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.

THE POSTNATAL DEVELOPMENT OF THE COAGULATION SYSTEM IN THE PREMATURE INFANT

1987 ◽  
Author(s):  
M Andrew ◽  
B A Paes ◽  
R A Milner ◽  
P J Powers ◽  
M Johnston ◽  
...  
Keyword(s):  
Premature Infant ◽  
Postnatal Development ◽  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Term Infant ◽  
Full Term ◽  
Screening Tests ◽  
Coagulation System ◽  
Term Infants

A cohort study was performed to determine the postnatal development of the coagulation system in the “healthy” premature infant. Mothers were approached for consent and a total of 132 premature infants were entered into the study. The group consisted of 64 infants with gestational ages of 34-36 weeks (prem 1) and 68 infants whose gestational age was 33 weeks or less (prem 2). Demographic information and a 2 ml blood sample were obtained on days 1, 5, 30, 90, and 180. Plasma was fractionated and stored at −70°C for batch assaying of the following tests: screening tests, PT, APTT; factor assays (biologic (B)); fibrinogen, II, V, VII, VIII:C, IX, X, XI, XII, prekallikrein, high molecular weight kininogen, XIII (immunologic (I)); inhibitors (I), antithrombin III, aα2-antiplasmin, α2-macroglobulin, α-anti-trypsin, Cl esterase inhibitor, protein C, protein S, and the fibrinolytic system (B); plasminogen. We have previously reported an identical study for 118 full term infants. The large number of premature and full term infants studied at varying time points allowed us to determine the following: 1) coagulation tests vary with the gestational age and postnatal age of the infant; 2) each factor has a unique postnatal pattern of maturation; 3) near adult values are achieved by 6 months of age; 4) premature infants have a more rapid postnatal development of the coagulation system compared to the full term infant; and 5) the range of reference values for two age groups of premature infants has been established for each of the assays. These reference values will provide a basis for future investigation of specific hemorrhagic and thrombotic problems in the newborn infant.

LEVEL OF HYALURONIDASE INHIBITOR IN THE SERUM OF PREMATURE INFANTS WITH RETROLENTAL FIBROPLASIA

PEDIATRICS ◽  
1952 ◽  
Vol 10 (5) ◽  
pp. 533-537
Author(s):  
JULIA B. MACKENZIE
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Term Infant ◽  
Full Term ◽  
Retrolental Fibroplasia ◽  
Full Term Infant ◽  
Hyaluronidase Inhibitor ◽  
Order Of Magnitude ◽  
Severity Of The Disease

The serum of the premature infant contains material which inhibits bovine hyaluronidase. This inhibitor was found to be present to about the same degree in infants with and without retrolental fibroplasia and appeared to be unrelated to the severity of the disease. The level of the physiologic inhibitor of hyaluronidase found in the blood of the premature and full term infant is approximately of the same order of magnitude.

Transfusion-Acquired Plasmodium malariae Infection in Two Premature Infants

PEDIATRICS ◽  
1983 ◽  
Vol 72 (4) ◽  
pp. 560-562
Author(s):  
D. A. PICCOLI ◽  
S. PERLMAN ◽  
M. EPHROS
Keyword(s):  
Premature Infant ◽  
Premature Infants ◽  
Antibacterial Therapy ◽  
Plasmodium Malariae ◽  
Term Infant ◽  
Full Term ◽  
Infected Blood ◽  
Full Term Infant ◽  
Premature Babies ◽  
Possible Cause

Several diseases can be transmitted to infants via transfusion. The risk of acquiring an infection via transfusion is greatly increased in sick premature infants because they receive frequent transfusions. The full-term infant is not fully competent immunologically,15 and the premature infant is even less able to deal with infection.6,15 Ideally, the transfusion of infected blood, especially into immunoincompetent recipients, should not occur. However, because screening for malaria in nonendemic regions is not practical, physicians caring for sick premature babies should consider transfusion-acquired malaria as a possible cause of illness, especially when there is no response to antibacterial therapy.

Premie Nipples: A Potential Aspiration Hazard

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 163-164
Author(s):  
Robert G. Scherz
Keyword(s):  
United States ◽  
Premature Infants ◽  
The United States ◽  
Term Infant ◽  
Full Term ◽  
Term Infants ◽  
Full Term Infant ◽  
Retail Outlets

Nipples for dispensing milk to infants are sold throughout the United States and Canada in a diversity of retail outlets. The nipples have been designed in a variety of forms to include soft nipples for premature infants. The nipples for premature infants tend to be of thinner stock and more pliable than nipples designed for full-term infants. Although the nipples may well have labeling indicating that they have been prepared for premature infants, the adult who purchases them may not recognize that difference when they are displayed in an area that also provides standard nipples. The use of nipples designed for premature infants may present an aspiration hazard if they are used by a full-term infant.

ALVEOLAR-ARTERIAL O2 AND CO2 DIFFERENCES AND THEIR RELATION TO LUNG VOLUME IN THE NEWBORN

PEDIATRICS ◽  
1968 ◽  
Vol 41 (3) ◽  
pp. 574-587 ◽  
Author(s):  
D. W. Thibeault ◽  
E. Poblete ◽  
P. A. M. Auld
Keyword(s):  
Carbon Dioxide ◽  
Premature Infants ◽  
Lung Volume ◽  
Term Infant ◽  
Full Term ◽  
Arterial Oxygen ◽  
Term Infants ◽  
Oxygen Gradient ◽  
Thoracic Gas Volume ◽  
Gas Volume

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient. In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants.

STUDIES OF THE IMMUNOLOGY OF THE NEWBORN INFANT

PEDIATRICS ◽  
1954 ◽  
Vol 13 (4) ◽  
pp. 339-345
Author(s):  
JOSEPH DANCIS ◽  
HANS W. KUNZ
Keyword(s):  
Premature Infant ◽  
Term Infant ◽  
Full Term ◽  
In Vitro Test ◽  
Bacteriostatic Activity ◽  
Older Individuals ◽  
E Coli ◽  
Full Term Infant ◽  
The Poor

The bacteriostatic activity of the serum of infants was compared by an in vitro test with that of older children and adults in an attempt to explain the increased susceptibility to septicemia of the former. The serum of newborn infants at birth has a bacteriostatic activity against E. coli comparable to that of older individuals. This property is lost during the first weeks of life. It reappears in some infants in a few months and is usually present after one year of age. The bacteriostatic activity of premature infant serum follows closely that of the full term infant. The complement activity of 9 of 11 sera from premature infants fell within the range found in normal adult sera. Experiments using guinea pig serum as a source of complement also indicate that the poor bacteriostatic activity of premature infant serum is not the result of deficient complement ent activity. This is probably also true of the full term infant. Experiments with gamma globulin indicate that a deficiency in this serum fraction is at least partly responsible for the poor bacteriostatic performance of premature infant serum. Concurrent bacteriostatic tests with E. coli, Neisseria catarrhalis and Salmonella derby suggest that the ability to inhibit one organism is usually paralleled by the ability to inhibit the others. The possible nature of the bacteriostatic substances is discussed.

MORTALITY RISK OF EXCHANGE TRANSFUSION

PEDIATRICS ◽  
1968 ◽  
Vol 41 (4) ◽  
pp. 797-801
Author(s):  
Virginia V. Weldon ◽  
Gerald B. Odell
Keyword(s):  
Premature Infants ◽  
Mortality Risk ◽  
Exchange Transfusion ◽  
Mortality Rates ◽  
Term Infant ◽  
Full Term ◽  
Present Series ◽  
Johns Hopkins Hospital ◽  
Large Group ◽  
Full Term Infant

The exchange transfusions performed at The Johns Hopkins Hospital over a 6-year period have been reviewed. During this period there were 351 exchange transfusions performed on 232 infants with 11 deaths. The mortality rates in the present series are as low as any in the literature, even though the procedures have been carried out by a large group of pediatric house officers. The mortality risk in the premature infants was no greater than that for the full-term infant.

Treatment of Apnea and Excessive Periodic Breathing in the Full-Term Infant

PEDIATRICS ◽  
1981 ◽  
Vol 68 (2) ◽  
pp. 183-186
Author(s):  
Dorothy H. Kelly ◽  
Daniel C. Shannon
Keyword(s):  
Serum Level ◽  
Periodic Breathing ◽  
Term Infant ◽  
Full Term ◽  
Average Dose ◽  
Term Infants ◽  
Full Term Infant ◽  
History Of ◽  
Average Serum

Twenty-two full-term infants, aged 0 to 6 weeks, with a history of unexplained apnea and respiratory abnormalities on pneumogram recordings, were treated with theophylline (average dose 7.5 mg/kg/day and average serum level 11 µg/ml). Subsequent recordings showed a significant decrease in the amount of periodic breathing (14.3% vs 0.7%) and apnea 10 to 14.9 seconds (12.8 vs 1.0/100 min) when compared to the initial pneumogram. It is concluded that theophylline therapy in this group of infants will result in a reduction of apnea and periodic breathing.

THE EFFECT OF POSITION ON THE RESPIRATORY RATE OF PREMATURE AND MATURE NEWBORN INFANTS

PEDIATRICS ◽  
1958 ◽  
Vol 22 (3) ◽  
pp. 432-435
Author(s):  
Harvey Kravitz ◽  
Lawrence Elegant ◽  
Bernard Block ◽  
Mary Babakitis ◽  
Evelyn Lundeen
Keyword(s):  
Respiratory Rate ◽  
Premature Infant ◽  
Prone Position ◽  
Premature Infants ◽  
Supine Position ◽  
Newborn Infants ◽  
Full Term ◽  
Term Infants ◽  
Definite Effect

Values for respiratory rates in the supine and prone positions in 96 premature and 49 full-term infants have been presented. Premature infants have a significant increase in respiratory rate in the prone position compared to the supine position. This difference decreases with increasing weight and age. Mature infants show a slight increase in respiratory rate in the prone compared to the supine position. The position of the premature infant has a definite effect on the physiology of respiration. Further studies must be done to establish whether the supine or prone position is superior. Irregularity of rate and amplitude of respirations are noted in the supine position, while respirations of regular rate and amplitude are frequently found in the prone position. The amplitude of respiration was greater in the supine position than in the prone position.

scholarly journals Development of the human coagulation system in the full-term infant

Blood ◽  
1987 ◽  
Vol 70 (1) ◽  
pp. 165-172 ◽  
Author(s):  
M Andrew ◽  
B Paes ◽  
R Milner ◽  
M Johnston ◽  
L Mitchell ◽  
...  
Keyword(s):  
Protein S ◽  
Coagulation Factors ◽  
Postnatal Period ◽  
Term Infant ◽  
Full Term ◽  
Coagulation System ◽  
Term Infants ◽  
Full Term Infant ◽  
Coagulation Tests ◽  
C1 Esterase Inhibitor Protein

The investigation of many hemostatic defects in the newborn is limited by the lack of normal reference values. This study was designed to determine the postnatal development of the human coagulation system in the healthy full-term infant. Consecutive mothers of healthy full-term infants born at St JosePh′s Hospital in the city of Hamilton were approached for consent. One hundred eighteen full-term infants (37 to 42 week's gestational age) were entered into the study. Demographic information and a 2-mL blood sample were obtained in the postnatal period on days 1, 5, 30, 90, and 180. Between 40 and 79 full-term infants were studied on each day for each of the coagulation tests. Plasma was fractionated and stored at -70 degrees C for batch assaying of the following tests: prothrombin time, activated partial thromboplastin time, thrombin clotting time, and factor assays (biologic): fibrinogen, II, V, VII, VIII, IX, X, XI, XII, and high- molecular weight kininogen. Factor XIII subunits A and S, von Willebrand factor, and the inhibitors antithrombin III, alpha 2- antiplasmin, alpha 2-macroglobulin, alpha 1-antitrypsin, C1 esterase inhibitor, protein C, and protein S were measured immunologically. Plasminogen, prekallikrein, and heparin cofactor II were measured by using chromogenic substrates. The large number of infants studied at each time point allowed us to determine the following: the range of normal for each test at five time points in the postnatal period; that coagulation tests vary with the postnatal age of the infant; that different coagulation factors show different postnatal patterns of maturation; and that near-adult values are achieved for most components by 6 months of life. In summary, this large cohort of infants studied consecutively in the postnatal period allowed us to determine the normal development of the human coagulation system in the full-term infant.

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