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

General neonatal mortality statistics and those for the respiratory distress syndrome (RDS) were examined for the State of Wisconsin from 1979 through 1982. The objectives were to ascertain whether there are differences in total neonatal mortality related to sex and birth weight, to determine the veracity of reported gender differences in deaths due to RDS, and to assess the contribution of other risk factors for neonatal mortality to overall and sex-specific deaths occurring secondary to RDS. Additionally, a prospective analysis was performed at one perinatal center during a 5-year period in attempts to determine whether gender remained a significant factor in deaths due to RDS after adjusting for incidence. Overall, the most frequent diagnoses in those who died were RDS (15.6%), deaths due to complications of pregnancy (8%), immaturity (4.2%), and asphyxia (3.4%). The majority of fatalities for both sexes occur in neonates weighing less than 1 kg and the percentage of deaths attributable to RDS is greatest between 1 and 1.5 kg. The difference between sexes is also maximal in the latter weight group. Deaths secondary to RDS are greater for males regardless of Apgar score at one and five minutes, mode of delivery, maternal age, or ancillary diagnosis. These data suggest that deaths secondary to RDS are consistently greater in male neonates and that delivery within a limited "window" of time during gestation increases male susceptibility to fatal RDS.
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PMID:Discordance between male and female deaths due to the respiratory distress syndrome. 373

Neonatal deaths in Iowa were reviewed for the years 1982 and 1983. As in a similar review of deaths in 1978 and 1979, respiratory distress syndrome, bacterial sepsis, asphyxia, lethal malformations, and extreme immaturity accounted for approximately 90% of deaths. Fewer deaths occurred in 1982 and 1983 and the causes of death shifted toward the nonpreventable. Lethal malformations became the leading cause of death and showed an increased incidence over the previous period. The greatest reduction of deaths was in level 1 hospitals. Ability to effect further reduction in neonatal deaths was estimated by calculation of an idealized neonatal mortality rate for the state and each level of care. These calculations suggest that future reduction in mortality must come primarily from improved care in level 2 and 3 centers rather than from further change in level 1 provider behavior.
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PMID:The changing pattern of neonatal mortality in a regionalized system of perinatal care. 375 34

One hundred ninety-three amniotic fluid samples were tested for fetal lung maturity using a maturity cascade scheme involving the sequential use of, in order, the shake test, fluorescence polarimetry, and lecithin: sphingomyelin (L:S) ratio. If any of these tests indicated maturity, the sequence was terminated and no further test was performed, and the fetus was considered mature. Seventy percent of the tests yielded mature values and of these, 85 (63%) required a shake test only, 37 (27%) had a shake test and a fluorescence polarimetry, and only 14 (10%) required all three tests. From these 193 amniocenteses, 111 patients delivered within 72 hours of the procedure. One of 94 infants had respiratory distress syndrome after a mature test (1% false maturity) and ten of 17 had respiratory distress syndrome after an immature cascade (41% falsely immature). This approach saves time and cost and by confirming immaturity with multiple tests only when necessary and may improve predictability of neonatal respiratory distress syndrome.
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PMID:Fetal maturity cascade: a rapid and cost-effective method for fetal lung maturity testing. 375 19

An immunological method to measure phosphatidylglycerol (PG) levels was studied in 48 neonates with respiratory distress, by comparing the results with the lecithin sphingomyelin ratio (L/S) and with radioclinical data. In hyaline membrane disease (HMD), PG suggested immaturity in 91% of cases, as did L/S in 78%. In 6 of 20 cases with respiratory distress (30%) from other causes, PG level was low, which allows for discussion on the significance of this biological criterion as opposed to radiological and clinical criteria. This method of PG determination appears to be a more sensitive and reliable measure of lung maturity than the L/S ratio.
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PMID:[Value of a rapid determination of phosphatidylglycerol in the endotracheal aspirate of the newborn infant in respiratory distress]. 377 89

The optical density of amniotic fluid at 650 nm (OD650) has been proposed as a rapid means of assessing fetal pulmonary maturity. Two hundred eighty-two amniotic fluid samples were analyzed for OD650, L/S ratio and creatinine concentration, and those values were related to the infants' pulmonary outcome. Among those infants delivered within 72 hours of amniocentesis, pulmonary maturity was predicted accurately in 98.3% by the OD650, 97.7% by the L/S ratio and 97.6% by the creatinine concentration. All three tests were unreliable in predicting pulmonary complications when the tests revealed pulmonary immaturity. OD650 values were found to vary inversely with centrifugation speed, reaffirming the need for standardized processing techniques to achieve reliable results. Marked discrepancies occurred between the diagnoses given by three neonatologists asked to retrospectively evaluate the likely etiology of pulmonary problems in nine infants suspected of having respiratory distress syndrome.
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PMID:Comparison of amniotic fluid optical density, L/S ratio and creatinine concentration in predicting fetal pulmonary maturity. 402 Jul 87

Amino acid analysis of human fetal lung elastin was undertaken in 49 instances of live-born neonates, ranging from 380 g to full term, and in 3 abortuses of 12-14 wk gestation. The data suggest that formation of the cross-linking agents, desmosine and isodesmosine, occurs early, between 14 and 22 wk. The ratio of neutral to charged amino acids remains low until the 36th wk when it attains adult levels. The composition of elastin was independent of sex and duration of survival. In three neonatal pulmonary diseases (respiratory distress syndrome, atelectasis, and hemorrhage) ratios were significantly lower than those found in nondiseased lungs. This may be a reflection of immaturity or may be a predisposing factor in neonatal lung disease. The latter hypothesis is attractive and receives indirect support from the association of a more polar elastin with other diseases, including adult emphysema and atheromatous aortic change.Our finding of relatively high polarity in elastin from human fetal lung is consistent with previous observations in a variety of fetal organs of other species.
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PMID:Lung tissue elastin composition in newborn infants with the respiratory distress syndrome and other diseases. 483 91

The amylase concentration in the amniotic fluid (ACAF) was studied in 138 subjects in relation to duration of pregnancy, fetal weight, L/S ratios and neonatal occurrence of respiratory distress syndrome (RDS). ACAF was found to be significantly correlated with duration of pregnancy (p less than 0.001) and fetal weight (p less than 0.005). The number of false immature predictions, based on a critical value of ACAF of 200 U/l, was relatively high: 36% for the gestational age greater than or equal to 36 weeks, and 38% for fetal weight greater than 2,500 g. ACAF also showed a significant relationship with the L/S ratio (p less than 0.0001). ACAF less than 300 U/l correctly predicted all instances of L/S ratio less than 2.0; however, the rate of false low predictions was 60%. In only 22 out of 138 AF samples (16%) could the performance of an L/S ratio have been avoided on the basis of the ACAF. ACAF less than 300 U/l correctly predicted both cases of neonatal RDS in the study population; however, 1 of these fetuses had an ACAF of 260 U/l. There were four times as many false predictions of lung immaturity on the basis of ACAF less than 300 U/l as from the L/S less than 2.0.
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PMID:Amniotic fluid amylase concentration: a reliable predictor of fetal maturity? 618 79

Shortly after birth, a 1,860-g premature male newborn with respiratory distress syndrome had brisk diuresis, rapid weight loss, and severe hyponatremia despite aggressive Na+ and fluid replacement. The serum cortisol level was normal, and the 17-OH progesterone concentration was low. He did not show any response to treatment with dexamethasone and desoxycorticosterone acetate. Results of renal function studies were within the normal range for his gestational age. The serum aldosterone level and plasma renin activity were grossly elevated, confirming the diagnosis of pseudohypoaldosteronism. This uniquely early and dramatic presentation was attributed to immaturity of the proximal renal tubule at 32 weeks' gestation. The subsequent improvement paralleled the rapid maturation of the kidney after birth.
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PMID:Pseudohypoaldosteronism. 634 58

The process of adaptation for extrauterine life can be easily disturbed by respiratory insufficiency. The surfactant deficiency as well as anatomical and physiological immaturity of a newborn can be considered as etiological factors in some diseases, such as respiratory distress syndrome (RDS), transient tachypnoea (TT) syndrome, segmental atelectasis or pneumonia complicated by atelectasis. The widespread used method of treatment is based on mechanical increase of difference between alveolar and atmospheric pressure. So-called constant distending pressure (CDP) increases functional residual capacity (FRC), keeps alveoli open and finally increases oxygenation of arterial blood. During 3 years period continuous positive airway pressure by nasal route (n-CPAP) was used as only one method in 26 newborns. The newborns were treated because of RDS (15 cases) and pneumonia with atelectasis (11 cases). n-CPAP was starting with pressure 8 cm H2O (0.8 kPa) and FIO2 0.5, if atelectasis with severe dyspnea, hypoxia and forced hyperventilation were found. This method was very well tolerated. 22 newborns treated for 2-7 days--survived, 4 small-for-date babies--died. The most common cause of death was septicaemia complicated by disseminated intravascular coagulation. The moderate hyperbilirubinemia, oliguria with tissue oedema was observed in many cases. The light nostril decubitus were only complications. No pneumothorax was detected. We found n-CPAP as a simple, safe method in treatment of atelectasis in newborns.
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PMID:[Continuous positive pressure respiration by nasal route (n-CPAP) as a preferred treatment method in various types of acute respiratory insufficiency in newborn infants]. 637 92

Thyroxine (T4), triiodothyronine (T3), and thyrotropin (TSH) concentrations were measured on cord sera of 21 preterm infants with idiopathic respiratory distress syndrome (IRDS) and were compared to the values obtained from 15 healthy preterm infants. When log T3, log T4, and log TSH were considered as the dependent variables in the multivariate test Hotelling-Lawley-Trace, there was an overall difference between the two groups: F = 3.94, p = 0.03. When log T3 and log T4 were considered separately in an analysis of covariance, there was a significant difference between the two groups for log T3 after adjusting for birth weight and gestational age (F = 7.98, p = 0.008). However, for log T4 and TSH, there was no difference between the IRDS and control infants. These findings exclude the possibility of antenatal thyroid dysfunction in babies with IRDS. An explanation for reduced cord blood T3 concentration in infants with IRDS is lacking at present. Extrathyroidal factors that predispose to IRDS may also affect peripheral T3 generation. Alternatively, one might postulate that there is relative immaturity of both peripheral T3 generating pathway and lung development in infants who develop IRDS.
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PMID:Prenatal thyroid function abnormalities in infants with idiopathic respiratory distress syndrome. 649 49


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