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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infant crying signals distress to potential caretakers who can alleviate the aversive conditions that gave rise to the cry. The cry signal results from coordination among several brain regions that control respiration and vocal cord vibration from which the cry sounds are produced. Previous work has shown a relationship between acoustic characteristics of the cry and diagnoses related to neurological damage, SIDS, prematurity, medical conditions, and substance exposure during pregnancy. Thus, assessment of infant cry provides a window into the neurological and medical status of the infant. Assessment of infant cry is brief and noninvasive and requires recording equipment and a standardized stimulus to elicit a pain cry. The typical protocol involves 30 seconds of crying from a single application of the stimulus. The recorded cry is submitted to an automated computer analysis system that digitizes the cry and either presents a digital spectrogram of the cry or calculates measures of cry characteristics. The most common interpretation of cry measures is based on deviations from typical cry characteristics. Another approach evaluates the pattern across cry characteristics suggesting arousal or under-arousal or difficult temperament. Infants with abnormal cries should be referred for a full neurological evaluation. The second function of crying--to elicit caretaking--involves parent perception of the infant's needs. Typically, parents are sensitive to deviations in cry characteristics, but their perception can be altered by factors in themselves (e.g., depression) or in the context (e.g., culture). The potential for cry assessment is largely untapped. Infant crying and parental response is the first language of the new dyadic relationship. Deviations in the signal and/or misunderstanding the message can compromise infant care, parental effectiveness, and undermine the budding relationship. (c) 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:83-93.
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PMID:Assessment of infant cry: acoustic cry analysis and parental perception. 1585 39

Four hundred and thirty pregnant women were recruited during their second trimester of pregnancy (M=20 weeks). They were designated depressed (N=172) or nondepressed (N=258) on the Structured Clinical Interview of Depression (SCID) and the Center for Epidemiological Studies Depression scale (CES-D). They were given a second assessment when they were approximately 32 weeks gestational age. At both assessments they were given self-report measures (CES-D, the State Anxiety Inventory, and the State Anger Inventory) and provided urine samples for assays of cortisol, catecholamines (norepinephrine, epinephrine and dopamine) and serotonin. They were also given the VITAS scale for lower back pain and leg pain and a sleep disturbance scale. The stability of mood states and biochemistry across pregnancy (20 and 32 weeks) were assessed inasmuch as mood states, and biochemistry have been noted to predict prematurity and low birthweight. Significant correlations were noted for all variables except serotonin. Relationships between mood states and biochemistry were also noted but only between cortisol and depression, cortisol and anxiety, and epinephrine and anxiety. Significant stability was noted between the 20-week measures and the 32-week measures including depression, anxiety, anger, and cortisol. These were, in turn, correlated with each other and with, low back pain, leg pain, and sleep disturbance. These data suggest the stability of mood states and cortisol across pregnancy.
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PMID:Stability of mood states and biochemistry across pregnancy. 1713 81

A review of research on prenatal depression effects on the fetus and newborn suggests that they experience prenatal, perinatal and postnatal complications. Fetal activity is elevated, prenatal growth is delayed, and prematurity and low birthweight occur more often. Newborns of depressed mothers then show a biochemical/physiological profile that mimics their mothers' prenatal biochemical/physiological profile including elevated cortisol, lower levels of dopamine and serotonin, greater relative right frontal EEG activation and lower vagal tone. Elevated prenatal maternal cortisol is the strongest predictor of these neonatal outcomes. Moderate pressure massage can alleviate these effects including reducing prematurity.
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PMID:Prenatal depression effects on the fetus and newborn: a review. 1713 97

A number of life-threatening clinical disorders may be amenable to treatment with a drug that can stimulate respiratory drive. These include acute respiratory failure secondary to chronic obstructive pulmonary disease, post-anesthetic respiratory depression, and apnea of prematurity. Doxapram has been available for over forty years for the treatment of these conditions and it has a low side effect profile compared to other available agents. Generally though, the use of doxapram has been limited to these clinical niches involving patients in the intensive care, post-anesthesia care and neonatal intensive care units. Recent basic science studies have made considerable progress in understanding the molecular mechanism of doxapram's respiratory stimulant action. Although it is unlikely that doxapram will undergo a clinical renaissance based on this new understanding, it represents a significant advance in our knowledge of the control of breathing.
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PMID:A new look at the respiratory stimulant doxapram. 1722 89

Prematurity continues to be the leading cause of neonatal death and developmental disability, highlighting the importance of identifying potential predictors of prematurity as well as interventions that can be linked to the predictors. This review covers recent research on potential psychological, physiological, and biochemical predictors. Among the psychological stressors are depression, anxiety, difficult relationships, and lack of social support. Biochemical predictors include corticotropin-releasing hormone, cortisol, and fetal fibronectin. A program of research that links an intervention for prematurity with a predictor for prematurity, that is, massage therapy to reduce cortisol and, in turn, reduce prematurity, is then presented.
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PMID:Prematurity and potential predictors. 1820 83

Although apnea is common in premature babies, there is a paucity of information concerning the pathophysiologic basis of these episodes and their relationship to other perinatal conditions such as hyperbilirubinemia. Unconjugated hyperbilirubinemia in premature infants, even in moderately high levels, may cause encephalopathy affecting brainstem functions and has been linked to increased incidence of apnea in these infants. Thus, there is a need to clarify mechanisms by which bilirubin may alter respiratory control and induce apnea of prematurity. In this study, bilirubin or placebo was infused i.v. in 9-d-old rat pups (n = 36). Serum hyperbilirubinemia peaked in the first hours after bilirubin infusion. Twenty-four hours after bilirubin infusion, respiration was recorded by plethysmography at rest and under hypercapnic and hypoxic conditions. In treated pups, minute ventilation in room air was significantly reduced, hyperventilatory response to CO2 was blunted, and hypoxic ventilatory depression was increased, compared with placebo-injected rat pups. Brainstem bilirubin deposition and immunoreactivity to bilirubin was detected in the brainstem on histologic analysis. We speculate that high serum bilirubin levels may cause prolonged inhibition of brainstem autonomic function and that this could underlie the exacerbation of apnea noted in premature babies who have experienced jaundice.
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PMID:Hyperbilirubinemia diminishes respiratory drive in a rat pup model. 1845 54

Elevated prenatal cortisol has been associated with several negative conditions including aborted fetuses, excessive fetal activity, delayed fetal growth and development, prematurity and low birthweight, attention and temperament problems in infancy, externalizing problems in childhood, and psychopathology and chronic illness in adulthood. Given that maternal prenatal cortisol crosses the placenta and influences other aspects of the prenatal environment, these effects on the fetus and later development are not surprising. Cortisol would appear to be a mediating variable, resulting from prenatal stress in several forms including depression, anxiety, anger, and daily hassles. Cortisol effects are further complicated by its interaction with neurotransmitters such as norepinephrine, which may itself.
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PMID:Cortisol: the culprit prenatal stress variable. 1858 21

This review covers research from the last 5 years on the most popular complementary and alternative therapies used during pregnancy and labor and potential underlying biological bases for their effects. MEDLINE was searched and papers were reviewed for the most popular complementary and alternative therapies used during pregnancy and labor, including massage therapy, acupuncture, relaxation, yoga, and exercise. The pregnancy research generally suggests that alternative therapies have been effective for reducing pregnancy-related back and leg pain and nausea and for reducing depression and cortisol levels and the associated prematurity rate. The labor research generally shows that alternative therapies reduce pain and thereby the need for medication. Although the literature suggests positive effects of alternative therapies for pregnancy and labor and some potential biological mechanisms, the research has several methodological limitations.
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PMID:Pregnancy and labor alternative therapy research. 1916 Oct 42

The objective of this study was to evaluate and compare symptoms of anxiety and depression before and after psychological intervention in mothers of babies born preterm with very low birth weight, hospitalized in the Neonatal Intensive Care Unit. Fifty nine mothers, without psychiatric antecedents, were distributed into two groups according to the type of psychological intervention received. Group G1 included 36 mothers who received routine psychological treatment associated with initial structured intake using support materials (video and guidance manual). Group G2 included 23 mothers who received routine psychological intervention without support material. The STAI and BDI, respectively, were used to evaluate maternal indicators of anxiety and depression. The results revealed that both groups showed a reduction in levels of state or trait anxiety and depression after psychological intervention and discharge of the baby from the hospital. In regard to the emotional symptoms at a clinical level, a statistically significant reduction in the level of state-anxiety was verified in G1. The findings confirmed the need for psychological support for mothers of preterm infants and the use of materials focusing on prematurity for reduction of the situational anxiety on a clinical level.
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PMID:Anxiety and depression in mothers of preterm infants and psychological intervention during hospitalization in neonatal ICU. 1947 29

Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly used medications, with a prescription frequency of 2.3% in pregnant women. Although most babies born to women who take SSRIs during pregnancy are normal, there is accumulating evidence that maternal SSRI treatment during pregnancy may cause adverse reproductive outcomes. Maternal SSRI treatment during the first trimester has been implicated in increased risks of birth defects, specifically cardiac abnormalities, in the infant, whereas third-trimester treatment has been linked to various neonatal complications, including symptoms of neonatal withdrawal and toxicity, prematurity, low birth weight and persistent pulmonary hypertension of the newborn. Although data on neurobehavioural and long-term cognitive problems among children of women who were treated with SSRIs during pregnancy remain limited, the possibility of such functional abnormalities is an additional concern. On the other hand, untreated maternal depression also carries serious risks for both the mother and the baby, and SSRIs are one of the best available treatments. Thus, pregnant women who require treatment for depression and their physicians often face a difficult choice regarding the use of SSRIs.
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PMID:Safety of selective serotonin reuptake inhibitors in pregnancy. 1948 Apr 68


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