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

Higher levels of obstetric risk observed among teenage mothers seem to be an artifact of lower socioeconomic status and inferior access to health care rather than biological immaturity. In a study of matched Arkansas birth-infant death records for 1978, the proxy variables for health access (month care started and number of visits) have the strongest association with each of the dependent variables. The indicators of social status (education, race, and marital status) have a weaker association, and there is virtually no age effect observable once the affects of socioeconomic status and health access have been controlled for. A series of stepwise regression analyses shows that the multiple partial for health access indicators and mortality is 0.036, while the same coefficients for social status indicators and age are 0.001 and 0.006, respectively. Similar results are obtained using the other dependent variables. Health consequences of adolescent pregnancy usually include higher rates of malnutrition and prematurity and lower birth weight. It seems that the elevated morbidity and mortality among newborns delivered by teenagers are not a result of biologic factors. After the effects of lower status and health care access have been removed, the apparent biological disadvantages attributed to teenagers disappear, and, in the case of mortality and birth weight, are replaced by a slight advantage. This advantage is observed through the use of statisitical controls and will not be observed in the population at large unless there are changes in the policies governing access to contraception, abortion, and health care by adolescents, especially those at the youngest ages.
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PMID:Age of mother and pregnancy outcome in the 1981 Arkansas birth cohort. 668 Feb 50

According to national mortality statistics and to epidemiologic surveys main causes of infant mortality are congenital malformations, prematurity with its immaturity related morbidity, asphyxia, and, more recently, the sudden infant death syndrome. In all these situations the full scale of possible preventive measures has not been exhausted. This applies, in particular, to disorders in the perinatal period. What is needed is a greater awareness of risks, more gynecological interest in the baby and better teamwork between gynecologist and pediatrician; this also means a more effective use of available resources. Infant mortality rate still could be reduced by 50 percent.
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PMID:[Infant mortality- course, causes, improvement possibilities]. 668 28

Besides oxygen administration and immaturity of the premature retinal vessels, there are other risk factors for retrolental fibroplasia: (1) respiratory distress syndrome; (2) multiple episodes of bradycardia apnoea; (3) exchange transfusions; (4) hyaline membrane disease; (5) anemia of prematurity; (6) hyperbilirubinemia; (7) avitaminosis E; (8) cardiovascular defects; (9) infectious diseases; (10) multiple births; (11) hypocalcemia; (12) hypothermia; (13) hemorrhagic tendency; (14) delayed coaptation of the retina, and (15) spastic diplegia.
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PMID:Risk factors for retrolental fibroplasia. 668 25

Sixty-one patients with preterm rupture of membranes were studied. Transabdominal amniocentesis was performed successfully in 42 patients (68.8%). Among these 42, 26 (61.9%) had a lecithin:sphingomyelin (L:S) ratio of 1.8 or greater and 16 (38.1%) demonstrated pulmonary immaturity. Amniotic fluid obtained from vaginal pooling was compared to fluid obtained transabdominally in seven patients and did not demonstrate any significant differences in L:S values. Gram stain and subsequent culturing of amniotic fluid obtained transabdominally was accomplished in 41 patients. Seven of the 41 patients (17.0%) had bacteria on Gram stain and/or subsequent amniotic fluid growth. All patients with either bacteria on Gram stain or a positive amniotic fluid culture developed clinical amnionitis or endometritis. Review of the neonatal morbidity and mortality in relation to gestational age of infants with preterm rupture of membranes suggests that: 1) In infants at less than 32 weeks' gestation, amniocentesis need not be done for pulmonary maturity as the morbidity of prematurity in this group is too high even in the presence of pulmonary maturity. 2) In infants at 32 to 34 weeks' gestation, amniocentesis for L:S ratio, Gram stain, and culture is helpful in selecting those in whom delivery should be instituted. 3) In infants at greater than 34 weeks' gestation, the neonatal morbidity is sufficiently reduced so that delivery should be considered except in cases of suspected delayed pulmonary maturation.
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PMID:Use of amniocentesis in preterm gestation with ruptured membranes. 669 Oct 16

Medical records of 261 hospitalized patients less than 1 year old with documented respiratory syncytial virus (RSV) infection were reviewed to determine the incidence of RSV-associated apnea and the accompanying risk of subsequent apnea or death. Apnea in association with RSV infection occurred in 18% of the infants. Premature birth and a young postnatal age were risk factors for development of apnea with RSV disease. Apnea of prematurity appeared to be a significant risk factor for RSV apnea development in infants with a gestational age of 32 weeks or less at birth, but infants with RSV apnea did not appear to be at risk for subsequent apnea. These results suggested that in hospitalized infants, RSV apnea may be related to immaturity of respiratory drive. Two of the 48 infants with RSV apnea subsequently died during the first year of life.
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PMID:Respiratory syncytial virus-related apnea in infants. Demographics and outcome. 670 69

The influence of intrahepatic pregnancy cholestasia on fetal risk is examined. Fetal risk depends predominantly on prematurity and immanent somatic and neurologic immaturity. The rate of premature labour is 35 per cent. The rate of premature labour increases in correlation to rising values of serum ALAL and bilirubin. Antepartum and intrapartum cardiotocography, urinary excretion of total estrogens during 24 hours, serum human placental lactogen, fetal outcome and birthweight are not influenced by pregnancy cholestasia.
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PMID:[Intrahepatic pregnancy cholestasis and fetal risk]. 671 Nov 87

Airway obstruction is a cause of apnea in preterm infants. The activity of protective respiratory reflexes was determined in 18 preterm infants with apnea (mean of 32 episodes of more than 20 seconds duration per day) and in 18 neonates without apnea used as control subjects. This was done in order to elucidate the role of respiratory reflexes in apnea of prematurity. The infants were matched for birth weight (1,068 g v 1,065 g), gestational age (30.2 weeks v 30.2 weeks), and postnatal age (8.6 days v 8.3 days). The airway occlusion technique was used to determine the inspiratory prolongation of the occluded breath and the effective elastance of the respiratory system. Inspiratory prolongation is a measure for the reflex influence on inspiratory duration, and effective elastance reflects load compensating ability. Inspiratory prolongation was 7.3% +/- 33.5% in infants with apnea and 30.6% +/- 22.7% in the control group (P less than .025). Effective elastance was 1.1 +/- 0.5 cm H2O/mL in the apneic group and 1.5 +/- 0.5 cm H2O/mL in the infants without apnea (P less than .025). The results indicate that during exposure to respiratory loads, the infants with apnea maintained inspiratory effort poorly and had a decreased ability for load compensation. Their respiratory reflexes were significantly more immature than the reflex activity of the infants without apnea. This functional immaturity of respiratory reflexes may be a contributing factor in the etiology of apnea of prematurity.
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PMID:Apnea of prematurity: II. Respiratory reflexes. 673 19

In studying the human lipid transport system as it changes from the fetal to the adult form, data were collected on cord sera levels of lipids and apolipoproteins (A-I, A-II, ApoB, C-I, C-II, C-III, ApoD, and ApoE) from infants whose lipid metabolism might have been modified by a variety of factors present before, at, or after delivery. The results clearly indicated that many factors affect the levels of both lipids and apolipoproteins at birth. Method of delivery had little effect except in relation to either fetal immaturity (increased total cholesterol) or fetal stress (increased triglycerides). Birth weight was related to changes in free cholesterol, C-I, C-III, and ApoE levels. Gestational age had greater impact upon both serum lipids and apolipoproteins. With increasing fetal maturity, total cholesterol, free cholesterol, A-II, C-II, and ApoE progressively fell whereas triglyceride and ApoD rose. A variety of clinical disorders were also associated with changes in serum lipid and apolipoproteins. Anencephaly produced marked increases in both free and total cholesterol as well as most apolipoproteins. Significant reductions in triglyceride and ApoD levels were found in infants who subsequently became ill in the postnatal period with problems relating to carbohydrate metabolism (e.g., infants of diabetic mothers). Infants with respiratory distress were found to have decreased levels of total cholesterol and ApoB, both of which are increased in prematurity, a condition with which respiratory distress (RD) is usually associated. The changes in cord sera lipid and apolipoprotein levels found in a variety of clinical situations may provide new diagnostic approaches to postnatal problems arising in the newborn.
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PMID:Factors affecting the lipid and apolipoprotein levels of cord sera. 682 36

Early studies suggest that transient tachypnea of the newborn is a benign disease of uncertain etiology. Consequently, prevention of this complication has not been a primary concern of obstetricians. In this study of amniotic fluid phospholipids, 55 pregnancies in which the neonate developed transient tachypnea were compared to 355 pregnancies after which respiratory distress did not occur. Thirteen neonatal complications and procedures, often associated with prematurity, were significantly increased in the infants who developed transient tachypnea. Potential risk factors for transient tachypnea were examined by stepwise discriminant analysis. Negative amniotic fluid phosphatidylglycerol, prematurity (less than 38 weeks), and 1-minute Apgar score less than 7 all made an independent contribution to the overall characterization of infants at increased risk for transient tachypnea. These findings suggest that mild fetal lung immaturity may be a factor in the pathophysiology of this syndrome, and that the relationship of perinatal factors associated with transient tachypnea of the newborn in previous studies, including maternal diabetes mellitus and cesarean birth, may be partially mediated through a neonatal surfactant deficiency.
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PMID:Transient tachypnea of the newborn: the relationship to preterm delivery and significant neonatal morbidity. 685 31

This study deals with clinical results obtained at the neonatal intensive care unit of the Kinderklinik der Stadt Wien - Glanzing since its inception in 1974. An analysis of our newborn cases-admitted from 14 obstetric departments in Vienna and some obstetric departments in Lower Austria and Burgenland soon after birth-points to the fact that prematurity is still the most important risk factor in neonatal mortality. The results show that the prognosis of high-risk newborn infants depends very much on condition in the delivery room following primary resuscitation, the neonatal mortality increases with immaturity, hyaline membrane disease is the most important indication for artificial ventilation of premature infants, 30% of all patients requiring artificial ventilation are fullterm infants; 45% of them suffer from cerebral respiratory dysfunction, the mortality rate in mechanically-ventilated infants could not be significantly decreased over the past years. The consequences are discussed.
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PMID:[A 5-year review of neonatal intensive care at the kinderklinik der stadt wien - glanzing, neonatal intensive care centre (author's transl)]. 732 71


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