Aminophylline Therapy for Idiopathic Apnea in Premature Infants: Effects on Lung Function

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 801-804
Author(s):  
Tilo Gerhardt ◽  
Jeane McCarthy ◽  
Eduardo Bancalari
Keyword(s):  
Birth Weight ◽  
Lung Function ◽  
Pulmonary Function ◽  
Premature Infants ◽  
Gestational Age ◽  
Lung Compliance ◽  
Normal Lung ◽  
Inspiratory Resistance ◽  
Arterial Po2

The effect of aminophylline on lung function was studied in 14 premature infants with apnea (gestational age, 30.2 weeks; birth weight, 1,052 gm). The infants showed compromised pulmonary function with a large difference in alveolar-arterial PO2 gradient (83.9 mm Hg), a low normal lung compliance of 1.1 ml/cm H2O • kg, and a normal inspiratory resistance of 45.3 cm H2O/liter/sec. Aminophylline therapy did not change these functions significantly, but it decreased the incidence of apneic episodes from 29.7 to 4.4 per day. The effectiveness of aminophylline in treating apnea in premature infants must be related to its central stimulating effect and not to an improvement in lung function and oxygenation.

scholarly journals Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age

2018 ◽  
Vol 104 (3) ◽  
pp. F242-F247 ◽  
Author(s):  
Chonnikant Visuthranukul ◽  
Steven A Abrams ◽  
Keli M Hawthorne ◽  
Joseph L Hagan ◽  
Amy B Hair
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Birth Weight ◽  
Human Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Insulin Level ◽  
Metabolic Outcomes ◽  
Catch Up

ObjectiveTo compare postdischarge growth, adiposity and metabolic outcomes of appropriate for gestational age (AGA) versus small for gestational age (SGA) premature infants fed an exclusive human milk (HM)-based diet in the neonatal intensive care unit.DesignPremature infants (birth weight ≤1250 g) fed an exclusive HM-based diet were examined at 12–15 months corrected gestational age (CGA) (visit 1) for anthropometrics, serum glucose and non-fasting insulin, and at 18–22 months CGA (visit 2) for body composition by dual-energy X-ray absorptiometry.ResultsOf 51 children, 33 were AGA and 18 were SGA at birth. The SGA group had weight gain (g/day) equal to AGA group during the follow-up period. SGA had a significantly greater body mass index (BMI) z-score gain from visit 1 to visit 2 (0.25±1.10 vs −0.21±0.84, p=0.02) reflecting catch-up growth. There were no significant differences in total fat mass (FM) and trunk FM between groups. SGA had significantly lower insulin level (5.0±3.7 vs 17.3±15.1 µU/mL, p=0.02) and homeostatic model of assessment-insulin resistance (1.1±0.9 vs 4.3±4.1, p=0.02). Although regional trunk FM correlated with insulin levels in SGA (r=0.893, p=0.04), they had lower insulin level compared with AGA and no difference in adiposity.ConclusionsSGA premature infants who received an exclusive HM-based diet exhibited greater catch-up growth without increased adiposity or elevated insulin resistance compared with AGA at 2 years of age. An exclusive HM-based diet may improve long-term body composition and metabolic outcomes of premature infants with ≤1250 g birth weight, specifically SGA.

scholarly journals Eruption chronology of the first deciduous teeth in children born prematurely with birth weight less than 1500g

2014 ◽  
Vol 32 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Pedro Garcia F. Neto ◽  
Mario Cicero Falcao
Keyword(s):  
Birth Weight ◽  
Nutritional Status ◽  
Premature Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Deciduous Teeth ◽  
Appropriate For Gestational Age ◽  
Eruption Age ◽  
Student’S T ◽  
Student’S T Test

Objective: To describe the eruption chronology of the first deciduous teeth in premature infants with birth weight less than 1500g and to compare it according to gender and nutritional status at birth. Methods: Longitudinal study including 40 low birth weight premature infants of both genders. The tooth was considered erupted when the crown went through the gum and became part of the oral environment. The comparison of the eruption chronology in relation to gender and among children appropriate or small for gestational age was done by Student's t-test, being significant p<0.05. Results: The eruption of the first tooth (teeth) occurred, on average, with 11.0±2.1 months of chronological age and with 9.6±1.9 months corrected for prematurity. The first erupted teeth were the lower central incisors. The average eruption for males was 9.7±1.9 and, for females, 9.5±1.9 months, both corrected for prematurity (p=0.98). The average eruption in children with birth weight appropriate for gestational age was 10.1±1.4 months; for small for gestational age, it was 9.4±2.2, also corrected for prematurity (p=0.07). Conclusions: The average eruption age of the first teeth, corrected for prematurity, was 9.6 months. Sex and nutritional status at birth did not change the eruption chronology.

HUMAN FETAL GROWTH RETARDATION: I. CLINICAL FEATURES OF SAMPLE WITH INTRAUTERINE GROWTH RETARDATION

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 547-558
Author(s):  
J. Urrusti ◽  
P. Yoshida ◽  
L. Velasco ◽  
S. Frenk ◽  
A. Rosado ◽  
...  
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Fetal Growth Retardation ◽  
Neonatal Deaths ◽  
Intrauterine Growth ◽  
Normal Term

Intrauterine growth was assessed in a series of 128 cases. Thirty-six infants were small for gestational age, and showed the usual signs of intrauterine growth retardation (IUM). The head circumference of these infants was small, with reference to normal term babies (FT) and comparable to premature infants, appropriately sized for a gestational age (ACA) five weeks less than that of the IUM's. There were 12 neonatal deaths, three among IUM infants within 24 hours and nine in the low birth weight AGA group within 72 hours. The mothers of these three groups of infants were similar with respect to age, weight, height, nutritional patterns, and prior pregnancy histories.

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 Micro-premature infants in New Jersey show improved mortality and morbidity from 2000– 2018

2021 ◽  
pp. 1-8
Author(s):  
M. Cohen ◽  
H. Perl ◽  
E. Steffen ◽  
B. Planer ◽  
A. Kushnir ◽  
...  
Keyword(s):  
New Jersey ◽  
Birth Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Morbidity And Mortality ◽  
Mortality And Morbidity ◽  
Premature Newborns ◽  
Premature Newborn ◽  
Mature Group ◽  
Over Time

BACKGROUND: Micro-premature newborns, gestational age (GA) <  25 weeks, have high rates of mortality and morbidity. Literature has shown improving outcomes for extremely low gestational age newborns (ELGANs) GA <  29 weeks, but few studies have addressed outcomes of ELGANs <  25 weeks. OBJECTIVE: To evaluate the trends in outcomes for ELGANs born in New Jersey, from 2000 to 2018 and to compare two subgroups: GA 23 to 25 weeks (E1) and GA 26 to 29 weeks (E2). METHODS: Thirteen NICUs in NJ submitted de-identified data. Outcomes for mortality and morbidity were calculated. RESULTS: Data from 12,707 infants represents the majority of ELGANs born in NJ from 2000 to 2018. There were 3,957 in the E1 group and 8,750 in the E2 group. Mortality decreased significantly in both groups; E1, 43.2% to 30.2% and E2, 7.6% to 4.5% over the 19 years. The decline in E1 was significantly greater than in E2. Most morbidities also showed significant improvement over time in both groups. Survival without morbidity increased from 14.5% to 30.7% in E1s and 47.2% to 69.9% in E2s. Similar findings held for 501– 750 and 751– 1000g birth weight strata. CONCLUSIONS: Significant declines in both mortality and morbidity have occurred in ELGANs over the last two decades. These rates of improvements for the more immature ELGANs of GA 230 to 256 weeks were greater than for the more mature group in several outcomes. While the rates of morbidity and mortality remain high, these results validate current efforts to support the micro-premature newborn.

Administration of Thyroxine to Very Low-Birth-Weight, Premature Infants

PEDIATRICS ◽  
1984 ◽  
Vol 74 (5) ◽  
pp. 900-900
Author(s):  
ROBERT P. SCHWARTZ ◽  
DOCIA E. HICKEY ◽  
MARY ANNE RATHBUN
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Thyrotropin Releasing Hormone ◽  
Releasing Hormone

To the Editor.— We question the advisability of administering thyroxine to premature infants with low thyroxine (T4) levels as reported by Chowdhry et al.1 The low T4 levels noted in this report would be expected in infants of 26 to 28 weeks of gestation. The serum thyrotropin (TSH) values were normal as was the response to thyrotropin-releasing hormone. Hadeed et al2 noted a prevalence of T4 levels less than 6.5 µg/dL in 52% of infants of 28 to 30 weeks of gestational age, 33% of infants of 31 to 33 weeks of gestational age, and 11% of infants of 34 to 36 weeks of gestational age.2

scholarly journals What should be the protein target for adjustable Human Milk fortification in premature infants?

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Bayram Ali Dorum ◽  
Hilal Ozkan ◽  
Salih Cagri Cakir ◽  
Nilgun Koksal ◽  
Gizem Ezgi Sen
Keyword(s):  
Birth Weight ◽  
Human Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Protein Supplementation ◽  
Physical Growth ◽  
Protein Target ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: To assess the short- and long-term effects of the adjustable fortification (ADJ) regimen on growth parameters in premature infants and to evaluate the amount of protein supplements given to reach the targeted blood urea nitrogen (BUN) levels. Methods: In this retrospective study, preterm babies who were born at ≤32 weeks gestational age and fed with human milk, were evaluated in two groups. Infants in Group-I were fed only standard fortification (STD). Infants in Group-II were fed the ADJ regimen. The study was conducted between 2011 and 2016. Results: There were 123 infants in the STD group and 119 in the ADJ group. The mean gestational age of the patients in Group-I was 29.7±1.8 weeks, and mean birth weight was 1266.1±347.1 g. The mean gestational age of the patients in Group-II was 29.5±1.9 weeks, and the mean birth weight was 1217.5±345.5 g. The daily increase in weight and weekly increase in HC were significantly higher in the ADJ group infants. Weight and HC of infants in the ADJ group were significantly higher at 40 weeks. At one year corrected age, weight, length, and HC measurements of both groups were similar. In Group-II, 63% of patients required additional protein supplementation up to 1.6 g/day to achieve the target BUN levels. Conclusion: A higher protein intake through the ADJ regimen improves the physical growth rate of premature infants in the NICU and after discharge. However, sometimes, the targeted growth and BUN values ​​cannot be achieved despite the administration of protein at the recommended increased doses. Increasing protein supplementation up to 1.6 g/day is safe, feasible, and beneficial for these infants. How to cite this:Dorum BA, Ozkan H, Cakir SC, Koksal N, Sen GE. What should be the protein target for adjustable Human Milk fortification in premature infants? Pak J Med Sci. 2019;35(1):277-281. doi: https://doi.org/10.12669/pjms.35.1.337 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals 27 Determinants of referral to developmental resources among neonatal follow-up patients discharged from tertiary neonatal unit from 2005 UNTIL 2014

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e10-e10
Author(s):  
Maad Saleem ◽  
Lamia Hayawi ◽  
Nick Barrowman ◽  
Nadya BenFadel ◽  
Jana Feberova ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Birth Weight ◽  
High Risk ◽  
Premature Infants ◽  
Gestational Age ◽  
High Risk Population ◽  
Risk Population ◽  
Neurodevelopmental Impairment ◽  
Developmental Support

Abstract Background Lower gestational age or birth weight and higher rate of neurodevelopmental impairment have been commonly linked to higher need for developmental resources in premature infants. Existing evidence on need for developmental support in premature infants is limited in description of the needs, timing and method of assessment. Objectives To identify predictors for the needs for developmental resources among high-risk groups of infants born less than 29 weeks or with a birth weight (BW) less than 1250 grams. Secondarily, to compare the need of referrals to developmental resources and the rate of neurodevelopmental impairment defined as cerebral palsy, global developmental delay, blindness and deafness for this high risk population. Design/Methods We conducted a retrospective chart review of premature infants &lt; 29+0 weeks GA or BW &lt; 1250 grams born between January 2005 and December 31st 2014, who had at least one visit at the neonatal follow up clinic. Univariate and multivariate logistic regression analyses were conducted to examine potential predictors for referral to developmental resources. Results The study included 687 infants. Within this high risk population, 579 (85.0%) of infants were referred, of these 153 (26.4%) had one referral, 132 (22.8%) had 2 and 294 (50.8%) had 3 or more referral/s to developmental resources. Most frequent referrals were for speech therapy (339, 50.0%) physiotherapy (319, 46.8%) occupational therapy (262, 38.3%) and infant development program (232, 34.1%). The rates of referral to developmental resources decrease with increasing gestational age. Multivariate logistic regressions showed that gestational age (OR: 1.19, 95% CI: 1.05 - 1.35), birth weight (OR: 0.87, 95% CI: 0.77 - 0.99), female gender (OR: 0.70, 95% CI: 0.49 - 0.99), intraventricular hemorrhage grades III-IV (OR: 3.02, 95% CI: 1.28 - 7.16), and days on mechanical ventilator (OR:1.03, 95% CI: 1.01 - 1.05) were predictors for 2 or more referrals to developmental resources. Cerebral palsy was present in 4.4 % of the study population, deafness in 4% and blindness in 0.6%. The rate of referral to developmental resources was 54 (98.2%) among infants with neurodevelopmental impairment (NDI) compared to 522 (83.9%) in infants without NDI (p value= 0.01). Conclusion There is substantial need for developmental support among high-risk premature infants. Infants without neurodevelopmental impairments still need significant developmental resources to achieve their outcome.

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