scholarly journals Longitudinal Evaluation of Pulmonary Function in Premature Infants

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Abigail Settle ◽  
Christina Tiller ◽  
Jeffrey Bjerregaard ◽  
Marylyn Robinson ◽  
James Slaven ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Premature Infants ◽  
Gestational Age ◽  
Vital Capacity ◽  
Full Term ◽  
Z Score ◽  
Alveolar Volume ◽  
Term Infants ◽  
Airway Function ◽  
Catch Up

Background: Infants born premature have decreased pulmonary function compared to full-term infants. Longitudinal infant studies are needed to determine whether impaired pulmonary function following premature birth demonstrates catch-up growth. This study measured airway and parenchymal function in infants born premature at approximately 6 months and 1 year of age to assess growth and the effects of gestational age (GA) and sex.   Methods: 37 infants born premature participated in two study visits (V1 and V2) at Riley Hospital in Indianapolis, IN. While sleeping, forced expiratory maneuvers were preformed to measure airway function. DLCO, diffusion capacity of the lung, and VA, alveolar volume, were measured under conditions of room air. Z scores were calculated to compare infants born premature and full-term, adjusting for size, race, and sex.   Demographics: The subjects consisted of 21 females and 16 males. There were 7 subjects born at 24 – 28 weeks, 6 at 29 – 31 weeks, and 24 at 32 – 36 weeks.   Pulmonary Testing Results: Variable Z Score V1 V2 V2-V1 Male Female GA DLCO -0.17 (-0.59, 0.26) *-0.75 (-1.18, -0.31) *-0.58 (-1.03, -0.12) *-0.86 (-1.42, -0.30) -0.05 (-0.53, 0.43) *0.13 (0.001,0.28) VA 0.06 (-0.24, 0.45) -0.24 (-0.70, 0.23) -0.30 (-0.72 ,0.14) -0.14 (-0.71, 0.43) -0.04 (-0.53, 0.45) 0.09 (-0.05, 0.23) FVC *-0.38 (-0.60, -0.17) **-1.05 (-1.36, -0.74) **-0.67 (-0.98, -0.36) **-0.71 (-1.04, -0.38) **-0.72 (-1.01, -0.44) 0.07 (-0.01, 0.15) FEF50 **-0.88 (-1.15, -0.62) **-1.36 (-1.63, -1.08) *-0.47 (-0.80, -0.14) **-1.12 (-1.44, -0.79) **-1.12 (-1.40, -0.84) **0.15 (0.07,0.23) FEF75 **-0.57 (-0.88, -0.26) **-1.16 (-1.48, -0.83) *-0.59 (-0.93, -0.24) **-0.76 (-1.16, -0.35) **-0.97 (-1.32, -0.62) **0.21 (0.11,0.31) * = p < 0.05    ** = p < 0.001   DLCO was decreased in male subjects compared to female subjects and male full-term infants. VA was not significantly different between subjects and full-term infants. Compared to full-term infants, subjects had decreased forced vital capacity (FVC) and forced expiratory flow at 50% and 75% vital capacity (FEF50 and FEF75). DLCO, FVC, FEF50, and FEF75 exhibited a significant decrease in pulmonary function from V1 to V2 among subjects. Gestational age showed a positive relationship for DLCO, FEF50, and FEF75.   Conclusion and Potential Impact: The subjects did not exhibit catch-up growth, or an increase in z score from V1 to V2, in parenchymal and airway function for DLCO, FVC, FEF50, and FEF75. Gestational age and sex were factors affecting pulmonary function. As premature infants are born with lower pulmonary function than full-term infants, it is important to understand how lungs continue to develop after release from the NICU.

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.

The Timing of Early Postnatal Catch-Up Growth in Normal, Full-Term Infants Born Short for Gestational Age

1997 ◽  
Vol 48 (1) ◽  
pp. 17-24 ◽  
Author(s):  
J.P.E. Karlberg ◽  
K. Albertsson- ◽  
E.Y.W. Kwan ◽  
B.C.C. Lam ◽  
L.C.K. Low
Keyword(s):  
Gestational Age ◽  
Full Term ◽  
Term Infants ◽  
Catch Up

scholarly journals The influence of birth weight and gestational age on kidney function in premature infants

2021 ◽  
Vol 24 (4) ◽  
pp. 222-230
Author(s):  
Bella D. Tsintsadze ◽  
Klavdiya A. Kazakova ◽  
Vladislav V. Chernikov ◽  
Andrey P. Fisenko ◽  
Aleksey N. Tsygin
Keyword(s):  
Early Childhood ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Serum Creatinine ◽  
Premature Infants ◽  
Gestational Age ◽  
Full Term ◽  
Enzymatic Method ◽  
Term Infants ◽  
Blood Creatinine

Introduction. The impact of prematurity on the functional state of the kidneys in infants has not yet been sufficiently studied. Aim. To determine the influence of birth weight and gestational age on the creatinine level in the blood and glomerular filtration rate (GFR) in early childhood. Materials and methods. A retrospective analysis was conducted on medical records of 316 children aged from 1 month to 1.5 years, hospitalized at the Department of Early Childhood Pathology (National Medical Research Center for Children’s Health, Moscow) from 2012 to 2020 due to consequences of perinatal CNS damage. Children without congenital kidney diseases, with normal urine values in medical history, without structural abnormalities on ultrasound were included in this study. Serum creatinine was determined by the enzymatic method, GFR - by the Schwartz’s formula using a coefficient of 0.413, as well as, previously proposed coefficients of 0.33 for premature and 0.44 for full-term infants. Results. In premature infants, notably born with extremely low birth weight and very low birth weight, at the age of 1 year, serum creatinine is reduced compared to full-term infants, GFR in deep-premature infants exceeds the level of GFR in full-term infants by the year. The results allow concluding the method of calculating GFR by formulas based on serum creatinine to be invalid. Due to possible hyperfiltration in preterm infants, they need regular monitoring urine tests, blood pressure, due to the risk of developing chronic kidney disease. Conclusions. It is necessary to search for other methods for determining GFR in extremely premature infants. The established indices of the blood creatinine content can be used as reference values for different periods of gestation and body weight at birth in institutions using the enzymatic method for determining blood creatinine. The obtained GFR indices as a reference can be recommended for full-term and premature babies born after 32 weeks of gestation and with a birth weight of more than 1500 g.

scholarly journals Lymphocyte-Specific Biomarkers Associated with Preterm Birth and Bronchopulmonary Dysplasia

2020 ◽  
Author(s):  
Soumyaroop Bhattacharya ◽  
Jared A. Mereness ◽  
Andrea M. Baran ◽  
Ravi S. Misra ◽  
Derick R. Peterson ◽  
...  
Keyword(s):  
Gene Expression ◽  
T Cells ◽  
Premature Infants ◽  
Cd8 T Cells ◽  
Gestational Age ◽  
Full Term ◽  
Oxygen Utilization ◽  
Term Infants ◽  
Transcriptomic Data ◽  
The University

AbstractMany premature babies who are born with neonatal respiratory distress syndrome (RDS) go on to develop Bronchopulmonary Dysplasia (BPD) and later Post-Prematurity Respiratory Disease (PRD) at one year corrected age, characterized by persistent or recurrent lower respiratory tract symptoms frequently related to inflammation and viral infection. Transcriptomic profiles were generated from sorted peripheral blood CD8+ T cells of preterm and full-term infants enrolled with consent in the NHLBI Prematurity and Respiratory Outcomes Program (PROP) at the University of Rochester and the University at Buffalo. We identified outcome-related gene expression patterns following standard methods to identify markers for oxygen utilization and BPD as outcomes in extremely premature infants. We further identified predictor gene sets for BPD based on transcriptomic data adjusted for gestational age at birth (GAB).RNA-Seq analysis was completed for CD8+ T cells from 145 subjects. Among the subjects with highest risk for BPD (born at <29 weeks gestational age (GA); n=72), 501 genes were associated with oxygen utilization. In the same set of subjects, 571 genes were differentially expressed in subjects with a diagnosis of BPD and 105 genes were different in BPD subjects as defined by physiologic challenge. A set of 92 genes could predict BPD with a moderately high degree of accuracy. We consistently observed dysregulation of NRF2, HIPPO and CD40-associated pathways in BPD. Using gene expression data from both premature and full-term subjects (n=116), we identified a 28 gene set that predicted the PRD status with a moderately high level of accuracy.Transcriptomic data from sort-purified peripheral blood CD8+ T cells from 145 preterm and full-term infants identified sets of molecular markers associated with independent development of BPD in extremely premature infants at high risk for the disease and of PRD among the preterm and full-term subjects.

scholarly journals Tidal breathing pulmonary function and influencing factors in late preterm and full-term neonates

2020 ◽  
Author(s):  
Xiaoyan Zhang ◽  
ShuZheng Xu ◽  
JunHong Liu ◽  
HuanHuan Huang ◽  
Bin Wu
Keyword(s):  
Factor Analysis ◽  
Pulmonary Function ◽  
Premature Infants ◽  
Neonatal Period ◽  
Full Term ◽  
Late Preterm ◽  
Single Factor ◽  
Tidal Breathing ◽  
Term Infants ◽  
Factors Influencing

Neonatal period is the key stage of lung development. However, tidal breathing pulmonary function (TBPF) of late preterm and full-term infants without pathology has rarely been studied. Our research focuses on the early neonatal period and aims to detect the factors influencing PF and implemente effective interventions earlier. Methods: This prospective study evaluated the PF characteristics of 142 infants admitted to our neonatology department. Potential explanatory variables for TBPF were analyzed using single-factor and multi-factor linear regression analyses. Results: PF characteristics, including tidal volume (VT) and minute ventilation (MV), were significantly lower in late preterm infants compared to full-term infants (P<0.01). TPTEF/TE and VPTEF/VE were not significantly different between groups (P>0.05). In the single-factor analysis, changes in parameters related to lung volume (VT, VT/kg, MV) were mainly correlated with gestational age (GA), corrected GA, birth weight, weight at examination, weight changes, and serum albumin(SAB). After birth, VT/kg and indicators of airway obstruction (VPTEF/VE and TPTEF/TE) changed significantly with increasing age. In the multiple-factor analysis, the main factors influencing VT, VT/kg, and MV were corrected GA and daily weight change, GA and corrected GA, and corrected GA and SAB, respectively. Conclusion: The main difference in PF between full-term and late premature infants was the lung volume. In these newborns PF was associated with GA, corrected GA, daily weight change, and SAB level. These results suggest that an adequate energy supply is critical for PF development in neonates, and especially for premature infants.

scholarly journals Lymphocyte-Specific Biomarkers Associated With Preterm Birth and Bronchopulmonary Dysplasia

2021 ◽  
Vol 11 ◽  
Author(s):  
Soumyaroop Bhattacharya ◽  
Jared A. Mereness ◽  
Andrea M. Baran ◽  
Ravi S. Misra ◽  
Derick R. Peterson ◽  
...  
Keyword(s):  
Gene Expression ◽  
T Cells ◽  
Premature Infants ◽  
Cd8 T Cells ◽  
Gestational Age ◽  
Full Term ◽  
Oxygen Utilization ◽  
Term Infants ◽  
Transcriptomic Data ◽  
The University

Many premature babies who are born with neonatal respiratory distress syndrome (RDS) go on to develop Bronchopulmonary Dysplasia (BPD) and later Post-Prematurity Respiratory Disease (PRD) at one year corrected age, characterized by persistent or recurrent lower respiratory tract symptoms frequently related to inflammation and viral infection. Transcriptomic profiles were generated from sorted peripheral blood CD8+ T cells of preterm and full-term infants enrolled with consent in the NHLBI Prematurity and Respiratory Outcomes Program (PROP) at the University of Rochester and the University at Buffalo. We identified outcome-related gene expression patterns following standard methods to identify markers for oxygen utilization and BPD as outcomes in extremely premature infants. We further identified predictor gene sets for BPD based on transcriptomic data adjusted for gestational age at birth (GAB). RNA-Seq analysis was completed for CD8+ T cells from 145 subjects. Among the subjects with highest risk for BPD (born at &lt;29 weeks gestational age (GA); n=72), 501 genes were associated with oxygen utilization. In the same set of subjects, 571 genes were differentially expressed in subjects with a diagnosis of BPD and 105 genes were different in BPD subjects as defined by physiologic challenge. A set of 92 genes could predict BPD with a moderately high degree of accuracy. We consistently observed dysregulation of TGFB, NRF2, HIPPO, and CD40-associated pathways in BPD. Using gene expression data from both premature and full-term subjects (n=116), we identified a 28 gene set that predicted the PRD status with a moderately high level of accuracy, which also were involved in TGFB signaling. Transcriptomic data from sort-purified peripheral blood CD8+ T cells from 145 preterm and full-term infants identified sets of molecular markers of inflammation associated with independent development of BPD in extremely premature infants at high risk for the disease and of PRD among the preterm and full-term subjects.

Percentile estimates of reference values for total protein and albumin in sera of premature infants (less than 37 weeks of gestation).

1987 ◽  
Vol 33 (3) ◽  
pp. 411-413 ◽  
Author(s):  
S H Zlotkin ◽  
C W Casselman
Keyword(s):  
Premature Infants ◽  
Reference Values ◽  
Gestational Age ◽  
Total Protein ◽  
Protein Concentration ◽  
Term Infant ◽  
Full Term ◽  
Albumin Concentration ◽  
Total Protein Concentration ◽  
Term Infants

Abstract We measured the concentrations of total protein and albumin in sera of 281 well-fed premature infants, gestational ages 22-36 weeks, and calculated reference values from the 10th to 90th percentiles. The mean serum albumin concentration (27.6 +/- 4.4 g/L, mean +/- SD) and total protein concentration (49.2 +/- 6.7 g/L) at a postnatal age of 14.5 days were lower than reference values for full-term infants. We detected a significant positive correlation between albumin concentration and gestational age (r = 0.34, p less than 0.01) and total protein concentration and gestational age (r = 0.43, p less than 0.01). Even though albumin values were low, generalized edema was not present. We conclude that values for total protein and albumin in the preterm infant are lower than in the full-term infant but are an expected physiological response to premature birth.

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.

scholarly journals Newborn Screening for Severe Combined Immunodeficiency: Do Preterm Infants Require Special Consideration?

2021 ◽  
Vol 7 (3) ◽  
pp. 40
Author(s):  
Anne E. Atkins ◽  
Michael F. Cogley ◽  
Mei W. Baker
Keyword(s):  
Newborn Screening ◽  
Premature Infant ◽  
Gestational Age ◽  
Linear Regression Analysis ◽  
Severe Combined Immunodeficiency ◽  
Cell Receptor ◽  
Full Term ◽  
Combined Immunodeficiency ◽  
Term Infants ◽  
Preterm Newborns

The Wisconsin Newborn Screening (NBS) Program began screening for severe combined immunodeficiency (SCID) in 2008, using real-time PCR to quantitate T-cell receptor excision circles (TRECs) in DNA isolated from dried blood NBS specimens. Prompted by the observation that there were disproportionately more screening-positive cases in premature infants, we performed a study to assess whether there is a difference in TRECs between full-term and preterm newborns. Based on de-identified SCID data from 1 January to 30 June 2008, we evaluated the TRECs from 2510 preterm newborns (gestational age, 23–36 weeks) whose specimens were collected ≤72 h after birth. The TRECs from 5020 full-term newborns were included as controls. The relationship between TRECs and gestational age in weeks was estimated using linear regression analysis. The estimated increase in TRECs for every additional week of gestation is 9.60%. The 95% confidence interval is 8.95% to 10.25% (p ≤ 0.0001). Our data suggest that TRECs increase at a steady rate as gestational age increases. These results provide rationale for Wisconsin’s existing premature infant screening procedure of recommending repeat NBS following an SCID screening positive in a premature infant instead of the flow cytometry confirmatory testing for SCID screening positives in full-term infants.

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