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1.
Neonatal neutropenia associated with maternal hypertension poses a risk for nosocomial infection 总被引:2,自引:0,他引:2
One hundred and six neonates of 24–32 weeks gestation born to hypertensive mothers and 106 concurrent control infants of
normotensive mothers were evaluated to determine the relationship between maternal hypertension and neonatal neutropenia and
the risk of nosocomial infection developing in neutropenic infants.. Complete blood counts were performed on both cohorts
and retrospectively evaluated. Neutropenia was diagnosed using published reference ranges for infants with birth weight ≤1500 g
and >1500 g. Evidence of nosocomial infection based on a positive blood culture with supportive clinical signs of sepsis was
documented. The incidence of neutropenia among infants of hypertensive mothers was not significantly different from that among
infants of normotensive mothers (21% vs 24%), but the duration of neutropenia was significantly longer in the infants of hypertensive
mothers (P = 0.0001). Nosocomial infection was more frequent in neutropenic than the non-neutropenic hypertensive mothers' infants (55%
vs 12%, P = 0.0002).
Conclusion Although there is no difference in the incidence of neonatal neutropenia between infants of hypertensive mothers and those
of normotensive mothers, the former group has an increased risk of nosocomial infection in neutropenic infants of hypertensive
mothers. This may be related to prolonged neutropenia which was found in these infants in the present study.
Received: 24 August 1997 and in revised form: 30 March 1998 / Accepted: 1 April 1998 相似文献
2.
The study concentrates on estimating the magnitude of the effect of a single risk factor, maximum total serum bilirubin (TSB)
in excess of 400 μmol/l (23.4 mg/dl), on the neurodevelopmental outcome of 50, singleton, Zimbabwean neonates at 1 year of
age. At 1 year corrected age the Bayley Scales of Infant Development (BSID) was administered. Two infants died and five were
lost to follow up. TSB was neither associated with birth weight nor with gestational age. Of 43 infants with a TSB >400 μmol/l
(23.4 mg/dl),11(26%) scored abnormal on the BSID at 1 year of age and 5 (12%) infants developed the choreo-athetoid type of
cerebral palsy.
Conclusion Infants with bilirubin levels between 400 and 500 μmol/l (23.4 and 29.2 mg/dl) who scored abnormal or suspect on the Bayley
Scales of Infant Development were preterm or had haemolytic disease. All term infants without haemolysis and with bilirubin
levels between 400 and 500 μmol/l (23.4 mg/dl–29.2 mg/dl) were normal at 1 year of age.
Received: 19 February 1998 / Accepted: 22 June 1998 相似文献
3.
Gunes T Koklu E Yikilmaz A Ozturk MA Akcakus M Kurtoglu S Coskun A Koklu S 《European journal of pediatrics》2007,166(10):1039-1044
Epidemiological studies have reported associations between a range of cardiovascular risk factors such as smoking and intima-media
thickness (IMT). Some reports indicate that the maternal tobacco smoking causes disturbances of the endocrine status of the
foetus. There are several potential mechanisms by which insulin-like growth factor I (IGF-I) could modify atherosclerotic
processes either locally or in a systemic manner. The aim of this study was to investigate the influence of maternal smoking
on neonatal aortic IMT (aIMT), serum IGF-I and IGF-binding protein-3 (IGFBP-3) levels. Aortic intima-media thickness was measured
in 28 neonates whose mothers smoked during the pregnancy and 28 control neonates. Mean and weight-adjusted aIMT were significantly
greater in the neonates whose mothers smoked (0.455 ± 0.009 mm and 0.151 ± 0.005 mm/kg, respectively) than in controls (0.403 ± 0.029 mm
and 0.118 ± 0.014 mm/kg, respectively). Birth-weight of newborns whose mothers smoked was less than that of the controls.
The decreases in serum IGF-I and IGFBP-3 observed in the infants whose mothers smoked were non-significant. Mean aIMT was
negatively associated with birth-weight and IGF-I level. In conclusion, neonates whose mothers smoked have significantly increased
aIMT. It might play a role in the pathogenesis of atherosclerosis in adult life. 相似文献
4.
Vossbeck S de Camargo OK Grab D Bode H Pohlandt F 《European journal of pediatrics》2001,160(2):128-134
The objective of our study was to examine the outcome of infants born at a gestational age <30 weeks with absent or reversed
end-diastolic flow velocity (AREDFV) in the umbilical artery in comparison with gestational age-matched eutrophic controls.
A group of 40 infants who had AREDFV were matched for gestational age and date of birth with 40 appropriate for gestational
age infants. Perinatal outcome variables were retrospectively reviewed. In 16 out of the 40 matched pairs, a standardized
neurological examination was done and, depending on age, the Kaufman Assessment Battery for Children or the Bayley Scales
of Infant Development were applied at a corrected age of 13 to 100 months to assess neurodevelopmental outcome. The results
were compared using Fisher's Exact Test or Mann Whitney U Tests as appropriate. In the AREDFV group, 26/40 (65%) survived
until discharge compared to 39/40 (97.5%) in the control group (P < 0.001). AREDFV was associated with a higher rate of chronic lung disease, retinopathy of prematurity ≥ grade III and impaired
intestinal motility. More AREDFV infants suffered from permanent neurological sequelae compared with control infants: 44%
versus 25% were mentally retarded (P=0.033), and 38% versus 19% showed severe motor impairment (P=0.073).
Conclusion Absent or reversed end-diastolic flow velocity is not only associated with a higher mortality and morbidity during the neonatal
period, but the surviving infants of this high risk group have an increased risk for mental retardation and severe motor impairment
as compared with appropriate for gestational age preterm infants of the same gestational age.
Received: 24 July 2000 and in revised form: 25 September 2000 / Accepted: 26 September 2000 相似文献
5.
Nagapoornima P Ramesh A;Srilakshmi Rao S Patricia PL Gore M Dominic M;Swarnarekha 《Indian journal of pediatrics》2007,74(6):545-549
Objective To determine the weighted incidence of hearing impairment in a standardized population of at risk and not at risk neonates
seeking care at a tertiary level hospital in India.
Methods A prospective study of a nonrandomized cohort of 1769 neonates (1490: Not at risk; 279: At risk) from a total of 8192 neonates
(6509: Not at risk; 1683: At risk) who sought care at St John’s medical College hospital from 1st September 2002 to 31st March 2006 were screened for hearing impairment using transient evoked otoacoustic emissions. Weighting was performed using
the expected value of 10 % at risk and 90 % not at risk infants in a typical tertiary care level center in India derived from
the National Neonatology and Perinatology database 2002–2003. Z test and 95 % confidence interval was used to determine the
external validity of the results. P less than 0.05 was considered as statistically significant. The power of the study is
90 %.
Results The incidence of hearing impairment in infants screened was 10 per 1769 infants screened (1490: Not at risk; 279: At risk)
which is 5.65 per 1000 screened. 279 at risk infants were screened and 3 were detected to have hearing impairment which is
an incidence of approximately 10.75 per 1000 screened. Of the 1490 not at risk infants screened 7 had hearing impairment that
is 4.70 per 1000 screened. If this was extrapolated to a standardized population consisting of 10 % at risk and 90 % not at
risk then the incidence would be 5.60 per 1000 screened with a 95 % confidence interval of 4.13–7.06. This narrow 95 % confidence
interval with a p equal to 0.001 indicates that this value may be close to the caseload in a typical tertiary care center.
Conclusion In this study the incidence of hearing impairment is 3 per 279 in at risk infants screened and 7 per 1490 in not at risk infants
screened. The weighted incidence in a standardized population of neonates seeking care at tertiary level center in India is
5.60 per 1000 as per this study. This high incidence calls for all pediatricians to consider incorporating a basic hearing
screen for all the neonates using cost effective and appropriate technology. Initial screening may be performed using behavioral
observation techniques and confirmation by otoacoustic emissions. 相似文献
6.
N. G. Beratis A. Varvarigou M. Christophidou P. Vassilakos V. Tsapanos G. Kourounis 《European journal of pediatrics》1999,158(7):583-588
To investigate the toxic effect of tobacco smoke on the fetus, we measured in cord blood the concentrations of α-fetoprotein
(AFP), the principal serum protein in early ontogenic development, and erythropoietin (EPO), as an index of chronic fetal
hypoxia. A total of 103 consecutively enrolled term newborns of smoking mothers and 103 term infants of nonsmoking parents
were studied. The mean ± SD AFP concentrations in the newborns of the mothers who smoked 1–50, 5–50, and 10–50 cigarettes/day
were 86.4 ± 88.9, 96.3 ± 91.9 and 118.7 ± 103.7 ng/ml, respectively. The difference of all three groups from the control neonates
(57.7 ± 37.2) was significant. The EPO concentrations in the newborns of the mothers who smoked 1–50 (53.9 ± 64.6 mU/ml) and
5–50 (56.3 ± 68.5) cigarettes/day were significantly greater than in the control neonates (29.5 ± 16.1). In the newborns of
the smoking mothers there was a significant positive correlation between AFP concentrations and number of cigarettes smoked
per day, and a negative correlation between AFP and birth weight or length. There was no correlation between AFP and EPO concentrations,
as well as between EPO and birth weight, length or number of cigarettes smoked per day.
Conclusion The absence of a correlation between erythropoietin and birth weight or length and the negative correlations between α-fetoprotein
and these anthropometric parameters suggest that the intra-uterine growth retardation caused by maternal smoking is not due
to tissue hypoxia, but that both growth retardation and elevated α-fetoprotein result from the direct or indirect toxic effect
of a factor(s) present in tobacco smoke.
Received: 22 June 1998 / Accepted in revised form: 17 November 1998 相似文献
7.
A prospective study was undertaken to characterize the rate of increase, time of peak values and rates of decrease in serum
concentrations of C-reactive protein (CRP) in a group of infants treated for neonatal bacterial infection. A total of 176
consecutively admitted neonates with birth weight >1500 g and without mechanical ventilation or central lines in situ, who
received antibiotic therapy for suspected bacterial infection, were enrolled. The changes in serum CRP concentration in 60
of 63 infants who had CRP values above 20 mg/l 24–48 h after the beginning of treatment were analysed in detail. Initial increase
rates in serum CRP levels of up to 4.5 mg/l per h were documented peak were reached at a mean of 19.5 h after antibiotic therapy
had been initiated, but in some patients an increase in serum CRP levels occurred up to 40–48 h after the beginning of treatment.
The mean serum half-life of CRP in infected neonates was 21 h (range 11.2–38 h).
Conclusion In neonates with bacterial infection (defined by a combination of clinical signs and increased C-reactive protein and immature-total
quotient values) no differences in the overall pattern nor in any of the particular phases of the C-reactive protein response
curves could be observed between neonates with positive (n = 13) or negative blood cultures (n = 47).
Received: 18 July 1997 / Accepted in revised form: 5 May 1998 相似文献
8.
T. Jahnukainen A. Lindqvist J. Jalonen P. Kero I. Välimäki 《European journal of pediatrics》1999,158(9):757-760
The present study was performed to measure the vasoregulatory reactions to dynamic changes in local skin temperature during
open bed phototherapy. Periodic thermal stimulation using warm and cool air currents was applied to the skin of ten term infants
with physiological jaundice, before and during open bed phototherapy. The reactivity of skin blood flow (SBF) and heart rate
was measured using laser Doppler flowmetry and power spectral analysis. The baseline SBF increased significantly by 70% (P = 0.008) during phototherapy without any significant change in skin or rectal temperature. Before phototherapy, the rhythmic
(0.08 Hz) thermal skin stimulation increased the oscillations of SBF (from 89 ± 26 au to 213 ± 37 au, P = 0.02) at the stimulation frequency band. This response was further increased (P = 0.03) during phototherapy (from 198 ± 54 au to 658 ± 115 au, P = 0.004). Phototherapy increased SBF in icteric otherwise healthy neonates. The cutaneous vasodilatation augments the cardiovascular
responsiveness to thermal stimulation.
Conclusions These results suggest that open bed phototherapy does not inhibit the cardiovascular responsiveness to local thermal skin
stimulation in healthy term infants.
Received: 30 March 1998 / Accepted in revised form: 10 September 1998 相似文献
9.
We compared the incidence of complications from meconium-containing gastric fluid in a group of neonates born with meconium-stained
amniotic fluid (MSAF) who did not routinely have gastric lavage prior to feeds, versus a group who had elective gastric lavage
before the first feed. In the first group, 275 neonates born with MSAF were fed without prior gastric lavage. While 13 developed
feeding problems, the other 262 infants (95%) who did not undergo routine gastric lavage remained free of later feeding difficulties
or secondary meconium aspiration. In the second group, all 227 neonates with MSAF had elective gastric lavage performed after
birth. All remained free of later feeding difficulties or secondary meconium aspiration.
Conclusion Our data suggest that gastric lavage is not necessary in most neonates born with meconium-stained amniotic fluid, regardless
of the thickness of the meconium-stained fluid, as no complications from meconium-containing gastric fluid were observed.
Received: 17 March 1998 / Accepted in revised form: 8 July 1998 相似文献
10.
A. Denjean J. Paris-Llado V. Zupan T. Debillon F. Kieffer J.-F. Magny L. Desfrères B. Llanas H. Guimaraes G. Moriette M. Voyer M. Dehan G. Breart 《European journal of pediatrics》1998,157(11):926-931
Early inflammatory lesions and bronchial hyperresponsiveness are characteristics of the respiratory distress in premature
neonates and are susceptible to aggravation by assisted ventilation. We hypothesized that treatment with inhaled salbutamol
and beclomethasone might be of clinical value in the prevention of bronchopulmonary dysplasia (BPD) in ventilator-dependent
premature neonates. The study was double-blinded and placebo controlled. We studied 173 infants of less than 31 weeks of gestational
age, who needed ventilatory support at the 10th postnatal day. They were randomised to four groups and received either placebo + placebo,
placebo + salbutamol, placebo + beclomethasone or beclomethasone + salbutomol, respectively for 28 days. The major criteria
for efficacy were: diagnosis of BPD (with score of severity), mortality, duration of ventilatory support and oxygen therapy.
The trial groups were similar with respect to age at entry (9.8–10.1 days), gestational age (27.6–27.8 weeks), birth weight
and oxygen dependence. We did not observe any significant effect of treatment on survival, diagnosis and severity of BPD,
duration of ventilatory support or oxygen therapy. For instance, the odds-ratio (95% confidence interval) for severe or moderate
BPD were 1.04 (0.52–2.06) for inhaled beclomethasone and 1.54 (0.78–3.05) for inhaled salbutamol.
Conclusion This randomised prospective trial does not support the use of treatment with inhaled beclomethasone, salbutamol or their
combination in the prevention of BPD in premature ventilated neonates.
Received: 20 November 1997 / Accepted: 2 March 1998 相似文献
11.
Chinmay Kumar Behera Jagdish Prasad Sahoo Saumya Darshana Patra Pratap Kumar Jena 《Indian journal of pediatrics》2020,87(6):427-432
To evaluate the effect of maternal/ neonatal vitamin D levels on culture positive neonatal sepsis. This prospective cohort study was conducted in the NICU of a tertiary care teaching hospital in Odisha, Eastern India from January 2015 through December 2016. Forty (40) neonates with culture positive sepsis were included in the study group. Forty (40) healthy neonates admitted for evaluation of neonatal jaundice who are similar in gender, gestational age, postnatal age and without any clinical signs of sepsis were recruited as control group after informed consent. Vitamin D level (25 OH D) was assessed in the neonates and their mothers in both the groups. Neonatal 25 OH vitamin D level in the study group (12.71 ± 2.82 ng/ml) was significantly lower than in the control group (25.46 ± 7.02 ng/ml). The Odds ratio was 273 (95% CI 30.39–2451.6) for culture positive sepsis in neonates with vitamin D deficiency/insufficiency. Mothers of septic neonates had significantly lower 25 OH vitamin D level (20.92 ± 3.92 ng/ml) than the mothers of healthy neonates in control group (27.31 ± 6.83 ng/ml). The Odds ratio was 4.71 (95% CI 1.69–13.1) for culture positive sepsis in babies born to mothers with vitamin D deficiency/insufficiency. Neonates with vitamin D deficiency/insufficiency are at higher risk for developing sepsis than those with sufficient vitamin D levels. Lower vitamin D levels in mothers is also associated with increased risk of sepsis in the neonates. 相似文献
12.
N. Linder M. Tsur J. Kuint B. German E. Birenbaum R. Mazkereth D. Lubin B. Reichman A. Barzilai 《European journal of pediatrics》1998,157(6):502-504
This prospective study was designed to assess the value of a simple clinical test, a “feeding test”, on the outcome of head
lag among term neonates. Of 5718 infants who were examined before their morning meal, 67 had moderate to severe head lag in
the absence of predisposing risk factors for head lag. Fifteen minutes following feeding, 62 infants (92%) showed an improvement
in or disappearance of head lag with concomitant rise in serum glucose. All of these infants had normal psychomotor development
on follow up. In 4 infants in whom no improvement occurred after feeding, an underlying pathological cause for head lag was
subsequently diagnosed.
Conclusion Use of the feeding test as a screening procedure in apparently healthy newborns with head lag may rule out pathological conditions
in over 90% of the cases.
Received: 18 February 1997 and in revised form: 30 September 1997 / Accepted: 2 October 1997 相似文献
13.
R. Bunikowski I. Grimmer A. Heiser B. Metze A. Schäfer M. Obladen 《European journal of pediatrics》1998,157(9):724-730
To study the developmental effects of prenatal exposure to opiates, a prospective follow up study of 34 drug-exposed (opiates
and nicotine) and 42 reference infants (nicotine exposure only) was conducted from January 1992 to September 1995. At the
time of delivery, 12 of 34 mothers used opiates without medical control. Twenty-two mothers participated in a methadone maintenance
programme. At 1 year, the average Griffiths Developmental Quotient (DQ) was lower in the drug-exposed group (mean: 100.5 vs.
references 107.9; P < 0.001). This difference was mainly due to lower subscales “locomotor” (mean 100.8 vs. 111.4; P < 0.05) and “intellectual performance” (mean 100.8 vs. 108.5; P < 0.05) in the drug-exposed group. Severe developmental retardation mean DQ (−2 SD) was diagnosed in 2 drug-exposed infants.
Mild developmental retardation (mean DQ: 1 SD– > 2 SD) was found in 7 drug-exposed and in 3 reference infants (P < 0.05). Neurological abnormalities were found more frequently in the drug-exposed group (11 vs. 3 infants; P < 0.01). Among the opiate-exposed infants, the subscales “hearing and speech” and “intellectual performance” were lower in
the uncontrolled drug-using than in the methadone group. The 17 fostered infants showed no difference in developmental outcome
compared with the 10 infants living with their biological parents (mean DQ: 100.0 versus 101.3).
Conclusions At 1 year infants prenatally exposed to opiates are at risk for mild psychomotor developmental impairment.
Received: 1 August 1997 / Accepted in revised form: 15 January 1998 相似文献
14.
T. Saarela P. Lanning M. Koivisto T. Paavilainen 《European journal of pediatrics》1999,158(8):668-672
In order to study the incidence and course of nephrocalcinosis in full-term infants with congestive heart failure receiving
long-term furosemide treatment, 36 such infants (median age 2.9 months, range 1.2–8.0) and 36 full-term control infants not
receiving any diuretics (median age 3.4 months, range 1.1–8.4) were studied by renal ultrasonography and random urine calcium
variables. The infants with nephrocalcinosis were followed at 3–6 month intervals up to 2 years of age, or until ultrasonic
resolution. Nephrocalcinosis was found in 5 out of the 36 (14%) treated infants, but in none of the controls (P = 0.03). The dose of furosemide was higher in the infants with nephrocalcinosis than in those without (1.9 ± 0.6 vs. 1.3 ± 0.4 mg/kg
per day; P = 0.01). The urinary calcium concentration was higher in the infants receiving furosemide than in& controls and a similar
trend was observed in the urinary calcium/creatinine ratio, but& these variables did not differ between the study infants
with and without nephrocalcinosis. Ultrasonic resolution of nephrocalcinosis was observed in 3 of the 5& infants at 12 months,
but in the other 2 the condition still persisted at 24 months.
Conclusions Long-term furosemide treatment in full-term infants with congestive heart failure entails a considerable risk of developing
nephrocalcinosis. Renal ultrasonography is warranted in these patients within a few months after initiation of the treatment
and in the case of nephrocalcinosis alteration of the diuretic regimen is to be considered.
Received: 8 September 1998 / Accepted in revised form: 12 January 1999 相似文献
15.
G. Dimitriou A. Greenough V. Kavvadia S. P. Devane J. M. Rennie 《European journal of pediatrics》1999,158(7):589-591
Our aim was to identify factors predictive of death in preterm infants in whom inhaled nitric oxide was administered in response
to poor oxygenation (oxygenation index ≥15). Of the 23 (median gestational age 28 weeks, range 24–36) infants consecutively
so treated, 15 died. Non-survival was commoner in infants with air leaks (12 of 12, P < 0.002) and/or a change in their oxygenation index of less than 30% in response to inhaled nitric oxide administration (P < 0.05).
Conclusion In preterm infants given inhaled nitric oxide because of poor oxygenation, a diagnosis of airleak and a lack of initial response
are predictive of death.
Received: 18 June 1998 / Accepted in revised form: 4 November 1998 相似文献
16.
Rubio AS Griffet JR Caci H Bérard E El Hayek T Boutté P 《European journal of pediatrics》2009,168(5):605-611
Postural deformities are frequent in neonates. The moulded baby syndrome (MBS) comprises one or more of the following disorders:
plagiocephaly, torticollis, congenital scoliosis, pelvic obliquity, adduction contracture of a hip and/or malpositions of
the knees or feet. We analysed the incidence of MBS in healthy neonates and identified the risk factors of its composing elements.
One thousand and one healthy neonates were examined on the second or third day of life by the same paediatrician. Familial,
obstetrical, perinatal history and putative risk factors for postural deformities were collected. Families of newborns with
a torticollis or plagiocephaly were given positioning advice and the outcome was evaluated by a phone survey 2 months later.
MBS was detected in 107 neonates (10.7%): 97 plagiocephalies or torticollis, 25 congenital scoliosis or pelvic obliquities,
and 13 malpositions of the knees or feet. We identified risk factors related to the mother (age: OR = 1.39, parity: OR = 0.643),
to the obstetrical history (preterm labour: OR = 1.65, oligoamnios: OR = 10.179, breech presentation: OR = 2.746, pregnancy
toxaemia: OR = 3.773, instrumental delivery: OR = 6.028) and to the newborn (male gender: OR = 1.982, birth length: OR = 1.196).
The initial plagiocephaly or torticollis improved in 77% of infants after 2 months of stimulation and positioning measures.
Paediatricians should be alert regarding the frequent but subtle MBS postural deformities and give positioning advice to the
parents. A neonate of male gender or greater birth length, with an older primiparous mother, a history of preterm labour,
oligoamnios or pregnancy toxaemia, a breech presentation or an assisted delivery is more likely to have MBS. 相似文献
17.
Kivivuori SM Virtanen M Raivio KO Viinikka L Siimes MA 《European journal of pediatrics》1999,158(2):147-151
The aim of this study was to compare two different doses and means of administration of iron in recombinant human erythropoietin
(rHuEPO)-treated very low birth-weight (VLBW) infants. VLBW infants (n = 41) were randomized to one of three groups. Fourteen infants were treated with rHuEPO (300 IU/kg three times a week s.c.)
and oral iron (ferrofumarate, 6 mg of iron/kg per day). Another 14 infants received the same erythropoietin dose and intramuscular
iron (ferroxypolymaltose, once 12 mg of iron/kg weekly). Thirteen infants were treated with the same dose of intramuscular
iron but did not receive rHuEPO. After the 3-week study period, haemoglobin concentrations and reticulocyte counts were similar
in the rHuEPO-treated groups and both were higher than in the group not receiving rHuEPO (P < 0.001). In both rHuEPO-treated groups the transferrin receptor concentration increased from 6.8–7.2 mg/l to 10.5–11.3 mg/l.
Conclusion In erythropoietin-treated very low birth weight infants the iron need for erythropoiesis can be met by oral administration
of iron.
Received: 17 November 1997 and in revised form: 6 March 1998 / Accepted: 30 April 1998 相似文献
18.
Böhles H Arndt S Ohlenschläger U Beeg T Gebhardt B Sewell AC 《European journal of pediatrics》1999,158(3):243-246
The enhanced transport of long-chain polyunsaturated fatty acids, in particular docosahexaenoic acid (22:6 ω-3) (DHA), to
the fetus is a placental function important for adequate membrane phospholipid formation and herewith decisive for the quality
of fetal CNS myelination. A compromised placental function is correlated with signs of vascular pathology. As elevated plasma
total homocysteine (tHcy) concentrations are considered an independent risk for premature occlusive vascular disease, the
influence of maternal plasma tHcy concentrations on placental function was indirectly studied, determining the DHA content
in erythrocyte membrane phospholipids of the newborn. A total of 60 unselected pregnant women (age range: 21 to 39 years)
were investigated at delivery. Gestational age ranged from 26 to 41 weeks. Prior to delivery a placental ultrasound scan was
performed. Complete sets of data could be obtained from 43 mothers and their offspring. tHcy concentrations were determined
in the plasma of cord and maternal blood. The fatty acid pattern of erythrocyte membrane phospholipids was determined in the
mothers and their newborns. Z-scores of the birth weights ranged from −3.4 to 2.1 and of the placental weights from −3.8 to
4.7. The mean maternal plasma tHcy concentration was 6.29 ± 3.34 μmol/l ranging from below our limit of detection up to 15 μmol/l.
These maternal concentrations were correlated with those of their infants (r = 0.71; P < 0.0001). The tHcy concentrations were significantly higher in mothers with pregnancies complicated by gestosis or placental
calcifications. The Z-scores of birth weights as well as placental weights showed a significant negative correlation with
maternal plasma tHcy concentrations. The mean DHA percentage of total fatty acids in erythrocyte phospholipids was 3.2 ± 2.2%
in the mothers and 3.4 ± 2.3% in their newborns. Most importantly the maternal plasma tHcy levels and the erythrocyte phospholipid
DHA concentrations of their offspring were significantly correlated (r = −0.51; P < 0.0003).
Conclusion In this study, total homocysteine concentrations were elevated in the plasma of pregnant women with signs of placental vasculopathy.
Maternal plasma total homocysteine concentrations were positively correlated with erythrocyte phospholipid docosahexaenoic
acid of their offspring and may be an indicator for the integrity of placental vascular function. The nutritional status as
well as predisposing genetic factors of pregnant mothers need to be investigated more thoroughly.
Received: 17 May 1998 / Accepted in revised form: 10 September 1998 相似文献
19.
Daoud AS Batieha A Al-Sheyyab M Abuekteish F Obeidat A Mahafza T 《European journal of pediatrics》1999,158(3):230-233
A clinical trial was conducted to determine whether dexamethasone as adjunctive therapy alters the outcome of bacterial meningitis
in neonates. Fifty-two full-term neonates with bacterial meningitis were enrolled in a prospective study. Infants were alternately
assigned to receive either dexamethasone or not. Twenty-seven received dexamethasone in addition to standard antibiotic treatment
and 25 received antibiotics alone. Dexamethasone therapy was started 10–15 min before the first dose of antibiotics in a dose
of 0.15 mg/kg per 6 h for 4 days. Baseline characteristics, clinical and laboratory features in the two groups were virtually
similar. Both groups showed a similar clinical response and similar frequency of mortality and sequelae. Six (22%) babies
in the treatment group died compared to 7 (28%) in the control group (P = 0.87). At follow up examinations up to the age of 2 years, 6 (30%) of dexamethasone recipients and 7 (39%) of the control
group had mild or moderate/severe neurological sequelae. Audiological sequelae were seen in two neonates in the dexamethasone
group compared to one in the control group.
Conclusion Adjunctive dexamethasone therapy does not improve the outcome of neonatal bacterial meningitis.
Received: 22 December 1997 / Accepted: 14 March 1998 相似文献
20.
Kantar M Kültürsay N Kütükçüler N Akisü M Cetingül N Caglayan S 《European journal of pediatrics》2000,159(3):156-157
Plasma granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-6 (IL-6) concentrations were determined
in 21 preterm infants with sepsis and nine healthy preterm neonates of the same postnatal age at sampling. Plasma GM-CSF levels
were elevated at diagnosis in the septic preterms as compared to the healthy preterms (P = 0.01), but did not differ significantly on recovery. IL-6 levels were also elevated markedly at diagnosis (P = 0.0003), but decreased to normal on recovery as compared to the healthy preterm infants. GM-CSF levels were more prominent
in septic preterms with neutropenia than those of non-neutropenic infants (P = 0.03).
Conclusion Preterm infants can produce high levels of granulocyte-macrophage colony-stimulating factor and interleukin-6 in response
to bacterial sepsis.
Received: 11 March 1998 / Accepted: 27 July 1999 相似文献