Hypophosphatemia in small for gestational age extremely low birth weight infants receiving parenteral nutrition in the first week after birth

All of the infants entered into the study were low-birth-weight infants (<2,500 gm). The majority of infants had a gestational age less than 37 completed weeks, and, of these, some were also small for gestational age. Sixteen infants had a gestational age of ≥37 weeks but were included in the study because their birth weight was below the tenth percentile for their gestational age. We agree with Drs Knobloch and Malone's comment about the interrelationship of all three figures: as gastation advances, birth weight and head circumference increase.

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INSENSIBLE WATER LOSS IN LOW BIRTH WEIGHT INFANTS

PEDIATRICS ◽

10.1542/peds.50.2.236 ◽

1972 ◽

Vol 50 (2) ◽

pp. 236-245 ◽

Cited By ~ 1

Author(s):

Avroy A. Fanaroff ◽

Michael Wald ◽

Howard S. Gruber ◽

Marshall H. Klaus

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Water Loss ◽

Thermal Environment ◽

Heat Shield ◽

Low Birth Weight Infants ◽

Water Losses ◽

Large Water

Insensible water loss (IWL) was determined from measurements of insensible weight loss during the first 7 weeks of life on 30 immature and nine small-for-gestational age, low birth weight infants. Under standard conditions (single-walled incubator, infant nude, gavage feeding), 10 infants with birth weights less than 1,250 gm, gestational age < 230 days (32 weeks) and postnatal age <10 days lost >2.5 gm/kg/hr (equivalent to 60-120 ml/kg/day), considerably higher than previously reported. Studies following the insertion of a plastic heat shield revealed a 25% reduction in IWL. The heat shield facilitates achievement of neutral thermal environment and reduced water losses in low birth weight infants. IWL measurements in infants with birth weights >1,500 gm and those small-for-gestational age were similar to previously reported studies. Because of the known limited ability of small immature infants to increase metabolic rate, these extremely high losses are believed to represent disproportionately larger water losses from skin. Skin factors predisposing to large water loss in immature infants include thinner epidermis, increased water content, and increased permeability.

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Serum Thymic Hormone Activity and Cell-Mediated Immunity in Healthy Neonates, Preterm Infants, and Small-for-Gestational Age Infants

PEDIATRICS ◽

10.1542/peds.67.3.407 ◽

1981 ◽

Vol 67 (3) ◽

pp. 407-411

Author(s):

R. K. Chandra

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Lymphocyte Stimulation ◽

Cell Mediated Immunity ◽

Low Birth Weight Infants ◽

Thymic Hormone ◽

Appropriate For Gestational Age

Groups of healthy, small-for-gestational age (SGA) and preterm appropriate-for-gestational age (AGA) infants were studied at birth, 1 month, 3 months, and 12 months of age. Serum thymic hormone (TH) activity was assayed, the number of T lymphocytes in the peripheral blood was counted, and in vitro lymphocyte stimulation responses to phytohemagglutinin (PHA) were evaluated. TH activity was decreased in 1-month-old SGA infants. T cells were reduced in all low birth weight infants; the number reverted to normal by 3 months of age in preterm AGA infants, whereas it remained low for at least 12 months in the SGA group. Lymphocyte stimulation response was decreased in low birth weight infants; the extent of depression paralleled reduction in T lymphocyte number. These observations indicate that cell-mediated immunity is impaired in low birth weight newborns and reduced TH activity may be one of the pathogenetic factors involved. Persistent depression of immunocompetence may underlie the increased susceptibility of SGA infants to infection-related morbidity and mortality.

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