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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study, the diagnostic and predictive value of brainstem, middle latency, and cortical auditory evoked responses (BMC-AERs) obtained in the neonatal period in 81 preterm infants was assessed in relation to neurodevelopmental outcome. The preterm infants were neonatally classified according to risk category and gestational age. The BMC-AERs were analyzed with respect to detectability, latencies, and amplitudes as well as derived latency and amplitude measures. At 5 y of age the neurodevelopmental outcome was assessed from neurologic and neuropsychologic evaluations. The results showed that BMC-AER differences mainly correlated with risk category (low risk/high risk) and to some extent with degree of prematurity. In view of these findings the degree of prematurity and the effect of risk category have to be taken into account, when BMC-AERs are applied in the preterm period to predict neurodevelopmental outcome. In this study the BMC-AERs for infants with abnormal neurodevelopmental outcome were scarcely distinguishable from the BMC-AERs for infants with normal neurodevelopmental outcome. Thus far, this and previous reports have indicated that BMC-AERs in preterm infants are useful in maturational studies and with infants showing symptoms related to lesions or dysfunction of the peripheral and/or central auditory system. For predicting neurodevelopmental outcome in preterm infants, BMC-AERs are of limited clinical value.
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PMID:Diagnostic and predictive value of auditory evoked responses in preterm infants: II. Auditory evoked responses. 935 42

The objective of this study was to evaluate the performance of dual energy x-ray absorptiometry (DXA) in forearm measurements of preterm and newborn term infants. The accuracy and linearity of DXA in measuring low mineral content levels (ranging from 30 to 300 mg) was assessed using bone-simulating K2HPO4 phantoms. For in vivo precision, DXA was performed twice on left forearms of four new-born term babies, 21 preterm infants at corrected age 3 mo, and 20 at corrected age 6 mo. Bone mineral content (BMC in mg) and areal bone mineral density (BMD in mg/cm2) at distal forearm and forearm shaft were measured. A special software program allowing a free adjustment of the bone detection threshold was used in the analysis of the scan data. The threshold level affected the overall ability of analysis to detect bone tissue and altered significantly the BMC and BMD values too. Given absolute success in detecting low amounts of bone mineral (BMC > 100 mg), the lowest bone detection threshold evaluated (0.040 g/cm2) became the preferable choice. The relationships between the actual and measured data were highly linear (r was 0.94 for BMC and 0.97 for BMD) but showed underestimation (corresponding slopes were 0.66 and 0.64). In vivo precision expressed as 95% limits of agreement was approximately +/-45 mg for BMC and +/-16 mg/cm2 for BMD. We conclude that DXA provides adequate reliability for in vivo determinations of BMC and areal BMD in the distal and shaft sites of forearm in term and preterm infants and thus strongly supports the clinical utility of DXA in the diagnosis and monitoring of metabolic disease of prematurity. Movements during scanning are typical of pediatric measurements and may decrease the precision considerably. Therefore, every effort must be made to prevent movement artefacts. In addition, special attention must be paid to keeping the analysis procedures consistent.
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PMID:Dual energy x-ray absorptiometry of the forearm in preterm and term infants: evaluation of the methodology. 989 Jun 16

BACKGROUND: Uncertainty remains about the potential harmful effects of antihypertensive therapy on the developing fetus, especially for beta-blockers (betab). METHODS: We prospectively enrolled all singleton women with a blood pressure >/= 140/90 mm Hg during pregnancy. The main analysis included 1948 women with all forms of hypertension and compared the use of betab drugs, non-betab drugs or a combination of both, to no treatment. The primary study outcome was a composite of the diseases of prematurity, need for assisted ventilation for greater than 1 day, or perinatal death. A sub-group analysis evaluated the four treatment options among 583 singleton women with chronic hypertension before 20 weeks gestation. RESULTS: In the main analysis, no association was observed between betab use and the primary composite outcome [adjusted odds ratio (OR) 1.4, 95% CI 0.9-2.2], while an association was seen with non-betab therapy (OR 5.0, 95% CI 2.6-9.6) and combination therapy (OR 2.9, 95% CI 1.8-4.7). In the sub-group of 583 women with hypertension before 20 weeks, use of a non-betab drug (OR 4.9, 95% CI 1.7-14.2) or combination therapy (OR 2.9. 95% CI 1.1-7.7) was significantly associated with the primary composite outcome, while betab monotherapy was not (OR 1.4, 95% CI 0.6-3.4). CONCLUSIONS: Maternal use of antihypertensive medications other than betabs was associated with both major perinatal morbidity and mortality, while betab monotherapy was not. The combined use of betab and non-betab medications demonstrated the strongest association. Before definitive conclusions can be drawn, a large multicentre randomized controlled trial is needed to address the issues of both maternal efficacy and fetal safety with the use of one or more antihypertensive agents in pregnancy.
BMC Pregnancy Childbirth 2001
PMID:Use of antihypertensive medications in pregnancy and the risk of adverse perinatal outcomes: McMaster Outcome Study of Hypertension In Pregnancy 2 (MOS HIP 2). 1173 73

BACKGROUND: To investigate obstetric prognosis in sisters of preeclamptic women. METHODS: We identified consecutive 635 sib pairs from the Birth Registry data of Kuopio University Hospital who had their first delivery between January 1989 and December 1999 in our institution. Of these, in 530 pairs both sisters had non-preeclamptic pregnancies (the reference group), in 63 pairs one of the sisters had preeclampsia and the unaffected sisters were studied (study group I). In 42 pairs both sister's first delivery was affected (study group II). Pregnancy outcome measures in these groups were compared. RESULTS: Unaffected sisters of the index patients had uncompromised fetal growth in their pregnancies, and overall, as good obstetric outcomes as in the reference group. The data on affected sisters of the index patients showed an increased prematurity rate, and increased incidences of low birth weight and small-for-gestational age infants, as expected. CONCLUSION: Unaffected sisters of the index patients had no signs of utero-placental insufficiency and they were at low risk with regard to adverse obstetric outcome, whereas affected sisters were high-risk. Clinically, affected versus unaffected status appears to be clear-cut in first-degree relatives regardless of their genetic susceptibility and unaffected sisters do not need special antepartum surveillance.
BMC Womens Health 2003 Feb 23
PMID:Obstetric prognosis in sisters of preeclamptic women - implications for genetic linkage studies. 1259 76

Prematurity is known to be associated with reduced bone mineral density (BMD) in childhood, but whether this condition has long-term detrimental consequences on adult bone structure is not known. In this study, we measured with peripheral quantitative computed tomography (pQCT) the total bone cross-sectional area, cortical area and wall thickness, cortical and trabecular density, and a density-weighed polar section modulus as a bone strength index (BSI) at distal and shaft sites of right radius and tibia in a group of 40 prematurely born, otherwise normally developed and healthy young adults (17 women and 23 men, aged 18 to 27 years) and compared their data to corresponding data obtained from a group of 42 control subjects born term (20 women and 22 men, aged 18 to 28 years). Body height and weight were similar in both groups, but the preterm group had significantly lower BSI values at distal sites of tibia (approximately -16%) and radius (approximately -13%) and at tibial shaft (approximately -11%) as compared to control group. In the weight-bearing tibia, BMC was lower and the lower BSI values were mainly due to smaller total bone cross-sectional area. For unknown reason, this prematurity-associated detrimental effect seemed to concern more men than women. In contrast, prematurity was not associated with volumetric trabecular and cortical densities at any measured bone site while the typical sex differences in bone density were observed. We conclude that prematurity is associated with somewhat smaller cross-sectional bone dimensions in terms of body size in young adulthood. Due to the cross-sectional design, this study could not reveal specific reasons but they may pertain to nutrition during the neonatal period and living habits in general.
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PMID:Bone structure and volumetric density in young adults born prematurely: a peripheral quantitative computed tomography study. 1578 Sep 65

The influence of dietary docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6) on infant central nervous system (CNS) composition has implications for neural development, including vision, cognition, and motor function. We consider here combined results of three published studies of DHA/AA-containing formulas and breastfeeding to evaluate the CNS tissue response of baboon neonates with varied concentration and duration of DHA/AA consumption [G.Y. Diau, A.T. Hsieh, E.A. Sarkadi-Nagy, V. Wijendran, P.W. Nathanielsz, J.T. Brenna, The influence of long chain polyunsaturate supplementation on docosahexaenoic acid and arachidonic acid in baboon neonate central nervous system, BMC Med. 3 (2005) 11; A.T. Hsieh, J.C. Anthony, D.A. Diersen-Schade, et al., The influence of moderate and high dietary long chain polyunsaturated fatty acids (LCPUFA) on baboon neonate tissue fatty acids, Pediatr. Res. 61 (2007) 537-45; E. Sarkadi-Nagy, V. Wijendran, G.Y. Diau, et al., The influence of prematurity and long chain polyunsaturate supplementation in 4-week adjusted age baboon neonate brain and related tissues, Pediatr. Res. 54 (2003) 244-252]. A total of 43 neonates born spontaneously at term, or preterm by Cesarean section, consumed diets with DHA-AA (%w/w) at several levels: none (0,0), moderate (0.3, 0.6), or high (>0.6, 0.67 or 1.2). CNS fatty acids were analyzed at 4 and 12 weeks postpartum for term baboons and 7.5 weeks for preterm neonates. CNS DHA was consistently greater by 5-30% in neonates consuming DHA and nearer 30% for cortex. In contrast, CNS AA was unaffected by dietary AA and decreased in all structures with age. Dietary DHA consistently supports greater CNS DHA and maintenance of cortex DHA concentration with feeding duration, while CNS AA is not related to dietary supply. These data on structure-specific LCPUFA accretion may provide insight into neural mechanisms responsible for suboptimal functional outcomes in infants consuming diets that do not support the highest tissue DHA levels.
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PMID:Dietary docosahexaenoic acid but not arachidonic acid influences central nervous system fatty acid status in baboon neonates. 1952 25