scholarly journals Baroreflex Sensitivity in Premature Infants – Relation to the Parameters Characterizing Intrauterine and Postnatal Condition

2017 ◽  
pp. S257-S264 ◽  
Author(s):  
K. HASKOVA ◽  
M. JAVORKA ◽  
B. CZIPPELOVA ◽  
M. ZIBOLEN ◽  
K. JAVORKA

At present, there are insufficient information about baroreflex sensitivity (BRS) and factors that determine BRS in premature newborns. The objective of this study was to determine the relationship between BRS and the characteristics that reflecting the intrauterine development (gestational age and birth weight), as well as postnatal development (postconception age and the actual weight of the child at the time of measurement). We examined 57 premature infants, who were divided into groups according to gestational age and postconception age as well as birth weight, and weight at the time of measurement. Continuous and noninvasive registration of peripheral blood pressure (BP) was performed in every child within 2-5 min under standard conditions using a Portapres (FMS) device. The results showed a close correlation of baroreflex sensitivity, heart rate and respiratory rate with gestational age, postconception age, birth weight and actual weight at the time of measurement premature newborns. An increase in the characteristics (ages and weights) resulted in increased BRS and diastolic arterial pressure (DAP), and in decreased heart and respiratory rates. Baroreflex sensitivity in the first week was in the group of very premature newborns the lowest (4.11 ms/mmHg) and in the light premature newborns was almost double (8.12 ms/mmHg). BRS increases gradually in relation to postnatal (chronological) and to postconception age as well as to birth and actual weight. The multifactor analysis of BRS identified birth weight and postconception age as the best BRS predictors. The two independent variables together explained 40 % of interindividual BRS variability.

Author(s):  
M. Cohen ◽  
H. Perl ◽  
E. Steffen ◽  
B. Planer ◽  
A. Kushnir ◽  
...  

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.


2021 ◽  
Vol 9 ◽  
Author(s):  
Longli Yan ◽  
Zhuxiao Ren ◽  
Jianlan Wang ◽  
Xin Xia ◽  
Liling Yang ◽  
...  

Background: Platelets play an important role in the formation of pulmonary blood vessels, and thrombocytopenia is common in patients with pulmonary diseases. However, a few studies have reported on the role of platelets in bronchopulmonary dysplasia.Objective: The objective of the study was to explore the relationship between platelet metabolism and bronchopulmonary dysplasia in premature infants.Methods: A prospective case-control study was performed in a cohort of premature infants (born with a gestational age &lt;32 weeks and a birth weight &lt;1,500 g) from June 1, 2017 to June 1, 2018. Subjects were stratified into two groups according to the diagnostic of bronchopulmonary dysplasia: with bronchopulmonary dysplasia (BPD group) and without bronchopulmonary dysplasia (control group). Platelet count, circulating megakaryocyte count (MK), platelet-activating markers (CD62P and CD63), and thrombopoietin (TPO) were recorded and compared in two groups 28 days after birth; then serial thrombopoietin levels and concomitant platelet counts were measured in infants with BPD.Results: A total of 252 premature infants were included in this study. Forty-eight premature infants developed BPD, 48 premature infants without BPD in the control group who were matched against the study infants for gestational age, birth weight, and admission diagnosis at the age of postnatal day 28. Compared with the controls, infants with BPD had significantly lower peripheral platelet count [BPD vs. controls: 180.3 (24.2) × 109/L vs. 345.6 (28.5) × 109/L, p = 0.001]. Circulating MK count in the BPD group was significantly more abundant than that in the control group [BPD vs. controls: 30.7 (4.5)/ml vs. 13.3 (2.6)/ml, p = 0.025]. The level of CD62p, CD63, and TPO in BPD group was significantly higher than the control group [29.7 (3.1%) vs. 14.5 (2.5%), 15.4 (2.0%) vs. 5.8 (1.7%), 301.4 (25.9) pg/ml vs. 120.4 (14.2) pg/ml, all p &lt; 0.05]. Furthermore, the concentration of TPO was negatively correlated with platelet count in BPD group with thrombocytopenia.Conclusions: Our findings suggest that platelet metabolism is involved in the development of BPD in preterm infants. The possible mechanism might be through increased platelet activation and promoted TPO production by feedback.


2015 ◽  
Vol 4 (1) ◽  
pp. 17
Author(s):  
Julan Yu

<p><strong>Objective: </strong>Analysis and discussion of the clinical statistics of the blood cell parameters in premature infants. <strong>Method: </strong>From May 2008 to January 2015, 85 cases of premature infants were selected to analyze the relationship between blood cell parameters and birth weight, gestational age and the changes of blood cell parameters in premature infants with intracranial hemorrhage. <strong>Results: </strong>Blood cell parameters PDW and PLT were decreased with the decrease of birth weight and gestational age. MPV increased with the decrease of birth weight and gestational age, the difference was statistically significant (<em>p </em>&lt; 0.05). Compared with the non-bleeding group, the intracranial hemorrhage in premature infants with PLT was significantly decreased, the difference was statistically significant <em>(p </em>&lt; 0.05), MPV and PDW were not statistically significant (<em>p </em>&gt; 0.05). <strong>Conclusion: </strong>The blood cell parameters were correlated with the birth weight and gestational age, and the parameters of blood cells were closely related to the complications of premature infants and premature infants with intracranial hemorrhage.</p>


Author(s):  
Ozdemir Ozdemir ◽  
Zuhal Ozen Tunay ◽  
Damla Erginturk Acar ◽  
Muhammet Kazım Erol ◽  
Ender Sener ◽  
...  

2018 ◽  
Vol 104 (3) ◽  
pp. F242-F247 ◽  
Author(s):  
Chonnikant Visuthranukul ◽  
Steven A Abrams ◽  
Keli M Hawthorne ◽  
Joseph L Hagan ◽  
Amy B Hair

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.


2014 ◽  
Vol 205 (5) ◽  
pp. 340-347 ◽  
Author(s):  
Christian Loret De Mola ◽  
Giovanny Vinícius Araújo De França ◽  
Luciana de Avila Quevedo ◽  
Bernardo Lessa Horta

BackgroundThere is no consensus on the effects that low birth weight, premature birth and intrauterine growth have on later depression.AimsTo review systematically the evidence on the relationship of low birth weight, smallness for gestational age (SGA) and premature birth with adult depression.MethodWe searched the literature for original studies assessing the effect of low birth weight, premature birth and SGA on adult depression. Separate meta-analyses were carried out for each exposure using random and fixed effects models. We evaluated the contribution of methodological covariates to heterogeneity using meta-regression.ResultsWe identified 14 studies evaluating low birth weight, 9 premature birth and 4 SGA. Low birth weight increased the odds of depression (OR = 1.39, 95% CI 1.21–1.60). Premature birth and SGA were not associated with depression, but publication bias might have underestimated the effect of the former and only four studies evaluated SGA.ConclusionsLow birth weight was associated with depression. Future studies evaluating premature birth and SGA are needed.


2014 ◽  
Vol 32 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Pedro Garcia F. Neto ◽  
Mario Cicero Falcao

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.


PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 74-77 ◽  
Author(s):  
Rowena Korobkin

Rapidly enlarging head circumference is a standard clinical sign of progressive hydrocephalus in an infant. Six neonates 29 to 36 weeks gestational age, with intraventricular hemorrhage, confirmed by ventricular tap, had head circumferences measured at intervals from birth. The sudden appearance of rapidly expanding head size, not associated with changing clinical status, occurred 9 to 20 days after the estimated time of hemorrhage in all of the infants. Air ventriculography within three days of abnormal acceleration of head circumference growth demonstrated moderately to severely dilated ventricles. The ventricles were probably enlarging slowing from the time of hemorrhage because there was no associated clinical deterioration in the infants coincident with the rapid increase in head circumference. After intraventncular hemorrhage, enlarging head circumference appears to be an insensitive sign of hydrocephalus in premature infants.


2021 ◽  
pp. 64-66
Author(s):  
Sambhunath Bandyopadhyay ◽  
Ritayan Sasmal ◽  
Debarshi Jana

Accurate gestational age determination is very important for management of continuation and termination planning of the pregnancy. rd To establish placental thickness as a parameter for determination of gestational age and fetal growth pattern at 3 trimester. 100 primigravida women who are fullling the inclusion criteria and attend gynae &obs OPD or admitted in their third trimester at IPGME&R from January 2017 to june 2018. Placental thickness at 3rd trimester USG scan is moderately correlated with gestational age, if placental thickness expressed in millimeter then it correlated with gestational age at weeks. rd st Placental thickness with >3.2 cm (32 mm) at 3 trimester almost associated with good fetal outcome, with APGAR score >8 at 1 min and birth weight >2500 gm.


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