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At least 271 records · Page 15Linked to original sources
PubMed2000

Neonatal echocardiograms of macrosomic neonates.

OBJECTIVE: To compare echocardiograms of macrosomic and healthy full term neonates whose weight was appropriate for gestational age (AGA). METHODS: Echocardiography was performed on 9 healthy full term AGA neonates and 15 macrosomic neonates. A data base was generated from valid echocardiographic measurements on each infant. RESULTS: Macrosomic infants were heavier than control infants and had a greater body surface area, but their mean cardiac dimensions were similar. The mean LVES volume was smaller than that of the control group when expressed as a fraction of individual LVED values (0.61 +/- 0.04 vs 0.64 +/- 0.02; p = 0.02). When comparing IVS/PW, it was observed that the ratio was up to and including 1.33 in the control group, while the upper limit of the ratio of the nondiabetic macrosomic infants was 1.6. The shortening fraction (SF%) was increased in comparison to infants of normal weight (40.67% +/- 3.34 vs 36.00% +/- 1.89; p = 0.0009). The thickened IVS did not elevate SF% by decreasing LVES; the macrosomic infants had a smaller LVES mean volume. CONCLUSION: IVS/PW ratio of macrosomic infants fell outside of the normal range. Macrosomic neonates were found to have an increased SF% secondary to a proportionally smaller LVES volume, regardless of IVS thickness.

Aorta↗
PubMed2002

Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network.

OBJECTIVE: Late-onset sepsis (occurring after 3 days of age) is an important problem in very low birth weight (VLBW) infants. To determine the current incidence of late-onset sepsis, risk factors for disease, and the impact of late-onset sepsis on subsequent hospital course, we evaluated a cohort of 6956 VLBW (401-1500 g) neonates admitted to the clinical centers of the National Institute of Child Health and Human Development Neonatal Research Network over a 2-year period (1998-2000). METHODS: The National Institute of Child Health and Human Development Neonatal Research Network maintains a prospective registry of all VLBW neonates admitted to participating centers within 14 days of birth. Expanded infection surveillance was added in 1998. RESULTS: Of 6215 infants who survived beyond 3 days, 1313 (21%) had 1 or more episodes of blood culture-proven late-onset sepsis. The vast majority of infections (70%) were caused by Gram-positive organisms, with coagulase-negative staphylococci accounting for 48% of infections. Rate of infection was inversely related to birth weight and gestational age. Complications of prematurity associated with an increased rate of late-onset sepsis included patent ductus arteriosus, prolonged ventilation, prolonged intravascular access, bronchopulmonary dysplasia, and necrotizing enterocolitis. Infants who developed late-onset sepsis had a significantly prolonged hospital stay (mean length of stay: 79 vs 60 days). They were significantly more likely to die than those who were uninfected (18% vs 7%), especially if they were infected with Gram-negative organisms (36%) or fungi (32%). CONCLUSIONS: Late-onset sepsis remains an important risk factor for death among VLBW preterm infants and for prolonged hospital stay among VLBW survivors. Strategies to reduce late-onset sepsis and its medical, social, and economic toll need to be addressed urgently.

Anti-Infective Agents↗
PubMed2003

Low-dose aspirin in pregnancy: maternal and neonatal aspirin concentrations and neonatal prostanoid formation.

OBJECTIVE: To evaluate maternal and neonatal plasma concentrations of acetylsalicylic acid and salicylic acid and the neonatal endogenous prostanoid formation during low-dose aspirin prophylaxis (LDA; 100 mg daily) in pregnant women. METHODS: Concentrations of acetylsalicylic acid and salicylic acid in maternal plasma after at least 4 weeks of LDA (n = 14) and in umbilical cord plasma of newborns after maternal LDA (n = 7) were determined by gas chromatography-mass spectrometry. Platelet and renal formation of thromboxane A2 and the formation of prostaglandin E2 and prostacyclin were evaluated in vivo by quantification of index metabolites in plasma and urine by gas chromatography-mass spectrometry in neonates after maternal LDA (n = 14) and in a control group. RESULTS: In the pregnant women, acetylsalicylic acid and salicylic acid concentrations rapidly increased after ingestion of LDA. Acetylsalicylic acid was completely eliminated within 4 hours, whereas salicylic acid was detected with low concentrations at 18 and 21 hours after dosing. In the neonates, acetylsalicylic acid was not detected. Salicylic acid was detected in 1 infant only. Platelet thromboxane A2 formation in the newborn infants was significantly suppressed but recovered within 2 to 3 days after discontinuation of LDA. Renal thromboxane A2 formation and the formation of prostaglandin E2 and prostacyclin were not affected by LDA. CONCLUSION: In pregnant women who are treated with LDA, acetylsalicylic acid is not completely inactivated in the portal circulation but reaches the uteroplacental circulation and exerts antiplatelet effects in the fetus and newborn.

Aspirin↗
PubMed2004

Maternal, neonatal, and placental features associated with diffuse chorioamniotic hemosiderosis, with special reference to neonatal morbidity and mortality.

OBJECTIVE: Our purpose was to examine the significance of diffuse chorioamniotic hemosiderosis (DCH) on neonatal morbidity and mortality. METHODS: Using data from a retrospective case-control study, we analyzed 46 singleton placentas with DCH from infants who were delivered and/or admitted to the neonatal intensive care unit of Kanagawa Children's Medical Center during 1987-2001 and 92 control placentas without DCH from infants of comparable gestational age, birth weight, and duration. RESULTS: Mean and standard deviation of gestational age and infants' birth weight at delivery from the DCH group were 27 +/- 3 weeks and 939 +/- 342 g, respectively. Macroscopically, the placentas with DCH were more likely to show old peripheral blood clots (46% in the DCH group vs 8% in control group), subchorionic hematoma (20% vs 1%), and circumvallation (13% vs 1%). Histologically, amniotic necrosis was significantly more frequent in the DCH group (63% vs 24%). Of the obstetric factors, incidence of recurrent episodes of vaginal bleeding (70% vs 11%), oligohydramnios (59% vs 8%), and chronic abruption-oligohydramnios sequence (57% vs 5%) were significantly higher in the DCH group. Of the neonatal factors, persistent pulmonary hypertension of the newborn (29% vs 8%) and dry lung and/or pulmonary hypoplasia (20% vs 4%) were more common. However, respiratory distress syndrome was rare (15% vs 45%) in the DCH group. Neonatal death including stillbirth was increased in the DCH group but was not significant (24% vs 15%). Of infants who survived beyond day 28, chronic lung disease (CLD) was more frequent in the DCH group (51% vs 22%). The association of DCH, especially accompanied by amniotic necrosis, with CLD was still evident using likelihood ratio test. CONCLUSION: DCH is closely associated with preterm delivery, pulmonary hypertension of the newborn, and dry lung syndrome and is a significant risk factor for CLD.

Abruptio Placentae↗
PubMedDate not supplied

[Echocardiographic post-neonatal progress of preterm neonates with patent ductus arteriosus].

OBJECTIVE: To identify clinical and echocardiography predictors of the spontaneous closure of patent ductus arteriosus in preterm neonates. METHODS: Sixty-one consecutive preterm neonates (gestational age 30+/-2 weeks, birth weight 1.2+/-0.2 kg) were evaluated by echocardiogram on their third day of life and those with patent ductus arteriosus were selected for a prospective cohort. Echocardiography was repeated weekly until they reached term. Based on their progress, the sample population was divided into two groups, depending on whether spontaneous closure of patent ductus arteriosus took place (Group A) or not (Group B). The prevalence of clinical signs of patent ductus arteriosus and echocardiography findings at baseline were compared between the groups. RESULTS: Patent ductus arteriosus was found in 21 neonates (34%). Spontaneous closure was observed during follow-up of seven patients (Group A, 33% of those with patent ductus arteriosus), in contrast with the remaining 14 patients (Group B, 67%). Clinical signs of patent ductus arteriosus were present in 14% of the patients in Group A, compared with 71% in group B (p = 0.01). At baseline, Group B had a larger ductus diameter in relation to Group A (2.6+/-0.6 mm vs. 1.4+/-0.6 mm; p = 0.003). The area under the ROC curve in relation to ductus diameter was 0.93 (p = 0.003) and 100% sensitivity for identifying cases without spontaneous closure was obtained at the cutoff point of 1.7 mm, while 100% specificity was observed taking 2.2 mm as the cutoff. CONCLUSIONS: In preterm neonates, a patent ductus arteriosus greater than 2.2 mm on the third day of life predicts no spontaneous closure and suggests a need for early treatment, especially when associated with clinical signs.

Birth Weight↗
PubMed2001

Transient heart murmur in the late neonatal period: its origin and relation to the transition from fetal to neonatal circulation.

To elucidate the origin of transient heart murmur during the late neonatal period, we examined 50 neonates with this type of heart murmur and compared them with 50 controls. We serially examined the morphology of and blood flow in the main pulmonary artery (MPA), the right pulmonary artery (RPA), and the left pulmonary arteries (LPA) using two-dimensional and Doppler echocardiography. The heart murmurs were first noticed at 6 to 60 days after birth (mean 33 +/- 14). At that time, the diameters of both the RPA and the LPA in the heart murmur group were significantly smaller than those in the control group, and the velocities of blood flow in the right and left pulmonary arteries in the heart murmur group were significantly greater than those in the control group. When the heart murmur disappeared, the diameters and the flow velocities of both the RPA and the LPA were not different compared with the control group. Two cases in the heart murmur group continued to have a heart murmur and were diagnosed as having intrinsic congenital peripheral pulmonary artery stenosis. In conclusion, our findings suggest that a transient heart murmur in the late neonatal period is caused by transient branch pulmonary arteries stenosis during the transitional circulation from fetus to neonates.

Adult↗
PubMed2006

Neonatal and adult CD4+ CD3- cells share similar gene expression profile, and neonatal cells up-regulate OX40 ligand in response to TL1A (TNFSF15).

We report here the quantitative expression of a set of immunity-related genes, including TNF family members, chemokine receptors, and transcription factors, in a CD4+ CD3- accessory cell. By correlating gene expression between cell-sorted populations of defined phenotype, we show that the genetic fingerprint of these CD4+ CD3- cells is distinct from dendritic cells, plasmacytoid dendritic cells, T cells, B cells, and NK cells. In contrast, it is highly similar to CD4+ CD3- cells isolated from embryonic and neonatal tissues, with the exception that only adult populations express OX40L and CD30L. We have previously reported that IL-7 signals regulate CD30L expression. In the present study, we show that both neonatal and adult CD4+ CD3- cells express the TNF family member, death receptor 3 (TNFRSF25), and that addition of TL1A (TNFSF15), the ligand for death receptor 3, up-regulates OX40L on neonatal CD4+ CD3- cells. Finally, we demonstrate that this differentiation occurs in vivo: neonatal CD4+ CD3- cells up-regulate both CD30L and OX40L after adoptive transfer into an adult recipient.

Aging↗
PubMed1984

[A study of neonatal behavioral characteristics: The relationship between Brazelton Neonatal Behavioral Assessment Scale and infant-perception by nurses].

The purpose of this study was to measure the behavioral characteristics of neonates and to investigate the relationship between these characteristics and infant-perception by adults (nurse). Brazelton Neonatal Behavioral Assessment Scale (BNBAS) were administered to 45 neonates three or four days after birth. Nurses were required to assess the perception of the neonates who received BNBAS during two to five days after birth. The main findings were as follows: A factor analysis was performed on the behavioral items of BNBAS, and six factors corresponding to Osofsky's factors (1977) were extracted. As for the behavioral items, there was no significant sex differences. Some of BNBAS factors related to the infant-perception by nurses.

Female↗
PubMed1975

Immune capacity of mice tolerating a weakly incompatible skin allograft. I. Tolerance induction by neonatal skin graft in adult recipients or by neonatal inoculation of adult cells.

An analysis was made of the so-called "tolergenic" effect of neonatal skin grafts which tend to survive longer than control adult grafts and confer this tendency also on simultaneously transplanted adult grafts of the same genotype. When the time interval between the neonatal and adult grafts varied from zero to 150 days, it could be demonstrated that neonatal skin grafts are capable of inducing second-set response comparable to that induced by adult grafts provided that the adult graft is not given simultaneously but only following 20 days or later. Signs of immune erises (i.e. various degrees of a round-cell infiltration) were, however, detected histologically even with shorter intervals of time. The involvement of some non-specific components in the early postgrafting period was indicated by a similar effect of sera from recipients of syngeneic grafts and MSA-incompatible grafts on the survival of grafts across the male-specific antigen barrier. Only long surviving allografts tend to specifically reduce the recipient's immune responsiveness. The possible mechanisms of the specific and non-specific components in the effect of neonatal skin grafts and the factor of time are discussed.

Age Factors↗
PubMed1975

Infant mortality in Macaca mulatta: neonatal and post-neonatal mortality at the California Primate Research Center, 1968-1972. A retrospective study.

Seven hundred forty-two Macaca mulatta births were recorded at the California Primate Research Center, 1968-1972. The neonatal mortality rate (deaths smaller than or equal to 30 days of age) was 10.8%, and the post-neonatal mortality rate (deaths at 31-183 days) was 6.9%. The neonatal mortality rate was higher in outdoor group cages than in indoor individual cages (24.8 vs. 8.0%). The post-neonatal mortality rate was also higher outdoors than indoors (15.9 vs. 5.9%). Outdoor mortality showed apparent seasonal variation, while indoor mortality did not.

Age Factors↗
PubMed2003

[Does the decreasing rate of neonatal mortality increase severe neonatal neurosensory morbidity?].

OBJECTIVE: To investigate relation between the mortality and the incidence of serious neonatal neurosensoric morbidity in very low birth weight newborns (VLBWN, birth weigh < or = 1499 g) during the three periods as defined by different quality of the parinatal and neonatal care. DESIGN: Retrospective analysis. SETTING: Perinatal center of the General Faculty Hospital. 1st Medical Faculty Charles University, Prague. SUBJECT AND METHODS: All live-born VLBWN in 1987-2001 were divided according to their birth-date to three five-year periods characterized by different quality of the perinatal and neonatal care. Ist period 1987-1991: the presurfactant area with no standard use of antenatal steroids and without defined border of the fetus viability; IInd period 1992-1996: the transient aera; IIIrd period 1997-2001: the surfactant aera with standard use of the antenatal steroids, and defined border of the fetus viability. VLBWN were divided according to birth weight to three subgroups (p. h. < 750 g, p. h. = 750-999 g, p. h. = 1000-1499 g). Mortality was defined by a death in our department until the discharge. VLBW newborns classified as newborns with serious neonatal neurosensoric morbidity (NNsM) had to have one of the following diagnoses at least: severe intraventricular haemorrhage (IVH gr. 3-4), posthemorhagic hydrocephaly (PHH), cystic periventricular leukomalacia (cPVL), meningitis, ventriculitis, encephalitis (M/E), retinopathy of prematurity > or = stage III (ROP > or = III st.). The chi 2 test was used for statistic evaluation. RESULTS: There were 873 VLBWN born and 208 of them died in the whole period (1987-2001). Mortality decreased in 5 year periods gradually: 1st period 111/226 (49%); IInd period 55/217 (25%); IIIrd period 42/430 (10%). The decrease of mortality was significant in all weight categories (p < 0.001). The incidence of NNsM was evaluated in 612 newborns and was similar in all periods regarding weight subcategories < 1000 g, but decreased significantly in the weight category 1000-1499 g (14/215 (6%) vs 13/73 (18%), p < 0.01). CONCLUSION: Improvement in survival of extremely low birth-weight infants did not increase the incidence of serious neurosensoric morbidity and evenmore NNsM was reduced in haevier very premature newborns during the nineties.

Brain Diseases↗
PubMed1992

Neonatal Legionnaires' disease. Histopathological findings in an autopsied neonate.

A neonatal case of legionnaires' disease (LD) is reported. A male neonate was admitted to our hospital with high fever and dyspnea, which had started 5 days after birth, and died due to severe pneumonia at 10 days old. An autopsy revealed small areas of granular consolidation scattered diffusely in the bilateral lungs. Microscopic examination of the lungs showed mainly lobularly distributed pneumonia. Extensive exudation of macrophages and neutrophils was observed in the terminal respiratory tract and alveolar spaces. Warthin-Starry and Gimenez staining and electron microscopy detected many coccobacilli in the cytoplasm of exudated macrophages and neutrophils. Immunofluorescence staining using antiserum against Legionella pneumophila, serogroup 1, showed a positive reaction. Bacteriological examinations of aspirate from the respiratory tract and autopsied lung tissue confirmed the presence of Legionella pneumophila, serogroup 1. Extrapulmonary LD was not detected. LD usually affects aged or immunocompromised hosts, but there was no evidence of immune deficiency in this case. Pediatric cases of LD have rarely been reported, and a survey of the literature revealed few neonatal cases. The present case may alert neonatologists and other medical personnel to the possibility of neonatal LD infection.

Autopsy↗
PubMedDate not supplied

[Transient neonatal hypothyrosis in premature neonates].

Plasma levels were measured of T4, free T4, T3, TSH in 64 premature neonates and in 41 those born at right time during the time-related course of the neonatal period. The results secured permit regarding the thyroid hypohormonosis syndrome in premature neonates as a consequence of the hypothalamic-hypophyseal-thyroid axis deficiency and of immaturity of the thyreostatic receptors as well. On the one hand, this promotes hypometabolism and, correspondingly, favours more economic utilization of bodily energy resources but on the other hand, such adaptation is not infrequently results in its failure and persistent thyrodeficiency, especially in very low-birth weight infants, during the whole of the neonatal period.

Fetal Blood↗
PubMedDate not supplied

[Convulsions in neonates and early neonatal mortality].

The relationship between the early onset of convulsions in the early neonatal period and mortality was studied in 130 (0.26%) children with the birth weight exceeding 2,000 g in whom early neonatal convulsions were recorded. Early neonatal mortality in this group was very high reaching 25.4%. The peak mortality was noted in the first 12 hrs after birth (80.9%) and in the first 24 hrs (60.0%). In the cases of a postponed occurrence of convulsions, the mortality rate of neonates significantly decreases (p less than 0.01).

Humans↗
PubMed1990

Maternal-neonatal immunoregulation: suppression of de novo synthesis of IgG and IgA, but not IgM, in neonatal pigs by bovine colostrum, is lost upon storage.

Fifty-four neonatal pigs were allotted to 4 groups and reared in an electrically controlled automatic feeding device (autosow). Each group was reared on a different pool of bovine colostrum: fresh, stored 1 month, stored 6 months, and stored 8 years. Bovine and porcine immunoglobulins in the sera of these pigs, and in a group of conventionally reared pigs, were measured periodically during the first 42 days after birth. The maximal concentration of absorbed bovine immunoglobulin was reached between 12 and 18 hours and equaled or exceeded the amount of porcine immunoglobulin absorbed by the conventionally reared pigs. Large differences in the concentrations of the bovine immunoglobulin isotypes among the various pools of colostrum were positively correlated with concentration of these isotypes in the sera of the neonatal pigs fed these pools. Relative to their concentrations in colostrum, approximately 41% of the IgG1, 55% of the IgG2, 29% of the IgM, and 67% of the IgA was absorbed. The IgA was absorbed the best and IgM was least absorbed. Significant trends or differences in absorption were not observed among groups. Neonatal pigs given fresh colostrum, which had a higher fat content, had significantly more weight gain (P less than 0.05). This occurred, despite the fact that the fresh colostrum had the lowest concentration of bovine immunoglobulin. Serum half-lives for bovine IgG1 and IgG2 were significantly less than for porcine IgG (P less than 0.05), whereas the half-lives for bovine and porcine IgM and IgA were similar. De novo-synthesized immunoglobulins were detectable in serum after 6 days; IgM concentrations reached a maximum at 15 days in neonatal pigs given stored, but not fresh, colostrum.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

[Transient neonatal hypothyroidism in a neonate born of a mother with Hashimoto's thyroiditis].

Transient neonatal hypothyroidism was found in a boy whose mother was treated for hypothyroidism due to Hashimoto's thyroiditis. During the neonatal period the infant had antithyroid microsomal and antithyroglobulin antibodies and immunoglobulins inhibiting cyclic AMP production by thyroid cells in vitro. After one year of treatment, all antibodies disappeared. Thyroid scintiscan and fixation in the neonatal period was negative and became positive 2 months after stopping treatment with normal fixation and cervical thyroid picture. The mother's serum contained the same antibodies: they crossed the placental barrier and were responsible for neonatal pathological manifestations.

Autoantibodies↗
PubMed1979

The immunological state of the neonate following surgery--consequences for immunotherapy of neonatal septicaemia.

In addition to an innate functional dysmaturity of the neonate's immune system, operation, anaesthesia, and intensive care measures can significantly worsen this physiological immune deficiency. Given the fact that antimicrobial therapy as well as progress in intensive care of infected operated neonates and prematures did not significantly decrease the high mortality rate in this patient age group we began performing fresh-blood exchange transfusions as supportive immunotherapy in the treatment of neonatal septicaemia. Since indication for exchange transfusion has been adopted as early as septicaemia was suspected only 46% of the operated neonates (13 out of 28) died of their infection, compared to 82% of the patients (23 out of 28) who did not undergo exchange transfusion.

Exchange Transfusion, Whole Blood↗
PubMed1983

Neonatal myotonic dystrophy as a cause of hydramnios and neonatal death. A case report and literature review.

A woman had three consecutive pregnancies complicated by hydramnios and early neonatal death. The identical prenatal and neonatal course, family history and, ultimately, maternal diagnosis supported the diagnosis of recurrent severe neonatal myotonic dystrophy. Ultrasonographic observation of the last fetus affected suggested and predicted the neonatal features of the disease.

Adult↗