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At least 19 recordsLinked to original sources
PubMed1998

Influence of increased survival in very low birth weight, low birth weight, and normal birth weight infants on the incidence of sudden infant death syndrome in the United States: 1985-1991.

OBJECTIVE: To examine the relationship between infant survival and the rates sudden infant death syndrome (SIDS) in very low birth weight (VLBW), low birth weight (LBW), and normal birth weight (NBW) infants from 1985 to 1991. METHODS: The National Center for Health Statistics Birth Cohort Linked Birth/Infant Death Data Sets were used to determine birth weight, age at death, and cause of death for US-born singleton infants with birth weights of 500 g or more. RESULTS: Increasing infant and postneonatal survival rates were greatest in VLBW infants. In contrast, SIDS rates did not change in VLBW infants (3.66 to 3.69; P = .70) but declined in both LBW (3.51 to 3.32; P = .041) and NBW (1.07 to 1.03; P = .008) infants. Postneonatal SIDS rates (per 1000 neonatal survivors) did not change in VLBW (4.93 to 4.58; P = .58) or LBW (3.36 to 3.22; P = .07) infants but declined in NBW infants (1.00 to 0.97; P = .018). Although there were differences among the slopes of survival rates, there was no statistical evidence of differences in the slope of SIDS rates among the three groups. CONCLUSIONS: The marked increase in survival of VLBW infants increased the pool of babies at potential risk for SIDS. VLBW infants' SIDS rates have not changed while they have declined in NBW and LBW infants.

Birth Weight↗
PubMed1995

The problem of low birth weight.

Low birth weight is a major public health problem in the United States, contributing substantially both to infant mortality and to childhood handicap. The principal determinant of low birth weight in the United States is preterm delivery, a phenomenon of largely unknown etiology. Preterm delivery is more common in the United States than in many other industrialized nations, and is the factor most responsible for the relatively high infant mortality rate in the United States. Within the United States, Asian populations experience the lowest preterm delivery rates, while Hispanic and Native American populations experience slightly higher preterm delivery rates than the white population. African Americans, however, have much higher rates of preterm delivery than any of the other major ethnic groups. Poverty is strongly and consistently associated with low birth weight, but the precise social and environmental conditions that produce preterm delivery have not been elucidated. Although it is popular to link illicit drug use to low birth weight, a high low birth weight rate was characteristic of the United States for decades before the cocaine epidemic of the 1980s. Neither the low birth rate nor the preterm delivery rate has improved in the United States in the past quarter century. Most efforts to prevent prematurity or low birth weight, when carefully evaluated, have not proven effective. A major goal of biomedical research ought to be better understanding of the causes of this important public health problem.

Cause of Death↗
PubMed2005

Low birth weight,very low birth weight rates and gestational age-specific birth weight distribution of korean newborn infants.

To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. The mean birth weight and GA of a crude population are 3,188 +/-518 g and 38.7+/-2.1 weeks, respectively. The LBW and the VLBW rates are 7.2% and 1.4%, respectively. The preterm birth rate (less than 37 completed weeks of gestation) is 8.4% and the very preterm birth rate (less than 32 completed weeks of gestation) is 0.7%. The mean birth weights for female infants, multiple births, and births delivered by cesarean section were lower than those for male, singletons, and births delivered vaginally. The risk of delivering LBW or VLBW infant was higher for the teenagers and the older women (aged 35 yr and more). We have also obtained the percentile distribution of GA-specific birth weight in infants over 23 weeks of gestation.

Birth Weight↗
PubMed1997

Iatrogenic vascular lesions in extremely low birth weight and low birth weight neonates.

PURPOSE: Aggressive treatment has improved the long-term outcome of extremely low birth weight (ELBW) and low birth weight (LBW) neonates, but it has also increased the risk of iatrogenic lesions. The aim of this paper is to evaluate the incidence of vascular injuries observed in the neonatal intensive care unit of our hospital. METHODS: From 1987 to 1994, 2898 neonates were admitted to the neonatal intensive care unit; 335 of them were either LBW or ELBW (11.5%). A review of the charts of these neonates disclosed nine neonates (four male, five female) with vascular lesions (2.6%); the mean gestational age of these patients was 28.7 weeks (range, 24 to 33 weeks), the mean weight at birth was 880 g (range, 590 to 1450 g), and the mean weight at diagnosis was 1825 g (range, 1230 to 2700 g). In the same period, 10 neonates with vascular injuries were reported in the 2563 neonates who weighed more than 1500 g (0.3%). The injuries observed in LBW and ELBW group were arteriovenous fistulas (two bilateral) at the femoral level (six neonates), carotid lesion (one neonate), and limb ischemia (two neonates). Injury was associated with venipuncture in seven neonates, and with umbilical catheter in one; the case of carotid lesion was related to surgical error. No general symptoms were observed. RESULTS: The carotid lesion and five arteriovenous fistulas were repaired by microsurgical techniques; one case of limb ischemia was resolved with thrombolytic drugs, whereas an amputation at the knee level was required in the other after 10 days of medical treatment. One neonate with an arteriovenous fistula was just observed according to the parents' wishes. At clinical and echo-color Doppler follow-up, seven of nine neonates had normal vascular function without sequelae. CONCLUSIONS: In our experience, LBW and ELBW neonates are at greater risk than older neonates of the development of iatrogenic vascular lesions. We advocate aggressive microsurgery, medical treatment, or both to obtain good results and prevent late sequelae.

Arteriovenous Fistula↗
PubMed2003

Normal insulin-stimulated endothelial function and impaired insulin-stimulated muscle glucose uptake in young adults with low birth weight.

Low birth weight has been linked to insulin resistance and cardiovascular disease. We hypothesized that insulin sensitivity of both muscle and vascular tissues were impaired in young men with low birth weight. Blood flow was measured by venous occlusion plethysmography during dose-response studies of acetylcholine and sodium nitroprusside in the forearm of fourteen 21-yr-old men with low birth weight and 16 controls of normal birth weight. Glucose uptake was measured during intraarterial insulin infusion. Dose-response studies were repeated during insulin infusion. The maximal blood flow during acetylcholine infusion was 14.1 +/- 2.7 and 14.4 +/- 2.1 [ml x (100 ml forearm)(-1) x min(-1)] in low and normal birth weight subjects, respectively. Insulin coinfusion increased acetylcholine-stimulated flow in both groups: 18.0 +/- 3.1 vs. 17.9 +/- 3.1 [ml x (100 ml forearm)(-1) x min(-1)], NS. Insulin infusion increased glucose uptake significantly in the normal birth weight group, compared with the low birth weight group: 0.40 +/- 0.09 to 1.00 +/- 0.16 vs. 0.44 +/- 0.09 to 0.59 +/- 0.1 [ micro mol glucose x (100 ml forearm)(-1) x min(-1)], P = 0.04. Young men with low birth weight have normal insulin-stimulated endothelial function and impaired insulin-stimulated forearm glucose uptake. Thus, endothelial dysfunction does not necessarily coexist with metabolic alterations in subjects with low birth weight.

Adipose Tissue↗
PubMed1986

Geographic distribution of unexplained low birth weight.

Low birth weight, largely in the form of intrauterine growth retardation, has been used in animal studies as a sensitive indicator of adverse reproductive outcomes to suspect toxic agents. Methodological problems have severely curtailed studies of low birth weight for human risk assessment. For white and black births, we explore the use of statistical techniques to adjust for maternal risk factors and to isolate US counties having a significantly elevated rate of unexplained low-birth-weight births in 1979. The data are derived from individual birth certificate information made available by the National Center for Health Statistics. Removing variation due to socioeconomic and other intrinsic factors available on birth certificates, clusters of high-risk counties appear. This paper discusses the methodology used to identify these counties.

Black People↗
PubMedDate not supplied

A comparison of the childhood health status of normal birth weight and low birth weight infants.

We analyzed previously unavailable data to describe the national health status in 1981 of noninstitutionalized children who were low birth weight infants. They were compared with normal birth weight children. All data contained in the analysis were based on weighted national estimates. Low birth weight children in general were found to have more chronic conditions, more hospitalizations, more days in bed because of illness, more limitations of activity, poorer health status as perceived by parents, and more school days lost because of illness. However, numbers of physician visits were not different even for low birth weight children younger than 2 years, which is inconsistent with the higher proportions of multiple hospitalizations, chronic conditions, and other illness measures. The proportions of children in the younger age groups at risk for health problems associated with low birth weight should be increasing. The proportion of very low birth weight children in the younger age groups with higher excessive morbidity measures tends to support the possibility. The increased survival of high-risk infants raises concern about their future requirements for special medical and educational services, and about the resulting stress on their families. Normal birth weight children were found to make a major contribution to the prevalence of morbidity. It is not the children identified as at risk as a result of low birth weight that comprise most of those with illnesses. The physical, social, and psychological environment after birth probably has the largest impact on the health status of our children. The attributable risk of excessive morbidity associated with low birth weight and very low birth weight reinforces the concept that while the overall impact is not large, the consistent pattern of poorer health for children born with low birth weight, compared to those of normal birth weight, shown in this analysis, is striking. The pattern reinforces concerns with the many factors associated with low birth weight and their effects on the present and future health of the population.

Birth Weight↗
PubMed2001

[High prevalence of islet cell and glutamate decarboxylase antibodies in healthy young adults born with low birth weight].

Low birth weight is an independent risk factor for several chronic adult diseases. The authors determined the prevalence of islet cell cytoplasmatic antibody (ICA), glutamic acid decarboxylase antibody (GADA) and tyrosine phosphatase antibody (IA2) in 41 women and 34 men born with a birth weight under 2500 grams. ICA and/or GADA positivity was detected in 32% of the subjects tested. Both antibodies were present in 11% of the subjects. IA2 positivity was not found in any of the enrolled subjects. The cause of the high prevalence of autoantibodies is still unclear. Further studies are needed to elucidate whether this phenomenon might have a role in the development of metabolic disturbances in late adulthood.

Adult↗
PubMed2004

Placental transport of leucine in a porcine model of low birth weight.

Low birth weight is a major factor in neonatal morbidity and mortality in humans and domestic species and is a predictor of physiological disorders in adulthood. This study utilised the naturally occurring variation in pig fetal size within a uterus to test the hypothesis that placental amino acid transport capability is associated with fetal growth. Leucine uptake by trophoblast vesicles prepared from placentas supplying an average-sized fetus and the smallest fetus in the uterus was assessed. On days 45 and 65 of gestation, uptake of leucine by the porcine placenta was predominantly sodium independent and was inhibited by the non-metabolised leucine analogue 2-amino-2-norbornane-carboxylic acid, indicating that uptake occurs via system L. By day 100 the uptake of leucine by placentas supplying average-sized fetuses had changed from being predominantly sodium independent to involving both sodium-dependent (system B0) and -independent (system L) pathways. This change was not seen in placentas supplying the smallest fetus, which continued to display predominantly sodium-independent uptake. In conclusion, these data show gestational- and fetal size-dependent changes in the transport of leucine across the porcine placenta.

Animals↗
PubMed1998

[Level of stress during pregnancy estimated by mothers and average weight of newborns and frequency of low birth weight].

Low birth weight is still important health problem in many countries. Children's low birth weight increases mortality, injures central nervous system, somatic, interferes with intellectual and emotional development. Low birth weight is frequently occurring in Poland--between 7-9% of live births. There are many risk factors, among them behavioural and environmental. In Poland an attention was put on chemical and physical environmental factors. Behavioural factors (stress) are disregarded. In the present paper it was decided to check the relationship between stress during pregnancy (estimated by pregnant), child birth weight and frequency of low birth weight. The research was carried out by use of a questionnaire using the "case-control study". In the research were involved 450 mothers of new-born children (the group of cases: untimely, premature delivery or child birth weight below 2500 g) and 450 mothers of new-born children (control group-physiologically delivered). Mothers were asked about their relations to the pregnancy; professional and personal stress during pregnancy was estimated. The results were analysed by counting risk ratio coefficient (RR) and correlation coefficient. The research showed, that there is no relation between acceptation of pregnancy, stress and frequency of low birth weight or the average child birth weight. The researches didn't prove unfavourable influence of stress reaction caused by professional and personal stressors on intrauterine foetus development.

Birth Weight↗
PubMed1997

The relationship between maternal weight gain in pregnancy, hemoglobin level, stature, antenatal attendance and low birth weight.

Low birth weight (birth weight less 2,500 g) remains a major public health problem in many communities. Five hundred and twenty-eight (528) consecutive singleton maternities delivered at the Armed Forces Hospital Tabuk, northwest Saudi Arabia were studied to identify the relationship between prenatal weight gain, maternal hemoglobin at delivery, maternal stature, antenatal clinic attendance and low birth weight (LBW). Of the total number, 9.5% (50/528) babies were of low birth weight, 56% of which were preterm while 44% were term and small for gestational age, resembling the pattern observed in developed countries rather than developing countries. Mothers who delivered LBW babies gained significantly less weight in the 3rd trimester and last 4 weeks of term pregnancy when compared with controls who had normal weight babies (NW > or = 2,500 g) who were delivered in the study period (t = 4.06, p < 0.0001, t = 3.7, p < 0.001). There was no significant difference in the prenatal weight gain in the second trimester for the two groups of mothers (p = 0.53). Mothers with LBW babies also had significantly lower Body Mass Index (BMI) at onset of pregnancy (t = 3.8, p = 0.001) and were shorter in height (t = 2.12, p < 0.03). Mothers who delivered preterm LBW babies had significantly lower hemoglobin levels at delivery when compared with those who had NW deliveries (p < 0.002). There was no difference in hemoglobin levels of mothers who had LBW babies at term and those with NW at term (p = 0.72). For this community, it is suggested that to reduce the LBW baby rate and improve birth weight, anemia must be prevented in pregnancy; attention needs to be paid to weight gained in the third trimester and the last 4 weeks of pregnancy encouraging antenatal clinic attendance, and improving the nutritional status of female children so that optimal height is achieved by the age of reproduction.

Birth Weight↗
PubMed2006

Targeted short-term fluconazole prophylaxis among very low birth weight and extremely low birth weight infants.

OBJECTIVES: To assess whether targeted short-term fluconazole prophylaxis reduces late-onset (>3 days of age) invasive fungal infection (IFI) among very low birth weight infants and extremely low birth weight (ELBW) infants and to assess mortality rates, toxicity, and costs associated with this intervention. METHODS: An observational study of 2 subsequent epochs of inborn infants with birth weight of <1500 g or gestational age of <32 weeks, 1 before (control) and 1 after (fluconazole) initiation of routine targeted fluconazole prophylaxis in March 2003, was performed. Targeted fluconazole (3 mg/kg) prophylaxis was administered to infants for whom a decision was made to administer broad-spectrum antibiotics for >3 days. RESULTS: IFI was observed for 13 (6.3%) of 206 infants in the control epoch and 2 (1.1%) of 178 in the fluconazole epoch, with a common odds ratio of 0.166. Logistic regression analysis taking into account all published factors (except for fungal colonization) showed that the fluconazole epoch was associated significantly with lower IFI rates. We observed no change in late (>3 days) mortality rates (11 of 206 infants in the control epoch vs 8 of 178 infants in the prophylaxis epoch). The mortality rate for ELBW infants with IFI was low (15%) in our study. Fluconazole was administered to 81% of ELBW infants, who received a median of 8 doses, and 41% of larger infants, who received a median of 5 doses. The intervention was cost-effective, and the effective number needed to treat to prevent 1 IFI was 10. CONCLUSIONS: This study suggests that targeted short-course fluconazole prophylaxis in very low birth weight and ELBW infants may be efficacious and cost effective.

Antibiotic Prophylaxis↗
PubMed2002

Measuring functional outcomes after prematurity: developmental impact of very low birth weight and extremely low birth weight status on childhood disability.

Our purpose was to describe functional outcomes in essential activities in preschool, school-age, and adolescent children who were born very (<32 weeks gestation) and extremely (<28 weeks gestation) prematurely. Very low birth weight (VLBW; 1000-1499 g), or extremely low birth weight (ELBW;<1000 g) populations are the focus of our analysis. We describe models of disablement and enablement for specifying the complexity of childhood outcomes using a framework of pathophysiology, impairment, functional limitation and functional strengths, disability in social roles and social participation, societal limitations and environmental facilitators. Representative early childhood, preschool, school-age, and adolescent studies were examined in terms of describing children's functional strengths and challenges after VLBW and ELBW survival. In early childhood, disability was assessed by diagnosing neurosensory impairments and delays on developmental testing. Instruments for measuring functional status in essential activities of self-care, mobility, communication and learning are described. Rates of neurosensory disability in the first three years among recent ELBW survivors ranged from 9-26% for cerebral palsy, 1-15% for blindness, 0-9% for deafness, and 6-42% for evolving cognitive disability (MDI <70). Rates of preschool functional limitation were 5-27% motor, 5-30% self-care, and 5-22% communicative. Rates of school-age functional educational disabilities exceeded 50%. Rates of adolescent activity limitation were 13-32% and vocational limitations were 27-71%. By examining the functional strengths and challenges of children with major neurodevelopmental impairments after very or extremely preterm birth, we can examine causal pathways that lessen the risk of severe functional disability. Among children with mild to moderate disability, we can enhance functional outcomes, optimize community participation, and provide quality family supports. In order to assess the changing outcomes of this vulnerable population of survivors, combinations of clinical and survey based methodologies are required.

Achievement↗
PubMed2002

[Resuscitation in very low birth weight and extremely low birth weight newborns in the delivery room].

THE AIM: Of the study is to discuss the need of delivery room cardio-pulmonal resuscitation (DR-CPR) in VLBW and ELBW infants and intensity, to determine its prognostic significance for the neonatal outcomes, and the influence of some perinatal criteria. MATERIALS AND METHODS: A retrospective study is performed in University Maternity Hospital: Maichin Dom", for the years 1998-1999 including: 61 ELBW (500-999 g) and 122 VLBW (1000-1499 g). Excluded are infants with great malformations. RESULTS: There were 54% survivors in the ELBW and 86.1% in the VLBW group. 1-st min Apgar scores were significantly lower in the ELBW-group 3.5 +/- 1.9 in comparison to the VLBW: 4.9 +/- 1.9 = pH from umbilical artery were lower too: 7.19 +/- 0.16 and 7.24 +/- 0.14 respectively. From 12 ELBW babies with cord arterial pH < 7.1 survived only 3, but all 3 with pH < 7.0 died; 8 from 10 VLBW babies with pH < 7.1 survived. Intubation rates were as followed: ELBW group--82%, 70% in the first 5 min; VLBW group--57% and 34% respectively. Adrenalin and/or chest compression received 6 ELBW infants, 5 of who died and 4 had severe IVH. The same resuscitation received 8 VLBW babies, 4 of who died and 2 survivors had 3-4 grade IVH. Any grade of IVH occurred in 65% of ELBW and in 44% of VLBW infants. Severe IVH was seen in 37% and 16% respectively. Overall, survivors with grade 3-4 IVH were 15% among the ELBW group and 7.6% among the VLBW. CONCLUSIONS: Birth weight and gestational age are the most important factors, determining the intensity of DR-CPR and the prognosis in newborns of < 1500 g. Low Apgar scores, cord arterial pH < 7.10, the need of Adrenaline application and/or chest compression by DR-CPR are reliable prognostic criteria for death and poor nevrodevelopmental outcome.

Cardiopulmonary Resuscitation↗
PubMed2002

[Non-invasive mandatory ventilation in extremely low birth weight and very low birth weight newborns with failed respiration].

Early extubation of ELBW and VLBW premature infants treated with IMV results in decreased incidence of tracheal and laryngeal injury, lowers the risk of nosocomial infection, decreases the severity and frequency of bronchopulmonary dysplasia (BPD). Due to prematurity this group of patients is especially susceptible to extubation failure because of apnoe, hypoventilation and atelectasis. In clinical practice attempt was made to provide adequate noninvasive ventilation by the use of nasal intermittent mandatory ventilation in the case of apnoe of prematurity. Advantages of noninvasive nasal IMV oppose the risk of stomach distension and regurgitation due to high tension of pylorus combined with inadequate cardia tension. The aim of study was the evaluation of noninvasive nasal IMV effectiveness along with a risk of abdominal distension caused by air trapping. 32 patients were examined during one year of studies. In all but one the use of nasal intermittent mandatory ventilation resulted in decreased incidence of apnoe of prematurity. Satisfactory levels of SaO2 and pCO2 were achieved without endotracheal tube placement, avoiding the risks of nosocomial pneumonia and bronchopulmonary dysplasia.

Humans↗
PubMedDate not supplied

Glutamine supplementation for low-birth-weight and very low-birth-weight infants.

Glutamine is a conditionally essential amino acid for low-birth-weight (LBW) and very low-birth-weight (VLBW) infants by virtue of its ability to serve as a primary respiratory fuel for proliferating cells, a carrier of nitrogen between tissues, maintain acid-base balance, promote the growth and integrity of the gastrointestinal tract and promote immunologic responses. While adults can synthesize glutamine in the muscles and brain to meet essential requirements under normal state of health, the LBW and VLBW infants may not be able to do so since the enzymes (glutamine synthetase and glutaminase) activities are low. In addition, these infants are under stress due to conditions like the respiratory distress syndrome, acid-base imbalances, infections, and inadequate immunologic responses. Current amino acid mixtures and formula preparations are inadequate to meet the needs of these infants for this amino acid. Thus supplementation of parenteral and enteral nutrition with glutamine would be beneficial.

Dietary Supplements↗
PubMed2004

The changes in the mortality rates of low birth weight infant and very low birth weight infant in Korea over the past 40 years.

Total 36 reports on the mortality rates (MRs) of low birth weight infants (LBWI) and very LBWI (VLBWI) in Korea from the 1967 through 2001 were analyzed. We compared the changes in the MR by 5 and 10-yr interval. The MRs observed by 5-yr intervals from the early 1960s through the 1990s have drastically decreased. The MRs of LBWI are as follows: 23.1% and 23.6% in the 1960s, 17.3% and 16.8% in the 1970s, 14.1% and 14.4% in the 1980s, and 8.1% in the early 1990s. The MRs of VLBWI have also fallen and were reported as follows: 68.2% and 63.7% in the 1960s, 55.8% and 57.6% in the 1970s, 56.2% and 48.1% in the 1980s, 33.5% and 24.5% in the 1990s, and 11.7% in the early 2000s. In every 10-yr period, the MRs of LBWI have decreased from 23.4% in 1960, to 17.0% in 1970, to 14.2% in 1980, and to 8.1% in 1990. The MRs of VLBWI also have decreased from 66.2% in 1960, to 56.7% in 1970, to 50.8% in 1980, to 32.9% in 1990, and to 11.7% in 2000. The MR of LBWI and VLBWI has gone down remarkably due to improvements in neonatology in Korea as shown above.

Humans↗