scholarly journals Prevalence of positional skull deformities in 530 premature infants with a corrected age of up to 6 months: a multicenter study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wang Yang ◽  
Jianping Chen ◽  
Wenzhi Shen ◽  
Chengju Wang ◽  
Zhifeng Wu ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Healthcare Providers ◽  
Age Groups ◽  
The United States ◽  
Adverse Outcomes ◽  
Cranial Measurements ◽  
Outpatient Departments ◽  
Low Incidence

Abstract Background Positional deformities (PD) are common during early infancy. Severe cases may result in facial abnormalities and be associated with delayed neurological development in infants. The earlier the detection of PD, the better the intervention effect and the lower the cost of treatment. Currently, there are many studies on PD in Europe and the United States. However, in China, there is little data on the basic metrics and incidence of PD. Premature infants have a high risk of PD. However, there are few studies on PD in premature infants globally, and none in Asia. This study aimed to investigate PD and its characteristics inpremature infants to help its early detection and intervention and thus improve the quality of life for premature infants. Methods We analyzed 530 preterm infants who visited the outpatient departments at Xinqiao Hospital of Army Medical University and Maternal and Child Health Care Hospitals of Wanzhou and Yongchuan Districts in Chongqing from September 1, 2016, to August 31, 2017. The head shape data measured by a simple manual method were recorded. The diagonal difference (DD) between the transcranial diagonals and the cranial index (CI) was calculated. PD and its incidences indifferent gestational ages and corrected age groups were analyzed. Results According to previously defined international diagnostic criteria, the incidence of plagiocephaly, brachycephaly, and dolichocephaly were 51.1, 85.1, and 3.0% respectively, and those of right and left plagiocephalywere69.4 and 30.6%, respectively. The incidence of PD was highest among infants with a gestational age of < 32 weeks and decreased as the gestational age increased. As the corrected age (CA) increased, the incidence of plagiocephaly and dolichocephaly decreased, and the incidence of brachycephaly increased. Conclusions PD incidence is high among preterm infants. As gestational age decreased, PD incidence and severity increased. Therefore, healthcare providers should implement early PD detection and intervention to prevent the adverse outcomes. The extremely high incidence of brachycephaly and extremely low incidence of dolichocephaly in this study are likely to be due to the variance of cranial metrics caused by cultural differences. The Chinese standards for infant cranial measurements must be established.

scholarly journals 1428. Lyme Disease Treatment in the United States: Prescribing Patterns from a Nationwide Commercial Insurance Database, 2016-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S720
Author(s):  
Amy M Beeson ◽  
Grace E Marx ◽  
Amy M Schwartz ◽  
Alison F Hinckley
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Standard Treatment ◽  
Age Distribution ◽  
Public Health Problem ◽  
The United States ◽  
Adverse Outcomes ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Low Incidence

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p&lt; 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p&lt; 0.0001) and during non-summer months (OR 2.2, p&lt; 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures

scholarly journals Pulse Oximetry Values in Very Preterm infants Asymtomatic at 34-36 weeks post menstrual age.

2020 ◽  
Author(s):  
Ignacio Oyarzún ◽  
Marcela Diaz ◽  
Paulina Toso ◽  
Alejandra Zamorano ◽  
Soledad Montes ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Oxygen Therapy ◽  
Healthy Children ◽  
Multicentric Study ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Postmenstrual Age

Background: Oxygen supplementation is an important component for preterm infants neonatal care. Pulse oximetry (SpO2) is essential to guide oxygen therapy. Evidence on SpO2 values in premature infants previous to discharge is limited. Objectives: To establish SpO2 values in asymptomatic premature infants at 34, 35, and 36 weeks postmenstrual age (PMA). Methods: Longitudinal, multicentric study. From May 2018 to May 2019 premature infants born ≤32 weeks gestational age, from three level III NICUs in Santiago, Chile (altitude 579mt), were enrolled. Healthy children without current apnea of prematurity were included. Continuous SpO2 was obtained with Masimo-Radical 7/8 (USA), averaging time 2-4 seconds. Results: 101 SpO2 recordings (n = 44, 33 and 24 at 34, 35 and 36 weeks PMA respectively) from 62 infants. Twenty eight (45%) male, median (range) gestational age at birth 30 (26-32) weeks, median (range) birth weight 1480 (785-2700) g. Oximetry variables for total recordings: mean SpO2, median (range) 96.9 (93.3-99.3); minimum SpO2, median (range) 74 (51-89); time of SpO2 <90%, median (range) 2% (0-10.6%); time of SpO2 <80%, median (range) 0.1% (0-1.3%); desaturation event by ≥4% (DI4) ≥ 0 and ≥ 10 seconds per sample hour, median (range) 45.2 (5.2-115) and median (range) 15 (3.5-62.5) respectively; desaturation event <80% (DI80), median (range) 0.58 (0-10.8). We found no differences between SpO2 values at different weeks PMA. Conclusions: We described SpO2 values in very preterm infants, asymptomatic at 34, 35 and 36 weeks PMA. These values could be used as a reference to guide oxygen therapy previous to discharge.

Reduction of Sleep Apnea and Bradycardia in Preterm Infants on Oscillating Water Beds: A Controlled Polygraphic Study

PEDIATRICS ◽  
1978 ◽  
Vol 61 (4) ◽  
pp. 528-533
Author(s):  
Anneliese F. Korner ◽  
Christian Guilleminault ◽  
Johanna Van den Hoed ◽  
Roger B. Baldwin
Keyword(s):  
Birth Weight ◽  
Sleep Apnea ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Periodic Breathing ◽  
Quiet Sleep ◽  
Severe Bradycardia

The sleep and respiratory patterns of eight apneic preterm infants were polygraphically recorded for 24 hours. This polygraphic study was designed to test and extend our previous finding that gently oscillating water beds reduce apnea in premature infants. The infants who ranged in gestational age from 27 to 32 weeks and in birth weight from 1,077 to 1,650 gm served as their own controls, off and on the water bed. The 24-hour recordings were divided into four time blocks with the infant being placed on the water bed during alternate six-hour periods. Apnea was significantly reduced while the infants were on the oscillating water beds, with the longest apneic periods and those associated with severe bradycardia being reduced the most. Reduction of apnea was most consistent during indeterminate sleep and most pronounced during quiet sleep. Short respiratory pauses and periodic breathing were not significantly reduced. Reductions of central, obstructive, and mixed apneas were approximately equal.

scholarly journals New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life

2019 ◽  
Vol 109 (5) ◽  
pp. 1353-1360 ◽  
Author(s):  
Tom Norris ◽  
Sara E Ramel ◽  
Patrick Catalano ◽  
Carol ni Caoimh ◽  
Paola Roggero ◽  
...  
Keyword(s):  
United States ◽  
Body Composition ◽  
Preterm Infants ◽  
Fat Mass ◽  
Gestational Age ◽  
The United States ◽  
Fat Free Mass ◽  
Term Infants ◽  
Air Displacement Plethysmography ◽  
Young Infants

ABSTRACT Background Air-displacement plethysmography (ADP) is a good candidate for monitoring body composition in newborns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first 6 mo of life. Objective Using pooled data from 4 studies, we aimed to produce new charts for assessment according to gestational age at birth (30 + 1 to 41 + 6 wk) and postnatal age at measurement (1–27 wk). Methods The sample comprised 222 preterm infants born in the United States who were measured at birth; 1029 term infants born in Ireland who were measured at birth; and 149 term infants born in the United States and 57 term infants born in Italy who were measured at birth, 1 and 2 wk, and 1, 2, 3, 4, 5, and 6 mo of age. Infants whose birth weights were <3rd or >97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. Results For each sex and measure (e.g., fat mass), the new charts comprised 2 panels. The first showed centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reached term. The second showed centiles according to postnatal age, allowing all infants to be monitored to age 27 wk. The LMS values underlying the charts were presented, enabling researchers and clinicians to convert measurements to centiles and z scores. Conclusions The new charts provide a single tool for the assessment of body composition, according to ADP, in infants across the first 6 mo of life and will help enhance early-life nutritional management.

EFFECTS OF AGE, ETHNICITY AND HEALTH BEHAVIOURS ON THE PREVALENCE OF ADVERSE BIRTH OUTCOMES IN TAIWAN

2012 ◽  
Vol 44 (5) ◽  
pp. 513-524 ◽  
Author(s):  
SHU-CHUAN WANG ◽  
MUNG-CHIH LEE
Keyword(s):  
African American Women ◽  
Birth Outcomes ◽  
Chinese Women ◽  
Age Groups ◽  
Health Behaviours ◽  
The United States ◽  
Teenage Mothers ◽  
Adverse Outcomes ◽  
Second Hand Smoke ◽  
Aboriginal Women

SummaryThis study sampled 8432 singleton first live births from Taiwan's 2005 Birth Registration Database to determine if there were more pre-term or low birth weight deliveries among aboriginal women than there were among Han Chinese women, and if the ‘weathering’ hypothesis applied to aboriginal women in Taiwan. Although the aboriginal women were socially disadvantaged and engaged in more unhealthy behaviours, including smoking, drinking, chewing betel quid and exposure to second-hand smoke, the evidence did not support the hypothesis that these teenaged minority women would have better birth outcomes, as has been demonstrated among teenage African-American women in the United States. Behaviours and not ethnicity were risk factors for teenage aboriginal mothers, who started deleterious health behaviours earlier than did their older counterparts. Teenage mothers had more adverse outcomes regardless of ethnicity and aboriginal mothers had more risky behaviours in all age groups. The prevalence of detrimental health behaviour among teenage mothers in Taiwan is of concern, particularly for aboriginal teenage mothers.

scholarly journals Low Gestational Age Is the Strongest Predictor for Severe Retinopathy of Prematurity and Adverse Outcomes at Two-Year Follow-Up in a Low Incidence Setting

2017 ◽  
Vol 07 (01) ◽  
pp. e106-e109
Author(s):  
Stefano Nobile ◽  
Linda Bordignon ◽  
Anna Peretti ◽  
Virgilio Carnielli
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Gestational Age ◽  
Univariate Analysis ◽  
Adverse Outcomes ◽  
Neurological Development ◽  
Neurodevelopmental Outcomes ◽  
Surfactant Administration ◽  
Low Incidence ◽  
Type 1 Rop

AbstractWe aimed to determine the risk factors for type 1 ROP and outcomes at 2 years of corrected age among preterms born < 30 weeks of gestational age (GA) in a low-incidence setting. A cohort study with 447 infants was conducted. Those who underwent laser therapy for type 1 ROP were compared with controls by univariate and multivariate analysis. Neurological development was assessed by Bayley scales. Using univariate analysis, gestational age, sepsis, necrotizing enterocolitis, and insulin administration were found to be associated with type 1 ROP. Only GA remained significant with logistic regression. Infants with type 1 ROP had worse visual and neurodevelopmental outcomes at 2 years. Predictors of impaired neurodevelopment were type 1 ROP, surfactant administration, and bronchopulmonary dysplasia. Low GA was found to be a strong predictor of type 1 ROP, which was associated (along with surfactant administration and bronchopulmonary dysplasia) with worse neurological development.

scholarly journals Reference values for N-terminal Pro-brain natriuretic peptide in premature infants during their first weeks of life

2020 ◽  
Author(s):  
Agnes-Sophie Fritz ◽  
Titus Keller ◽  
Angela Kribs ◽  
Christoph Hünseler
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Preterm Infants ◽  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Temporal Distribution ◽  
Cross Sectional ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract The aim of our study was to observe the temporal distribution of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in premature infants of ≤ 31 weeks of gestational age (GA) during the first weeks of life. NT-proBNP values of 118 preterm infants born ≤ 31 weeks GA were determined during the first week of life, after 4 ± 1 weeks of life, and at a corrected GA of 36 ± 2 weeks. Infants were divided into two groups: those without relevant complications and those with complications related to prematurity. NT-proBNP values of infants without complications define our exploratory reference values. The Median NT-proBNP level of these infants was 1896 ng/l (n = 27, interquartile range (IQR): 1277–5200) during the first week of life, 463 ng/l (n = 26, IQR: 364–704) at 4 ± 1 weeks of life, and 824 ng/l (n = 33, IQR: 714–1233) at a corrected GA of 36 ± 2 weeks. Infants born < 28 + 0 weeks GA had significantly higher NT-proBNP values (n = 9, median: 5200, IQR: 1750–8972) than infants born ≥ 28 + 0–31 weeks GA (n = 18, median: 1528, IQR: 838–3052; p = 0.017). Growth restriction or PDA status could not account for the difference in NT-proBNP values between GA groups. Conclusions: The results of our observational and cross-sectional study describe exploratory reference values for NT-proBNP levels in preterm infants of ≤ 31 weeks GA according to postnatal age. NT-proBNP levels during the first week of life are high and widely distributed in preterm infants and decrease subsequently to reach a distinctly lower and stable plateau at around 1 month of life. Our results suggest an influence of GA on NT-proBNP values in the first week of life. What is Known:• Several complications related to prematurity, e.g., hemodynamically significant PDA, pulmonary hypertension, bronchopulmonary dysplasia, and retinopathy of prematurity, have been associated with a temporary rise in NT-proBNP values in preterm infants during their first weeks of life.What is New:• This observational study provides reference values for NT-proBNP levels of very and extremely preterm infants during their first weeks of life.• In premature infants without complications, NT-proBNP values during their first week of life depend on gestational age at birth.

scholarly journals Placental Vascular Obstructive Lesions: Risk Factor for Developing Necrotizing Enterocolitis

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Laure Dix ◽  
Matthias Roth-Kleiner ◽  
Maria-Chiara Osterheld
Keyword(s):  
Risk Factor ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Strong Association ◽  
Age Groups ◽  
Control Group ◽  
Age Group ◽  
Significant Difference ◽  
And Control

Necrotizing enterocolitis (NEC) is a severe neonatal disease affecting particularly preterm infants. Its exact pathogenesis still remains unknown. In this study, we have compared the prevalence of vascular obstructive lesions in placentae of premature newborns which developed NEC and of a control group. We further compared separately the findings of placentae of infants of less than 30 weeks of gestation, the age group in which NEC occurs most frequently. We found signs of fetal vascular obstructive lesions in 65% of the placentae of preterm patients developing NEC, compared to only 17% of the placentae of preterm patients in the control group. In the age groups below 30 weeks of gestation, 58.5% of placentae of later NEC patients presented such lesions compared to 24.5% in the control group. The significant difference between NEC and control group suggests a strong association between fetal vascular obstructive lesions and NEC. Therefore, we propose that fetal vascular obstructive lesions might be considered as a risk factor for the development of NEC in premature infants.

Amplitude Integrated Electroencephalogram Integration to Monitor the Relationship Between Development and Changes of the Nervous System in Late Preform Infants

2021 ◽  
Vol 11 (6) ◽  
pp. 1704-1712
Author(s):  
Sehua Qu ◽  
Lianqiang Shan ◽  
Xin Chen ◽  
Rui Zhou ◽  
Huaixiang Yin ◽  
...  
Keyword(s):  
Nervous System ◽  
Premature Infants ◽  
Gestational Age ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Age Groups ◽  
Voltage Difference ◽  
Randomized Controlled ◽  
Neuroprotective Strategy ◽  
The Relationship

This article uses amplitude integration of electroencephalogram integration to detect the development of the nervous system of late perform infants, and to study its changes, using a stratified randomized controlled trial method. The preform infants in the neonatal department of postnatal birth had the research object. The sample size was calculated, according to the first set of tires into small gestational age groups, and gestational age large. The subjects of each group were randomly divided into small gestational age groups, small gestational age intervention groups, large gestational age groups and large gestational age intervention groups. Two preterm children increased with age growth. The performance of the broadband and narrowband sector decreased voltage need the voltage lower bound ofa growing trend to the voltage difference becomes smaller. Oral exercise intervention is safe and effective for premature infants over 30 weeks old and can be used clinically as a neuroprotective strategy.

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.

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