scholarly journals Nonphysiological anaemia of prematurity.

1978 ◽  
Vol 53 (11) ◽  
pp. 855-860 ◽  
Author(s):  
C A Wardrop ◽  
B M Holland ◽  
K E Veale ◽  
J G Jones ◽  
O P Gray
Keyword(s):  
Preterm Infants ◽  
Clinical Features ◽  
Gestational Age ◽  
Clinical Consequence ◽  
Feeding Difficulties ◽  
High O2 ◽  
Anaemia Of Prematurity ◽  
Hb Concentration ◽  
Gestational Age At Birth ◽  
Age At Birth

Clinical and haematological findings at the nadir of the refractory, early anaemia of prematurity were compared in a study of 95 preterm infants. 53% of 30 babies less than 32 weeks' gestational age at birth had abnormal clinical features resulting from anaemia at its nadir, with a combination of tachycardia, tachypnoea, dyspnoea and feeding difficulties, diminished activity, and pallor. The expression 'available oxygen', derived from the Hb concentration and Hb-O2 affinity, correlated more closely with clinical features of anaemia that did the Hb concentration alone. A formula is presented that predicts the 'available oxygen', provided the Hb concentration and post-conceptual age are known; this avoids the need for direct measurement of Hb-O2 affinity. Clinical anaemia is common in preterm infants with Hb concentrations of up to 10.5 g/dl, consequent on the high O2 affinity of fetal Hb. This is the first description of any common clinical consequence of high Hb-O2 affinity.

scholarly journals Time to regain birth weight - a marker to predict the severity of retinopathy of prematurity?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ajay Anvekar ◽  
Sam Athikarisamy ◽  
Shripada Rao ◽  
Andy Gill ◽  
Elizabeth Nathan ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Oxygen Therapy ◽  
Control Groups ◽  
Gestational Age At Birth ◽  
And Control ◽  
Type 1 Rop ◽  
Age At Birth

Abstract Background Poor weight gain in the first few weeks of life has been studied as a predictor of retinopathy of prematurity (ROP). Our aim was to assess whether time taken to regain birthweight (BW) be used as an additional marker to identify infants with type 1 ROP. Methods In this retrospective study, preterm infants (< 27 weeks gestational age at birth) born during the period from 1/1/2010–31/12/2015 at a tertiary neonatal intensive care unit in Australia were included. Twenty-seven preterm infants with Type 1 ROP were identified. Controls (No ROP or ROP other than type 1) were matched with cases on gestational age at birth and BW (1:4 ratio). Data were collected from the database and medical records. Results The median (IQR) gestational age for Type 1 ROP and control groups were 24 (24–26) and 25 (24–26) weeks respectively and median (IQR) BW for Type 1 ROP and control groups were 675 (635–810) and 773 (666–884) grams respectively. Preterm infants with Type 1 ROP were more likely to be small for gestational age (SGA) (18.5% vs 3.7%, p = 0.015) and had increased weeks on oxygen therapy (median 11.9 vs 9.1, p = 0.028). Time to regain BW was longer in preterm infants with type 1 ROP than controls but did not reach statistical significance (median 9 vs 7 days, OR 1.08, 95% CI 1.00–1.17, p = 0.059) adjusted for SGA and duration of oxygen therapy. The area under the curve from the time to regain BW model with adjustment for SGA and duration of oxygen therapy was 0.73 (95% CI 0.62–0.83). Conclusion We hypothesize that time to regain BW has potential to aid prediction of Type 1 ROP and this warrants further investigation in a larger prospective study.

Serial changes in myocardial function in preterm infants over a four week period: the effect of gestational age at birth

2014 ◽  
Vol 90 (7) ◽  
pp. 349-352 ◽  
Author(s):  
Muhammad Shahid Hussain Saleemi ◽  
Afif El-Khuffash ◽  
Orla Franklin ◽  
John David Corcoran
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Myocardial Function ◽  
Gestational Age At Birth ◽  
Age At Birth

scholarly journals Preterm Birth Affects Early Motor Development in Pigs

2021 ◽  
Vol 9 ◽  
Author(s):  
Charlotte Vanden Hole ◽  
Miriam Ayuso ◽  
Peter Aerts ◽  
Steven Van Cruchten ◽  
Thomas Thymann ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Motor Skills ◽  
Gestational Age ◽  
Gait Pattern ◽  
Gestation Length ◽  
Gestation Time ◽  
Gestational Age At Birth ◽  
Normal Gestation ◽  
Age At Birth

Background: Preterm infants frequently show neuromotor dysfunctions, but it is not clear how reduced gestational age at birth may induce developmental coordination disorders. Advancing postnatal age, not only post-conceptional age, may determine neuromuscular development, and early interventions in preterm newborns may improve their later motor skills. An animal model of preterm birth that allows early postnatal detection of movement patterns may help to investigate this hypothesis.Methods: Using pigs as a model for moderately preterm infants, preterm (106-day gestation, equivalent to 90% of normal gestation time; n = 38) and term (115-day gestation, equivalent to 99% of normal gestation time; n = 20) individuals were delivered by cesarean section and artificially reared until postnatal day 19 (preweaning period). The neuromotor skills of piglets were documented using spatiotemporal gait analyses on video recordings of locomotion at self-selected speed at postnatal age 3, 4, 5, 8, and 18 days. Results were controlled for effects of body weight and sex.Results: Both preterm and term piglets reached mature neuromotor skills and performance between postnatal days 3–5. However, preterm pigs took shorter steps at a higher frequency, than term piglets, irrespective of their body size. Within preterm pigs, males and low birth weight individuals took the shortest steps, and with the highest frequency.Conclusion: Postnatal development of motor skills and gait characteristics in pigs delivered in late gestation may show similarity to the compromised development of gait pattern in preterm infants. Relative to term pigs, the postnatal delay in gait development in preterm pigs was only few days, that is, much shorter than the 10-day reduction in gestation length. This indicates rapid postnatal adaptation of gait pattern after reduced gestational age at birth. Early-life physical training and medical interventions may support both short- and long-term gait development after preterm birth in both pigs and infants.

scholarly journals Population Pharmacokinetics of Metronidazole Evaluated Using Scavenged Samples from Preterm Infants

2012 ◽  
Vol 56 (4) ◽  
pp. 1828-1837 ◽  
Author(s):  
Michael Cohen-Wolkowiez ◽  
Daniele Ouellet ◽  
P. Brian Smith ◽  
Laura P. James ◽  
Ashley Ross ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Minimal Risk ◽  
Dosing Regimen ◽  
Data Set ◽  
Relative Standard ◽  
Population Pk ◽  
Postmenstrual Age ◽  
Gestational Age At Birth ◽  
Age At Birth

ABSTRACTPharmacokinetic (PK) studies in preterm infants are rarely conducted due to the research challenges posed by this population. To overcome these challenges, minimal-risk methods such as scavenged sampling can be used to evaluate the PK of commonly used drugs in this population. We evaluated the population PK of metronidazole using targeted sparse sampling and scavenged samples from infants that were ≤32 weeks of gestational age at birth and <120 postnatal days. A 5-center study was performed. A population PK model using nonlinear mixed-effect modeling (NONMEM) was developed. Covariate effects were evaluated based on estimated precision and clinical significance. Using the individual Bayesian PK estimates from the final population PK model and the dosing regimen used for each subject, the proportion of subjects achieving the therapeutic target of trough concentrations >8 mg/liter was calculated. Monte Carlo simulations were performed to evaluate the adequacy of different dosing recommendations per gestational age group. Thirty-two preterm infants were enrolled: the median (range) gestational age at birth was 27 (22 to 32) weeks, postnatal age was 41 (0 to 97) days, postmenstrual age (PMA) was 32 (24 to 43) weeks, and weight was 1,495 (678 to 3,850) g. The final PK data set contained 116 samples; 104/116 (90%) were scavenged from discarded clinical specimens. Metronidazole population PK was best described by a 1-compartment model. The population mean clearance (CL; liter/h) was determined as 0.0397 × (weight/1.5) × (PMA/32)2.49using a volume of distribution (V) (liter) of 1.07 × (weight/1.5). The relative standard errors around parameter estimates ranged between 11% and 30%. On average, metronidazole concentrations in scavenged samples were 30% lower than those measured in scheduled blood draws. The majority of infants (>70%) met predefined pharmacodynamic efficacy targets. A new, simplified, postmenstrual-age-based dosing regimen is recommended for this population. Minimal-risk methods such as scavenged PK sampling provided meaningful information related to development of metronidazole PK models and dosing recommendations.

scholarly journals Identification of epigenetic memory candidates associated with gestational age at birth through analysis of methylome and transcriptional data

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kohei Kashima ◽  
Tomoko Kawai ◽  
Riki Nishimura ◽  
Yuh Shiwa ◽  
Kevin Y. Urayama ◽  
...  
Keyword(s):  
Cord Blood ◽  
Preterm Infants ◽  
Gestational Age ◽  
Disease Susceptibility ◽  
Disease Risk ◽  
Association Studies ◽  
Epigenetic Memory ◽  
Chronic Disease Risk ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractPreterm birth is known to be associated with chronic disease risk in adulthood whereby epigenetic memory may play a mechanistic role in disease susceptibility. Gestational age (GA) is the most important prognostic factor for preterm infants, and numerous DNA methylation alterations associated with GA have been revealed by epigenome-wide association studies. However, in human preterm infants, whether the methylation changes relate to transcription in the fetal state and persist after birth remains to be elucidated. Here, we identified 461 transcripts associated with GA (range 23–41 weeks) and 2093 candidate CpG sites for GA-involved epigenetic memory through analysis of methylome (110 cord blood and 47 postnatal blood) and transcriptional data (55 cord blood). Moreover, we discovered the trends of chromatin state, such as polycomb-binding, among these candidate sites. Fifty-four memory candidate sites showed correlation between methylation and transcription, and the representative corresponding gene was UCN, which encodes urocortin.

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