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Biomedical subjects

R Paludetto

Publications and source records attributed to R Paludetto.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Cigarette smoking in pregnancy: relationship to perinatal outcomes in six Italian centres.

In this study the relationship of maternal smoking in pregnancy to low birth weight, fetal growth retardation, preterm delivery, and perinatal deaths has been investigated in a sample of 36,544 women with their single newborns, from 6 Italian centers (Triese, Milan, Parma, Rome, Naples, Bari), where a multicenter survey of perinatal preventive medicine (MPPI) was carried out, between 1973 and 1979, with the financial support of the Consiglio Nazionale dell Ricerche. The proportions of babies weighing 2500 g or less, and of babies with birth weight, head circumference or crown-heel length below the 10th centile were similar among nonsmokers and "stopped" smoker mothers, while they increased with increasing smoking levels. As regards head circumference and crown-heel length below the 10th centile, odds ratios are essentially the same before and after adjustment for age, parity, and socioeconomic class (about 1.5 for "1-10CGT" and up to 2.5 for "11+CGT"). Only slight increases have been observed in the odds ratios concerning low birthweight below the 10th centile (about 1.5 for "1-10CGT" and up to 3.5 for "11+CGT") after adjusting for the socioeconomic demographic variables (i.e. mainly removing the favourable effect of high socioeconomic class or low parity, which more frequently characterize smoker mothers). Owing to the lower smokers' frequencies, cigarette smoking estimated attributable risks concerning low birth weight and "small for dates" babies in the MPPI centres (between 4% and 19%) are considerably lower than those estimated in studies carried out in the US or Canada. Data analyzed in the present study do not indicate any relationship between maternal smoking and preterm delivery or perinatal deaths.

Behavior↗
PubMedDate not supplied

[Efficacy of early cerebral MR in the detection of brain lesions in high risk preterm infants compared with conventional US].

To identify the efficacy of early cerebral MR, performed in the first month of birth, in the detection of brain lesions in high risk preterm infants, compared with conventional US, we recruited into the study a group of 30 preterm infants born at or below a gestational age of 30 weeks, who had a pathologic scan. The findings on US were compared with those of the early MR scan, performed in the same days, the results of which were considered as the final diagnosis. The value of cranial US as a predictor of MR signal intensity was assessed by calculating sensitivity, specificity, positive and negative predictive values. Agreement between two investigations was evaluated by calculating the K coefficient. US showed 33 haemorrhagic lesions in 25 preterms; MR showed 27 haemorrhagic lesions in 22 infants: in 16 cases MR gave the same results of US. Cranial US was reliable in detecting lesions such as GLH and IVH, but less sensitive in the definition of their size and distribution. Sensitivity of US for haemorrhagic lesions was 96.3%, PPV 78.8%, K coefficient 0.55 (p < 0.001). About the White Matter, cranial US demonstrated 20 lesions in 20 preterms; MR showed 16 lesions in 16 infants: in 3 cases MR was agree to US. US showed high reliability in the detection of cystic lesions, but significant limitations in the demonstration of non-cystic injury. We founded that normal WM echogenicity on US is not a good predictor of normal WM signal intensity on MR (30%). Sensitivity of US for WM lesions was 81.3%, PPV 65%, K coefficient 0.23 (p = 0.04). Finally US showed 4 lesions in other brain locations, MR confirmed 3 of them and discovered other 10. Sensitivity of US for these lesions was 23.1%, PPV 75%, K coefficient 0.21 (p = 0.11). We founded that cranial US is a good method for detecting GLH, IVH, HPI and severe WM lesions (cystic PVL), but it can miss non-cystic PVL, punctate haemorrhages, WMD and lesions in other brain locations, that, on the other hand, MR detects clearly.

Brain Diseases↗
PubMedDate not supplied

[Assistance procedures and physiologic balance in newborn infants].

The authors assume that an appropriate sensory input care can improve the conditions of the very-low-birth-weight (VLBW) infant with RDS. The VLBW preterm infant, in the intensive care unit, takes advantage both medically and developmentally of an individualized behavioral care. The authors present their positive experience with the auditory, visual and tactile stimulations of the preterm infant, after the period of intensive care, with the method of Brazelton.

Humans↗
PubMedDate not supplied

[Non-nutritional sucking in the preterm neonate].

The authors briefly review the available data on nonnutritive sucking (NNS) in preterm infants focusing mainly on NNS as a form of intervention and on the relationship of NNS with cardiorespiratory control. The previous studies on the positive effects of NNS on weight gain and oxygenation called for deeper investigation on the mechanism involved. The authors report the main results of their work on this field. The effects of NNS on transcutaneous oxygen tension, heart rate and respiration were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygenation tension increased during NNS in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. A subsequent study however, demonstrated a small and transient increase of respiratory rate during NNS bursts. Although further longitudinal studies will be needed these data offer further support for the beneficial effects of NNS in preterm infants.

Heart Rate↗
PubMedDate not supplied

[Neurologic pathology in the neonatal period: relation to birth weight and gestational age].

Six Italian university centers have taken part in the Perinatal Preventive Medicine Project of the National Research Council since 1973. In this report the preliminary data on neonatal neurological disorders of 38775 single not malformed infants are presented. Neurological abnormality has been defined by the presence of at least one of the following symptoms: seizures, hypertonia, hypotonia, apneic spells. The relative frequencies of seizures vary from a minimum of 0.28% to a maximum of 0.75% in the six centers. The frequencies of the other symptoms demonstrate a greater variability among centers. Males are more affected than females. The relative frequency of neurological abnormalities is higher among babies with low birthweight, short gestational age or retarded intrauterine growth. Also, the frequency of seizures is higher among babies with low birthweight or retarded intrauterine growth while the relationship between seizures and gestational age is not clear.

Apnea↗
PubMedDate not supplied

[Breech presentation: vaginal delivery or elective cesarean section?].

The incidence of asphyxia and mortality has been evaluated retrospectively in 716 breech newborns who were vaginally or by elective caesarean section delivered. In the group of 171 preterm infants the rate of asphyxia and mortality has been more elevated in the newborns vaginally delivered; in the group of 545 term infants has not been any difference between those who were delivered vaginally or by caesarean section. About the 50% of the term infants and only the 8% of the preterm infants were delivered by caesarean section. Consequently, we can deduce that the elective caesarean section would be used also in infants of GA less than or equal to 36 weeks.

Asphyxia Neonatorum↗