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1.
Background
Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing.Aim
Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth.Study design
A prospective study.Subjects
Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies).Methods
MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth.Main outcome measures
Cord blood gases were related to signs of centralization of fetal circulation in the MCA.Results
No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5′ < 7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p < 0.04) and had a longer duration of stay in NICU (p < 0.03) compared to newborns without brain sparing.Conclusion
Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia. 相似文献2.
Fleur M. Rosier-van Dunné Gerda van Wezel-Meijler Laila de Groot Johanna I. de Vries 《Early human development》2010,86(2):83-86
Background
In preterm born infants abnormal general movements (GMs) generally normalize before three months post term, but may persist when perinatal brain injury is present.Aims
To assess the continuity of GM quality from fetal to early neonatal period and its relation to brain echogenicity changes.Study design
Prospective study examining GMs and three vulnerable brain areas before and 7 days after birth. The quality of GMs was classified as normal or abnormal by Gestalt-perception. The brain was examined for moderate echogenicity changes (periventricular: brighter than choroid plexus, intraventricular: filling equal or more than 50% of the ventricle, and locally increased basal ganglia/thalami).Subjects
94 fetuses from pregnancies complicated by preterm hypertensive disorders or labour at a gestational age between 26 and 34 weeks.Outcomes measures
Correlations of fetal GMs, echogenicity changes, and clinical parameters (e.g. gestational age, parity, hypertensive disorders or preterm labour, oligohydramnios and fetal growth restriction) with neonatal GMs.Results
Fetal GMs were abnormal in 64%, normalizing in 68% within 7 days after birth. Fetal GMs were significantly related to postnatal GMs (p = 0.045). Moderate fetal brain echogenicity changes and clinical parameters were not significantly related to neonatal GM.Conclusions
In this population of pregnancies compromised by hypertensive disorders or preterm labour fetal GMs correlated with neonatal GMs. Presence of moderate echogenicity changes in the fetal brain was not related to neonatal GMs. 相似文献3.
Hedwig K. Kikkert 《Early human development》2010,86(3):171-1158
Background
Parental anxiety and stress may have consequences for infant neurological development.Aims
To study relationships between parental anxiety or well-being and infant neurological development approximately one year after birth.Study design
Longitudinal study of a birth cohort of infants born to subfertile couples. Subjects: 206 parent-child dyads.Outcome measures
Infant neurology was assessed with the Touwen Infant Neurological Examination (TINE) at 10 months and a developmental questionnaire at 12 months. Parental measures included trait anxiety measured by the State-Trait Anxiety Inventory (STAI) and well-being measured by the General Health Questionnaire (GHQ).Results
Maternal trait anxiety was associated with a less optimal neurological condition (rs = − 0.19, p < 0.01) of the infant. This association persisted after adjusting for confounders and results were confirmed by the outcome of the developmental questionnaire. Paternal trait anxiety and parental well-being were not related to the infant's neurodevelopmental outcome.Conclusions
Infants of mothers with high trait anxiety have an increased vulnerability to develop a non-optimal nervous system. The association may be mediated in part by early programming of monoaminergic systems. Future research should include an exploration of specific windows of vulnerability to maternal anxiety. 相似文献4.
Growth and health outcome of 102 2-year-old children conceived after preimplantation genetic diagnosis or screening 总被引:1,自引:0,他引:1
Sonja Desmyttere Maryse Bonduelle Mathieu Roelants Jean De Schepper 《Early human development》2009,85(12):755-759
Objective
The major objective of this study was to determine whether the embryo biopsy procedure might cause growth restriction or affect health outcome of children.Study design
Auxological data and physical findings were compared at birth and age 2 for 102 children (70 singletons and 32 twins) born after PGD/PGS and 102 matched children born after intracytoplasmic sperm injection (ICSI) in a prospective study.Results
No statistically significant differences regarding weight, height and head circumference standard deviation scores (SDS) at birth and at age two years were observed. At two years of age the mean BMI SDS tended to be lower in PGD/PGS children (p = 0.058). PGD/PGS babies had been more often breastfed (p = 0.013), but mostly during a shorter time.The prevalence of major as well as minor congenital anomalies, hospital admissions and surgical interventions was similar.Conclusion
Children born after embryo biopsy applied in PGD/PGS present similar prenatal and postnatal growth and health outcome in the first two years of life compared to ICSI children. Up till now, PGD and PGS appear not to be associated with a higher risk for health problems. 相似文献5.
Background
Late-onset sepsis is a relatively common complication particularly of preterm birth that affects approximately a quarter of very low birth weight infants.Aim
We aimed to determine the motor, cognitive, and behavioural outcome at school age of preterm children with late-onset sepsis compared to matched controls.Study design and subjects
A prospective case-control study that included preterm infants (gestational age < 32 weeks and/or birth weight < 1500 g) admitted to our Neonatal Intensive Care Unit in 2000-2001 with a culture-proven late-onset sepsis, and controls matched for gestational age.Outcome measures
At school age we assessed motor skills, intelligence, visual perception, visuomotor integration, verbal memory, attention, executive functioning, and behaviour.Results
At 6-9 years, 21 of 32 children with late-onset sepsis (68%) had borderline or abnormal motor outcome with most problems in fine motor skills. Their total IQ was 89 compared to 98 in controls. In addition, verbal memory and attention were affected compared to controls (0.61 standard deviations (SD), 95% confidence interval (CI) 0.04-1.17, p = 0.033 and 0.94 SD, 95% CI 0.32-1.62, p = 0.011, respectively). Multiple episodes of sepsis and gram-negative sepsis were risk factors for worse cognitive outcome.Conclusions
At school age, a majority of preterm children with late-onset sepsis had motor problems. Their IQ was considerably lower than matched controls, and memory and attention were specifically impaired. Outcome at school age of preterm children with late-onset sepsis was worse than previously thought. 相似文献6.
Uwe Schneider Anja Fiedler Susann Jaekel Angelika Stacke Ekkehard Schleussner 《Early human development》2010,86(5):319-688
Background
Steroid administration to accelerate fetal lung maturation reduces neonatal morbidity and mortality in the case of preterm delivery. Behavioral observations suggest effects on fetal cardiovascular regulation.Aim
We hypothesize that beat to beat heart rate variability (fHRV) derived from fetal magnetocardiography (fMCG) will reveal a direct, acute steroidal effect on fetal autonomic heart rate regulation.Subjects
Eight patients between 29 and 34 weeks of gestation at risk for preterm birth who were treated with betamethasone (2 × 12 mg within 24 h).Study design
Subjects were studied prior to the first and within 6 h after the second administration. Continuous fMCG was recorded with a 31-channel-SQUID biomagnetometer. Each dataset was processed by subtracting maternal cardiac artefacts and determining the time instants of the fetal heart beats. fHRV analysis was applied to periods of fetal quiescence of 4 min length.Outcome measures
We compared fHRV prior versus post steroid administration.Results
Steroid exposure reduced all parameters of overall fHRV significantly. The fHRV parameters representing short term variability remained unaffected. Mean fetal heart rate significantly decreased. The complexity of the heart rate patterns increased.Conclusion
Our results suggest an acute shift in the symptaho-vagal balance of fetuses exposed to betamethasone in utero toward sympathetic suppression. 相似文献7.
Josanne Munsters Linda WallströmJohan Ågren Torgny NorstedRichard Sindelar 《Early human development》2012,88(1):21-26
Background
To assess pain or stress in newborn infants submitted to intensive care is important but difficult, as different observational pain scales are not always reliable in premature infants. As an indicator of pain, skin conductance (SC) measurements have detected increased sweating in newborn infants > 28 gestational age (GA) submitted to heel lancing.Objective
To measure SC during heel lancing and routine care in newborn infants, born at 22 to 27 GA, with special relation to postnatal age (PNA).Methods
In six infants < 28 + 0 GA and 4 infants ≥ 28 + 0 GA spontaneous SC activity and behavioural state (Neonatal Pain Agitation and Sedation Scale (N-PASS)) was measured before, during and after each intervention. Measurements were repeated in each patient at different PNA.Results
Baseline SC prior to intervention took longer time to stabilise and was higher in < 28 than in ≥ 28 + 0 PNA. The combination of heel lancing and squeezing gave an increased SC in < 28 PNA, whereas heel lancing alone gave the same SC response in ≥ 28 + 0 PNA. A possibly continued immature response in SC measurements was not observed. Oral glucose admission prior to heel lancing increased SC. Routine care did not give any changes in SC. Except during orogastric tube placement no signs of discomfort or pain could be detected by the neonatal pain, agitation and sedation scale (N-PASS) in < 28 PNA.Conclusion
Changes in SC could be detected in infants at < 28 + 0 PNA and related to the combination of heel lancing and squeezing. A maturational development of the SC was observed in infants born < 28 GA. SC seems to be able to differentiate between pain and discomfort. 相似文献8.
Rovira N Alarcon A Iriondo M Ibañez M Poo P Cusi V Agut T Pertierra A Krauel X 《Early human development》2011,87(4):253-257
Background
The role of chorioamnionitis in neurodevelopment of preterm infants is not fully understood.Aim
To examine the association between different indicators of intrauterine inflammation (clinical chorioamnionitis, histological chorioamnionitis and funisitis) and neurodevelopmental impairment in very preterm infants.Methods
Preterm infants with a birth weight of < 1500 g or a gestational age of < 32 weeks were included. Follow-up evaluation up to 2 years of age consisted of neurological examination, neurodevelopmental assessment and visual and audiologic tests. Outcome data were compared between the chorioamnionitis and the control groups, controlling for gestational age, birth weight and Apgar score at 5 min.Results
One hundred seventy-seven patients comprised the study population (mean gestational age 29 ± 2 weeks, mean birth weight 1167 ± 344 g). Histological chorioamnionitis was present in 49% of placentas, whereas funisitis was observed in 25%. In 57% cases clinical maternal chorioamnionitis was suspected. Follow-up was available for 130 (82%) patients. Infants with funisitis, compared with controls, had a significantly higher incidence of moderate to severe disability (18% vs 5%, OR 4.07; 95% CI 1.10-15.09).Conclusion
The results of this study suggest that, unlike a broad definition of histological chorioamnionitis including inflammation of maternal or fetal placental tissues, funisitis may entail a higher risk of moderate to severe disability at 2 years of age in preterm infants. 相似文献9.
Background
Previous studies using ultrasound technology showed that fetal heart rate (HR) may be responsive to maternal aerobic exercise. Although it is recognized that cardiac autonomic control may be influenced by the intrauterine environment, little is known about how maternal exercise affects fetal heart development.Aims
This study tested the hypothesis that regular maternal exercise throughout gestation influences fetal cardiac autonomic control of HR and heart rate variability (HRV) when compared to fetuses of non-exercising women.Study design
Magnetocardiograms (MCGs) were recorded using a dedicated fetal biomagnetometer at 28, 32 and 36 weeks gestational age (GA) from 26 regularly exercising (> 30 min of aerobic exercise, 3× per week) and 35 healthy, non-exercising pregnant women. Fetal MCG was isolated and normal R-peaks were marked to derive fetal HR and HRV in the time and frequency domains. We applied a mixed-effects model to investigate the effects of exercise, GA and fetal activity state.Results
At 36 weeks GA, during the active fetal state, fetal HR was significantly lower in the exercise group (p = < 0.0006). Post-hoc comparisons showed significantly increased HRV in the exercise group during the active fetal state at 36 weeks GA for both time and frequency domain measures.Conclusion
These results indicate that regular maternal exercise throughout gestation results in significantly lower fetal HR and increased HRV. 相似文献10.
Background
Although a number of studies have found that maternal stress affects the fetus, it is unclear whether jerky fetal movements observed on ultrasound scans are indicative of fetal stress, or whether they are part of normal development.Aims
The present study was designed to examine the relationship between jerky fetal arm movements in relation to fetal age and stress.Methods
Video recordings were made of routine ultrasound scans of 57 fetuses (age range 8 to 33 weeks) classified into three age groups: 1st trimester (8-12 weeks, N = 9), 2nd trimester (13-24 weeks, N = 38), and 3rd trimester (26-33 weeks, N = 10). Following previous research on stress behaviour in neonates, a fetal index of stress was derived from frequency of hiccup, back arch and rhythmical mouthing.Results
Results indicated that while stress level was unrelated to fetal age, jerkiness of arm movements was significantly associated with the fetal stress index but not age.Conclusions
Our findings suggest that jerky arm movements in fetuses are suggestive of fetal stress. 相似文献11.
Treyvaud K Doyle LW Lee KJ Roberts G Cheong JL Inder TE Anderson PJ 《Early human development》2011,87(6):427-431
Background
Examining rates of difficulties in family functioning following very preterm birth has been a relatively neglected area of research.Aims
To examine family functioning, burden and parenting stress in families with very preterm compared with term born children, and investigate influences of parental mental health problems and child neurodevelopmental disability on family outcomes in families with preterm children.Study design
Participants were 184 very preterm and 71 term children and their parents. Parents completed the Family Assessment Device, Parenting Stress Index and Impact on Family questionnaires when their children were 2 years old (corrected for prematurity). Parental mental health and social risk information were also collected. Children were assessed for neurodevelopmental disability.Results
Families with very preterm children reported poorer family functioning (p = .03) compared with families with term born children, with less evidence for differences between families with very preterm and term born children in parenting stress and family burden. Within very preterm families, parental mental health problems were associated with higher levels of parenting stress (p = .001), and parents of children with a neurodevelopmental disability were more likely to report higher family burden (p = .04).Conclusions
For families with very preterm children, parental mental health symptoms and child neurodevelopmental disability may identify families at risk of greater stress and burden who may benefit from additional support. 相似文献12.
Ida Sue Baron Kristine Erickson Kelly Coulehan Fern R. Litman 《Early human development》2009,85(12):751-754
Background
Late-preterm children constitute a majority of all preterm deliveries (75%). Their immature brain development at birth has been associated with an increased risk for morbidities. Data have been sparse regarding neuropsychological outcomes in the preschool years.Aim
To examine general cognition, attention/working memory, language, manual coordination/motor dexterity, visuomotor, visuospatial, and executive functions in preschoolers born late-preterm (LPT; 34-36 gestational weeks) who required NICU admission compared to term-born participants.Design
Single-center retrospective cohort study of 95 three-year-old children; 60 born LPT in 2004-2005 and admitted to the NICU compared to 35 healthy term-born participants born ≥ 37 gestational weeks and ≥ 2500 g.Results
LPT birth was associated with visuospatial (p = .005), visuomotor (p = .012), and executive function (noun [p = .018] and action-verb [p = .026] fluency) relative deficits, but not attention/working memory, receptive or expressive language, nonverbal reasoning, or manual coordination/dexterity deficit.Conclusions
Late-preterm birth is likely to be associated with negative neuropsychological sequelae, although subtle and selective compared to effects reported for children born at an earlier gestational age. Visuospatial function appears to be especially vulnerable to disruption even at preschool age, and verbal fluency may be useful as an early predictor of executive dysfunction in childhood. Routine preschool neuropsychological evaluation is recommended to identify delay or deficit in LPT children preparing for school entry, and may highlight underlying vulnerable neural networks in LPT children. 相似文献13.
R.H.F. van Oppenraaij H. Nik J.L. McPartland S. Quenby N. Exalto 《Early human development》2010,86(8):469-472
Background
For normal fetal growth and development a well-developed chorionic villous vascularization is essential.Aim
The aim of this study is to investigate whether idiopathic second trimester fetal loss is associated with an underdeveloped chorionic villous vascularization.Methods
38 placentas after late miscarriage, classified as idiopathic fetal loss (IFL, n = 16) or as fetal loss due to intrauterine infection (IUI, n = 22) were collected. After CD34 immunohistochemical staining the villous stromal area, number of villous vessels, vascular area and vascular area density (central, peripheral and total) were measured in randomly selected immature intermediate villi.Results
The mean gestational age was 19 + 4 weeks for the IFL group and 20 + 6 weeks for the IUI group. After controlling for gestational age, we found no differences in fetal weight, placental weight, villous stromal area, number of vessels and central vascular features. The mean peripheral vascular area and peripheral vascular area density were, after adjusting for gestational age, reduced in the IFL group.Conclusion
Idiopathic second trimester fetal loss is associated with a reduced peripheral chorionic villous vascularization. We hypothesize that in these cases, placentation is already disturbed in first trimester of pregnancy, leading to a reduced materno-fetal interface in second trimester, thus to early postplacental fetal hypoxia and fetal death. 相似文献14.
Hahurij ND Blom NA Lopriore E Aziz MI Nagel HT Rozendaal L Vandenbussche FP 《Early human development》2011,87(2):83-87
Background
Cardiac arrhythmias are commonly observed in the fetus, however, may have major consequences for fetal development and post natal life.Aims
To evaluate the perinatal management and cardiac outcome of fetuses with tachy- or bradyarrhythmia.Study design
Perinatal management, outcome and long-term cardiac follow-up were evaluated retrospectively in consecutive fetuses with cardiac arrhythmias.Results
Forty-four fetuses were diagnosed: supraventricular tachycardia (SVT, n = 28), atrial flutter (AF, n = 7) and atrioventricular block (AVB, n = 9). The overall incidence of cardiac anomalies was 18% mainly in the AVB group; hydrops was present in 34%. Direct or transplacental fetal anti-arrhythmic medication was given in 76%. Mortality was 6% in SVT/AF and 78% in the AVB group, respectively. AF resolved in all patients. In the SVT group, Wolff-Parkinson-White (WPW) syndrome was present in 21%, diagnosed at birth or later in life. After the age of one year about 90% of patients in the SVT group remained asymptomatic and free of drugs (median follow-up 76 months).Conclusions
Mortality rate is low in patients with fetal SVT and AF but high in patients with AVB. Related morbidity includes WPW-syndrome and congenital cardiac anomalies. Electrocardiographic screening is recommended in all fetal SVT cases before adolescence since WPW-syndrome may occur later in life. 相似文献15.
Yuki Kodama Hiroshi Sameshima Tomoaki Ikeda Tsuyomu Ikenoue 《Early human development》2009,85(4):235-238
Background
Cases suggestive of non-acidemia related cerebral palsy (CP) are likely misdiagnosed as acidemia related CP because of the presence of nonreasuring fetal heart rate (FHR) patterns.Aims
Our purpose was to compare intrapartum FHR patterns between the cases of neurological damage and the cases without disability after severe metabolic acidemia and neonatal encephalopathy, and also to compare the FHR patterns between cases with CP due to asphyxia and cases with CP of other etiology in infants born after 34 weeks.Study design
From 1998 to 2003, our peer review conferences determined 136 infants with high-risk factors for neurological impairment in the unselected 65,197 live births. High-risk infants were chosen according to our criteria. Among them 58 were eligible infants because they were born at ≥ 34 weeks of gestation and also had legible FHR traces.Outcome measures
Incidence of nonreassuring FHR patterns.Results
Fifteen infants were acidemia related and 43 were non-acidemia related high-risk infants. Ten of the 15 acidemia infants developed CP and all had shown bradycardia ≥ 13 min with a nadir < 80 bpm. In the 43 non-acidemia infants, 35 had CP, mental retardation, epilepsy, or hearing loss and 74% (26/35) of them had shown nonreassuring FHR patterns. Incidence of severe bradycardia was significantly elevated in the acidemia related CP compared with acidotic infants without disability, and those with non-acidemia related CP.Conclusions
Even in infants with non-acidemia related CNS impairments, who were born at ≥ 34 weeks of gestation, 74% had shown intrapartum nonreassuring FHR patterns. 相似文献16.
Jin Liang Zhu Carsten Obel Bodil Hammer Bech Jørn Olsen 《Early human development》2009,85(12):745-749
Background
Mixed-handedness, which may reflect atypical brain laterality, has been linked to a number of medical conditions as well as prenatal stress.Aims
The aim of the study was to examine whether infertility or infertility treatment was associated with an increased risk of mixed-handedness in children.Study design, subjects and outcome measures
We used data from three population-based birth cohorts in Denmark: the Aalborg-Odense Birth Cohort (1984-1987), the Aarhus Birth Cohort (1990-1992) and the Danish National Birth Cohort (1996-2002) (N = 7728, 5720 and 29486, respectively). Data on time to pregnancy and infertility treatment were collected during pregnancy. Handedness was reported in a follow-up questionnaire when the children were at least 7 years old. Children were categorized as mixed-handed if their mothers reported that they used both hands equally.Results
Children born after infertility treatment, particularly intrauterine insemination, had a higher risk of being mixed-handed compared to children of fertile couples with a time to pregnancy ≤ 12 months (odds ratio 1.41, 95% confidence interval 1.09-1.82). Children of couples with unplanned pregnancies, particularly after an oral contraceptives failure, were also more likely to be mixed-handed. There was no association between a long waiting time to pregnancy and mixed-handedness in children.Conclusions
Children born after infertility treatment, particularly intrauterine insemination, and children exposed to oral contraceptives during early gestation may have a higher risk of being mixed-handed. 相似文献17.
Daniela Ricci Domenico M. Romeo Francesca Serrao Daniela Leone Emilio Albamonte Domenico Mazzone Frances Cowan 《Early human development》2010,86(1):29-33
Background
Several studies reported on various aspects of visual function at term age and in the first months after birth but less has been reported in preterm infants before they reach termequivalent age.Aims
To assess the suitability of a battery of tests of visual function for use in infants born at < 33 weeks gestation (GA) and assessed before 34 weeks post-menstrual age (PMA); to evaluate the distribution of the findings according to GA, and to compare the data with those previously published on preterm infants assessed at 35 weeks PMA.Study design
Cross-sectional study.Subjects
Sixty-four preterm infants with a GA < 33 weeks were studied.Outcome measures
We used a battery of visual function tests previously validated at 35 and 40 weeks PMA in low-risk preterm infants. All the infants in this current study underwent the same assessment before 34 weeks PMA.Results
Before 31 weeks PMA most infants could not be reliably assessed because of clinical instability, whilst after 31 weeks PMA most infants could be assessed and they showed progressive maturation in their responses with PMA. Some items (spontaneous ocular motility, horizontal tracking, tracking a coloured stimulus, and ocular fixation) showed similar results at 32-33 weeks PMA to those found in low-risk preterm at 35 weeks PMA. Ocular movements to a target and arc tracking were the items with the most immature responses.Conclusions
Our results provide further evidence that a structured assessment of visual function can be used in clinical routine and for research purposes in infants as young as 31 weeks PMA. 相似文献18.
Wolfgang Thomas Silvia Seidenspinner Johannes Wirbelauer Christian P. Speer 《Early human development》2010,86(9):593-598
Background
A systemic fetal inflammatory response, reflected by histological funisitis is associated with pulmonary morbidity and increased mortality after premature birth. The receptor for advanced glycation end products (RAGE) is a membrane-bound multiligand receptor with a key role in inflammation. Soluble RAGE (sRAGE) is created by alternative mRNA splicing or shedding of the receptor's extracellular domain and can inhibit RAGE-activation.Aims
To assess the association of funisitis with airway and systemic concentrations of sRAGE in very premature infants.Methods
Forty-two ventilated infants (gestational age: 27.4 ± 1.8 weeks, birth weight: 1017 ± 229 g [mean ± SD]) were studied. sRAGE concentrations were measured in tracheobronchial aspirate fluid (TAF) on days of life 1, 3, 5, 7 and 10 and in umbilical cord serum of 28 infants by ELISA. The secretory component for IgA (SC) served as reference protein in TAF. Placental tissue, membranes and umbilical cords were examined microscopically to distinguish three groups: chorioamnionitis (n = 9), funisitis (n = 17) and controls (n = 16).Results
The funisitis group had lower sRAGE concentrations than both other groups in cord blood serum (median: 0.52 ng/ml [25th-75th centile: 0.32-0.91]; control, 1.72 [1.02-2.69]; chorioamnionitis, 1.44 [0.92-1.63], p < 0.01) and TAF on day 1 (290 ng/ngSC [140-400]; control, 2750 [1470-28920]; chorioamnionitis, 2150 [1220-7140], p < 0.01). sRAGE in TAF remained lower in the funisitis than in the chorioamnionitis group on days 3 and 10, p < 0.01 respectively.Conclusions
Decreased sRAGE in airways and circulation after funisitis may contribute to an imbalance between pro- and anti-inflammatory factors priming very premature infants for pulmonary injury and increasing the risk of adverse outcome. 相似文献19.
Background
Spectral analysis of fetal heart rate variability is promising for assessing fetal condition. Before using spectral analysis for fetal monitoring it has to be determined whether there should be a correction for gestational age or behavioural state.Aims
Compare spectral values of heart rate variability between near term and post term fetuses during active and quiet sleep.Study design
Case-control. Cases had a gestational age of ≥ 42 weeks; controls were 36 to 37 weeks. Fetuses were matched for birth weight percentile.Subjects
STAN® registrations from healthy fetuses. For each fetus one 5-minute segment was selected during active and one during quiet sleep.Outcome measures
Absolute and normalized low (0.04-0.15 Hz) and high frequency power (0.4-1.5 Hz) of heart rate variability.Results
Twenty fetuses were included. No significant differences were found between cases and controls in absolute (481 and 429 respectively, P = 0.88) or normalized low (0.78 and 0.80 respectively, P = 0.50) or absolute (41 and 21 respectively, P = 0.23) or normalized high frequency power (0.08 and 0.07 respectively, P = 0.20) during active state. During rest, normalized low frequency power was lower (0.58 and 0.69 respectively, P = 0.03) and absolute (16 and 10 respectively, P = 0.04) and normalized high frequency power were higher (0.21 and 0.14 respectively, P = 0.01) in cases compared to controls. Absolute and normalized low frequency power were higher during active state compared to rest in both groups (all P values < 0.05).Conclusions
We found sympathetic predominance during active state in fetuses around term. Post term parasympathetic modulation during rest was increased compared to near term. 相似文献20.
Frances V. O'Callaghan Abdullah Al Mamun Alexandra Clavarino William Bor Jake M. Najman 《Early human development》2010,86(7):419-424