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

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

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

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

The study was aimed to evaluate possible relation between the probability of brain stem gliosis at the autopsy in infants who died of SIDS and of other known causes of death and some major infants characteristics. 131 infants (78 boys, 53 girls) who died in St. Petersburg in 1983 to 1989 of SIDS and 60 infants (37 boys, 23 girls) who died suddenly during the same period of time of other than SIDS known causes of death without signs of inborn malformations, tumours and intrauterine infections entered the study. Stepwise logistic regression was used in data analysis. No statistically significant association was found between the probability of brain stem gliosis and the following explanatory variables: gender, gestational and calendar age, weight at birth and at death. It was shown that the probability of brain stem gliosis depended of the cause of death (whether SIDS or not) and postconceptional age, two variables interacting. The probability of brain stem gliosis decreased with growing postconceptional age in the infants from both groups, less prominent in SIDS babies. The findings may serve an argument that delayed brain myelination and maturation is more often the case in the babies who died of SIDS, and that excessive brain stem gliosis may serve a marker of biological immaturity in a part of SIDS victims.
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PMID:Brain stem gliosis in the victims of sudden infant death syndrome (SIDS): a sign of retarded maturation? 775 48

SIDS (Sudden Infant Death Syndrome) is the major cause of death in young, apparently healthy, infants, yet its etiology and pathogenesis remain unknown. SIDS peaks at 2-4 months, is more prevalent in the winter months and typically occurs in the early morning hours when most babies are asleep, suggesting that sleep may be part of the pathophysiological mechanism of SIDS. The sleep patterns of infants at high risk for SIDS were analyzed to test the hypothesis that there are abnormalities specific to nighttime sleep which may be indicative of a central nervous system (CNS) deficit that contributes to a high frequency of SIDS during the night. Electrophysiological sleep variables were recorded at monthly intervals in 1-6 months-old infants during the peak age of SIDS. The risk group (R) was resuscitated from a potentially life-threatening Sudden A-Ventilatory Event (S.A.V.E.) and compared to a group of control infants (C) with no family history of SIDS. The data representing four equal time intervals from 11 p.m.-11 a.m. show an abrupt, statistically significant increase in REM sleep from 2-5 a.m. in R infants. In C infants, time spent in REM sleep after 2 a.m. becomes progressively shorter while NREM sleep is proportionately longer. From 11 p.m.-2 a.m., however, R and C infants do not differ either in the duration or in the percent of total sleep time (TST) of REM sleep. We hypothesize that these REM sleep abnormalities in vulnerable infants are indicative of a pervasive CNS immaturity. The higher prevalence of SIDS in the cold winter months and in the early morning hours, when darkness is prolonged, is discussed in relation to the possible involvement of the circadian rhythm of melatonin.
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PMID:SIDS, abnormal nighttime REM sleep and CNS immaturity. 963 61

SIDS is almost invariably sleep-related. Viable syndrome aetiology must be compatible with its many epidemiologically diverse risk factors, each of which directly or indirectly associates with the creation of psychological and/or physiological infant stress, and the subsequent disruption of normal, contented sleep. During essential deep 'rebound' recovery sleep, arousal ability and upper airway muscle tone decrease further to that in normal sleep, with subsequent upper airway obstruction. When stress impact causes sufficient sleep disruption and physiological fatigue, a failure to arouse and so restore sufficient tone to overcome such obstruction results in sudden, unexpected death. SIDS has therefore many causes which share a final lethal mechanical pathway. Evidence is presented for obstructive apnoea during sleep as being the primary syndrome death mode, for sleep disruption, reduced arousal ability, and infant stress in SIDS, and for risk factor association with the creation of this stress. Specific infant vulnerability in the first 6 months of life to stress predominantly related to total dependency on a carer for gratification of need, and to obstructive sleep apnoea due to normal anatomical, physical, and respiratory immaturity, including rapid physiological fatigue, and peaks in sleep and thermal stress vulnerability, are discussed. Further reasons for the limited age period of SIDS, and for reduced neonatal risk, are given. Prone sleeping risk can relate to positional airway obstruction during normal sleep without prior infant stress. Much of SIDS aetiology appears to concern factors related to socio-economic deprivation and subsequent sub-optimal infant care.
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PMID:Infant stress and sleep deprivation as an aetiological basis for the sudden infant death syndrome. 1117 74

The annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is attached. This Committee has as its mission the review of infant and child death so that information can be transformed into action to protect young lives. The 2002 review area includes South Dakota's Minnehaha, Turner, Lincoln, Moody, Lake, McCook, and Union counties. In 2002 there was one death in this region due to SIDS, plus one infant death due to positional asphyxia that illustrates the hazards of soft bedding and prone sleeping. These data reflect the need to remain vigilant in the public campaign to promote "back to sleep" and safe sleeping environments for infants. There were four other deaths due to accidental injury, mostly representing immaturity in driving various vehicles. In 2002 there were two child abuse homicides, and three teenage suicides. The RICMRC invites other communities to join in its efforts to review deaths to prevent potential life-threatening hazards to children in their local environs.
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PMID:The 2002 annual report of the Regional Infant and Child Mortality Review Committee. 1473 38