Iron status of the preterm infant during the first year of life

The iron status of 49 preterm infants (mean gestational age 33.1 weeks) was assessed serially during the 1st year of life. Haemoglobin concentration, serum ferritin, serum transferrin, serum iron, and transferrin saturation were measured on nine occasions in each infant. In 16 infants of gestational age 28-32 weeks the haemoglobin concentration was significantly lower at 3, 6, and 9 weeks when compared to 33 infants of gestational age 33-36 weeks. For all other measures of iron status there were no significant differences between these gestational age groups. For the entire group of 49 infants the mean haemoglobin concentration reached a nadir of 11.2 g/dl at 9 weeks. Mean serum iron and transferrin saturation reached peaks of 24 mumol/l and 65%, respectively, at 3 weeks. The mean serum ferritin remained over 100 micrograms/l until after 18 weeks. 13 infants (26%) had iron deficiency defined as either serum ferritin less than 10 micrograms/1 (n = 10) or transferrin saturation less than 10% (n = 5) or both (n = 3).     

Snoring in the first year of life

AIM: To describe the prevalence of snoring in infancy and the factors associated with snoring. METHODS: The investigation comprised a cross-sectional study of 1800 infants. Snoring was ascertained by interviewer-administered questionnaire. RESULTS: The prevalence of snoring was 15.8% in the first 4 wk of life and 26.1% in the past 2 wk. Snoring in the past 2 wk was associated with increasing age of the infant, male gender, maternal smoking, sleep position, number of respiratory infections and snoring in the first 4 wk of life after adjustment for potential confounders. No associations were found with snoring in the first 4 wk of life. CONCLUSION: Snoring is common in infancy. The identified risk factors for snoring are probably causally related to snoring. Further studies are needed to establish whether snoring in infancy is associated with current or subsequent morbidity.     

Arterial trauma in the first year of life

Traumatic vascular lesions in neonates are usually due to preoperative iatrogeny. In the last ten years, we attended 11 patients aged less than one year with arterial lesions due to deliberate puncture. All required endovascular, surgical or combined treatment. The intra- and postoperative follow-up of severe congenital malformations necessitates appropriate arterial access. This should be achieved following strict protocols, with a limited number of punctures carried out by experienced staff and only in large arteries. When a vascular lesion occurs, first an endovascular and then a surgical approach is required in the shortest time period possible. In conclusion, care of arterial routes of access and their maintenance is the best preventive therapy. Appropriate and early treatment in fistulas, pseudoaneurysms and thrombosis must be provided to prevent serious complications, especially in underweight patients.     

Serum immunoglobulins in the first year of life

Serum IgG, IgM, and IgA were measured in 316 infants younger than 12 months of age. Information including the child's race, sex, age, and past history of infections or atopy was collected. Birth records were also reviewed to ascertain the child's birthweight and gestational age. Serum IgG levels were higher in black infants than in white infants after the age of 4 months. Serum IgM levels were higher in black females than in black males for infants older than 1 month. For infants younger than 4 months of age, those weighing less than 2500 g at birth had lower IgG levels than those weighing more than 2500 g. Infants younger than 1 month whose gestational age had been less than 36 weeks had lower IgG levels than those greater than 36 weeks. Infants aged 1 to 4 months whose gestational age had been less than 36 weeks had lower IgG levels than did those 40 or more weeks. Infants with a positive history for atopy had lower IgG levels than similarly aged infants with a negative history.     

Effect of circumcision status on periurethral bacterial flora during the first year of life

To determine whether bacterial colonization is a factor in the pathogenesis of urinary tract infection, we compared the periurethral bacterial flora of uncircumcised versus circumcised boys during the first year of life. Intraurethral and circumferential glans cultures were obtained from 25 circumcised and 25 uncircumcised infants at 2 days, 2 weeks, 2 months, 4 months, 6 months, and 12 months of age. Different children were used at each age (300 total). The types of bacteria and the total and specific colony counts were compared. The results of the glans cultures were similar to those from the urethra. Uncircumcised boys had significantly higher total colony counts (p less than 0.003) at all ages except 12 months. Escherichia coli was present significantly more often (p less than 0.01) in the urethras of uncircumcised boys at 2 weeks, 2 months, 4 months, and 6 months. Gram-negative uropathogenic organisms (Klebsiella-enterobacter, Proteus mirabilis, and Pseudomonas aeruginosa) were cultured more frequently (p less than 0.0005) from the urethras of uncircumcised boys at 2 months, 4 months, and 6 months. The specific colony counts for E. coli and the other uropathogenic organisms were significantly higher (p less than 0.05) at all ages except 12 months. We conclude that during the first 6 months of life, the presence of a foreskin is associated with a greater quantity of periurethral bacteria and a greater likelihood for the presence of, as well as higher concentrations of, potentially uropathogenic organisms.     

Pancreatic ascites in the first year of life.

A case of pancreatic ascites in a 4-month-old baby girl is reported. To the best of our knowledge only 4 previous cases occurring in the first year of life have been reported in the pediatric literature. In patients with unexplained ascites, amylase determination should be performed on ascitic fluid and serum. The baby was first treated by external drainage and later by internal drainage of the pseudocyst which had formed along the fistula.     

Chlamydia trachomatis infection in the first year of life

BackgroundChlamydia trachomatis (C. trachomatis) is the most frequent bacterial sexual infection in women. Pregnant women screening is controversial, with asymptomatic colonization occurring in 2–20%, and 40–70% newborns can be infected.ObjectivesThe aim of this work is to characterise C. trachomatis infections in children under 12 months.Material and methodsRetrospective study was carried out from January 1997 to December 2009 (13 years), on Chlamydia infections, diagnosed by immunofluorescence of ocular scraping or serum immunoglobulin M (IgM). Demographic, clinical features, imaging findings, and outcomes were analysed.ResultsA total of 46 children were identified, with an overall incidence of 0.7/1,000 deliveries. Mean age was 2 months (range from 7 days to 11 months). Seven mothers had co-infections: Human Immunodeficiency Virus (HIV) (1), HBs antigen (HBsAg) (1) and group B Streptococcus (5). Most (81.4%) children had a vaginal delivery, with membrane rupture over 12 hours in 13.0%. Respiratory infection occurred in 41 (89.1%) cases and conjunctivitis in 17 (36.9%). Conjunctivitis manifested in the first 30 days of life (range from 7 days to 52 days). Respiratory symptoms occurred at age 45 days (range from 8 days to 11 months). Ten (29.4%) children had complications: hypoxemia (9), acute medial otitis (2), apnoea (3) and atelectasis (1). Chest X-ray revealed interstitial infiltrate in 25 (65.8%), and was normal in 4 children. Most children (80.5%) had a good outcome.ConclusionsC. trachomatis should be considered as an aetiologic agent of conjunctivitis and respiratory infections in the first year of life. The prevalence of C. trachomatis infection in Portugal is unknown, and is probably an underdiagnosed disease.