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At least 649 records · Page 36Linked to original sources
PubMed2004

Predicting outcome in neonatal hypoxic respiratory failure with the score for neonatal acute physiology (SNAP) and highest oxygen index (OI) in the first 24 hours of admission.

OBJECTIVE: To determine the clinical utility of SNAP score versus the highest oxygen index (OI) in first 24 hours of admission in predicting outcome of HRF. STUDY DESIGN: All admissions (1991 to 1999) > or =36 weeks gestation, ventilated for > or =12 hours with FiO(2)> or =0.50, without congenital anomalies were reviewed. Primary outcome measure was survival (without ECMO) versus ECMO and/or death. RESULTS: From 184 infants with HRF, 148 survived (without ECMO) versus 36 died and/or received ECMO. SNAP score and highest OI were similar in predicting outcome of HRF (area under ROC curve: 0.813+/-0.037 versus 0.814+/-0.041; P=0.72). Death and/or ECMO requirement were best predicted by a SNAP score of 19 (Sensitivity 75.0%, Specificity 71%) or an OI of 28 (Sensitivity 75.0%, Specificity 76.4%). CONCLUSION: Although both, the SNAP score and highest OI, are useful and similar in predicting outcome of HRF, OI is preferable because of its ease of use. We believe the predictive value of these parameters should be evaluated in a multicenter setting.

Airway Resistance↗
PubMed1986

[Neonatal septicemia and bacterial neonatal infection. Manifestation and course in early antibiotic therapy].

The authors studied in the Paediatric Department of the Leverkusen Municipal Hospital retrospectively the influence of an early dose of antibiotics (broad-spectrum penicillin combined with an aminoglycoside) in respect of the manifestation of bacterial newborn infections in infants with an increased risk of infection, during a period of 3 years (1981-1983). Among the infants born in the Gynaecological Department of the Leverkusen Municipal Hospital (exact data were available on the number of births and referrals) the incidence of bacterial newborn infections was 3.3% referred to the total number of deliveries (n = 3598); 0.7% of these newborn has sepsis. In the total group of children treated for newborn infection, the infection mortality was 5.5%; the mortality of the manifest newborn sepsis was 16.2%, i.e. lower than reported in literature. Early administration of antibiotics proved particularly effective in preventing purulent bacterial meningitis of newborn; this disease did not occur with any of the infants observed during the study period. Diagnosis of newborn infection included discolouration of the skin, respiratory disturbances, fever, shift to the left in the differential blood picture, and anaemia; these signs proved particularly suitable for arriving at a correct diagnosis. Identification of the pathogens was most frequently successful in gastric juice culture and anal smear. The latency period of more than 24 hours between rupture of the amnion and delivery does not represent an increased risk of infection for the newborn, as our results confirm, and this is, therefore, not an indication for initiating prophylaxis with antibiotics if there are no other abnormal findings.

Anti-Bacterial Agents↗
PubMed1992

Vitamin B-6 status of breast-fed neonates: influence of pyridoxine supplementation on mothers and neonates.

Vitamin B-6 concentrations in human milk are known to respond rapidly to changes in maternal vitamin B-6 intake. In this study, mothers were supplemented during the first 28 d of lactation with 2 or 27 mg pyridoxine (PN)-HCl/d and a subgroup of breast-fed infants of the 2-mg/d-supplemented mothers were supplemented with 0.4 mg PN-HCl/d. Vitamin B-6 intakes of breast-fed infants reflected the amount of their mother's supplement; intakes were highest for the vitamin-supplemented infants. Vitamin B-6 intake of mothers was a strong indicator of infant vitamin B-6 status. Vitamin intake of infants correlated significantly with five measures of vitamin B-6 status. Plasma pyridoxal-5'-phosphate (PLP) concentrations and birth weight were the strongest predictors of infant growth that were examined. Alkaline phosphatase activity in the mother's milk and infant plasma reflected pyridoxal-PLP ratios in these fluids, suggesting that the enzyme acts in regulating circulating vitamer concentrations.

Adult↗
PubMed1979

Relationship of neonatal pneumonia to maternal urinary and neonatal isolates of group B streptococci.

Of 1,500 consecutive deliveries, there were 41 term infants with suspected sepsis in association with a positive culture for group B streptococci (GBS) from either the infant soon after birth, or the mother's urine routinely collected three days postpartum. A statistically higher incidence of pneumonia was found in these infants as compared to matched controls. Infants born to mothers with GBS in the urine had a high incidence of suspected sepsis (43.6%) as well as a high incidence of pneumonia (38.6%). We conclude that term infants colonized at birth with GBS or born to mothers with GBS isolated from their urine are at high risk of having pneumonia.

Bacteriuria↗
PubMed2004

Cord plasma concentrations of adiponectin and leptin in healthy term neonates: positive correlation with birthweight and neonatal adiposity.

OBJECTIVE: Adiponectin is negatively associated with leptin, insulin and obesity in children and adults. Whereas increases in fetal insulin and leptin are associated with increased weight and adiposity at birth, the role of adiponectin in fetal growth has not yet been determined. The aims of this study were to examine the relationships between adiponectin and insulin, leptin, weight and adiposity at birth in healthy term infants. DESIGN AND METHODS: Anthropometric parameters including weight, length, circumferences and skinfold thickness were measured, and plasma lipid profiles, insulin, leptin and adiponectin concentrations in cord blood samples from 226 singleton infants born at term after uncomplicated pregnancies were assayed. RESULTS: Cord plasma adiponectin, leptin and insulin levels correlated significantly and positively with birthweight (P = 0.001, P < 0.001, P < 0.001, respectively) and the sum of skinfold thicknesses (P < 0.001, P < 0.001, P < 0.001, respectively). Mean cord plasma adiponectin and leptin levels, but not insulin level, were significantly higher in large-for-gestational-age (LGA) infants compared with appropriate-for-gestational-age (AGA) infants. Cord plasma leptin concentration, but not adiponectin concentration, was significantly higher in female infants than in male infants (P = 0.003 and P = 0.94, respectively). Cord plasma adiponectin concentration correlated positively with leptin level (P = 0.007) but not with insulin level (P = 0.78). CONCLUSIONS: High adiponectin levels are present in the cord blood. Cord plasma adiponectin and leptin levels are positively correlated with birthweight and adiposity. This suggests that adiponectin may be involved in regulating fetal growth.

Adiponectin↗