Mortality rates.
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Biomedical subjects
Publications and source records attributed to S G Babson.
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The high incidence of sudden infant death syndrome in infants born to teenage mothers prompted us to search for epidemiologic clues that might relate to SIDS causation. The death rate for SIDS was compared with that of other major causes of infant mortality in two maternal age groups (younger than 20 years and 30 to 34 years). In the neonatal period, a significantly greater overall mortality occurred in infants born to the younger mothers. This difference was primarily related to an excess of low-birth-weight infants dying from diseases of early infancy. "Weight-specific" mortality, however, was similar for the two groups. In the postneonatal period, when most SIDS occurs, the incidence was 5.2 per 1000 among infants of teenage mothers, compared with 1.0 in infants of the older mothers. A similar maternal-age-related incidence was observed for death from infections, accidents, and "other causes." By contrast, death from congenital anomalies was unrelated to maternal age in both periods. We conclude that many postneonatal deaths are influenced by environmental factors, including the age and maturity of the mother.
Although a soy-based lactose-free infant formula is sometimes used for feeding very low-birth-weight infants, the nutritional adequacy of this diet has not been thoroughly investigated. This study used the metabolic balance technique to compare nutrient retention rates in 19 very low-birth-weight (less than 1,530 gm) infants fed either a soy-based formula or a conventional milk-based formula. Serum chemistries and anthropometric measurements were assessed serially. The soy isolate supplemented with methionine as the sole dietary protein appeared to be adequately utilized, and nitrogen retention rates comparable to fetal accretion rates could be achieved in soy-fed infants in the limited period of study. The absence of lactose in the diet of soy-fed infants did not interfere with calcium metabolism. However, phosphorus absorption was diminished with the feeding of soy formula, which resulted in relative hypophosphatemia. Although the soy-fed infants showed increased renal conservation of phosphorus during the study period, the lesser absorption may, over time, stress phosphorus homeostatic control mechanisms. It is concluded that routine use of soy formula without specific therapeutic indications is undesirable in feeding very low-birth-weight infants. Extended use of such a formulation needs to be monitored for potential adverse effects on skeletal mineralization.
An experimental infant developed to meet the specific nutritional needs of very-low-birth-weight infants was evaluated by 96-hour balance studies in ten preterm infants (birth weight: 1,130 to 1,530 gm). The formula contained 23.2 gm/liter of protein (whey protein/casein ratio, 60:40), 44.1 gm/liter of fat (50% medium-chain triglycerides) and 85.0 gm/liter of carbohydrate (50% lactose, 50% Polycose), and provided relatively higher amounts of calcium, phosphorus, vitamin D, and electrolytes than are in human milk. All infants were fed 150 ml/kg/day (120 calories/kg/day) by intermittent gavage. Balance studies were carried out nine days following establishment of oral intake. The mean (+/- SEM) nutrient retention rates revealed by balance studies in these infants (calcium, 170 +/- 4 mg/kg/day; phosphorus, 78 +/- 3 mg/kg/day; nitrogen, 426 +/- 8 mg/kg/day; sodium, 1.4 +/- 0.1 mEq/kg/day) were comparable to normal fetal accretion rates. The mean (+/- SEM) fat absorption was 92.5 +/- 0.9%. No clinical intolerances or biochemical abnormalities were observed, and adequate postnatal growth was achieved in all infants. The diet proved to be nutritionally advantagaeous and safe for very-low-birth-weight infants.
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Two graphs are presented showing means and 1 and 2 SD for growth in weight, length, and head circumference: (1) a fetal-infant graph with lines of growth from 26 weeks of gestational age until one year of age after ""term'' has been reached: and (2) a similarly constructed graph for children ages one through ten years. The standards of growth were obtained from published data in which the subjects received optimal health care. The graphs allow comparisons of infants of varying gestational age with standards for that age. Normal and abnormal deviations in growth are easily identified. Some examples of common variations in physical growth are described.
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