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

Observations of nutritional level were made in 2338 lower income whi te women receiving care at the Vanderbilt University obstetric clinic. 73% received no dietary supplement while the remaining 27% received varied supplementation seldom extending through the whole period of gestation. There was a decrease of approximately 200 calories daily in the average intake between the second and third trimesters, partly in response to the physician's request and partly due to the mother's initiative. It is postulated that this reflects lessened activity on the part of the mother. The change in blood constitutents fell into 4 patterns: 1) for total serum protein, serum Vitamin A, and urinary excretion of thiamine and riboflavin there was a decline during Weeks 32-34 of gestation followed by a postpartum rise; 2) for serum carotene, tocopherol, and the urinary excretion of N'-methylnicotinamide there was a progressive increase during pregnancy followed by a postpartum decline ; 3) for serum Vitamin C there was a slight decrease during gestation followed by a sharp decline in lactating mothers; 4) for iron there was a progressive increase in the absorption and utilization as pregnancy advances. Although the group had generally good nutrition some were underweight or overweight, some ate poorly, some excessively, some had low nutrient levels, and some had obstetric and pediatric complications. The underweight women were concentrated in the lower parity groups and had a higher incidence of prematurity but fewer neonatal deaths and congenitally malformed infants. The overweight group had a threefold increase in preeclampsia, more stillborn children, lowered frequency of puerperal morbidity, and more toxemia. The low hemoglobin group had excessive blood loss during the later 1/2 of pregnancy, delivery, or puerperium. Other studies have shown that infants of such women have anemia at 1 year and supplemental infant feeding is indicated. It appears that the recommended standards for calories are too high for the expectant mother of today. A diet that will provide essential nutrients is readily obtainable from food sources and except for specific supplementation in specific cases, the common obstetric routine of broad-spectrum nutrition supplementation is questioned.
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PMID:Vanderbilt cooperative study of maternal and infant nutrition. 1223 89

Public health and social policies at the population level (e.g., oral rehydration therapy and immunization) are responsible for the major reduction in infant mortality worldwide. The gap in infant mortality rates between developing and developed regions is much less than that in maternal mortality rates. This indicates that maternal and child health (MCH) programs and women's health care should be combined. Since 1950, 66% of infant deaths occur in the 1st 28 days, indicating adverse prenatal and intrapartum events (e.g., congenital malformation and birth injuries). Infection, especially pneumonia and diarrhea, and low birth weight are the major causes of infant mortality worldwide. An estimated US$25 billion are needed to secure the resources to control major childhood diseases, reduce malnutrition 50%, reduce child deaths by 4 million/year, provide potable water and sanitation to all communities, provide basic education, and make family planning available to all. This cost for saving children's lives is lower than current expenditures for cigarettes (US$50 billion in Europe/year). Vitamin A supplementation, breast feeding, and prenatal diagnosis of congenital malformations are low-cost strategies that can significantly affect infant well-being and reduce child mortality in many developing countries. The US has a higher infant mortality rate than have other developed countries. The American College of Obstetricians and Gynecologists and the US National Institutes of Health are focusing on prematurity, low birth weight, multiple pregnancy, violence, alcohol abuse, and poverty to reduce infant mortality. Obstetricians should be important members of MCH teams, which also include traditional birth attendants, community health workers, nurses, midwives, and medical officers. We have the financial resources to allocate resources to improve MCH care and to reduce infant mortality.
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PMID:Reducing infant mortality. 1228 45

Bronchopulmonary dysplasia (BPD) is a chronic lung disease of infancy which is associated with prematurity and early lung injury resulting from mechanical ventilation. Oxygen toxicity, barotrauma, and volutrauma play key roles in its pathogenesis. Parenteral administration of Vitamin A to the newborn is the current recommended preventive therapy for BPD. Vitamin A has been found to upregulate genes necessary for fetal lung growth and increase surfactant production in animal models. Supplementation of Vitamin A in late pregnancy increases the cord blood vitamin A levels proportionately. Hence, we hypothesize that Vitamin A supplementation during late pregnancy can decrease the incidence of BPD in newborns. This can be an effective adjunct to postnatal preventive therapy. Vitamin A supplementation in late pregnancy carries no risk of teratogenicity unlike in early pregnancy. Moreover, vitamin A deficiency in pregnancy is associated with depressed immune function leading on to increased infectious morbidity and can cause intrauterine growth retardation, low birth weight and anemia in newborns. Combining antenatal Vitamin A supplementation to the mother with postnatal supplementation to the newborn can effectively prevent BPD better than the traditional postnatal preventive therapy alone. It will also treat the highly prevalent vitamin A deficiency in pregnant mothers and newborns of the developing world.
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PMID:Vitamin A supplementation in late pregnancy can decrease the incidence of bronchopulmonary dysplasia in newborns. 2029 8

Prematurity is a high risk factor threatening the well-being of newborns and their somatic and psychological development in the future. Preterm babies need special medical care in which proper nutrition and metabolic control play an evident role. Our review presents the current knowledge concerning the clinical value of different methods investigated in the neonatal unit setting, including: protein markers of nutritional status (albumin,prealbumin, transferrin, and Retinol Binding Protein (RBP) and hormonal markers of nutritional status (somatomedin C, visfatin and ghrelin). Moreover, there is a discussion of the methods used for evaluating body composition. A variety of different techniques based on the physical properties of organisms was tested on neonates, e.g. the Dual Energy X-ray Absorptiometry (DEXA) method and Bioelectrical Impedance Analysis (BIA). Based on the review of the literature, we can speculate that none of the above methods represents a good single marker of the babies' nutritional status, or a prognostic factor for the future development of premature infants and infants born with IUGR. A combination of several methods from different groups seems to be a promising possibility. It is critical to continue looking for markers that will in a simple and efficient way help to optimize the correct nutritional therapy in infants with IUGR and those who were born prematurely.
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PMID:HOW TO DETERMINE THE NUTRITIONAL STATUS OF PRETERM BABIES?--REVIEW OF THE LITERATURE. 2695 97

Bronchopulmonary dysplasia (BPD) is one of the few diseases affecting premature infants that have continued to evolve since its first description about half a century ago. The current form of BPD, a more benign and protracted respiratory failure in extremely preterm infants, is in contrast to the original presentation of severe respiratory failure with high mortality in larger premature infants. This new BPD is end result of complex interplay of various antenatal and postnatal factors causing lung injury and subsequent abnormal repair leading to altered alveolar and vascular development. The change in clinical and pathologic picture of BPD over time has resulted in new challenges in developing strategies for its prevention and management. While some of these strategies like Vitamin A supplementation, caffeine and volume targeted ventilation have stood the test of time, others like postnatal steroids are being reexamined with great interest in last few years. It is quite clear that BPD is unlikely to be eliminated unless some miraculous strategy cures prematurity. The future of BPD prevention will probably be a combination of antenatal and postnatal strategies acting on multiple pathways to minimize lung injury and abnormal repair as well as promote normal alveolar and vascular development.
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PMID:Prevention of bronchopulmonary dysplasia: current strategies. 2877 56