Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Prematurity”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1978

Haemophilus influenzae amnionitis associated with prematurity and premature membrane rupture.

Prematurity and premature rupture of the membranes present major obstetric problems. When associated with amnionitis, the result may be disastrous. A case of Haemophilus influenzae aminionitis in association with premature rupture of the membranes is presented. The rarity of this organism as a causative agent in amnionitis and its possible causative role in premature membrane rupture are considered in review of the scant relevant literature.

Adult↗
PubMed1980

[Risk of premature rupture of membranes and prognosis of premature delivery (author's transl)].

Premature rupture of the membranes was found to suppress rather than step up mortality, as was shown by examination of 919 newborns with birth weights of 2,500 g and less. The same conclusion was statistically secured for birth weights between 1,500 g and just below 2,000 g (p less than or equal to 0.05).-The above findings are likely to underscore results obtained by other authors who reported less occurrence of respiratory distress syndromes in premature newborns delivered after premature rupture of the membranes.-The frequency of premature ruptures tends to rise strongly along with declining birth weight, and similar correlations exist between perinatal mortality and birth weight. The authors, therefore, insist on the need for comparing only infants of one and the same birth weight (100 g-intervals), in order to forestall erroneous conclusions, otherwise inevitable.

Birth Weight↗
PubMed1993

[What is the present best scale to estimate infants' prematurity to predict retinopathy of prematurity? Aichi Retinopathy Study Group].

The present study is the second report using the data of the epidemiological survey of retinopathy of prematurity (ROP) obtained during the 2 year period 1986-1987 in Aichi Prefecture. To study ROP we have used birthweight and gestational age for estimation of infants' prematurity. These two parameters were found to have a very close relation with the incidence of ROP. Although gestational age is close to the embryonic age, birthweight is greatly influenced by intrauterine environmental factors. To confirm the importance of using birthweight, the relationship between the incidence of ROP and the influence of intrauterine environmental factors must be close. Using data on 1,887 premature infants, the mean and standard deviation of birthweight in each gestational weeks were calculated. Deviation of birthweight was considered to reflect the influence of intrauterine environmental factors and was evaluated by comparing the birthweight of a baby with the mean birthweight for the same number of gestational weeks. The incidence of ROP had no close relationship with the deviation of birthweight at each gestational age. Therefore, it was concluded that the influence of the modifying factors of birthweight had not any close relation with the incidence of ROP. At present we should use gestational age as the best scale to estimate infants' prematurity to predict ROP.

Birth Weight↗
PubMed2000

Involution of retinopathy of prematurity. Cryotherapy for Retinopathy of Prematurity Cooperative Group.

OBJECTIVE: To report the timing of involution of acute retinopathy of prematurity (ROP). DESIGN: An analysis of prospective retinal observational data recorded at infants' eye examinations. PARTICIPANTS: Infants from the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) had birth weights less than 1251 g and served as subjects. The study population included 766 children who were examined in 5 of the 23 study centers and who developed at least 1 clock hour of acute ROP, stages 1 through 3. One eye from each patient was randomly chosen for analysis. MAIN OUTCOME MEASURES: Investigators documented the location, extent, and severity of ROP during serial retinal examinations. The onset of the ROP's involution was determined from a review of these data, applying a set of predetermined criteria. RESULTS: Acute-phase ROP began to involute at a mean of 38.6 weeks postmenstrual age. In 90% of patients, the ROP began to involute before 44 weeks of postmenstrual age. Acute ROP that demonstrated involution by moving from zone II to zone III was associated with an unfavorable outcome in 2 (1%) of 200 cases. Retinopathy of prematurity that was present only in zone III during a child's serial retinal examinations was never associated with the development of a partial or total retinal detachment. CONCLUSIONS: The onset of involution of acute retinopathy of prematurity correlates better with postmenstrual rather than with chronological age. This is reminiscent of the reported similar correlation of postmenstrual age to the time of onset of prethreshold and threshold ROP. Zone III ROP was nearly always associated with a favorable outcome.

Acute Disease↗
PubMed1991

Erythropoietic progenitor cells from premature neonates studied using a validated serum-deprived medium. Evidence that peripheral blood BFU-E from premature neonates are increased in number and are highly dependent upon burst promoting activity for in vitro growth.

We have examined a serum-deprived culture system in order to verify that it is suitable for the study of burst forming unit erythroid (BFU-E) progenitor cells from premature neonates. Optimum growth of BFU-E from premature neonates was observed with each media constituent using the same concentration as that previously described for adult subjects. Growth of immature BFU-E from premature neonates were highly dependent upon a source of Burst Promoting Activity and mature BFU-E derived colonies emerged at day 12 compared to day 14 in adults. Our preliminary results with the validated medium suggest that premature infants have increased peripheral blood concentrations of BFU-E compared to healthy adult controls.

Adult↗
PubMed2004

The distance from the skin to the subarachnoid space can be predicted in premature and former-premature infants.

PURPOSE: Spinal anesthesia can be technically challenging in young infants. We studied whether the distance between the skin and the lumbar subarachnoid space in premature and former-premature young infants could be predicted prior to lumbar puncture. METHODS: The distance from skin entry point to tip of the spinal needle was measured using a caliper after lumbar spinal anesthesia at the L4-5 interspace. This distance was correlated to the patient's weight, postconceptual age and lumbar ultrasonographic measurement of the skin-to-subarachnoid space and predictive statistical models were sought. RESULTS: Thirty-five premature or former-premature infants were studied. Three models were examined: all three independent variables, weight and postconceptual age only, and weight only. The model selected contained the weight and postconceptual age, because it had the highest value for adjusted R squared, as well as the lowest value for the mean squared error. Adding the ultrasonic measurement to the model worsened the results. The statistical model that described the depth of the subarachnoid space at the L4-5 level was Y = 13.19 + 0.0026 x W - 0.12 x PCA, where Y is the distance (mm) from the skin to the subarachnoid space, W is the patient's weight (g) and PCA is the postconceptual age (weeks). Adjusted R squared was 0.72, mean square error was 2.63 and P < 10(-9). CONCLUSION: The distance between the skin and the subarachnoid space at the level of L4-5 interspace can be predicted using a statistical model based on the infant's weight and postconceptual age. Spinal ultrasound has no value in L4-5 subarachnoid space depth prediction.

Anesthesia, Spinal↗
PubMed2002

Spinal anesthesia in 62 premature, former-premature or young infants--technical aspects and pitfalls.

PURPOSE: To highlight technical aspects and pitfalls of spinal anesthesia (SA) in infants. METHODS: The medical history and perioperative course of all infants who underwent SA over a 28-month period were collected (retrospectively in the first 20). RESULTS: Sixty-two infants underwent surgery under SA. Fifty-five were premature and former-premature, postconceptional age 43.3 +/- 5.0 weeks, weight 3261 +/- 1243 g. Of these, 21 had co-existing disease: cerebral (six), cardiac (nine), pulmonary (11) and urological (six). Hyperbaric tetracaine or bupivacaine 1 mg x kg(-1) with adrenaline was administered. Four infants (three premature) required N(2)O supplementation and three needed general anesthesia. The supplementation rate was similar or lower than in previous studies. Postoperatively, all seven were shown to have lower limb motor and sensory blockade. Complications in premature patients included intraoperative hypoxemia (two), apnea (two) and bradycardia (one). Postoperative complications included bradycardia (three), hypoxemia (one) and apnea and hypoxemia (one). The postoperative complication rate was similar to previous studies. CONCLUSION: Successful SA in infants depends on close attention to preoperative assessment, appropriate patient positioning during and after lumbar puncture, drug dosing and intra- and postoperative cardiorespiratory monitoring. A relatively high dose of hyperbaric solution of tetracaine or bupivacaine with adrenaline should be administered.

Anesthesia, Spinal↗
PubMed1998

International multicenter term PROM study: evaluation of predictors of neonatal infection in infants born to patients with premature rupture of membranes at term. Premature Rupture of the Membranes.

OBJECTIVE: Our objective was to determine significant predictors for the development of neonatal infection in infants born to patients with premature rupture of membranes at term. STUDY DESIGN: Multivariate analysis was used to determine the significant predictors of neonatal infection in infants born to women with premature rupture of the membranes who were enrolled in the Term PROM Study. In a randomized, controlled trial, the Term PROM Study recently compared induction of labor with expectant management for premature rupture of membranes at term. RESULTS: The following variables were identified as independent predictors of neonatal infection: clinical chorioamnionitis (odds ratio 5.89, P < .0001), positive maternal group B streptococcal status (vs negative or unknown, odds ratio 3.08, P < .0001), 7 to 8 vaginal digital examinations (vs 0 to 2, odds ratio 2.37, P = .04), 24 to < 48 hours from membrane rupture to active labor (vs < 12 hours, odds ratio 1.97, P = .02), > or = 48 hours from membrane rupture to active labor (vs < 12 hours, odds ratio 2.25, P = .01), and maternal antibiotics before delivery (odds ratio 1.63, P = .05). CONCLUSIONS: Among infants born to patients with premature rupture of membranes at term, clinical chorioamnionitis and maternal colonization with group B streptococci are the most important predictors of subsequent neonatal infection.

Adult↗
PubMed1996

Is it necrotizing enterocolitis, microcolon of prematurity, or delayed meconium plug? A dilemma in the tiny premature infant.

Failure of a small premature newborn to adequately evacuate meconium for days or weeks has been attributed to "probable necrotizing enterocolitis (NEC)" or "microcolon of prematurity." The authors present an unusual type of "meconium plug syndrome" with the same clinical picture, seen in tiny premature babies (500 to 1,500 g), which required a contrast enema or Gastrografin upper gastrointestinal (UGI) series to evacuate the plugs. The obstruction resolved. Twenty babies (480 to 1,500 g) presented with the same clinical picture without any x-ray suggestion of NEC; contrast enemas were performed because of the suspicion of meconium plug syndrome. All 20 had extensive meconium plugs that were evacuated by the enema or by a Gastrografin UGI series. Most of them improved after the plugs were passed. These infants differ from typical full-term babies with meconium plug syndrome in a number of ways: (1) many of the mothers were on magnesium sulfate (MgSO4) or had eclampsia; (2) the plugs were diagnosed late rather than shortly after birth; and (3) the plugs were significant, extending to the right colon. The authors believe that when a tiny premature baby has findings consistent with meconium plug syndrome, the baby should be transported to radiology, for a Gastrografin enema, despite the difficulties involved. Delay postpones the start of feedings, and increases the number of radiographic studies.

Contrast Media↗
PubMed2001

The outcome of retinopathy of prematurity: screening for retinopathy of prematurity using an outcome predictive program.

PURPOSE: The purpose of this study was to compare the calculated risk of progression to threshold retinopathy of prematurity (ROP) and risk of an unfavorable structural outcome using the computer program, RM-ROP, with the observed incidence for infants born at Jackson Memorial Hospital (JMH) and to determine how many children would have been treated unnecessarily if the threshold criteria for treatment were lowered on the basis of the clinical findings and RM-ROP risk calculations. DESIGN: Noncomparative interventional case series. PARTICIPANTS: All 292 surviving premature infants weighing 1250 g or less at birth and born at JMH between January 1, 1997, and December 31, 1998, were included in the study. METHODS: Baseline demographic factors and data from sequential ophthalmic examinations were entered into the RM-ROP program for risk calculation. Infants reaching threshold disease received diode laser indirect photocoagulation of the avascular retina. Three-month follow-up was obtained for infants receiving laser treatment. MAIN OUTCOME MEASURES: The development of threshold ROP and an unfavorable structural outcome, defined as a posterior retinal fold or posterior retinal detachment occurring within 3 months of threshold disease. RESULTS: Thirty-eight eyes were diagnosed with threshold ROP, with 18 of 20 subjects having bilateral disease. Three-month posttreatment follow-up was obtained on all 20 children, with 19 having good structural outcomes. Thirty-two percent of eyes (12 of 38) reaching threshold never had a risk estimate greater than 0.10. However, only 6% of eyes (35 of 546) that did not reach threshold ever had a model predicted risk greater than 0.15. All right eyes with zone 1 prethreshold disease, 60% of those with zone 2 stage 2+ disease, and 23% with zone 2 stage 3 disease progressed to threshold ROP. CONCLUSIONS: The similarity between the risk distributions for the Miami and the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity study indicates the similarity in the populations with respect to risk factors identified as important by the model. The Miami data validated the model, with eyes reaching threshold having higher risks than eyes that did not. Actual risk estimates for eyes reaching threshold can be small. Changing the threshold criteria for treatment on the basis of various clinical and computer-generated prethreshold risk levels in our population would have resulted in the unnecessary treatment of many infants who never progressed to threshold disease. In the Miami population, if the model were used to manage an individual subject, close attention would have to be paid to small differences in risk. Although the RM-ROP software program may be a useful tool for following premature infants with ROP, the clinical examination remains the "gold standard."

Disease Progression↗
PubMed1980

[The problem of the increased perinatal mortality in premature breech deliveries, compared to premature vertex deliveries (author's transl)].

The perinatal mortality of 115 premature breech deliveries is compared to that of 843 vertex deliveries. No difference is found when birth weights at 100 gram intervals are compared. These results are statistically checked. The authors show that comparisons at 500 gram intervals are insufficient and can lead to wrong conclusions. When all premature deliveries without birth weight groups are compared the contrary results are statistically very significant. These results are in concordance with the perinatal mortality figures of mature infants born by various methods. The investigations lead to the conclusion that the mode of delivery has no essential influence on the neonatal prognosis. Mere breech presentation by itself is no indication for different delivery than for all premature deliveries. It is not so important to treat the breech presentation as it is to prevent premature deliveries.

Berlin↗
PubMed2005

Aerobic and lung performance in premature children with and without chronic lung disease of prematurity.

OBJECTIVE: This study intended to identify pulmonary and exercise-related effects of chronic lung disease of infancy (CLD) versus prematurity (PRE) without CLD in children 5 to 7 years old who were born prematurely (24-30 weeks of gestation) with very low and extremely low birthweight of 500 to 1500 g (VLBW, ELBW). SUBJECTS: Seventeen CLD and 14 PRE were compared with 24 term controls (CON). The premature children had no overt manifestations of a neuromuscular disease. METHODS: Pulmonary function at rest and following exercise, and aerobic exercise performance were measured. RESULTS: Peak [latin capital V with dot above]O2 and maximal aerobic power were not different among the groups, but O2 uptake at a given mechanical power was higher in the CLD than in PRE and in CON (P < 0.05). At rest, forced vital capacity was significantly lower in CLD than in PRE (P < 0.05) and CON (P < 0.0005), and FEV1 and FEF25-75 were lower in CLD than CON (P < 0.0005 and P < 0.005, respectively). Exercise-induced bronchoconstriction (EIB) was more prevalent among the 2 premature groups (P < 0.05). CONCLUSIONS: Our children 5 to 7 years old born at VLBW or ELBW, with or without CLD, have some degree of pulmonary dysfunction at rest and following exercise and a higher prevalence of EIB with no reduction in maximal aerobic exercise performance. The findings suggest that the pulmonary limitations are associated with low birthweight even in the absence of CLD. The higher O2 uptake at a given mechanical power in the CLD group may cause early fatigability during prolonged exercise, even when aerobic performance is normal.

Body Mass Index↗
PubMed1999

Early intervention promotes intellectual development of premature infants: a preliminary report. Early Intervention of Premature Infants Cooperative Research Group.

OBJECTIVE: To evaluate the effect of early intervention on the intellectual development of the premature infants. METHODS: Premature infants at gestational age of 28-36.9 weeks were randomly divided into two groups: intervention and conventional care groups. Normal newborn infants during the same period were included in the control group (routine care). Up to March 1996, 156 cases were over the age 1.5-2 years (corrected age), 52 in the intervention group, 51 in the conventional care group and 53 in the normal control group. Parents were taught to carry out the 0-2 year intervention program, which included motor, cognitive, speech development and social behavior. Every three months, height, weight and head circumference were measured. At the age of one and a half and two years, all infants in the three groups received infant development tests of Child Development Center of China (CDCC) scale. The examiner did not know which infant had received intervention. RESULTS: There was no significant difference in biological factors among the two premature groups and in cultural and social factors among the three groups. Intelligence tests at the age of one and a half and two years showed that the average mental development index (MDI) in the intervention group was 13.8 and 14.6 higher than those in the conventional care group and the differences were significant. The psychomotor development index (PDI) was 5.2 and 4.7 higher but the differences were not significant. The MDI and PDI in the intervention group and normal control were quite close, but at two years, the MDI and PDI in the intervention group were 5.7 and 7.3 higher than those in the normal control and the differences were significant (P < 0.05). Compared with the normal control, the MDI in conventional care group at one and a half and two years of age were 11.5 and 8.9 lower. The difference was very significant. There were four cases of mental retardation, whose mental development index (MDI) was less then 70 in the conventional care group, but none in the intervention group. CONCLUSIONS: Early intervention can promote intellectual development of the premature infants and may be beneficial to the prevention of mental retardation. Early and intensive intervention can produce better results. Bringing parent's initiative into full play through deepening their understanding of the importance of early intervention is the key to success.

Child Development↗
PubMed1982

[Prematurity and placental insufficiency in twin pregnancies. Results during the care of multiple pregnancies at a center for premature births].

An analysis was made of 151 twin pregnancies, in 1975, 1978 and 1979, to study the effectiveness of obstetrico-neonatological attention to bigeminal pregnancies in a premature infant centre. -- Significant rise in early detection of bigeminal pregnancy due to much wider use of ultrasonic diagnosis and intensification of hospital treatment have drastically reduced the number of extremely immature twin births by delaying delivery to somewhere between the 34th and 36th weeks of gravidity. With the use of tocolysis nearly unchanged throughout the period of observation, change in average gestational age at birth should be interpreted primarily as the result of more long-time prepartum hospitalisation, with attention being offered for periods of more than three weeks. This conclusion was supported by unsatisfactory results regarding average gestational age and birth weight, following exclusive outpatient attention to women with bigeminal pregnancies. Improvement of foetal prognosis was found to depend primarily on proper therapeutic approach to prematurity. -- The authors' own experience differed from reports of other workers, in that the rate of hypotrophy declined in the wake of intensive prepartum care. Substantial reduction of the gap between average birth weights of first multiple foetuses and those of second multiple foetuses as well as declining differences between average birth weights of heavier twins, on the one hand, and those of less heavy twins, on the other, were recorded from all gestational age groups and attributed to improvement in intra-uterine care for all multiple foetuses due to intensified treatment. -- Significant rise in survival rates (after deduction of all foetal loss up to the 28th day of age) of all premature twins is considered an expression of increasingly improving life chances of twins, in general. It was based on growing numbers of highly immature survivors, but even more on significant rise in the number of premature survivors between the 34th and 36th weeks of gestation.

Birth Weight↗
PubMed1975

[Investigations on the utilization of parenterally administered amino acids by premature and small-for-dates neonates. I. Free amino acids in the blood of premature and small-for dates neonates (author's transl)].

The fasting levels of free amino acids were determined in the serum of 23 premature and 7 small-for-dates newborns during the first 4 weeks of life. This was done by ion-exchange chromatography after ultrafiltration of the serum, which allowed quantification. Differences were recognized in regards to age, and nutritional state: 1. Small-for-dates newborns at term showed significantly lower asparagine and glycine levels when compared to hypotrophic prematures. 2. Leucine was lower in male than in female prematures. 3. Leucine and phenylalanine were lower in hypotrophic than in eutrophic prematures. 4. Nearly all investigated fasting amino acid levels were highest in the 3rd week of life. A decrease was observed during the 4th week of life. Threonine, Proline, Alanine, Valine, Isoleucine, Lysine and Arginine were significantly higher in the 3rd compared to the 1st week.

Age Factors↗
PubMed1997

The problem of prematurity: premature labour.

Premature labour is a major medical problem. At present, premature labour cannot be predicted. Premature labour cannot be prevented effectively at present. Currently used drugs are not effective overall in reducing infant mortality. There is a need for further research and the development of effective agents for the prevention of premature labour.

Female↗
PubMed2005

The incidence and course of retinopathy of prematurity: findings from the early treatment for retinopathy of prematurity study.

OBJECTIVES: To estimate the incidence of retinopathy of prematurity (ROP) in the Early Treatment for Retinopathy of Prematurity (ETROP) Study and compare these results with those reported in the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) Study. METHODS: The ETROP Study, as part of its protocol, screened 6998 infants at 26 centers throughout the United States. Serial eye examinations were conducted for infants born weighing <1251 g, making it possible to estimate the frequency of ROP in different birth weight and gestational age categories. ROP was categorized according to the International Classification for ROP. RESULTS: The incidence of any ROP was 68% among infants of <1251 g. The findings were compared with those for infants born in 1986 and 1987 in the CRYO-ROP Study. The overall incidences of ROP were similar in the 2 studies, but there was more zone I ROP in the ETROP Study. Among infants with ROP, more-severe ROP (prethreshold) occurred for 36.9% of infants in the ETROP Study and 27.1% of infants in the CRYO-ROP Study. The gestational age of onset of ROP of different severities has changed very little since the CRYO-ROP Study was conducted. CONCLUSIONS: ROP remains a common important problem among infants with birth weights of <1251 g. The incidence of ROP, time of onset, rate of progression, and time of onset of prethreshold disease have changed little since the CRYO-ROP natural-history study.

Cryotherapy↗
PubMed1989

[Differential diagnosis of so-called premature performance failure or premature aging].

In a district of about 70,000 inhabitants (two thirds urban, one third rural population) from 1978 to 1987 32 women at the age between 50 and 60 years and 63 men at the age between 50 and 65 years with premature decrease in vitality on cerebrovascular basis were observed and treated. The cases were differential-diagnostically subdivided. 32 patients belonged to the group of more distinct chronic cerebro-organic psychosyndromes, additionally also involution psychoses; the number of the untimely retirement from the working process was 100%. In 24 patients there were pseudoneurasthenic syndromes of the cerebral arteriosclerosis; 75% early retired from the working process. In 39 patients the cases in question were the proper premature decrease in vitality or a so-called premature ageing on biophysical basis; 41% early retired. A premature ageing may exist also without any so-called organ-valued findings, the symptoms are credibly described. Conflicts with the environment and psychic false reaction may be the result. Optimum therapeutic and rehabilitative troubles may bring successes which are not to be underestimated in the cases without distinct organic processes. The question of invalidization is thoroughly to be examined individually.

Aged↗