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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

All 1998 resident infant deaths in the 1969--1977 King County, Washington birth cohort of 139,132 resident live births comprise the data base for epidemiologic comparisons of the sudden infant death syndrome (SIDS) with eight other major infant mortality components: hyaline membrane disease; respiratory distress syndrome; asphyxia of the newborn; immaturity; birth injury; congenital malformation; infection; and "all other." These components were compared with respect to age at death; sex; race; prior fetal loss; prior live-born, now dead; birth plurality; birth weight; maternal age; birth order; marital status; prenatal care; and season of death in an attempt to determine the uniqueness of these purported SIDS risk factors. Only the age at death distribution unequivocally distinguished SIDS from the other components. The combination of low maternal age and multiparity was demonstrated to be putatively synergistic for risk of SIDS, hyaline membrane disease, and respiratory disease syndrome. Only deaths from infection exhibited seasonal variation similar to SIDS. These observations probably reflect secondary associations with as yet unidentified primary risk factors relatable to maternal experience.
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PMID:Epidemiologic comparisons of the sudden infant death syndrome with other major components of infant mortality. 55 88

Although brainstem immaturity has been postulated as one of the pathogenesis underlying cyanosis during feeding (CDF), there has been no widely accepted physiologic parameter that reflects brainstem function. We recently proposed that the dissociation index (DI), one of the phasic sleep parameters, is a reliable and quantitative sleep parameter for assessing brainstem maturation during early infancy. In the present study, we evaluated brainstem impairment in infants with CDF using phasic sleep components. Polysomnographies were obtained for 12 infants with CDF who were equally divided into 2 groups: one had or subsequently experienced apparent life-threatening events or sudden infant death syndrome (ALTE-SIDS group) and the other did not (CDF group). Rapid eye movement density and the number of gross movements (body movements, including the trunk, lasting greater than or equal to 2 sec) in the patients were identical to those in the controls. In the CDF group, the decrease of the average DI value from the controls was significantly less than the decrease in the ALTE-SIDS group. CDF may be a mild expression of brainstem immaturity. DI appears to be useful when evaluating infants with cyanosis during feeding.
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PMID:Phasic sleep components in infants with cyanosis during feeding. 187

A hypothesis is present that explains Sudden Infant Death Syndrome (SIDS) as an outcome of biological immaturity. This hypothesis fits the known characteristics of SIDS and does not conflict with other possible explanations of its genesis.
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PMID:Generalized view of the origins of the sudden infant death syndrome. 229 83

In the submitted paper the author gives an account of different affection associated with the syndrome of hypersomnia with sleep apnea. They include diseases and malformations with stenosis of the upper airways in the oropharyngeal area, particularly marked during sleep. They comprise also affections of nervous structures which innervate muscles in this area. The author pays attention to the frequent incidence of this syndrome in children with hypertrophic tonsils and adenoid vegetations. In this connection he mentions the cot death syndrome where very often death occurs during the apnoic interval as a result of immaturity of nervous structures which regulate respiration during sleep. The author describes also pathophysiological mechanisms of development of HSA and the diagnosis of this affection where examination by sleep polygraphy is essential. In the subsequent part of the work the author reviews contemporary conservative and surgical treatment of HSA.
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PMID:[Hypersomnia with sleep apnea. II]. 233 39

Infant mortality rates in Scotland have fallen by 56.6 per cent from 19.6 per 1000 live births in 1970 to 8.5 per 1000 in 1987. The reduction has been more marked in the early neonatal period than at later ages. The causes of death, based on generally high post-mortem rates, have been examined in functional groups and the changes over time are described. Ninety per cent of neonatal deaths throughout the period reviewed were due to congenital anomalies, asphyxia or immaturity-associated conditions. Eighty per cent of post-neonatal deaths are now due to congenital anomaly or sudden infant death syndrome (SIDS). The principal shifts in cause of death groups from infections and external causes in the 1970s to SIDS in the 1980s are described in detail and are probably related to improved recognition of the syndrome of sudden infant death, rather than to true changes.
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PMID:Trends in infant mortality in Scotland, 1970-1987. 239 Mar 14

The aim of the present study was to examine whether immaturity of cardiorespiratory control corresponds to a less mature behavioural state pattern and/or to less efficient feeding behaviour. Fifty-four infants were observed and data polygraphically recorded for 6 hours; a feeding session was included. It was found that infants with immature cardiorespiratory control spent more time in REM-sleep, less time in the active awake state, and were more likely to be inefficient feeders. In addition, 100 infants were observed for risk signs of sudden infant death syndrome and their parents were asked to answer a questionnaire on the sleeping and feeding behaviour of their infants. The majority of the infants with immature cardiorespiratory control were described as bad feeders but good sleepers. We conclude that gathering information about sleeping and feeding behaviour is useful when screening for immaturity of cardiorespiratory control.
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PMID:Feeding, behavioural state and cardiorespiratory control. 338 29

We have examined in a group of normal infants and in an "at-risk" group with clinical sleep apnea syndrome the duration and frequency distribution of apneas during sleep. In order to improve the estimation of an apnea factor, we introduced a weighting function which is based on the expected frequency distribution of apnea durations of normal infants. We were able to observe a good agreement between clinical rating, based on anamnestic symptoms, and numerical scoring. All infants of the at-risk group were treated with aminophylline, and the respiratory state improved significantly in nearly all cases. Breathing hypoxic gas mixtures tended to depress respiration, especially in the at-risk group, with a pronounced drop of pO2-values. Investigations on the coordination of respiration, sucking, and swallowing during nutritive sucking demonstrated a correspondence between disturbed coordination ability and the sleep apnea syndrome (SAS). This relationship is interpreted to be a result of an immaturity of the autonomic nervous system. In order to evaluate possible hereditary components in conjunction with respiratory disorders and, possibly, SIDS, we studied siblings of SIDS victims, of near-miss infants, and of infants with SAS. Only siblings of SAS and near-miss infants showed clinical signs of respiratory disorders with a rather high prevalence, whereas most of the siblings of SIDS victims were completely lacking conspicuous respiratory symptoms. Our results suggest that not all infants with sleep apnea syndrome are necessarily at increased risk for SIDS.
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PMID:Physiological approaches to respiratory control mechanisms in infants. Assessing the risk for SIDS. 342 35

Clinical apnoea in infants is defined as a pause in breathing of more than 20 s duration or a briefer pause associated with bradycardia. Such events are uncommon in term infants and usually are due to some precipitating factor. They occur more commonly in preterm infants and there is an exponential increase in incidence with decreasing gestational age at birth. Although insults such as infection or hypoxia can accentuate the problem, the major factor appears to be immaturity. Studies of brain-stem maturity using auditory evoked responses indicate that infants with immature responses have a higher incidence of apnoea. Brain-stem immaturity has also been implicated in histopathological studies of infants dying from Sudden Infant Death Syndrome (SIDS). In preterm infants, upper airway obstruction occurs commonly at the end of longer events and some infants have a predominantly obstructive pattern. These latter infants are often neurologically abnormal and have had prolonged endotracheal intubation. Both of there factors could be associated with disordered control of upper airway patency. This notion is supported by the finding of upper airway instability during nasal occlusion in these infants. A link with SIDS is uncertain, although preterm infants with chronic pulmonary insufficiency, usually following a prolonged intubation, are said to be at particularly high risk of dying suddenly and unexpectedly during infancy.
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PMID:Apnoea in the newborn infant. 353 81

Apneas in the different sleep states are commonly observed in the full-term healthy newborn infant. Central and short apneas prevail whilst apneas greater than 15 sec. are rare; a marked incidence of short apneas (less than 10 sec.) was observed in active sleep, even though apneas are not exclusive of active sleep. There is a strong inter-individual variability of apnea incidence. Apnea incidence in a state is not positively correlated to apnea incidence in different behavioural states: on the contrary there seems to be an opposite correlation between incidence in AS and QS. Apnea occurrence is positively correlated, in individuals, to the periodic breathing percentage. Apneas number and their duration is markedly lowered already in the second month of life. Periodic breathing must be considered a feature of immaturity. Obstructive apneas are less frequent than central apneas: their survey requires sophisticated technics with the aid of simultaneous recording of several breathing parameters. Relationship between central apneas/ obstructive apneas and mixed apneas is not known. Certainly obstructive and mixed apneas occurrence has been underestimated because of technical difficulties deriving from their survey. The meaning of an incidence of short apneas markedly higher than normal in full-term newborn infants is controversial and not clear, individuals with long apneas and subjects with short apneas in excess have been considered infants at SIDS risk. It is not clear whether periodic breathing and apneas depend on a common pathogenesis; the correlation between high incidence of periodic breathing in postnatal period and SIDS risk is still controversial. Few Authors suggest to treat newborn infants with extended apneas in sleep and considerable percentage of periodic breathing with aminophylline. The relation between gastro-oesophageal reflux and apnea has been recently evidenced. Central apneas and obstructive apneas during breast and bottle feeding have also been documented. Differently from pre-term infant apneas, bradycardia, although not exceptional, is not frequent during apneas in full-term newborn infants.
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PMID:[Apnea during sleep and wakefulness in term newborns]. 360 11

An evident coincidence exists between increased and extended apneas during sleep and frequent gastroesophageal reflux as well as disturbances of propulsive esophageal peristalsis. The tendency to develop apnea and disturbed esophageal function are related to the degree of the maturity of the patient. This indicates that in some infants, a combined regulatory immaturity of the autonomic centers persists. Moreover, the gastroesophageal reflux fosters the clinical manifestation of sleep apneas. The risk of a reflex apnea accompanied by gastroesophageal reflux increases in proportion to the disturbance in the central respiratory regulation present at the same time. This pathomechanism can be considered one of the causes of the sudden infant death syndrome. The possibility of effective prophylaxis consists in treating the apneic tendency with aminophylline and the treatment of reflux by elevating the upper body and thickening the nourishment given.
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PMID:Combined disturbance of respiratory regulation and esophageal function in early infancy. 392 31


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