Coagulation System ◽  
Term Infants

A cohort study was performed to determine the postnatal development of the coagulation system in the “healthy” premature infant. Mothers were approached for consent and a total of 132 premature infants were entered into the study. The group consisted of 64 infants with gestational ages of 34-36 weeks (prem 1) and 68 infants whose gestational age was 33 weeks or less (prem 2). Demographic information and a 2 ml blood sample were obtained on days 1, 5, 30, 90, and 180. Plasma was fractionated and stored at −70°C for batch assaying of the following tests: screening tests, PT, APTT; factor assays (biologic (B)); fibrinogen, II, V, VII, VIII:C, IX, X, XI, XII, prekallikrein, high molecular weight kininogen, XIII (immunologic (I)); inhibitors (I), antithrombin III, aα2-antiplasmin, α2-macroglobulin, α-anti-trypsin, Cl esterase inhibitor, protein C, protein S, and the fibrinolytic system (B); plasminogen. We have previously reported an identical study for 118 full term infants. The large number of premature and full term infants studied at varying time points allowed us to determine the following: 1) coagulation tests vary with the gestational age and postnatal age of the infant; 2) each factor has a unique postnatal pattern of maturation; 3) near adult values are achieved by 6 months of age; 4) premature infants have a more rapid postnatal development of the coagulation system compared to the full term infant; and 5) the range of reference values for two age groups of premature infants has been established for each of the assays. These reference values will provide a basis for future investigation of specific hemorrhagic and thrombotic problems in the newborn infant.

Percentile estimates of reference values for total protein and albumin in sera of premature infants (less than 37 weeks of gestation).

1987 ◽  
Vol 33 (3) ◽  
pp. 411-413 ◽  
Author(s):  
S H Zlotkin ◽  
C W Casselman
Keyword(s):  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Total Protein ◽  
Protein Concentration ◽  
Term Infant ◽  
Full Term ◽  
Albumin Concentration ◽  
Total Protein Concentration ◽  
Term Infants

Abstract We measured the concentrations of total protein and albumin in sera of 281 well-fed premature infants, gestational ages 22-36 weeks, and calculated reference values from the 10th to 90th percentiles. The mean serum albumin concentration (27.6 +/- 4.4 g/L, mean +/- SD) and total protein concentration (49.2 +/- 6.7 g/L) at a postnatal age of 14.5 days were lower than reference values for full-term infants. We detected a significant positive correlation between albumin concentration and gestational age (r = 0.34, p less than 0.01) and total protein concentration and gestational age (r = 0.43, p less than 0.01). Even though albumin values were low, generalized edema was not present. We conclude that values for total protein and albumin in the preterm infant are lower than in the full-term infant but are an expected physiological response to premature birth.

Round Table Discussion

PEDIATRICS ◽  
1951 ◽  
Vol 8 (3) ◽  
pp. 431-434
Author(s):  
HEYWORTH N. SANFORD ◽  
J. HAROLD ROOT ◽  
R. H. GRAHAM
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Death Rate ◽  
Round Table ◽  
Term Infant ◽  
Full Term ◽  
Round Table Discussion ◽  
Premature Births ◽  
Term Infants ◽  
Full Term Infant

Chairman Sanford: Dr. Herman N. Bundesen, Commissioner of Health of Chicago, organized 12 years ago the "Chicago Premature Plan." This consists in registering all premature infants with the City Health Department within a few hours after birth. The premature infant who is born at home, or in a hospital that does not have adequate premature care, is transported in an oxygenated incubator ambulance to a hospital which specializes in such care. From 1936 to 1947 premature infant deaths in Chicago have been lowered 6½%. The full term infant death rate during the same period has been lowered about 3%. Inasmuch as the premature death rate has been lowered about double that of the full term infant rate, we believe this procedure has been the cause of reduction. In 1936 there were 47,000 live births in Chicago. In 1947 there were 82,000, or an increase of 80%. In this number the full term infants increased from 45% to 60%, whereas the premature infants increased from 2000 to over 5000, or about 140% increase of premature infants born in Chicago during the last 10 years. This adds a considerable increase to the number of infants for our available premature infants beds. Where formerly we planned 5 premature births to each 100 full term births, we now find that prematures have increased to 8 per 100 full term infants. Causes of prematurity are multiple births, toxemia, heart disease, syphilis, tuberculosis, infections, accidents, premature separation of the placenta and abnormalities of the reproduction tract. It is generally understood that there is a tendency for more premature births among the Negro race than the white race.

scholarly journals Newborn Screening for Severe Combined Immunodeficiency: Do Preterm Infants Require Special Consideration?

2021 ◽  
Vol 7 (3) ◽  
pp. 40
Author(s):  
Anne E. Atkins ◽  
Michael F. Cogley ◽  
Mei W. Baker
Keyword(s):  
Newborn Screening ◽  
Premature Infant ◽  
Gestational Age ◽  
Linear Regression Analysis ◽  
Severe Combined Immunodeficiency ◽  
Cell Receptor ◽  
Full Term ◽  
Combined Immunodeficiency ◽  
Term Infants ◽  
Preterm Newborns

The Wisconsin Newborn Screening (NBS) Program began screening for severe combined immunodeficiency (SCID) in 2008, using real-time PCR to quantitate T-cell receptor excision circles (TRECs) in DNA isolated from dried blood NBS specimens. Prompted by the observation that there were disproportionately more screening-positive cases in premature infants, we performed a study to assess whether there is a difference in TRECs between full-term and preterm newborns. Based on de-identified SCID data from 1 January to 30 June 2008, we evaluated the TRECs from 2510 preterm newborns (gestational age, 23–36 weeks) whose specimens were collected ≤72 h after birth. The TRECs from 5020 full-term newborns were included as controls. The relationship between TRECs and gestational age in weeks was estimated using linear regression analysis. The estimated increase in TRECs for every additional week of gestation is 9.60%. The 95% confidence interval is 8.95% to 10.25% (p ≤ 0.0001). Our data suggest that TRECs increase at a steady rate as gestational age increases. These results provide rationale for Wisconsin’s existing premature infant screening procedure of recommending repeat NBS following an SCID screening positive in a premature infant instead of the flow cytometry confirmatory testing for SCID screening positives in full-term infants.

Dysphagia and Oral Feeding Problems in the Premature Infant

2002 ◽  
Vol 21 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Martha Wilson Jones ◽  
Elaine Morgan ◽  
Jean Shelton
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Term Infant ◽  
Oral Feeding ◽  
Feeding Disorders ◽  
Feeding Problems ◽  
The Past ◽  
Common Problems

FEEDING DISORDERS AND dysphagia are common problems seen in premature infants following their discharge from the NICU. A major factor in the growing incidence of these problems is the number of infants born and surviving between 23 and 25 weeks gestational age, which has increased dramatically over the past decade. These infants experience both a lengthier exposure to noxious oral stimuli and a longer time until they develop the suck/swallow coordination that makes oral feeding safe.1 Oral feeding is generally not offered before 32–34 weeks gestational age, when the preterm infant’s sucking pattern begins to resemble that of a term infant.2,3 Therefore, there may be an 8- to 9-week lag between birth and oral feedings in a 23- or 24-week gestational age infant.

ALVEOLAR-ARTERIAL O2 AND CO2 DIFFERENCES AND THEIR RELATION TO LUNG VOLUME IN THE NEWBORN

PEDIATRICS ◽  
1968 ◽  
Vol 41 (3) ◽  
pp. 574-587 ◽  
Author(s):  
D. W. Thibeault ◽  
E. Poblete ◽  
P. A. M. Auld
Keyword(s):  
Carbon Dioxide ◽  
Premature Infants ◽  
Lung Volume ◽  
Term Infant ◽  
Full Term ◽  
Arterial Oxygen ◽  
Term Infants ◽  
Oxygen Gradient ◽  
Thoracic Gas Volume ◽  
Gas Volume

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient. In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants.

scholarly journals The influence of birth weight and gestational age on kidney function in premature infants

2021 ◽  
Vol 24 (4) ◽  
pp. 222-230
Author(s):  
Bella D. Tsintsadze ◽  
Klavdiya A. Kazakova ◽  
Vladislav V. Chernikov ◽  
Andrey P. Fisenko ◽  
Aleksey N. Tsygin
Keyword(s):  
Early Childhood ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Serum Creatinine ◽  
Premature Infants ◽  
Gestational Age ◽  
Full Term ◽  
Enzymatic Method ◽  
Term Infants ◽  
Blood Creatinine

Introduction. The impact of prematurity on the functional state of the kidneys in infants has not yet been sufficiently studied. Aim. To determine the influence of birth weight and gestational age on the creatinine level in the blood and glomerular filtration rate (GFR) in early childhood. Materials and methods. A retrospective analysis was conducted on medical records of 316 children aged from 1 month to 1.5 years, hospitalized at the Department of Early Childhood Pathology (National Medical Research Center for Children’s Health, Moscow) from 2012 to 2020 due to consequences of perinatal CNS damage. Children without congenital kidney diseases, with normal urine values in medical history, without structural abnormalities on ultrasound were included in this study. Serum creatinine was determined by the enzymatic method, GFR - by the Schwartz’s formula using a coefficient of 0.413, as well as, previously proposed coefficients of 0.33 for premature and 0.44 for full-term infants. Results. In premature infants, notably born with extremely low birth weight and very low birth weight, at the age of 1 year, serum creatinine is reduced compared to full-term infants, GFR in deep-premature infants exceeds the level of GFR in full-term infants by the year. The results allow concluding the method of calculating GFR by formulas based on serum creatinine to be invalid. Due to possible hyperfiltration in preterm infants, they need regular monitoring urine tests, blood pressure, due to the risk of developing chronic kidney disease. Conclusions. It is necessary to search for other methods for determining GFR in extremely premature infants. The established indices of the blood creatinine content can be used as reference values for different periods of gestation and body weight at birth in institutions using the enzymatic method for determining blood creatinine. The obtained GFR indices as a reference can be recommended for full-term and premature babies born after 32 weeks of gestation and with a birth weight of more than 1500 g.

scholarly journals Lymphocyte-Specific Biomarkers Associated with Preterm Birth and Bronchopulmonary Dysplasia

2020 ◽  
Author(s):  
Soumyaroop Bhattacharya ◽  
Jared A. Mereness ◽  
Andrea M. Baran ◽  
Ravi S. Misra ◽  
Derick R. Peterson ◽  
...  
Keyword(s):  
Gene Expression ◽  
T Cells ◽  
Premature Infants ◽  
Cd8 T Cells ◽  
Gestational Age ◽  
Full Term ◽  
Oxygen Utilization ◽  
Term Infants ◽  
Transcriptomic Data ◽  
The University

AbstractMany premature babies who are born with neonatal respiratory distress syndrome (RDS) go on to develop Bronchopulmonary Dysplasia (BPD) and later Post-Prematurity Respiratory Disease (PRD) at one year corrected age, characterized by persistent or recurrent lower respiratory tract symptoms frequently related to inflammation and viral infection. Transcriptomic profiles were generated from sorted peripheral blood CD8+ T cells of preterm and full-term infants enrolled with consent in the NHLBI Prematurity and Respiratory Outcomes Program (PROP) at the University of Rochester and the University at Buffalo. We identified outcome-related gene expression patterns following standard methods to identify markers for oxygen utilization and BPD as outcomes in extremely premature infants. We further identified predictor gene sets for BPD based on transcriptomic data adjusted for gestational age at birth (GAB).RNA-Seq analysis was completed for CD8+ T cells from 145 subjects. Among the subjects with highest risk for BPD (born at <29 weeks gestational age (GA); n=72), 501 genes were associated with oxygen utilization. In the same set of subjects, 571 genes were differentially expressed in subjects with a diagnosis of BPD and 105 genes were different in BPD subjects as defined by physiologic challenge. A set of 92 genes could predict BPD with a moderately high degree of accuracy. We consistently observed dysregulation of NRF2, HIPPO and CD40-associated pathways in BPD. Using gene expression data from both premature and full-term subjects (n=116), we identified a 28 gene set that predicted the PRD status with a moderately high level of accuracy.Transcriptomic data from sort-purified peripheral blood CD8+ T cells from 145 preterm and full-term infants identified sets of molecular markers associated with independent development of BPD in extremely premature infants at high risk for the disease and of PRD among the preterm and full-term subjects.

LEVEL OF HYALURONIDASE INHIBITOR IN THE SERUM OF PREMATURE INFANTS WITH RETROLENTAL FIBROPLASIA

PEDIATRICS ◽  
1952 ◽  
Vol 10 (5) ◽  
pp. 533-537
Author(s):  
JULIA B. MACKENZIE
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Term Infant ◽  
Full Term ◽  
Retrolental Fibroplasia ◽  
Full Term Infant ◽  
Hyaluronidase Inhibitor ◽  
Order Of Magnitude ◽  
Severity Of The Disease

The serum of the premature infant contains material which inhibits bovine hyaluronidase. This inhibitor was found to be present to about the same degree in infants with and without retrolental fibroplasia and appeared to be unrelated to the severity of the disease. The level of the physiologic inhibitor of hyaluronidase found in the blood of the premature and full term infant is approximately of the same order of magnitude.

MATERNAL, CORD, AND SERIAL VENOUS BLOOD: PROTEIN-BOUND IODINE, THYROID-BINDING GLOBULIN, THYROID-BINDING ALBUMIN, AND PREALBUMIN VALUES IN PREMATURE INFANTS

PEDIATRICS ◽  
1965 ◽  
Vol 35 (5) ◽  
pp. 759-764
Author(s):  
Ralph E. Perry ◽  
Joan E. Hodgman ◽  
Paul Starr
Keyword(s):  
Cord Blood ◽  
Premature Infant ◽  
Premature Infants ◽  
Gestational Age ◽  
Venous Blood ◽  
Blood Protein ◽  
Term Infants ◽  
Protein Levels ◽  
Weight Groups ◽  
Abrupt Rise

1. P.B.I. and thyroid-binding protein levels in mothers delivering premature infants of varying weights are the same as those reported for mothers delivering at term. The maternal T.B.G. is from 50-60% greater than the T.B.G. of the cord blood. 2. The cord P.B.I. in the smallest infants is significantly lower than their mothers' and is lower than that of the babies weighing over 1,500 gm. 3. The characteristic newborn P.B.I. pattern of abrupt rise in the 48 hours after birth followed by a more gradual fall has been established for the premature infant. The magnitude of rise is less in the smallest prematures. The increase in P.B.I. following delivery is found in all weight groups and does not appear to be associated with the gestational age. 4. T.B.G. levels in prematures are the same as those reported in term infants, and are stable throughout the first 10 days. The rise in P.B.I. cannot be attributed to a change in T.B.G. 5. A pattern of alterations in T.B.A. and T.B.P.A. has been described.

THE EFFECT OF POSITION ON THE RESPIRATORY RATE OF PREMATURE AND MATURE NEWBORN INFANTS

PEDIATRICS ◽  
1958 ◽  
Vol 22 (3) ◽  
pp. 432-435
Author(s):  
Harvey Kravitz ◽  
Lawrence Elegant ◽  
Bernard Block ◽  
Mary Babakitis ◽  
Evelyn Lundeen
Keyword(s):  
Respiratory Rate ◽  
Premature Infant ◽  
Prone Position ◽  
Premature Infants ◽  
Supine Position ◽  
Newborn Infants ◽  
Full Term ◽  
Term Infants ◽  
Definite Effect

Values for respiratory rates in the supine and prone positions in 96 premature and 49 full-term infants have been presented. Premature infants have a significant increase in respiratory rate in the prone position compared to the supine position. This difference decreases with increasing weight and age. Mature infants show a slight increase in respiratory rate in the prone compared to the supine position. The position of the premature infant has a definite effect on the physiology of respiration. Further studies must be done to establish whether the supine or prone position is superior. Irregularity of rate and amplitude of respirations are noted in the supine position, while respirations of regular rate and amplitude are frequently found in the prone position. The amplitude of respiration was greater in the supine position than in the prone position.

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