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PubMed2004

[Postpartum seizures in 2 epileptic patients].

We report the cases of 2 women with epilepsy who suffered generalized postpartum seizures on the first day after giving birth. The first had a history of febrile convulsions in childhood and had a seizure in the 36th week of gestation due to sleep deprivation. She had received epidural analgesia for labor pain. The second patient had had her most recent crisis at the beginning of the third trimester of pregnancy. Both patients had low serum levels of antiepileptic drugs. The pharmacokinetics of antiepileptic drugs can change during pregnancy, making seizures more difficult to control. Serum levels of these drugs should therefore be monitored more often, given that a generalized maternal seizure can have devastating consequences for the fetus. More careful planning and management of pregnancy is necessary for epileptic patients to ensure successful outcomes for both mother and fetus.

Adult↗
PubMed1981

Factors associated wih high and low risk of cervical neoplasia.

Among 34,318 participants in a cervical cancer screening program conducted in 12 California counties between 1975 and 1979, biopsy-proved cervical neoplasia was found in 166. These women served as cases in a case-control study to investigate the association of selected characteristics with the risk of cervical dysplasia and/or cancer. A random sample of program participants with only negative cytologic tests formed the control group. The following factors showed no association with cervical neoplasia: ethnic affiliation, age at menarche, age at first marriage, age at first pregnancy, age at birth of first child, mean number of children, and ever use of oral contraceptives. Risk of cervical neoplasia was increased in women who were less than 40 years of age; were of poverty or low income status; and were separated, divorce, or widowed. A decrease in risk was associated with nulliparity, ever use of estrogens for relief of menopausal symptoms, and ever use of the diaphragm.

Adult↗
PubMed1999

The pharmacokinetics of theophylline in premature neonates during the first few days after birth.

The aims of the study were to estimate the pharmacokinetic parameters, clearance rate (CL), and volume of distribution (V) of theophylline in premature neonates during the first few days after birth, and to identify factors contributing to interindividual variability. The authors obtained 263 serum concentrations from 105 apneic premature neonates receiving intravenous (IV) theophylline. Mean (SD) birth weight and postnatal ages were 1.3 (0.3) kg and 1.1 (0.3) days, respectively. The data were analyzed using the nonlinear mixed effects model (NONMEM). A one-compartment model with first order elimination was used. The final models were: CL (L/h) = 0.006 * WGT 0.75 * P, V (L) = 0.63 * WGT, WGT = weight (kg) P = 1.47 with oxygen support and 1.0 without oxygen support. The CL in the study population was low, resulting in long half-lives. After inclusion of the above covariates, as well as interoccasion variability, the interindividual variability in CL was 56% and in V was 47%. Interoccasion variability in CL and V was 34% and 35% respectively. Theophylline pharmacokinetics are variable in the premature neonate during the first week of life, and this high variability makes it difficult to predict drug concentrations with the same degree of accuracy as in other populations.

Bronchodilator Agents↗
PubMed2001

Pregnancy outcome and birth spacing among Palestinian women between 1940 and 1989.

In a sample of 1,250 Palestinian women living in cities, villages and refugee camps of the West Bank over a period of 50 years, we studied the number of pregnancies, children and miscarriages per woman, the waiting time to the first pregnancy, birth spacing between children, and the average age of women at first live birth. The average number of pregnancies, the percentage of miscarriages, the waiting time to the first pregnancy and the birth interval between children decreased with time in all locations. The average age of women at first live birth in cities and villages showed very little difference, but slightly lower in refugee camps.

Abortion, Spontaneous↗
PubMed2000

Breathing patterns, oxygen and carbon dioxide levels in sleeping healthy infants during the first nine months after birth.

UNLABELLED: Data on arterial oxygen saturation (SaO2), transcutaneous PO2, pCO2 (tcpO2, tcpCO2) and breathing patterns in sleeping healthy term infants were obtained during the first 9 mo after birth. Forty-four healthy infants, mean GA at birth 40 +/- 1.0 wk, mean BW 3520 +/- 562 g were examined between 2 wk and 9 mo postnatally in a cross-sectional study. SaO2, tcpO2, tcpCO2, heart rate (HR), rib cage and abdominal respiratory movements were recorded during natural nocturnal sleep, stratified for sleep states (active sleep (AS), indeterminate sleep (IS), quiet sleep (QS)). The data on AS and IS were pooled as in previous studies. The variables were analysed with respect to age. SaO2 in AS + IS and QS was 96.1 +/- 1.3%, 96.6 +/- 1.4%, respectively. TcpO2 in AS + IS was 10.6 +/- 1.1 kPa and 10.7 +/- 1.3 kPa in QS, while tcpCO2 in AS + IS was 5.4 +/- 0.3 kPa and 5.4 +/- 0.4 kPa in QS. Neither SaO2 nor tcpO2 was influenced by age. TcpCO2 decreased significantly postnatally. Five infants (11.3%) experienced episodes of hypoxaemia with a mean decrease in SaO2 to 86 +/- 1.5%. In four infants these hypoxaemic episodes were linked to upper airway obstructions. Episodes of SaO2 < 90% in conjunction with a decrease in HR to < 100 bpm were detected in one infant only. Periodic breathing (PB) was observed in 38.6% of infants. CONCLUSION: Oxygenation and carbon dioxide levels in sleeping healthy term infants were comparable to those reported in older children. Hypoxaemic episodes, if present, are associated with upper airway obstruction. PB, often assumed to be a pathological feature, is a normal breathing pattern in this age group.

Age Factors↗
PubMed1990

The influence of birth injuries in first-born and second-born twins.

This study showed that biological handicap with many complications at birth was much more recognized in the second-born than in the first-born twins. One of the most prominent intrapair differences was, for example, the weight at birth. However, intrapair differences, which were observed also in other physical measurements, diminished gradually with age. Moreover, as for intellectual ability, which was represented by the scores of the entrance examination test or standard achievement test, no remarkable influences due to handicap of the second-born were identified. Thus, it was concluded that the biological handicap seen in the second-born twin at birth did not give any significant effect on later development.

Birth Injuries↗
PubMed1993

Time of first stool in extremely low birth weight (< or = 1000 grams) infants.

The time of first stool was studied in 144 infants with a birth weight of 1000 gm or less. Median age at passage of the first stool was 3 days, and 90% of the infants passed stool by 12 days after birth. There was no relationship between the time of passage of the first stool and either birth weight or gestational age. Of the 114 infants, 88 (77%) passed stool before the initiation of any enteral feeding. The passage of the first stool was delayed in male compared with female infants (p = 0.03).

Birth Weight↗
PubMed1996

Co-sleeping: gender differences in college students' retrospective reports of sleeping with parents during childhood.

161 women and 111 men, Caucasian college students, provided retrospective information about their patterns of sleeping during childhood. The practice of co-sleeping was common, with 33.7% reporting that they co-slept in their parents' room during their first week after birth, 29.4% during the first month after birth, and 27.5% during their second month after birth. In addition, 6.3% of women and 11.9% of men reported that they co-slept during the entire first year after birth. Finally, a sex-specific pattern of co-sleeping was found with more women reporting that they co-slept with their parents during their first week and first month after birth, but a greater percentage of men than women reported that they co-slept with their parents at older ages. It appears that girls are removed from the parents' room at a younger age and more frequently than are boys.

Child, Preschool↗
PubMedDate not supplied

First established pregnancy and birth after induction of ovulation with recombinant human follicle stimulating hormone during in vitro fertilization-embryo transfer and intracytoplasmic sperm injection.

This case report describes the first established pregnancy and birth in the Philippines after induction of ovulation with recombinant follicle stimulating hormone (rec FSH) during In Vitro Fertilization-Embryo Transfer (IVF-ET) and Intracytoplasmic Sperm Injection (ICSI) in a Filipino woman with pelvic endometriosis who underwent right oophorectomy for endometrioma 1 year prior to IVF-ET and ICSI. Husband's semenalysis revealed adequate volume with 10% normal forms. Gonadotrophin releasing hormone agonist (Lupron) 375 mg subcutaneous was given for 2 cycles. 100 IU B.I.D. (a total of 2200 IU) of rec FSH was administered intramuscularly daily with single preovulatory follicle seen upon transvaginal ultrasonographic examination of 10,000 IU of human chorionic gonadotrophin, after which a viable singleton pregnancy was revealed at a gestational age of 8 weeks. The course of pregnancy until term was uneventful and ended with abdominal delivery at a gestational age of 37.3 weeks secondary to poor Fetopelvic Index with oligohydramnios. A healthy girl was born and pediatric examination did not demonstrate any abnormality.

Asia↗
PubMed1976

Gastrin concentration in plasma of the neonate at birth and after the first feeding.

Plasma gastrin was determined simultaneously in 19 newborn infants and their respective mothers shortly after birth and in ten neonates before and after the first feeding. The gastrin concentrations in the umbilical vein plasma of the newborn infants were significantly higher than in the peripheral vein plasma of their mothers. The values were statistically not different from those obtained in the neonates before the first feeding. There was an increase in gastrin concentrations after the first feeding. From these results it is suggested that gastrin is produced in the neonate independently from the mother. It is already secreted after the first feeding. Experiments in rats showed that 125I-gastrin is not transported through the placenta. From these findings we assume that most likely the gastrin measured in plasma of newborn infants is of neonatal origin.

Adult↗
PubMed1989

[Restricted intake of sodium in newborn infants with very low birth weight in the first days of life].

A prospective study on the amount of sodium administered in the first five days of life in a group of 18 low-birth-weight infants is presented. Their mean birth weight, and gestational age were 1.150 gm., and 28.8 weeks. Patients were cared for in radiant warmers, and protected with a plastic blanket. Minimum amount of sodium necessary to maintain a normal plasma sodium concentration was given. Mean daily sodium and free water given was 0.96 mEq/kg/day, and 108.4 ml/kg/day, respectively. In day 5, there was a mean accumulated body weight loss of ten per cent. This group of patients were compared with a similar group in whom plastic blanket was not used, and who received a sodium intake of 1.5 mEq/kg/day. In this latter group of patients there was a higher incidence of hypernatremia (p less than 0.005). The incidence of hyponatremia was similar in both groups. Daily sodium intake might be very low, in infants of very-low-birth-weight if a negative weight balance is allowed in the first days of life.

Drinking↗
PubMed1987

Testicular hormones during the first few hours after birth augment the tendency of adult male rats to mount receptive females.

In the male rat, a dramatic increase in serum testosterone of testicular origin occurs during the first two hours of postnatal life. This experiment was designed to determine whether this increase contributes to the development of the propensity for adult male rats to mount sexually receptive females. Male rats were castrated at either 0-hours (virtually at the moment of birth), or at 6 hours, or at 24 hours after birth. Some males castrated at 0-hours were injected with 1 microgram of testosterone after surgery. Control males were sham-operated at birth, and castrated in adulthood. At about 90 days of age, each male was given testosterone replacement therapy and tested over a period of 6 weeks for mounting. Castration of newborn males retards the development of mounting in the sense that males castrated at 0-hours require a longer period of hormone stimulation before beginning to mount, a greater percentage of males castrated at 0-hours fail to mount altogether, and even those who do mount do so at a frequency significantly lower than that for males castrated later in life. These effects are not seen when males are given an injection of testosterone immediately after castration at 0-hours, or when castration occurs at 6 hours after birth or later. We conclude that gonadal hormonal stimulation during the first several hours after birth contributes to, although is perhaps not essential for, the development of mounting.

Animals↗
PubMed1981

Metabolic effects of obstetric regional analgesia and of asphyxia in the newborn infant during the first two hours after birth. III. Adjustment of arterial blood gases and acid-base balance.

Effects of obstetric regional analgesia and of asphyxia on the arterial blood gases and acid-base balance in the first two hours after birth were investigated in 85 newborn infants divided into a control group, an asphyxia group and a continuous epidural, an intermittent epidural and a paracervical + pudendal block group. Lidocaine was the drug used in the analgesia groups. In the asphyxia group the metabolic acidosis decreased and pH was normalized to the level of the control group between 10 and 30 min after birth. During this period in the asphyxia group PaO2 was higher than and PaCO2 similar to the corresponding control values. Compared with the control group, in the regional analgesia groups the metabolic acidosis tended to be less extensive and PaO2 higher, whereas PaCO2 was similar. A lower packed red cell volume in the asphyxia and in the regional analgesia groups, probably due to differences in placental transfusion, may have had influence on the results. Within the regional analgesia groups infants with hyperglycemia showed signs of an increased metabolic acidosis while infants with hypoglycemia had low base deficit and lactate values supporting the assumption that neonatal blood glucose concentration may reflect perinatal distress.

Acid-Base Equilibrium↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. I. Changes in plasma glucose, insulin and glucagon.

Changes in plasma glucose, nonantibody-bound insulin and glucagon concentrations were studied in 32 newborn infants of diabetic mothers (IDM) during the first 24 hours after birth. Ten infants were born to White class A mothers and 22 to class B-F mothers. The infants were kept fasting during the investigative period and blood was sampled from an umbilical artery catheter. At birth, plasma glucose and glucagon levels were similar in the class A and B-F infants, whereas nonantibody-bound insulin levels were approximately 15-fold higher in the class B-F infants than in the class A infants (p less than 0.001). After birth, plasma glucose fell in all infants, the nadir being reached at two hours (p less than 0.01). Plasma glucose fell by approximately 35% in the class A infants and 63% in the class B-F infants (p less than 0.01). Eight IDM had asymptomatic hypoglycemia (plasma glucose less than 1.9 mmol/l) and four of these infants had glucose levels below 1.7 mmol/l and were withdrawn from further study. In the remaining four hypoglycemic IDM, plasma glucose was about 1.6-fold higher (p less than 0.01) and insulin about 11-fold higher (p less than 0.001) at birth compared to the 24 normoglycemic IDM. The hypoglycemia was attended by unchanged insulin levels in the class A infants, whereas insulin fell in the class B-F infants (p less than 0.01). However, during the whole investigative period, plasma insulin of the class B-F infants was higher than that of the class A infants (p less than 0.01). After birth, plasma glucagon increased slowly in all IDM and peak values were reached after 12 hours in the class A infants (p less than 0.05) and 24 hours in the class B-F infants (p less than 0.01). Only those infants who became hypoglycemic after birth exhibited a significant increment in plasma glucagon from 0.2 hours (p less than 0.05). These results suggest that neonatal hypoglycemia of IDM results from high plasma levels of nonantibody-bound insulin together with a very retarded increment in plasma glucagon levels. The degree of neonatal hypoglycemia and hyperinsulinemia of an individual IDM seems to be positively correlated to the severity of the diabetes of the mother.

Adult↗
PubMed2002

Rehospitalization of extremely-low-birth-weight infants in first 2 years of life.

AIMS: To determine whether (1) chronic lung disease (CLD) is the prime reason for extremely-low-birth-weight (ELBW) infant readmission during the first 2 years of life, (2) surfactant and other advanced therapies have reduced ELBW infant readmissions, (3) home oxygen therapy (HOT) is efficacious for this group. STUDY DESIGN: The hospital records of these ELBW infants were reviewed retrospectively. Data on age, diagnosis, treatment, and duration of each hospitalization were compiled and analyzed for their association to CLD and to readmission for CLD and other reasons. SUBJECTS: All 60 surviving infants with a birth body weight of less than 1001 g (ELBW) born from January 1993 to February 1998 were followed up to 2 years (mean 20.4 +/- 7.4 months) to evaluate their respiratory outcome. RESULTS: Forty-two percent of these infants developed CLD. Upon discharge from the hospital, 28% (7/25) of the patients were given HOT for a median period of 60 days. Of the 47 ELBW infants who were studied the entire 2-year period, 72% were readmitted. Infants with CLD were readmitted more frequently (p=0.045) and had longer hospital stays during the first 2 years of life (p=0.034) than those without CLD. Respiratory illness was the main reason for readmission (55%) of these ELBW infants. The incidence of readmission due to respiratory tract infection was not significantly different in infants with CLD (61%) and infants without respiratory complications (44%) (p=0.159). CONCLUSIONS: Infants with CLD (whether receiving HOT or not) showed no higher readmission rate due to respiratory infection, but the HOT group did have higher morbidity. The premature lung itself rather than the presence of CLD, as we would expect, makes ELBW infants more prone to readmission for respiratory illness.

Chronic Disease↗
PubMed1995

Ketone body turnover at term and in premature newborns in the first 2 weeks after birth.

Using the infusion of D-(-)-3-hydroxy-[1,2,3,4,-13C4]butyrate at tracer doses, we measured total ketone body turnover in 13 premature and 10 at term infants in the first 2 weeks after birth. The premature infants received parenteral and/or oral feeding. The normal newborns were either recently fed or briefly fasting. The premature and the fed at term infants had comparable concentrations of ketone body (476 +/- 86 and 406 +/- 78 mumol/l) and free fatty acids (FFA) (309 +/- 47 and 325 +/- 75 mumol/l). In the premature newborns, ketone body turnover rates (3.2 +/- 0.2 mumol kg-1 min-1) were 74% that of fed newborns at term (4.3 +/- 0.3 mumol kg-1 min-1, p < 0.05), and 18% that of normal newborns during a brief fast (17.3 +/- 1.3 mumol kg-1 min-1, p < 0.01). Ketone body production rates correlated with plasma FFA concentrations in both groups (r = 0.62 and 0.69, p < 0.05). However, for a similar plasma FFA content, ketone production was 2- to 3-fold lower in the premature, indicating an immature hepatic capacity to convert FFA into ketones. Our study therefore shows that ketogenesis is already active in infants born 10 weeks before normal term and continuously fed, but that daily ketone production is lower than at term.

Fasting↗
PubMed1986

Reproductive history and body mass index in black and white women.

The relationships of timing, spacing, number of births, and demographic variables to body mass index were examined in 844 white and 289 black women. Subjects were interviewed in 1978-1979 as mothers or female guardians of a stratified random sample of all Minneapolis children in grades 1-3. Results indicate that among black and white women, number of births, age at last birth, and years between first and last births were positively associated with body mass index. However, when age, education, and income were included in the regression equation for black women, none of the reproductive variables predicted body mass index. When number of births, age at last birth, and years between first and last birth were included in the same regression for white women, only number of births was independently associated with body mass index.

Adult↗
PubMed2001

Modification of BRCA1- and BRCA2-associated breast cancer risk by AIB1 genotype and reproductive history.

Women who have inherited a germ-line mutation in the BRCA1 or BRCA2 (BRCA1/2) genes have a greatly increased risk of developing breast cancer compared with the general population. However, there is also substantial interindividual variability in the occurrence of breast cancer among BRCA1/2 mutation carriers. We hypothesize that genes involved in endocrine signaling may modify the BRCA1/2-associated age-specific breast cancer penetrance. We studied the effect of alleles at the AIB1 gene using a matched case-control sample of 448 women with germ-line BRCA1/2 mutations. We found that these women were at significantly higher breast cancer risk if they carried alleles with at least 28 or 29 polyglutamine repeats at AIB1, compared with women who carried alleles with fewer polyglutamine repeats [odds ratio (OR), 1.59; 95% confidence interval (CI), 1.03-2.47 and OR, 2.85; 95% CI, 1.64-4.96, respectively]. Late age at first live birth and nulliparity have been associated with increased breast cancer risk. We observed increases in BRCA1/2-associated breast cancer risk in women who were either nulliparous or had their first live birth after age 30 (OR, 3.06; 95% CI, 1.52-6.16). Women were at significantly increased risk if they were nulliparous or had a late age at first live birth and had AIB1 alleles no shorter than 28 or 29 or more AIB1 polyglutamine repeats (OR, 4.62; 95% CI, 2.02-10.56 and OR, 6.97; 95% CI, 1.71-28.43, respectively) than women with none of these risk factors. Our results support the hypothesis that pathways involving endocrine signaling, as measured through AIB1 genotype and reproductive history, may have a substantial effect on BRCA1/2-associated breast cancer risk.

Adult↗