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Prolactin responses to infant cues in men and women: effects of parental experience and recent infant contact.

We used a longitudinal design to test whether parental experience differentially affects the development of prolactin responses to infant cues in men and women. Couples provided two blood samples at three tests, one test just before their babies were born, and two tests during the early postnatal period (n=21). Nine couples repeated the tests near the birth of their second babies. In the 30 min between the two samples, couples listened to recorded infant cries at the prenatal test and held their baby (fathers) or a doll (mothers) at the postnatal tests. Blood samples were analyzed for prolactin concentrations. Prolactin values were then related to sex and parity differences as well as to questionnaire data concerning emotional responses to infant cries and previous infant contact. We found that (1) prior to the birth of both the first and second babies, women's prolactin concentrations increased after exposure to infant stimuli, whereas men's prolactin concentrations decreased; postnatal sex differences varied with parity; (2) women's prolactin reactivity did not change significantly with parental experience; (3) the same men's prolactin concentrations decreased after holding their first newborns but increased after holding their second newborns; this change was not gradual or permanent; (4) men reporting concern after hearing recorded infant cries showed a different postnatal pattern of prolactin change after holding their babies than men not reporting concern; and (5) men who had little contact with their babies just prior to testing had a more positive prolactin response than men who had recently held their babies for longer periods. Although parental experience appears to affect men's prolactin responses, differences in reactivity were also related to patterns of recent infant contact and individual differences in responses to infant cues.

Adult↗

Pulmonary excretion of carbon monoxide in the human infant as an index of bilirubin production. IIc. Evidence for the possible association of cord blood erythropoietin levels and postnatal bilirubin production in infants of mothers with abnormalities of gestational glucose metabolism.

A total of 20 infants who had levels of erythropoietin (Ep), the major hormone regulating erythropoiesis, measured in their cord blood also had determinations of the pulmonary excretion rate of CO (VECO) performed, as an index of total bilirubin production. They were either infants of normal mothers or those of mothers with diabetes, gestational diabetes, and missed abnormalities of gestational glucose metabolism. The mean VECO (13.0 +/- 3.5 mu 1/kg/hr) and the mean Ep (20.0 +/- 9.7 SD mU/ml) of the infants with normal mothers (n = 9) were not different from the means previously established by our laboratories (13.9 +/- 3.5 SD mu 1/kg/hr, n = 20; and 23.7 +/- 12.8 SD mU/ml, n = 30, respectively); they were significantly lower than those of the infants of the abnormal mothers in this study. The 5 infants who had a cord blood Ep level greater than 50 mU/ml had a higher mean VECO, 27.8 +/- 7.1 mu 1/kg/hr, compared with 17.2 +/- 4.9 SD mu 1/kg/hr, of the six infants with cord blood Ep levels that were within 2 SD of the previously established normal mean cord blood Ep level (p less than .025). These data suggest that increased cord blood Ep levels and postnatal bilirubin production in infants whose mothers had abnormalities of gestational glucose metabolism are associated phenomena. Since polycythemia did not occur in these infants, ineffective erythropoiesis or mild, compensated hemolysis remains a likely cause of the increased total bilirubin production. In some cases, perinatal hypoxic stress may have affected the Ep response.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilirubin↗

Effect of infant formula zinc and iron level on zinc absorption, zinc status, and immune function in infant rhesus monkeys.

To evaluate the effects of marginal zinc (Zn) deficiency on Zn absorption and metabolism, three groups of infant rhesus monkeys (n = 4/group) were fed from birth to 5 months of age either a regular infant formula (5 mg Zn/L) or a low-Zn formula (1 mg Zn/L). Since iron (Fe) intake may affect Zn absorption, the low-Zn formula was given without (1 mg Fe/L) or with Fe fortification (12 mg/L). At monthly intervals, Zn absorption and retention were assessed by gavage feeding with 65Zn and whole-body counting immediately after and on days 4, 7, and 11 after intubation. Blood samples were drawn before dosing for analyses of various potential markers of Zn status. Infants fed low-Zn formula had lower weight gain than controls; however, length growth was similar in all groups. 65Zn retention was considerably higher in both groups fed low-Zn formula (40%) than in the control group (20%), whereas plasma Zn levels were normal in all infants. Plasma metallothionein levels were generally very low and detectable in only 5 samples of 48; however, 4 of these were found in control infants. Neutrophil chemotaxis assessed at the end of the study was impaired in low-Zn infants compared to controls. In addition, low-Zn infants had increased levels of interleukin-2 at the end of the study. No differences were seen between the groups in hemoglobin levels, total white blood cells/absolute neutrophil counts, or plasma activities of 5'-nucleotidase or angiotensin converting enzyme. In conclusion, marginal Zn intake in infant rhesus monkeys resulted in increased Zn retention, which was not enough to completely compensate for the lower Zn intake. The higher level of iron fortification studied did not affect Zn retention significantly.

5'-Nucleotidase↗

The Movement Assessment of Infants (MAI) as a predictor of two-year neurodevelopmental outcome for infants born at term who are at social risk.

PURPOSE: This prospective longitudinal study was designed to evaluate whether the four-month Movement Assessment of Infants (MAI), predicted two-year cognitive and motor developmental status measured by the Mental (MDI) and Psychomotor (PDI) Scales of the Bayley Scales of Infant Development (BSID). METHODS: The subjects were 134 infants born at term who were considered at developmental risk due to biological and social risk factors. Different masked examiners assessed the infants at each age. RESULTS: Infants' average MAI total risk scores (MAI TRS) at four months were negatively correlated with their BSID MDI scores (r = -0.23, p = 0.007) but not PDI scores at two years. Infants classified as high risk on the MAI (TRS >13) were approximately three times more likely than infants with a lower risk MAI classification (TRS < or =13) to have a high-risk MDI (< or =84) classification. Lower MAI risk status at four months was a predictor of cognitive functioning falling within normal limits for age (MDI >84) at two years, with 76% negative and 50% positive predictive values. CONCLUSION: The MAI appears to be valid for use with infants born at term who are at risk of developmental delay and may be a useful tool to help clinicians make decisions about intervention services.

Journal Article↗

[Biological specificity of the neonate and infant heart, with reference to selenium and glutathione peroxidase--the study to clarify the cause of vulnerability of neonate and infant heart].

Selenium (Se) is known to be an integral part in glutathione peroxidase (GSHPx). There are some reports serum Se levels are lower in infants than in adults and GSHPx activity is parallel to Se levels. There may be reasons why myocardial reperfusion injury occurs more easily in infants than in adults by reperfusion of ischemic myocardium. Serum and myocardial Se levels and GSHPx activity in experimental rats were measured to clarify the vulnerability of infant heart. Wistar rats were divided into three groups. First, infant rats 8-12 days after birth (infant rats), second, adult rats fed Se-deficient diet for two months (Se-deficient rats), and third, adult rats fed normal diet for two months (control rats). Serum Se levels, serum GSHPx activity and myocardial GSHPx activity in both infant and Se-deficient rats were significantly lower than that in control rats (p less than 0.01). However myocardial Se levels in infant rats were significantly higher than that in both Se-deficient and control rats (p less than 0.01). The lipid peroxide levels in heart mitochondria of Se-deficient rats were significantly higher than that in control rats (p less than 0.01). These results suggest that in infant heart Se does not manifest an effective function for a integral part of GSHPx despite its high level, its reason is not clear, and this phenomenon generates more oxygen-derived free radicals after reoxygeneration of the ischemic myocardium.

Animals↗

Detection of RS-virus IgG-subclass-specific antibodies: variation according to age in infants and small children and diagnostic value in RS-virus-infected small infants.

The variation according to age of RS-virus IgG-subclass specific antibodies was investigated by ELISA in 140 acute phase sera from 140 infants and children 1-47 mo of age who were hospitalized with acute respiratory disease. Sixty-nine of these serum samples were obtained from patients with RS-virus infections. Mean OD values of IgG-1 antibodies decreased corresponding to the decrease in maternal antibodies. In patients with RS-virus infections, the mean IgG-1 OD values increased in children who were 3 yr old, but in patients without RS-virus infections this increase was observed in children at 1 yr of age. RS-virus IgG-3 antibodies were detected only in children 1-3 yrs of age, and only in 18% of samples from children without RS-virus infections. The concept of the transient nature of RS-virus IgG-3 antibodies as compared with RS-virus IgG-1 antibodies is supported by these results. RS-virus subclass specific antibodies were studied in paired serum samples from 12 infants 1-5 mo of age with acute lower RS-virus disease. IgG-1 antibodies developed in six infants, but only in one of six infants aged 1-3 mo. IgG-3 antibodies developed in nine infants, including four of six infants who were 1-3 mo old. These results suggest that in small infants with RS-virus infections the detection of IgG-3 antibodies is of higher diagnostic value than the detection of IgG-1 antibodies.

Acute Disease↗

A critical comparison of the history of sudden-death infants and infants hospitalised for near-miss for SIDS.

To determine whether significant historical differences distinguish the near-miss for Sudden Infant Death from the infants who died of SIDS, we analysed the histories and clinical data from two groups of infants seen in our University Hospital and from collaborative research group. The data were obtained with the use of a standardised questionnaire and consultation of all available medical data. Sixty-five infants were identified as near-miss for SIDS after they had suffered a severe cardiorespiratory incident during sleep for which no cause could be found despite a complete medical examination. After an autopsy had failed to reveal a cause for the unexpected death 95 cases of SIDS were retained in the study. A series of 353 variables were collected from the parents, the gynaecologists, neonatologists and attending physicians. After statistical analysis, only 15 of the 353 items studied significantly differentiated between the two groups. A step-wise discriminant analysis performed on these items led to the identification of six independent variables: the time of the incident; the circumstances leading to the observation of the child; the child's sleep position; previous minor intestinal problems; the size of the family and the mother's coffee consumption. Most variables indicate that the near-miss infants were discovered and rescued earlier than the infants who died. No other historical information appeared significantly to differentiate between the two groups of infants. These data need confirmation from a prospective epidemiological survey.

Family Characteristics↗

Assessment of infant cry variability in high-risk infants.

Two studies were conducted to determine the relationship between variability in acoustic features of the infant cry and medical risk factors. In study 1, 3 groups of preterm infants (healthy, sick and CNS pathology) were compared with term infants at 40 weeks gestational age. The cry was analyzed by computer. The coefficient of variability of cry amplitude and the formant features of the cry differed among the groups of preterm infants. In study 2, 3 groups of term infants at low, moderate and high levels of hyperbilirubinemia were compared on the cry measures. More variability in the formant features of the cry was found in infants with higher levels of bilirubin. The correlation between the coefficient of variation in the cry formants and level of bilirubin was statistically significant. These two studies suggest that variability in the acoustic features of the cry relate to the medical status of the infant and may provide a measure of neurophysiological integrity.

Acoustics↗

Development in mother-infant en face interaction of high-risk newborn infants: a longitudinal follow-up from 0 to 7 months.

In order to evaluate mother-infant en face interaction of high-risk infants and their mothers, we followed three dyads from a high-risk group and three dyads from a low-risk group, every 3 weeks from 0 to 30 weeks of corrected postnatal age. The mother-infant en face interaction was analyzed by conditional probability analysis with a lag sequential concept. The main findings of this study were: (1) there was almost no clear difference in the amount of movement between the high-risk group infants and the low-risk group infants; (2) behavioral responsiveness of the high-risk group dyads was unclear, however, behavioral responsiveness of the low-risk group dyads was very clear; and (3) in common to all subjects of the low-risk group, an increasing frequency of responsive mother-infant interaction was found during the postnatal period. However, in the high-risk group, each dyad showed a very different developmental course. The findings suggest qualitative differences in mother-infant en face interactions between the high-risk group dyads and the low-risk group dyads.

Child Development↗

Withdrawn and intrusive maternal interaction style and infant frontal EEG asymmetry shifts in infants of depressed and non-depressed mothers.

The effects of maternal interaction style (intrusive/withdrawn) on the development of brain electrical activity were studied in infants of depressed and non-depressed mothers shortly after birth and again at 3-6 months of age. Infants of depressed mothers exhibited significantly greater relative right frontal EEG activation than infants of non-depressed mothers. Infants of depressed withdrawn mothers exhibited greater relative right frontal EEG activation than infants of depressed intrusive mothers. Furthermore, while infants of depressed mothers with intrusive interaction styles showed a shift towards greater relative left frontal EEG activation from birth to 3-6 months, infants of depressed mothers with withdrawn interaction styles showed a shift towards greater relative right frontal EEG activation.

Brain↗

Infant behavioral responses to infant-directed singing and other maternal interactions.

Seventy, 6-9-month-old infants were videotaped during six interactions: mother sings assigned song, "stranger" sings assigned song, mother sings song of choice, mother reads book, mother plays with toy, and mother and infant listen to recorded music. Infant-directed (ID) singing conditions elicited moderately positive cognitive behavior, low levels of positive physical behavior and minimal amounts of vocal behaviors, mostly negative. Across all conditions, cognitive scores remained positive at low to moderate levels. Physical responses were most positive during book and toy, most negative during recorded music, and differed by gender, especially during ID singing. Vocally, infants responded positively to toy, and 8-month-old infants vocalized more than younger infants, particularly during ID singing conditions. ID singing appears just as effective as book reading or toy play in sustaining infant attention and far more effective than listening to recorded music, while interactions involving objects may provide opportunity for shared attention.

Adult↗

Choline status in newborns, infants, children, breast-feeding women, breast-fed infants and human breast milk.

This study assessed the choline status in newborns, infants, children, breast-feeding women, breast milk, infant formula, breast-fed and formula-fed infants. The serum free choline level was 35.1+/-1.1 micromol/L at birth and decreased to 24.2+/-1.6, 18.1+/-0.8, 16.3+/-0.9, 14.3+/-0.8, 12.9+/-0.6 or 10.9+/-0.6 micromol/L at 22-28, 151-180, 331-365, 571-730, 731-1095 or 4016-4380 days after birth, respectively. The serum phospholipid-bound choline level was 1997+/-75 micromol/L at birth and increased gradually to 2315+/-190 or 2572 +/-100 micromol/L at 571-730 or 4016-4380 days after birth, respectively. In breast-feeding women, serum free and phospholipid-bound choline levels were doubled at 12-28 days after birth, they decreased toward the control values with time. Free choline, phosphocholine and glycerophosphocholine were major choline compounds in breast milk. Their concentrations in mature milk were much greater than in colostrum and serum. Choline contents of breast milk varied greatly between mothers, and milk free choline levels were correlated with serum free choline (r=.541; P<.001), phospholipid-bound choline (r=.527; P<.001) and glycerophosphocholine (r=.299; P<.01) concentrations and lactating days (r=.520; P<.001). In breast-fed infants, serum free choline concentrations were correlated with free choline (r=.47; P<.001), phosphocholine (r=.345; P<.002), glycerophosphocholine (r=.311; P<.01) and total choline (r=.306; P<.01) contents of breast milk. Serum free choline concentration in formula-fed infants was lower than breast-fed infants. These data show that (a) circulating choline status is elevated during infancy and lactation, (b) choline contents of breast milk vary between mothers and milk free choline contents are influenced by maternal circulating choline status, and (c) the choline contents of breast milk can influence infants' circulating choline status.

Adult↗

Adequacy of energy intake among breast-fed infants in the DARLING study: relationships to growth velocity, morbidity, and activity levels. Davis Area Research on Lactation, Infant Nutrition and Growth.

Breast-fed infants grow less rapidly after the first 2 to 3 months of age than current standards. The DARLING study (Davis Area Research on Lactation, Infant Nutrition and Growth) was designed to evaluate whether this pattern should be considered "faltering" or is a normal outcome even under optimal conditions. Data on intake, growth, morbidity, activity, and motor development were collected longitudinally from infants who were breast fed for at least 12 months. Gross energy intake, calculated from 4-day records of milk and food intake at 3, 6, 9, and 12 months, averaged 91.4, 84.1, 86.7, and 91.8 kcal/kg per day, respectively, well below recommended amounts of metabolizable energy. Nevertheless, infants usually left some food unconsumed. Growth velocity was also below current reference data and was weakly correlated with energy intake. There were no significant negative associations between energy intake at any time and incidence, prevalence, or duration of any category of morbidity during the subsequent 3 months. There were no consistent associations between energy intake and activity level, time spent sleeping, or achievement of key developmental milestones. Similarly, infants with slower growth velocity were just as active and were ill no more often in subsequent months than infants who were growing more rapidly. Thus the deviation from current recommendations for energy intake and growth can be considered a normal pattern with no apparent deleterious consequences in our population of breast-fed infants.

Body Weight↗

Bone mineral content is not reduced despite low vitamin D status in breast milk-fed infants versus cow's milk based formula-fed infants.

The effect of low or borderline vitamin D status on bone mineralization of exclusively breast milk-fed infants has not been studied. The low vitamin D status of Korean breast milk-fed infants may theoretically have adverse effects on bone mineralization. Assuming that bone mineral content (BMC) relates in part to vitamin D status, we hypothesized that serum 25-hydroxyvitamin D (25-OHD) concentration and BMC would be low, and serum osteocalcin concentration high, reflecting active bone turnover, in breast milk- versus formula-fed infants born in the winter. Eighteen breast milk- and 17 formula-fed infants were recruited at ages 2 to 5 months. The BMC of the lumbar1-4 spine region was measured by using dual energy x-ray absorptiometry. The BMC and serum osteocalcin levels were similar for both groups. The serum 25-OHD level was significantly lower in breast milk- than formula-fed infants; 44% of the breast milk group versus 6% of the formula group had serum 25-OHD levels less than 28 nmol/L (11 ng/ml), the lower limit of normal. The BMC did not correlate with the serum 25-OHD level. Thus BMC and serum osteocalcin levels in 2- to 5-month-old infants were not different by type of feeding, despite low vitamin D status in breast milk-fed infants. We speculate that adequate mineral absorption occurs during this period from a predominantly (vitamin D independent) passive transport mechanism.

Absorptiometry, Photon↗

Cytogenetic studies of infant acute lymphoblastic leukemia: poor prognosis of infants with t(4;11) - a report of the Children's Cancer Group.

Infants less than 1 year of age at diagnosis of acute lymphoblastic leukemia (ALL) have a poor prognosis, which has been attributed primarily to a breakpoint in chromosomal band 11q23 or the MLL gene. Most infants with an 11q23 breakpoint have a t(4;11)(q21 ;q23). We studied the cytogenetics of the leukemia cells of 56 infants on CCG-1883, a single-arm clinical treatment protocol for infant ALL. Twenty-one patients had t(4;11)(q21;q23), seven had other rearrangements with breakpoints in 11q23 (other 11q23), 16 had normal chromosomes, two had t(1;19)(q32;p13), one had >50 chromosomes, and nine had non-recurring structural abnormalities. To determine whether there is a difference in outcome for infants with t(4;11), other 11q23 and the remaining patients, we compared event-free survival (EFS) and other clinical and laboratory features of the above infants. Infants without t(4;11) and those with other 11q23 rearrangements had significantly better EFS than those with t(4;11) (P= 0.007 and P= 0.02, respectively). t(4;11) correlated with age less than 6 months and with CD10 negativity, both of which also were poor prognostic indicators. After adjustment for age, there was still a significant difference in EFS between patients with t(4;11) and those with other 1lq23 rearrangements (P=0.02), and between patients with t(4;11) and those without t(4;11) (P=0.04). Among CD10 negative patients, t(4;11) was associated with a worse EFS (P=0.01). Multivariate analysis showed that after adjusting for a variety of clinical and laboratory features, t(4;11) was the most important prognostic factor for poor outcome, and patients with other 11q23 rearrangements had as good an outcome as the remaining patients without t(4;11).

Chromosomes, Human, Pair 11↗

Neurologic examination of preterm infants at term age: comparison with term infants.

OBJECTIVES: The aim was to establish the range of neurologic findings in preterm infants reaching term age, their relation to gestational age at birth, and the possible differences with healthy term newborns tested during the first days of life. STUDY DESIGN: The Dubowitz neonatal neurologic examination was performed at term age in 157 low-risk preterm infants born between 25 and 34 weeks' gestation who had cranial ultrasonograms that were normal or showed minor abnormalities. Infants were subdivided in 3 groups according to their gestational age at birth. RESULTS: Within the preterm cohort, the range of scores for the 3 gestational age subgroups was different from each other for 21 of the 34 items, although the median scores were different only in 10 of the 34 items. The range of scores and their median in preterm infants however was wider than that found in term infants. Preterm infants examined at term were also more hyperexcitable and tended to have less flexor tone in the limbs and less extensor tone in the neck in the sitting posture. CONCLUSIONS: The distribution of scores provides useful guidelines when a preterm infant is examined at term.

Female↗

CHOP Infant Coma Scale ("Infant Face Scale"): a novel coma scale for children less than two years of age.

The Glasgow Coma Scale (GCS) is the most frequently used tool worldwide for assessing the severity of neurologic injury after brain trauma, although applying this scale to infants and younger children can be problematic. The CHOP Infant Coma Scale, or Infant Face Scale (IFS), is a novel scale for children under 2 years of age which differs from other pediatric coma scales in the following ways: (1) it relies on objective behavioral observations; (2) it assesses cortical as well as brainstem function; (3) it parallels the GCS in scoring but is based on infant-appropriate behaviors; and (4) it can be applied to intubated patients. We report the results of a prospective study designed to compare interrater reliability between the IFS and GCS in children less than 2 years of age. Seventy-five hospitalized children less than 2 years of age were assessed simultaneously by a pair of observers, representing a spectrum of health care professionals, who scored the children using both the IFS and GCS. Interrater reliability for each pair of observers for each scale was assessed using the kappa statistic. A second series of 10 infants in the intensive care unit with specific diagnoses of acute traumatic or hypoxic/ischemic brain injury were similarly assessed. In the 75 hospitalized infants with a variety of diagnoses, interrater reliability for the GCS was in the "almost perfect," "slight," and "fair" range for the eye-opening, motor, and verbal subtests, respectively. In contrast, the IFS showed interrater reliability in the "almost perfect," "substantial," and "almost perfect" ranges for the three subtests. When applied to infants in an intensive care unit with acute traumatic brain injury or hypoxia/ischemia, the GCS interrater reliability scores were in the "fair" range, while the IFS scores were in the "almost perfect" range. The IFS demonstrates improved interrater reliability in direct comparison to the GCS, particularly in the "verbal/face" component where most pediatric coma scales are deficient. The IFS may prove to be a simple and practical bedside index of brain injury severity in children less than two years of age.

Brain Injuries↗

Comparison of leg movements in preterm infants at term with healthy full-term infants.

This study describes the differences and similarities in movement of low-risk preterm and full-term infants of comparable postgestational ages using a sensitive and quantitative measurement system, kinematic analysis. Subjects were 25 low-risk infants, 10 born at 34 to 36 weeks gestational age and 15 at term. Spontaneous leg movements were videotaped, and a 10-second segment was digitized to provide kinematic data. Data obtained were compared to evaluate the neurological maturation of preterm infants and to investigate the influence of the extrauterine environment on movement. Results showed that all infants had organized movement as determined by high interjoint correlations, small phase lags, and constrained movement durations. Pause durations and joint angles differed among infants. Infant leg movements are highly organized synergies and are not influenced by extrauterine environmental events. Differences in movements are attributed to dynamic interaction of elements in the motor control system. Additional studies with full-term infants may provide further insight into the constraints and supports of the immediate environment on movement outcome.

Biomechanical Phenomena↗