Serum Aldosterone Concentrations Related to Sodium Balance in the Newborn Infant

PEDIATRICS ◽  
1974 ◽  
Vol 53 (3) ◽  
pp. 410-413
Author(s):  
Sharon R. Siegel ◽  
Delbert A. Fisher ◽  
William Oh

Serum aldosterone concentrations and sodium (Na) balance were studied between 24 and 48 hours of life in 39 newborn infants of various gestational ages and in infants with or without respiratory distress syndrome (RDS) . The serum aldosterone levels in the neonatal period were high but not related to gestational age. The serum aldosterone levels of small-for-gestational-age (SGA) infants were similar to those of the full-term infants. In normal infants (preterm and full term) and in SGA infants, the mean oral Na intake was 1.0 mEq/kg/24 hr; in this group of infants, no correlation was observed between Na intake and excretion or between Na intake and serum aldosterone concentrations, probably due to the narrow range of Na intake. In preterm infants with RDS, Na was given in larger quantities and by the parenteral route. In this group, significant correlations were observed between Na intake and Na excretion and between Na intake and serum aldosterone concentrations. These data suggest that the expected sodium dependent regulatory mechanism for aldosterone secretion is functional 10 the preterm infants with RDS when given a large sodium load; and that the quantity of Na excretion is consistent with the variations in aldosterone concentrations.

2005 ◽  
Vol 51 (11) ◽  
pp. 2131-2137 ◽  
Author(s):  
Tania Siahanidou ◽  
Helen Mandyla ◽  
Maria Vounatsou ◽  
Dimitris Anagnostakis ◽  
Ioannis Papassotiriou ◽  
...  

Abstract Background: Peptide YY (PYY) and ghrelin are gastrointestinal tract–derived hormones that play roles in the regulation of food intake and energy balance. Negative energy balance often occurs in hospitalized preterm infants. Methods: To measure serum concentrations of PYY in preterm and full-term infants and to investigate their correlations with anthropometric characteristics, food intake, and serum ghrelin concentrations, we measured serum PYY and ghrelin concentrations by RIA in 62 healthy preterm infants [mean (SD) gestational age, 32.0 (2.1) weeks; postnatal age, 40.9 (14.8) days] and 15 healthy full-term infants of comparable postnatal age. All of the infants were formula-fed every 3 h. Results: PYY concentrations were significantly higher in preterm [1126.2 (215.4) ng/L] than in full-term infants [825.3 (234.4) ng/L; P <0.001]. In the entire study population, serum PYY concentrations correlated negatively with gestational age and anthropometric measurements (birth weight, body weight, body length, body mass index, and head circumference) and positively with serum ghrelin concentrations, whereas there was no significant correlation between PYY concentration and caloric intake or weight gain. Multiple regression analysis, after correction for prematurity, revealed that serum PYY concentrations correlated independently with serum ghrelin concentrations and infant body weight or body mass index. Conclusions: Circulating concentrations of PYY may increase in preterm infants to compensate for the negative body-weight balance. The physiologic mechanisms behind the correlation between PYY and ghrelin remain to be elucidated.


1999 ◽  
Vol 42 (4) ◽  
pp. 850-861 ◽  
Author(s):  
Alexander M. Goberman ◽  
Michael P. Robb

The acoustic characteristics of crying behavior displayed in 2 groups of newborn infants are reported. The crying episodes of 10 full-term and 10 preterm infants were audio recorded and analyzed with regard to the long-time average spectrum (LTAS) characteristics. An LTAS display was created for each infant's non-partitioned crying episode, as well as for 3 equidurational partitions of the crying episode. Measures of first spectral peak, mean spectral energy, and spectral tilt were revealing of differences between full-term and preterm infants' non-partitioned crying episodes. In addition, the full-term infants demonstrated significant changes in their crying behavior across partitions, whereas the preterm infants changed little across the crying episode. Discussion focuses on possible differences between full-term and preterm infants in their neurophysiological maturity, and the subsequent impact on their speech development. The importance of examining entire crying episodes when evaluating the crying behavior of infants is also discussed.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e28-e28 ◽  
Author(s):  
Thivia Jegathesan ◽  
Michael Sgro ◽  
Vibhuti Shah ◽  
Aidan Campbell ◽  
Douglas Campbell

Abstract BACKGROUND Currently there are limited guidelines for the management of hyperbilirubinemia in preterm infants. Current guidelines are limited to individual sites and are consensus-based opinions. The current decrease in chronic bilirubin encephalopathy in preterm infants is a result of liberal use of phototherapy that are not based on evidence from a large dataset of preterm infants. The pattern of bilirubin levels in preterm is unclear and currently based on clinical judgement. Nomograms in term infants has been proven to be beneficial and effective in reducing unnecessary treatment of hyperbilirubinemia. A nomogram designed for preterm infants would allow health professionals to quantify risk based on evidence based methods and reduce the number of test done on preterm infants. OBJECTIVES The objectives of this study are 1) To determine photherapy thresholds in preterm infants and 2) To determine the normative pattern of bilirubin values in preterm infants. DESIGN/METHODS A multi-site retrospective chart review of preterm infants ≤ 35 weeks gestation born between January 2012- November 2017 was conducted. The following data was collected; all TSB, postnatal hours of age, duration of phototherapy, infant characteristics (gestational age, birth weight, outcomes) and maternal history (inter and anter partum medication). TSB samples prior to the initiation of phototherapy were analyzed per hour and stratified by gestational age groups. RESULTS A total of 330 preterm infants were included in the retrospective review (50 24-28 weeks gestation, 100 29-32 weeks gestation, and 180 33–35 weeks gestation). The mean peak bilirubin in infants 33-35 week gestation was 198 umol/L at 4 days. These infants were started on phototherapy at a mean age of 89 hours. At 24 hours of age these infants’ bilirubin was 104 umol/L (72-189umol/L). The mean peak bilirubin in infants 29–32 weeks gestation was 181umol/L at 5 days. At 24 hours of age the mean bilirubin was 109 umol/L. Finally in infants 24–28 weeks gestation the mean peak bilirubin was 127 umol/L at 4 days. These infants were started on phototherapy at 44 hours of age. CONCLUSION Bilirubin values in preterm infants is hetergenous across gestional ages. Phototherapy treatment thresholds are lower in preterm infants between 24–28 weeks gestation. A nomogram for preterm infants maybe possible in infants between 29–35 weeks. Further research is required to determine hour specific bilirubin levels in preterm infants.


1989 ◽  
Vol 61 (3) ◽  
pp. 559-572 ◽  
Author(s):  
Klaus Dörner ◽  
Stefan Dziadzka ◽  
Andreas Höhn ◽  
Erika Sievers ◽  
Hans-Dieter Oldigs ◽  
...  

1. Mn and Cu intake and retention in twenty full-term infants and six preterm infants were studied on the basis of 72 h balances. The age of the infants was 2–16 weeks and the gestational age of the preterm infants (triplets) 34 and 36 weeks. Three nutrition schemes were pursued: breast-fed, formula-fed with unsupplemented adapted formula and formula-fed with trace element supplementation.2. The mean Mn concentration of all breast-milk samples (n 2339) was 6·2 μg/1. The two formulas had similar Mn concentrations (77 and 99 μg/1) but had different Fe, Cu (121 and 619 μg/1), Zn and I contents. The mean Cu concentration in mother's milk was 833 μg/1.3. The following mean daily Mn intakes and retentions (μg/kg) respectively were measured: breast-fed fullterm 1·06 (sd 0·43) and 0·43 (sd 0·65), formula-fed full-term 14·2 (sd 3·1) and 2·8 (sd 4·8), formula-fed preterm 15·0 (sd 2·2) and 0·06 (sd 5·87). The results for Cu were 114·5 (sd 22·3) and 88·0 (sd 46·5) μg/kg in breast-fed, 19–8 (sd 4·2) and 4·6 (-11·5–9·6) in the unsupplemented formula-fed and 106·4 (sd 18·9) and 55·5 (sd 20·3) in the supplemented formula full-term infant group. No significant influence of the trace element contents of the formulas on the relative retention of Mn or Cu was found.4. Young preterm infants, and to some degree young full-term infants, often had negative Mn balances caused by a high faccal excretion. The formulas with a Mn concentration below 100 μg/l gave a sufficient supply of Mn. Preterm infants fed on the unsupplemented formula had a marginal Cu supply and their first balances were negative (-3·8 (sd 1·8) μg/kg).5. In accordance with the estimated safe and adequate daily dietary intakes (recommended dietary allowances), formula-fed infants receive much more Mn than breast-fed infants and their absolute retention is higher.6. Cu from breast-milk had a significantly better biological availability than that from cow's milk formula. If retentions similar to those in breast-fed infants are intended, we conclude, therefore, that cow's milk formula should be fortified with Cu up to a level of at least 600 μg/l.


1991 ◽  
Vol 70 (6) ◽  
pp. 2479-2484 ◽  
Author(s):  
C. K. Thoppil ◽  
M. A. Belan ◽  
C. P. Cowen ◽  
O. P. Mathew

Arousal is an important protective mechanism that aids in the resolution of obstructive sleep apnea in adults and children, but its role in neonatal apnea has not been investigated. The primary aim of the present study was to determine the role of arousal in the termination of apnea in preterm infants. Videorecording was used to identify spontaneous behavioral arousal in a group of healthy full-term (n = 7) and preterm (n = 10) infants before and during polygraphic monitoring of cardiorespiratory variables and in a group of preterm infants with apnea (n = 10) during similar polygraphic monitoring. Spontaneous arousal rates (mean +/- SE) in full-term infants before and during polygraphic monitoring were 0.18 +/- 0.03 and 0.23 +/- 0.07 episodes/min, respectively. Corresponding values in nonapneic preterm infants were 0.24 +/- 0.03 and 0.24 +/- 0.02 episodes/min. In apneic preterm infants, mean spontaneous arousal rate during polygraphic recording was 0.26 +/- 0.02, but it was considerably higher during apneic sleep periods (0.59 +/- 0.17) than during nonapneic sleep periods (0.25 +/- 0.01). The frequency of occurrence of arousal was significantly higher (P less than 0.005) in long vs. short apnea, mixed vs. central apnea, and severe vs. mild apnea. Although a clear association between arousal and apneic resolution was observed in preterm infants, lack of arousal responses in a large number of apneic episodes suggests that behavioral arousal is not essential for the termination of apnea in these infants.


2019 ◽  
pp. 63-70

Prematurity predisposes the neonate to greater risks of comorbidities, one of which is the delay in motor development due to the immaturity of the organs and systems. Thus, this study aimed to evaluate the motor performance of preterm infants. Preterm infants with gestational age ≤ 37 weeks and excluded full-term infants with associated neurological diseases and syndromes were included in the study. The infants were screened from the Basic Health Units and evaluated through the Alberta motor Infant scale scale (AIMS). After the analysis of the development, 72,72% of the babies had normal motor development, while 27,28% presented suspicious motor performance.


PEDIATRICS ◽  
1970 ◽  
Vol 45 (1) ◽  
pp. 21-28
Author(s):  
Arthur H. Parmelee ◽  
Franz J. Schulte

Twenty-five full-term, newborn infants and 22 small-for-date infants born at term had comparable nerve conduction velocities and were considered to be of equal neurological maturity. Twenty-six pre-term infants equal in weight to the small-for-date infants had significantly slower nerve conduction velocities and were considered on this basis more immature at birth than the term and small-for-date infants. All of these infants were given Gesell developmental tests at approximately 40 weeks of age by an examiner with no knowledge of their neonatal condition. The objective was to determine to what degree performance later in infancy is dependent on neurological maturity at birth. The full-term infants and the small-for-date infants performed at their age level with average developmental quotients of 99 and 96, respectively. The pre-term infants performed at less than their age from birth with an average D.Q. of 88; but, when their age was corrected for weeks of prematurity, the average D.Q. was 99. These findings substantiate the concept that performance on the Gesell schedules is dependent on time from conception rather than time from birth. Preterm infants should have their age determined from their expected date of birth for purposes of calculating a developmental quotient.


2002 ◽  
Vol 82 (2) ◽  
pp. 148-159 ◽  
Author(s):  
Suh-Fang Jeng ◽  
Li-Chiou Chen ◽  
Kuo-Inn Tsou Yau

Abstract Background and Purpose. Study of kicking development provides important information to understand how early spontaneous movements change in infants as they acquire voluntary control. Researchers have investigated the kicking movements of preterm infants; however, the movement patterns that they have described were inconsistent. The purpose of this study, therefore, was to examine the development of kicking movements with kinematic analysis in preterm infants with very low birth weight (VLBW) and full-term infants. Subjects and Methods. Twenty-two infants with VLBW who were divided into low gestational age (gestational age of <30 weeks, n=9) and high gestational age (gestational age of ≥30 weeks, n=13) classes and 22 full-term infants were evaluated during kicking movements using 4 synchronized cameras and 3-dimensional kinematic analysis when the infants were 2 and 4 months of corrected age. Results. The infants with VLBW and a high gestational age showed similar kicking movements compared with the full-term infants. In contrast, the infants with VLBW and a low gestational age exhibited a higher kick frequency and a shorter flexion phase at 4 months of corrected age. They also exhibited a higher hip-knee correlation and lower variability in the interlimb coordination pattern at 2 and 4 months of corrected age. Discussion and Conclusion. The findings indicate that infants with VLBW, particularly those with a low gestational age, have age-related differences in movement organization and coordination of kicking compared with full-term infants.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S764-S764
Author(s):  
Diana Bowser ◽  
Reissa Gervasio ◽  
Elizabeth Glaser ◽  
Dhwani Harihan ◽  
Katie Rowlands ◽  
...  

Abstract Background Respiratory syncytial virus (RSV) is a human orthopneumovirus spread by direct contact with symptomatic, infected individuals. An estimated 587,000 RSV LRTIs result in inpatient or outpatient encounters annually among US infants (Rainisch et al 2019). The health care costs associated with RSV include medical costs to insurers, governments, and households, travel, and loss of wages. Initial summary of Inpatient and Ambulatory Medical Costs p Infant w RSV.JPG Jun 17th, 2020 @ 2:44 PM 852 x 572 122.3 Kb Methods A systematic literature review of the costs associated with children who have RSV was conducted. Following PRISMA methodology, key search terms were searched within article titles and abstracts through PubMed, EconLit, and Scopus. A total of 1,942 unique abstracts were screened independently by two authors and reduced to 180 articles after applying inclusion and exclusion criteria. The number of included articles after reviewing the full text was 66. Costing results were adjusted to USD2020 based on the Medical Care Consumer Price Index. Results Costing results were reported mainly for medical costs in inpatient settings. Initial results show that annual mean inpatient costs per RSV patient range among individual studies from $9,825 (SD=$25,227) for full term infants to $26,120 (SD unspecified) for late preterm infants (Table 1). Costing results vary by gestational age, with late preterm infants having an annual mean inpatient cost almost 1.6 times that of a full term infant. Inpatient costs for RSV infants are higher for commercial pay versus Medicaid, for both full term infants (commercial mean=$16,489 SD=$31,068, Medicaid mean=$10,291 SD=$64,625) and late preterm infants (commercial mean=$23,836; SD=$43,709, Medicaid mean=$18,864 SD=$28,716). Annual RSV ambulatory costs per infant vary between $4,371 (SD=$13,411) and $19,963 (SD=$27,269), depending on gestational age. Other relevant RSV costs include preventative drug costs, such as palivizumab (average $11,954 per infant). Conclusion The literature describes the economic impact of RSV primarily for hospitalization of children with underlying comorbidities. There is a need to better understand costing results for RSV, including the burden in ambulatory settings and indirect costs to families affected. Disclosures All Authors: No reported disclosures


2013 ◽  
Vol 4 (1) ◽  
pp. 6-9
Author(s):  
Mumtahina Setu ◽  
Md Abid Hossain Mollah ◽  
Syed Khairul Amin ◽  
S M Nahid Morshed ◽  
Mehdi Pervez ◽  
...  

Delayed first passage of meconium and also prolongation of meconium passage creates great anxiety among parents. Some study showed that that first passage of meconium is delayed in preterm infants compared to term infants. The difference in duration of meconium passage in term and preterm infant has however never been assessed before. This cross sectional study was carried between July 2010 to December 2010 among 100 Newborn babies ranging from 28 to 42 weeks of gestation who were delivered in the Department of Obstetrics and Gynaecology or admitted in the Department of Neonatology of Dhaka Medical college Hospital were included in the study. Gestational age was determined from first day of last menstruation (when available) and also by using Expanded Ballard Scoring System. In case of any discrepancy of more than 2 weeks, the later was accepted. This study was carrying out to determine the time of first passage of meconium and duration of passage of meconium in term and preterm infants. Out of total 100 infants, 58 were male and 42 were female. The numbers of babies were 21, 28, 25 and 26 in group I, II, III and IV respectively. The mean age at which the babies passed first meconium were 23.5±3.5, 33.0±3.8, 25.7±4.2 and 17.3±4.6 hours in group I, II, III and IV respectively, which was<48 hours irrespective of gestational age. The mean gestational age of the babies who passed meconium for <4 days was 37.1±2.2 weeks. On the contrary, mean gestational age of the babies who passed meconium for>4 days was 32.6±4.3 weeks and this observation was statistically significant (p<0.001). First passage of meconium in all newborn was within 48 hours irrespective of gestational age. Duration of passage of meconium was significantly prolonged among babies with lower gestational age. DOI: http://dx.doi.org/10.3329/akmmcj.v4i1.13677 AKMMC J 2013; 4(1): 6-9


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