STUDIES ON PHYSIOLOGIC HYPERBILIRUBINEMIA OF NEGRO AND WHITE PREMATURE INFANTS

PEDIATRICS ◽  
1958 ◽  
Vol 22 (6) ◽  
pp. 1115-1133
Author(s):  
Gerald H. Holman
Keyword(s):  
Premature Infants ◽  
Exchange Transfusion ◽  
Statistical Significance ◽  
White Child ◽  
Full Term ◽  
Racial Groups ◽  
Term Infants ◽  
Significant Difference ◽  
Group A

Serial determinations of the concentration of bilirubin in the plasma were obtained with 39 premature infants commencing with cord blood in 18 cases. The group consisted of 25 Negro infants and 14 white infants. Concentrations in the plasma were followed until the level fell below 2 mg/100 ml. The hyperbilirubinemia exhibited by these prematures appeared to be due to so-called "physiologic processes" as all procedures to establish other causes were uniformly negative. A definite inverse relationship between the degree of bilirubinemia and the maturity of the infant was shown in both white and Negro infants. Statistical significance was demonstrated when the mean peak concentrations of bilirubin in the plasma of the least mature infants were compared with those of the most mature infants, within each racial group. There was a statistically significant difference between the concentrations of bilirubin in the plasma reached in the two racial groups in the most immature infants. The concentrations were lower in the Negro group. A similar trend was present in the more mature infants, but this was not statistically significant. These findings agree with the fact that the Negro infant is a more mature baby than a white child of the same weight. They also lend support to the thesis that the degree of bilirubinemia is a reflection of the functional maturity of the infant. The possible causes of physiologic hyperbilirubinemia in full-term and premature infants were discussed. Several fields for experimental research are still unexplored. The role of the excretory capacity of the liver, particularly the functional activity of glucuronyl transferase, appears to be preeminent in the etiology of neonatal bilirubinemia. The sudden changes in the dynamics of hepatic blood flow which occur at birth may account, in part at least, for the hepatic immaturity. That the premature infant can develop kernicterus in the presence of hyperbilirubinemia without evidence of isoimmunization is becoming more generally accepted. The incidence of kernicterus in this hospital and in this study is quite low. The possible role of racial groups and administration of vitamin K in this regard was discussed. The bulk of the evidence indicates that premature infants exhibit jaundice and hyperbilirubinemia more frequently and to a greater degree than is reported in full-term infants. The duration of this hyperbilirubinemia is related to fetal maturity, persisting longer in the most immature infants. Because of the variability of concentrations of bilirubin in the plasma of premature infants, and because of the multitude of factors that play a possible role in determining the ultimate concentration of bilirubin, routine exchange transfusion for elevated concentrations of bilirubin does not seem warranted. The critical level over which exchange transfusion should be done cannot be stated on the basis of any available data.

scholarly journals Levels of Cytokines (IL-1β, IL-2, IL-6, IL-8, TNF-α) and Trace Elements (Zn, Cu) in Breast Milk From Mothers of Preterm and Term Infants

2005 ◽  
Vol 2005 (6) ◽  
pp. 331-336 ◽  
Author(s):  
Bilal Ustundag ◽  
Erdal Yilmaz ◽  
Yasar Dogan ◽  
Saadet Akarsu ◽  
Halit Canatan ◽  
...  
Keyword(s):  
Trace Elements ◽  
Immune System ◽  
Human Milk ◽  
Premature Infants ◽  
Full Term ◽  
Mature Milk ◽  
Term Infants ◽  
Necrosis Factor Alpha ◽  
Significant Difference ◽  
Cytokine Levels

It has been well documented that human milk contains several immunomodulator components which are important during infant period when the newborn's immune system is still under development. In this study, we aim at examining levels of cytokines, zinc (Zn), and copper (Cu) in milk from mothers of premature and mature infants, and comparing changes during lactation periods consequently. Milk was collected from total of 40 mothers (group M: mothers of mature infants,n=20; group PM: mothers of premature infants,n=20) from four lactation stages: colostrum (0–7 days), transitional (7–14 days), mature milk (21 days), and mature milk (2nd month). Levels of cytokines (interleukin [IL]-lβ, IL-2, IL-6, IL-8, tumor necrosis factor-alpha [TNF-α]) were determined by chemiluminesence method, whereas atomic absorption spectrophotometer was used for the determination of Zn and Cu levels. Cytokine levels were determined to be high in colostrum and transient milk from mothers of full-term infants, whereas their levels were reduced drastically in the 21st day and the 2nd month milk (P<.01,P<.001). Similar trends were observed in milk from mothers of premature infants, but cytokine levels were significantly lower in colostrum compared to colostrum from mothers of mature infants (P<.01). The differences in cytokine levels were continuous in transient milk (P<.05) and mature milk (21 days) (P<.05), whereas there was no statistically significant differences between milk from both groups of mothers in the 2nd month (P>.05). Zn levels in milk from mothers of premature infants were significantly lower compared to the ones from mothers of mature infants (P<.01) and these differences continued through the 2nd month. Although Cu levels were lower in milk from mothers of premature infants, there was no statistically significant difference except colostrum (P>.05). Our results clearly demonstrate that the level of immunomodulating agents such as cytokines and trace elements in milk from mothers of premature infants is less than the level of the same agents in milk from mothers of full-term infants. Although there are commercially available products for infant feeding, human milk is still the best natural nutrient for newborns. Therefore, when premature infants are breastfed, necessary precautions such as supplemantary diets must be considered for possible infections and risks related with immune system deficiency.

scholarly journals Feeding Performance in Preterm Infants and Full Term Infants at 40 Weeks Postmenstrual Age

2016 ◽  
Vol 36 (2) ◽  
pp. 136-140
Author(s):  
Gunjan Gupta ◽  
Kaniyanoor Venkatesan Vijay Kumar ◽  
R. Anitha ◽  
Binu Ninan
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Feeding Behaviour ◽  
Full Term ◽  
Term Infants ◽  
Feeding Performance ◽  
New Born ◽  
Neural Processes ◽  
Significant Difference ◽  
Innate Behaviour

Introduction: Feeding problems are commonly reported among preterm infants. As premature infants are born before adequate maturation, inadequate feeding capabilities are common among preterm infants. Feeding is an innate behaviour in a new born. Swallowing is evident in a foetus by 16th week of gestation (Tuchman, 1994). By 40th week of gestation, neural processes are expected to mature completely. Feeding is an innate behaviour in a new born. Swallowing is evident in a foetus by 16th week of gestation. By 40th week of gestation, neural processes are expected to mature completely. Since the premature infants are born before adequate maturation of the systems, it is not unusual for them to have inadequate feeding capabilities.Material and Methods: This study aimed to compare feeding performance in preterm (between 30 and 34 weeks GA) and full term infants at 40 weeks Post menstrual age. Seventy infants and their mothers served as participants. A close ended questionnaire documented the oral reflexes, oro-motor skills, oro-sensory skills and feeding history in infants.Results: Results were tabulated under feeding history, (viz; history of use of nasogastric feeding, duration of feeding, episodes of coughing/ choking and vomiting, fussing during feeding, noisy breathing) and oral skills. Significant difference in feeding behaviour was observed between the term and preterm infants at 40 weeks post menstrual age. Conclusion: Hence the need for Speech Language Pathologist to evaluate feeding behaviour at 40 weeks post menstrual age becomes necessary.

Urinary Excretion of Catecholamines by Full-term and Premature Infants

PEDIATRICS ◽  
1969 ◽  
Vol 44 (2) ◽  
pp. 262-265
Author(s):  
Demetre Nicolopoulos ◽  
Anthony Agathopoulos ◽  
Maria Galanakos-Tharouniati ◽  
Constantin Stergiopoulos
Keyword(s):  
Urinary Excretion ◽  
Premature Infants ◽  
Full Term ◽  
Enzymatic System ◽  
Term Infants ◽  
Methyl Transferase ◽  
Catecholamine Biosynthesis ◽  
The Difference

As part of a study of the role of catecholamines during the newborn's adaptation to extra-uterine life, the excretion of dopamine, norepinephrine, and epinephrine in the urine of nine full-term and 11 premature infants was determined on the first and fifteenth day after birth. The following observations were made. On the first day the excretion of dopamine by the premature infants was questionably less than that by full-term infants. On the fifteenth day, excretion by the premature infants had more than tripled in amount, whereas that by the full-term infants had increased only by about 50%. On the first day, the norepinephrine excreted by premature infants was about one third of the amount excreted by full-term infants. On the fifteenth day, although the amount excreted had increased, it remained lower than the amount excreted on the first day by the full-term infants. On the first day, the amount of epinephrine excretion by premature and full-term infants differed very slightly. On the fifteenth day, excretion by both groups had increased so that the amounts were about equal. The difference noted between premature and full-term infants in this study and the high amount of VMA excreted by premature infants on the fifteenth day measured in a previous study, permit the supposition of a defect in catecholamine biosynthesis—a defect due to an insufficiency of the enzymatic system of dopamine-oxidase and of catechol-O-methyl-transferase.

The Auditory Steady-State Response: Full-Term and Premature Neonates

2002 ◽  
Vol 13 (05) ◽  
pp. 260-269 ◽  
Author(s):  
Barbara Cone-Wesson ◽  
John Parker ◽  
Nina Swiderski ◽  
Field Rickards
Keyword(s):  
Steady State ◽  
Premature Infants ◽  
Modulation Frequency ◽  
Otoacoustic Emission ◽  
Full Term ◽  
Steady State Response ◽  
Pass Rates ◽  
Term Infants ◽  
State Response ◽  
Auditory Steady State Response

Two studies were aimed at developing the auditory steady-state response (ASSR) for universal newborn hearing screening. First, neonates who had passed auditory brainstem response, transient evoked otoacoustic emission, and distortion-product otoacoustic emission tests were also tested with ASSRs using modulated tones that varied in frequency and level. Pass rates were highest (> 90%) for amplitude-modulated tones presented at levels ≥ 69 dB SPL. The effect of modulation frequency on ASSR for 500- and 2000-Hz tones was evaluated in full-term and premature infants in the second study. Full-term infants had higher pass rates for 2000-Hz tones amplitude modulated at 74 to 106 Hz compared with pass rates for a 500-Hz tone modulated at 58 to 90 Hz. Premature infants had lower pass rates than full-term infants for both carrier frequencies. Systematic investigation of ASSR threshold and the effect of modulation frequency in neonates is needed to adapt the technique for screening.

STUDIES OF THE IMMUNOLOGY OF THE NEWBORN INFANT

PEDIATRICS ◽  
1953 ◽  
Vol 12 (2) ◽  
pp. 151-157
Author(s):  
JOSEPH DANCIS ◽  
JOHN J. OSBORN ◽  
HANS W. KUNZ
Keyword(s):  
Antibody Response ◽  
Newborn Infant ◽  
Premature Infants ◽  
Single Injection ◽  
Diphtheria Toxoid ◽  
Birth Date ◽  
Term Infants ◽  
Normal Birth ◽  
Significant Difference

The antibody response of premature infants immunized at birth with a single injection of diphtheria toxoid was compared to that of a group of term infants similarly immunized. No significant difference was demonstrated. A group of premature infants was immunized about the time that was estimated to be their normal birth date and the antibody response compared to that of term infants at birth. The performance of the premature infants was superior to that of the term infants. The significance of these findings is discussed.

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.

URINARY EXCRETION OF PHENOLIC AND INDOLIC COMPOUNDS, METACATECHOLAMINES, AND VMA BY FULL-TERM AND PREMATURE INFANTS

PEDIATRICS ◽  
1968 ◽  
Vol 41 (4) ◽  
pp. 777-783
Author(s):  
Demetre Nicolopoulos ◽  
Anthony Agathopoulos ◽  
Calliope Danelatou-Athanassiadou ◽  
Marianthi Bafataki
Keyword(s):  
Urinary Excretion ◽  
Phenolic Acids ◽  
Premature Infants ◽  
Homogentisic Acid ◽  
Full Term ◽  
Term Infants ◽  
Catabolic Pathways ◽  
Indolic Compounds

The 24-hour urinary excretion of phenolic and indolie compounds, metacatechol-amines, and VMA by full-term and premature infants on their first and fifteenth days of life was studied. The presence of metabolites from all three main catabolic pathways of tryptophan was noted in both groups of infants. 3-indole-acetic and 3-indole-propionic acids were present on the first day of life in the urine of full-term infants, but they were absent on the fifteenth day. Twenty phenolic acids were observed in both groups of infants, but their excretion varied a great deal. Homogentisic acid was not excreted on the first day of life of full-term and premature infants, but it was found in the urine of full-term infants on the fifteenth day of life. The variations of excretion of VMA generally followed that of metacatecholamines. The excretion of VMA by the premature infants on their fifteenth day of life is four- to fivefold that of the first day and reaches adult levels, in contrast to the moderate decrease of VMA excretion of the fuil-term infants on the fifteenth day. The degree of maturation of the enzymic systems involved is discussed as a probable cause of these variations.

Reduction in Obstructive Breathing Events During Body Rocking: A Controlled Polygraphic Study in Preterm and Full-Term Infants

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 64-68
Author(s):  
J. Groswasser ◽  
M. Sottiaux ◽  
E. Rebuffat ◽  
T. Simon ◽  
M. Vandeweyer ◽  
...  
Keyword(s):  
Eye Movement ◽  
Preterm Infants ◽  
Upper Airway ◽  
Periodic Breathing ◽  
Full Term ◽  
Rapid Eye Movement ◽  
Term Infants ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Obstructive Sleep Apneas

Objective. To investigate the effect of body rocking on infant respiratory behavior during sleep. Methods. Eighteen infants with documented obstructive sleep apneas were studied. There were eight premature infants with persistent bradycardias and 10 infants born full-term, admitted after an idiopathic apparent life-threatening event. No cause for the obstructive apneas was found. The infants were recorded with polygraphic techniques during two successive nights. They were randomly assigned to a rocking or a nonrocking mattress. The conditions were reversed the following night, in a crossover design. Results. In both groups of infants, no significant difference was seen between the two consecutive nights for most of the variables studied: total sleep time, the proportion of non-rapid-eye-movement and rapid-eye-movement sleep, the number of arousals, the number and maximal duration of central apneas, the frequency of periodic breathing, the level of oxygen saturation, and heart rate. During the nonrocking nights, all infants had repeated obstructive breathing events. In seven of the eight preterm infants and in nine of the 10 full-term subjects, body rocking was associated with a significant decrease in the frequency of obstructive events. During rocking, in the preterm infants the obstructions fell from a median of 2.5 to 1.8 episodes per hour (P = .034). In the full-term infants, rocking reduced the obstructive events from a median of 1.5 obstructions per hour to 0.7 (P = .005). No difference was seen for the duration of the obstructive episodes. Conclusion. In preterm and full-term infants prone to obstructive sleep apneas, gentle side-to-side body rocking is associated with a significant decrease in the frequency of upper-airway obstructions.

Carbohydrate Malabsorption in Necrotizing Enterocolitis

PEDIATRICS ◽  
1976 ◽  
Vol 57 (2) ◽  
pp. 201-204
Author(s):  
Linda Sue Book ◽  
John J. Herbst ◽  
August L. Jung
Keyword(s):  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Clinical Symptoms ◽  
Advanced Disease ◽  
Full Term ◽  
Term Infants ◽  
Stool Specimens ◽  
Reducing Substances ◽  
Carbohydrate Intolerance ◽  
Prospective Investigation

A prospective investigation was conducted to determine if infants with necrotizing enterocolitis had evidence of carbohydrate intolerance prior to the onset of clinical symptoms of advanced disease. Stool specimens were examined for fecal reducing substances with Clintest tablets from well, full-term infants and sick premature infants. Only two of 45 (4.4%) formula-fed, full-term infants demonstrated higher than 2 + fecal reducing substances. Ten of 14 (71%) formula-fed premature infants who developed necrotizing enterocolitis had higher than 2 + reducing substances detected in their stools. Daily measurement of fecal reducing substances can be a useful adjunct in the management of sick premature infants.

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