A simple method for the assessment of infants of diabetic mothers at birth.

Twenty-five infants of diabetic mothers were analysed over a 6-month period from three hospitals to determine the value of arm/head ratio in the identification of infants of diabetic mothers at birth. The infants were grouped according to control of maternal disease and quality of intra-uterine growth. The sensitivity and specificity of arm/head ratio in the identification of infants based on maternal control were 82 and 93 per cent, respectively. The ratio is a simple method and is suggested for routine evaluation of infants of diabetic mothers especially in developing countries.     

Echocardiographic assessment of infants born to diabetic mothers.

Echocardiography was carried out in 31 neonates (group 1) born to diabetic mothers and 37 control infants (group 2) matched for weight and gestational age. The interventricular septum was significantly thicker in group 1 babies (mean (SD) 4.77 (1.4) mm) compared with those in group 2 (2.5 (0.7) mm); in eight it was more than 5 mm, but had regressed in six over a period of three months. There was no significant difference between the two groups in the left ventricular internal dimension, right ventricular outflow tract, or size of the left atrium or the aorta. The left ventricular mass was significantly greater in infants born to diabetic mothers. The left ventricular contractility (judged by the percentage of shortening of the internal dimension and the ejection fraction) was significantly greater in group 1. No evidence of left ventricular outflow obstruction was found on pulse Doppler echocardiography in group 1.     

Small thymus in very low birth weight infants born to mothers with subclinical chorioamnionitis.

Chorioamnionitis, a major cause of preterm birth with significant neonatal morbidity and mortality, frequently occurs in mothers who are free of symptoms. A combined clinical, radiologic, and pathologic study of 129 very low birth weight infants indicated a significant association between a markedly decreased thymic size at birth and subclinical chorioamnionitis.     

Neuroimaging findings (ultrasonography,CT, MRI) in 3 infants with congenital rubella syndrome

Neuroimaging observations of three infants with congenital rubella syndrome are reported. We have observed congenital rubella syndrome lesions in the subependymal area, the basal ganglia and the deep white matter. Cranial ultrasonography defines subependymal cysts, calcification and possible vascular changes in the basal ganglia while MRI is the most sensitive to minor atrophic changes and white matter lesions. Although CT defines calcification, it is less sensitive than MRI to white matter changes and does not demonstrate subependymal cysts.     

Subsequent pregnancy in mothers of infants with congenital heart disease

Pregnancy rates for mothers of infants with conotruncal cardiac malformations and mothers of healthy control infants were compared for a 3-year period. Mothers of infants who died of congenital heart disease had the highest pregnancy rates, followed by control mothers, and then by mothers of surviving infants with congenital heart disease. Comparison in relation to the number of living children showed similar subsequent pregnancy rates for mothers of deceased infants with congenital heart disease and mothers of control infants, but lower rates for mothers of surviving infants with congenital heart disease. "Replacement" of a deceased infant occurs frequently, apparently in order to achieve a desired family size, whereas decreased reproduction in families of living infants with congenital heart disease may reflect the psychosocial and economic impact of the continuing care of a child with severe heart disease.     

Females born large for gestational age have a doubled risk of giving birth to large for gestational age infants

AIM: To analyse if females born large for gestational age (LGA) have an increased risk to give birth to LGA infants and to study anthropometric characteristics in macrosomic infants of females born LGA. METHODS: The investigation was performed as an intergenerational retrospective study of women born between 1973 and 1983, who delivered their first infant between 1989 and 1999. Birth characteristics of 47,783 females, included in the Swedish Birth Register both as newborns and mothers were analysed. LGA was defined as >2 SD in either birth weight or length for gestational age. The infants were divided into three subgroups: born tall only, born heavy only and born both tall and heavy for gestational age. Multiple logistic and linear regression analyses were performed. RESULTS: Females, born LGA with regard to length or weight, had a two-fold (adjusted OR 1.96, 95% Cl 1.54-2.48) increased risk to give birth to an LGA infant. Females, born LGA concerning weight only, had a 2.6 (adjusted OR 2.63, 95%, 1.85-3.75) fold increased risk of having an LGA offspring heavy only and no elevated risk of giving birth to an offspring that was tall only, compared to females born not LGA. In addition, maternal obesity was associated with a 2.5 (adjusted OR 2.56, 95%, 2.20-2.98) fold increased risk of having an LGA newborn, compared to mothers with normal weight. CONCLUSION: Females, born LGA, have an increased risk to give birth to LGA infants, compared to mothers born not LGA. Maternal overweight increases this risk even further.     

先天性心脏病婴儿生长发育状况及其危险因素分析

目的 调查评估先天性心脏病婴儿生长发育状况,探讨其生长落后的发生率及其危险因素.方法 采用Z评分法对2010年8月至2011年8月期间在我科住院行心脏手术的354例先天性心脏病婴儿进行营养状况评估,根据评估结果分为营养不良组及非营养不良组,采用卡方检验及多元回归分析对造成生长发育落后的可能危险因素进行单因素及多因素回归分析.结果 354例中低体重患儿108例(30.5％),经多元回归分析,低出生体重(OR=3.844,P=0.001)、肺动脉高压(OR=5.702,P=0.000)、肺炎(OR=2.161,P=0.005)与其显著相关;生长迟缓患儿62例(17.5％),经多元回归分析,低出生体重(OR=4.137,P=0.000)、肺动脉高压(OR=2.352,P=0.047)、肺炎(OR=3.417.P=0.000)与其显著相关;消瘦患儿95例(26.8％),经多元回归分析,肺动脉高压(OR=2.747,P=0.001)与其显著相关.结论 低出生体重、肺动脉高压、肺炎对先天性心脏病婴儿生长发育可产生显著影响;是否紫绀与小婴儿营养不良无显著相关.     

超早产儿出生窒息的危险因素分析

目的 探讨超早产儿发生出生窒息的危险因素.方法 选取2017年1月至2020年6月,解放军总医院第七医学中心儿科医学部超早产重症监护病房收治的超早产儿为研究对象,纳入窒息组184例,对照组153例.回顾性收集超早产儿及其母亲的临床资料,分析超早产儿发生出生窒息的危险因素.统计学方法采用t检验、χ2检验、单自变量和多自变...     

Hypocapnia and other ventilation-related risk factors for cerebral palsy in low birth weight infants.

Ventilatory management patterns in very low birth weight newborns, particularly iatrogenic hypocapnia, have occasionally been implicated in perinatal brain damage. However, such relationships have not been explored in large representative populations. To examine the risk of disabling cerebral palsy in mechanically ventilated very low birth weight infants in relation to hypocapnia and other ventilation-related variables, we conducted a population-based prospective cohort study of 1105 newborns with birth weights of 500-2000 g born in New Jersey from mid-1984 through 1987, among whom 777 of 902 survivors (86%) had at least one neurodevelopmental assessment at age 2 y or older. Six hundred fifty-seven of 777 assessed survivors (85%), of whom 400 had been mechanically ventilated, had blood gases obtained during the neonatal period. Hypocapnia was defined as the highest quintile of cumulative exposure to arterial PCO(2) levels <35 mm Hg during the neonatal period. Disabling cerebral palsy was diagnosed in six of 257 unventilated newborns (2.3%), 30 of 320 ventilated newborns without hypocapnia (9.4%), and 22 of 80 ventilated newborns with hypocapnia (27.5%). Two additional ventilatory risk factors for disabling cerebral palsy were found-hyperoxia and prolonged duration of ventilation. In a multivariate analysis, each of the three ventilatory variables independently contributed a 2- to 3-fold increase in risk of disabling cerebral palsy. These risks were additive. Although duration of mechanical ventilation in very low birth weight newborns likely represents severity of illness, both hypocapnia and hyperoxia are largely controlled by ventilatory practice. Avoidance of arterial PCO(2) levels <35 mm Hg and arterial PO(2) levels >60 mm Hg in mechanically ventilated very low birth weight infants would seem prudent.     

Sudden infant death syndrome in infants born to HIV-infected and opiate-using mothers.

OBJECTIVE: This study was undertaken to determine the role of opiate use during pregnancy as a predisposing factor for sudden infant death syndrome (SIDS) in infants born to HIV-infected mothers. METHODS: In order to identify all infant deaths and their cause and association with maternal opiate use, the data of a nationwide prospective cohort study of HIV-infected mothers and their children were extracted and analysed for a 13-year period. RESULTS: 24 (5.1%) infant deaths were observed out of 466 infants followed up until death or at least 12 months of life. 3 (0.6%) of them were due to non-accidental trauma and were not associated with maternal opiate use. 7 (1.5%) died due to SIDS, which was confirmed by autopsy. All SIDS cases occurred in infants born to mothers reporting use of opiates during pregnancy (n = 124). The relative risk of SIDS compared to the general population was 18 (95% CI 9 to 38) for all infants of HIV-infected mothers, and 69 (95% CI 33 to 141) for those with intrauterine opiate exposure (p<0.001). CONCLUSIONS: Compared to the Swiss general population, the risk for SIDS in this cohort of infants born to HIV-infected mothers was greatly increased, but only for mothers reporting opiate use during pregnancy. This effect appeared not to be mediated by prematurity, low birth weight, perinatal HIV infection or antiretroviral drug exposure.