Relationship Between Periventricular Intraparenchymal Echodensities and Germinal Matrix-Intraventricular Hemorrhage in the Very Low Birth Weight Neonate

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 474-480 ◽  
Author(s):  
Jeffrey M. Perlman ◽  
Nancy Rollins ◽  
Dennis Burns ◽  
Rick Risser
Keyword(s):  
Birth Weight ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Germinal Matrix ◽  
Birth Weight Neonate ◽  
Group 3 ◽  
Surfactant Administration ◽  
Group 2 ◽  
Emergent Cesarean Section ◽  
Group 1

The pathogenesis of the periventricular intraparenchymal echodense lesion (IPE) observed in association with germinal matrix-intraventricular hemorrhage (GM-IVH) in premature neonates is unclear. The objectives of this study were to determine (1) the temporal characteristics of GM-IVH and IPE, (2) the basic characteristics of the IPE, and (3) the relationship of clinical events, including surfactant administration, to IPE. One hundred twenty-four neonates of less than 1250 g birth weight were prospectively evaluated. IPE was defined as an echodensity greater than 1 cm in diameter by cranial sonography. Fifteen (12%) neonates developed IPE in association with GM-IVH (group 1); 33 neonates developed GM-IVH only (group 2) and 76 neonates without GM-IVH served as comparison group (group 3). IPE was essentially an asymmetrical lesion; both sides of cerebrum were equally affected. The lesion was diffuse in 9 neonates and focal in 5. IPE occurred both early, at 36 hours or before (n = 8), and later, ie, between 48 and 96 hours (n = 6). In one neonate IPE was diagnosed at autopsy. GM-IVH and IPE were noted simultaneously in neonate with the earlier onset IPE (diagnosed within 36 hours); GM-IVH preceded the IPE by 6 to 48 hours when the lesion was of a later onset. Surfactant was administered to 13 (87%) group 1, 24 (73%) group 2, and 35 (46%) group 3 neonates. Pulmonary hemorrhage developed in 9 (60%) of group 1, 3 (9%) group 2, and no group 3 neonates. Symptomatic patent ductus arteriosus occurred in 12 (75%) group 1, 15 (45%) group 2, and 15 (20%) group 3 neonates. The onset of symptoms associated with patent ductus arteriosus was earlier in group 1 vs group 2 or group 3 neonates, ie, 70 vs 172 hours. Nine (60%) group 1 neonates, 6 (18%) group 2, and 5 (7%) group 3 neonates died. The cranial sonogram was markedly abnormal in all 6 group 1 survivors. Stepwise polytomous logistic regression indicated that birth weight, gestational age, and emergent cesarean section were the best predictors of GM-IVH + IPE. These data indicate that (1) the large IPE observed with GM-IVH remains a major problem of the very low birth weight neonate, despite surfactant administration; (2) complications during labor that lead to emergent cesarean section appear to increase the risk for IPE; and (3) IPE was frequently associated with PH, but the precise mechanism(s) that link these two lesions are unclear. Attempts at prevention of IPE need to consider both perinatal and postnatal provocative factors.

scholarly journals Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Liu ◽  
Jing Li ◽  
Wanyu Zhang ◽  
Yihong Guo
Keyword(s):  
Birth Weight ◽  
Ovarian Stimulation ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
The Impact ◽  
Ivf Et ◽  
Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

Macrosomic Newborns Delivered at Term after Labor among Nondiabetic Women: Maternal and Neonatal Morbidities

2019 ◽  
Author(s):  
Han-Yang Chen ◽  
Suneet P. Chauhan
Keyword(s):  
Birth Weight ◽  
Birth Certificate ◽  
Adverse Outcomes ◽  
Adjusted Risk ◽  
Live Births ◽  
Adjusted Risk Ratio ◽  
Group 3 ◽  
Group 2 ◽  
Weight Groups ◽  
Group 1

Abstract Objective This study aimed to compare morbidities among nonmacrosomic versus macrosomic singleton live births of nondiabetic women who labored. Study Design This retrospective study utilized the 2003 revision of U.S. birth certificate data of singleton live births (2011–2013) at 37 to 41 weeks who labored. The primary outcomes were composite maternal and neonatal morbidities (CMM and CNM, respectively). We compared these outcomes by birth weight, 2,500 to 3,999 g (group 1; reference), 4,000 to 4,449 g (group 2), and 4,500 to 5,999 g (group 3). We used multivariable Poisson regression analyses to examine the association between birth weight groups and the outcomes. Results Among 6,691,338 live births, 92.0% were in group 1, 7.1% in group 2, and 0.9% in group 3. The overall CMM and CNM rates were 4.4 and 6.8 per 1,000 live births, respectively. Compared with group 1, the risk of CMM was significantly higher in group 2 (adjusted risk ratio [aRR] = 1.50; 95% confidence interval [CI]: 1.44–1.56) and group 3 (aRR = 2.00; 95% CI: 1.82–2.19). Likewise, the risk of CNM was significantly higher in group 2 (aRR = 1.38; 95% CI: 1.33–1.43) and group 3 (aRR = 2.57; 95% CI: 2.40–2.75) than in group 1. Conclusion Nondiabetic women who labor with a macrosomic newborns have a significantly higher rate of adverse outcomes than nonmacrosomic.

Outcomes among preterm infants with patent ductus arteriosus: Relationship with treatment, gestational age, hemodynamic status and timing of treatment

2021 ◽  
pp. 1-9
Author(s):  
S.M. Chikkabyrappa ◽  
N. Chaudhary ◽  
A. Agarwal ◽  
D. Rastogi ◽  
P. Filipov ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Retrospective Case ◽  
Chi Square ◽  
Hemodynamic Status ◽  
Group 3 ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

BACKGROUND: There remains controversy regarding the outcomes resulting from treatment versus conservative management of patent ductus arteriosus (PDA) among preterm infants. The effects of extreme prematurity, hemodynamic status of the PDA, and age at treatment remain poorly defined. STUDY DESIGN: This retrospective case-control study including infants <  1250 gm who were categorized into 3 groups: Group 1: without PDA, Group 2: with untreated PDA, and Group 3: treated PDA. Diagnosis and treatment of PDA extracted from the medical records. Demographics, clinical characteristics, and outcomes compared using chi-square and analysis of variance. Logistic regression used to estimate adjusted odds ratios. RESULTS: The study included 734 infants, with 141(19%) in Group 1, 329 (45%) in 2, and 264 (36%) in 3. Group 3 had higher incidence of bronchopulmonary dysplasia (BPD) (aOR, 2.9; 95%CI 1.7–4.8). Infant treated for hemodynamically significant PDA (HSPDA) had higher incidence of BPD (aOR, 1.9; 95%CI 1.0–3.8) and retinopathy of prematurity (ROP) (aOR, 3.4; 95%CI 1.6–6.9). There were no differences in outcome associated with treatment among≤26 weeks gestation and the age when treated. CONCLUSION: Infants with PDA who were treated had higher incidence of BPD. Among those who were treated, those with HSPDA had a higher incidence of BPD and ROP.

Persistently Low Blood Retinol Levels During and After Parenteral Feeding of Very Low Birth Weight Infants: Examination of Losses Into Intravenous Administration Sets and a Method of Prevention by Addition to a Lipid Emulsion

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 894-900
Author(s):  
Harry L. Greene ◽  
Barry L. Phillips ◽  
Linda Franck ◽  
Capri Mara Fillmore ◽  
Hamid M. Said ◽  
...  
Keyword(s):  
Birth Weight ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Enteral Feeding ◽  
Very Low Birth Weight ◽  
Serum Retinol ◽  
Low Birth Weight Infants ◽  
Group 2 ◽  
Low Serum ◽  
Group 1

Very low birth weight infants have little storage of hepatic retinol and are, therefore, highly dependent upon an exogenous supply. The recent association between low serum retinol level and bronchopulmonary dysplasia and the persistently low serum levels of retinol during total parenteral nutrition prompted a prospective study to evaluate serial changes in serum retinol levels during 1 month of total parenteral nutrition (retinol dose 455 µg/d) and again during 1 month of total enteral feeding (retinol dose 200 to 300 µg/d) in the same infants. Infants were divided into two groups. Group 1 consisted of infants weighing less than 1,000 g (n = 24) and group 2 consisted of infants weighing 1,000 to 1,500 g (n = 17). Although initial mean levels of retinol were similar in both groups (14.8 ± 0.9 and 13.5 ± 0.7 µg/dL), there was wide variation between infants. In group 1 infants, there was a significant (P &lt; .01) decline in retinol level by the second week of life (to 9.2 ± 1 µg/dL), which persisted during total parenteral nutrition, but increased to 13.4 ± 2 after 1 week of enthral feeding. This level was maintained throughout enteral feeding. In group 2 infants, there was no significant change in serum retinol level throughout the study. During total parenteral nutrition, several infants had retinol levels below 10 µg/dL, a level associated with signs of retinol deficiency in older children. Because losses of retinol are known to occur in smaller volume total parenteral nutrition solutions, it was speculated that losses of retinol in our patients were due to retinol losses in the total parenteral nutrition delivery system. Because lipid might prevent these losses, in vitro studies were done to compare retinol losses in total parenteral nutrition v the usual daily dose of Intralipid. Results indicated 80% loss of retinol in total parenteral nutrition compared to only 10% loss in Intralipid. Lipid stability, as monitored by light microscopy and laser light scatter, indicated no changes in the stability of the lipid particles with the addition of the vitamin.

Plasma concentrations of insulin-like growth factor-I and insulin in the infant calf: ontogeny and influence of altered nutrition

1988 ◽  
Vol 119 (1) ◽  
pp. 43-50 ◽  
Author(s):  
B. H. Breier ◽  
P. D. Gluckman ◽  
J. J. Bass
Keyword(s):  
Birth Weight ◽  
Growth Factor ◽  
Plasma Insulin ◽  
Plasma Concentrations ◽  
Factor I ◽  
Igf I ◽  
Group 3 ◽  
Group 2 ◽  
Milk Feeding ◽  
Group 1

ABSTRACT The developmental pattern of plasma insulin-like growth factor-I (IGF-I) and insulin in calves subject to different patterns of weaning was investigated from birth until the age of 6 months. Fifteen male Friesian calves were fed on whole milk (10% of body weight per day) for the first 8 weeks after birth, then allocated into three balanced groups. Group 1 was weaned at 8 weeks; group 2 was weaned at 8 weeks, returned to milk-feeding at 13 weeks to be weaned again at the age of 16 weeks; group 3 was weaned at 12 weeks. After weaning the calves were fed on concentrates and lucerne hay. At birth, circulating concentrations of IGF-I correlated with birth weight (r = 0·78, P< 0·001). There was a significant (P<0·001) fall in plasma IGF-I from birth (40·3 ± 2·5 μg/l) until 5 weeks (23·8± 1·3 μg/l), and then a gradual (P<0·01) rise until week 8 (35·0 ± 2·2 μg/l). Weaning (groups 1 and 2 after week 8) caused a significant (P<0·01) decrease in plasma IGF-I (20·5 ± 1·9 μg/l); thereafter plasma levels of IGF-I rose gradually (P<0·01) in animals fed on concentrates. The milk-fed calves (group 3) showed a progressive increase in plasma IGF-I with age until they were weaned at 12 weeks (51·0 ± 3·4 μg/l); IGF-I levels then decreased to be similar to group 1 (32·5 ± 2·1 μg/l). When group 2 was returned to milk-feeding, plasma IGF-I concentrations increased to 58·2 ±3·8 μg/l within 4 days and then continued to rise gradually until decreasing upon weaning. The age-related increase in the plasma concentration of IGF-I after 6 weeks was parallel in milk- and concentrate-fed calves. Binding of 125I-labelled bovine GH to hepatic membranes of neonatal calves was low at birth (specific binding; 1·56 ±0·29% n=3). Somatotrophic binding was apparent at 6 weeks (6·43 ±0·42%, n = 3) and increased (9·2± 1·1%, n=3) at the age of 12 weeks. Thus the early postnatal changes in plasma IGF-I may reflect the transition from GH-independent to GH-dependent IGF-I secretion. Plasma concentrations of insulin at birth correlated with IGF-I (r = 0·54, P<0·05). However, regression analysis suggested no effect of insulin on birth weight independent of IGF-I. Plasma insulin levels rose gradually until weaning and thereafter were significantly (P<0·01) higher in the milk- than concentratefed calves. Major changes in plasma concentrations of IGF-I related to monogastric (milk feeding) or ruminant (concentrate feeding) nutrition of the young calf are demonstrated. They may be mediated through changing plasma insulin concentrations. An age-dependent prepubertal rise in plasma IGF-I apparently independent of nutritional factors commenced with the appearance of functional somatotrophic receptors in the liver. J. Endocr. (1988) 119, 43–50

Surgical Closure of Patent Ductus Arteriosus in Infants Weighing Less than 2.5kg

1995 ◽  
Vol 3 (1) ◽  
pp. 13-15
Author(s):  
Somboon Boonkasem ◽  
Boonchob Pongpanich ◽  
Anant Tejavei
Keyword(s):  
Heart Failure ◽  
Birth Weight ◽  
Renal Insufficiency ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Surgical Closure ◽  
Group 2 ◽  
Patent Ductus ◽  
Group 1

Persistent heart failure is a major problem in low birth weight infants with patent ductus arteriosus (PDA). There is a considerable incidence of renal insufficiency and reopening of the ductus after pharmacologic closure. Surgical closure of symptomatic PDA should therefore be indicated to avoid morbidity or mortality from heart failure and renal failure. Between March 1990 and December 1993 there were 33 low birth weight infants who underwent surgical closure of PDA, ranging in age from 5 to 90 days (mean = 25) with 15 males and 18 females (M:F = 1:1.2). The patients were classified into 3 groups: group 1 (< 1000gm) 11 cases, group 2 (1000-1499gm) 10 cases, group 3 (1500-2499gm) 12 cases. The indications for surgical closure of PDA included: persistent heart failure in 28, renal insufficiency in 20, reopening of the ductus after pharmacologic closure in 16 and growth failure in 1. The early mortality was 6% (2/33). Both of them were in group 1: one from necrotizing enterocolitis (NEC), and one from cytomegalovirus (CMV) infection on the 6th and 20th postoperative day respectively. Late death occurred twice: the first case in group 1 from sepsis 35 days postoperatively, and the second in group 2 from pneumonia 3 months after surgery. The causes of late mortality in both cases were not related to surgery. The 29 survivors are doing reasonably well during follow-up period.

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