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

Maternal and cord blood samples were collected in 60 cases with or without rupture of membranes before and at term. Serum concentrations of calcium, copper, iron and zinc were determined by proton-induced X-ray emission. Maternal and cord serum ceruloplasmin and maternal hemoglobin were also determined. Mothers with preterm delivery showed significantly lower hemoglobin values than those with delivery at term. Concentrations of calcium, iron and zinc were higher in cord than in maternal serum whereas maternal copper levels were higher than respective cord levels in all groups. The cord copper and ceruloplasmin and also their fetal/maternal ratios were significantly lower in the group with preterm premature rupture of fetal membranes (PROM) than in other groups. Maternal serum zinc and calcium were lower in preterm groups than in term groups. The study suggests a possible role of copper in preterm PROM and of zinc in the initiation of preterm labor, whereas calcium and iron do not seem to be involved in the etiology of prematurity or PROM.
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PMID:The role of calcium, copper, iron and zinc in preterm delivery and premature rupture of fetal membranes. 653 71

Preterm infants with birth weights between 1,001 and 1,600 gm were randomly assigned at one week of age to three groups and fed a standard milk-based formula, the same formula with iron, or a soy-based formula with iron. Hematologic values and selenium status were then studied prospectively for five weeks. Rates of decline in hematocrit and hemoglobin did not differ significantly among the three groups and did not correlate with red cell selenium values or glutathione peroxidase activity. Attainment of vitamin E sufficiency was variable among the infants, with no significant intergroup differences. Plasma selenium concentrations did not change significantly, but plasma glutathione peroxidase activity declined consistently in all three groups. Under the conditions of this study, iron at a concentration of 12 mg/L of infant formula did not accelerate hemolysis; nor was there evidence of a direct association between selenium values and early anemia of prematurity.
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PMID:Hematologic and selenium status of low-birth-weight infants fed formulas with and without iron. 719 31

Ferritin concentrations in cord blood were determined in 22 normal term and 32 preterm infants (birth weights 600-2000 g). Eight of the preterms were SGA infants. AGA preterm infants had significantly lower concentrations than term infants, and the SGA preterm newborn had even lower levels. Plasma ferritin in cord blood of the term and AGA preterm infants correlated positively with plasma iron and transferrin saturations, but not with the transferrin level, while plasma iron and transferrin concentrations correlated positively. In a longitudinal study, 17 AGA preterm infants (birth weights 850-1500 g) were followed during the early anaemia of prematurity. Iron was supplemented from 4 weeks of age. Plasma ferritin rose rapidly during the first days after birth, peak levels being reached at 1-4 weeks. Thereafter linear falls (semilog) occurred with similar slopes in different infants. Transferrin concentrations showed a slow progressive increase from 0-8 weeks. Plasma ferritin, after reaching the peak value, correlated negatively with weight gain. No infant had low ferritin values indicating iron deficiency during the early anaemia.
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PMID:Plasma ferritin concentrations in preterm infants in cord blood and during the early anaemia of prematurity. 723 84

Ceruloplasmin plasma levels and erythrocyte superoxide dismutase activity were studied in appropriate for gestational age preterm infants (birth weights less than or equal to 1500 g) during the first 10 weeks of life. Preterm infants had significantly lower ceruloplasmin concentrations in cord blood than term infants, the mean level in the preterm infants being 0.07 g/l. At 1 week of age ceruloplasmin levels had risen significantly, whereupon a fall occurred at 2 weeks of age. Ceruloplasmin concentrations increased slowly and progressively from 4 weeks of age. The low ceruloplasmin concentration during the early anemia of prematurity seems not to interfere with iron mobilization. The superoxide dismutase activity per gram hemoglobin in cord blood erythrocytes from normal term infants was significantly lower than that of red blood cells from adults. When the activity was expressed per erythrocyte no difference was found. The normochromic macrocytic red blood cells of the neonate most likely explain this discrepancy. The erythrocyte superoxide dismutase activity of the preterm infants did not change from birth until 10 weeks of age, and the levels seemed adequate judged from the levels found in red blood cells from adults and cord blood from term infants. Neither ceruloplasmin nor erythrocyte superoxide dismutase activity seem to play a role in the etiology of the early anemia of prematurity.
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PMID:Ceruloplasmin levels and erythrocyte superoxide dismutase activity in small preterm infants during the early anemia of prematurity. 732 38

Twenty-four premature infants, < 32 weeks gestational age, were randomly assigned in a double-blind, placebo-controlled trial to 6 weeks of treatment with either recombinant human erythropoietin (rHuEpo) 150 U/kg three times per week given sc (n = 12) or placebo (n = 12). The infants were fed a diet rich in protein (3.2 g/kg/day) and energy (130 kcal/kg/day) based on their own mother's milk fortified with bovine protein together with moderate iron supplementation (4 mg/kg/day). During the treatment (rHuEpo versus placebo) significant differences in mean (+/- SD) reticulocyte count (4.8 +/- 1.2 versus 2.7 +/- 1.4%; p < 0.01), mean packed red cell volume (PCV) (0.38 +/- 0.03 versus 0.34 +/- 0.04, p < 0.05) and mean haemoglobin concentration (12.6 +/- 1.1 versus 11.5 +/- 1.2 g/100 ml; p < 0.05) were found. Within the rHuEpo group, PCV and haemoglobin concentration remained unaltered from entry to 1 week after cessation of treatment whereas a significant decline was observed in the placebo group. No indications of iron deficiency were seen. We conclude that moderate doses of rHuEpo given to infants fed a diet rich in protein and energy are effective in ameliorating anaemia of prematurity. High iron supplementation does not seem to be essential for a significant erythropoietic response. No adverse effect attributable to rHuEpo was observed.
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PMID:Enhancement of erythropoiesis by erythropoietin, bovine protein and energy fortified mother's milk during anaemia of prematurity. 754 3

In order to prevent or to treat anemia of prematurity, more than 800 preterm infants were enrolled into controlled studies with recombinant erythropoietin (rhEPO) during the past five years. The effective dosage seems to be within the range of 300 to 1200 IU/kg per week, markedly higher than in adults or children with anemia due to renal failure. No adverse events nor impairment of granulopoiesis or platelet formation could be attributed to erythropoietin. Statistical metaanalysis of eight controlled trials revealed an 18% reduction of transfused infants. The preventive effect was scarce in very small and very sick preterm infants, and during the first two weeks of life, when hemorrhagic anemia due to diagnostic blood loss is predominant. rhEPO treatment is one step in the concept to prevent anemia of prematurity. This concept should also include placental transfusion, minimizing of diagnostic sampling, miniaturized laboratory tests, adequate iron supplementation, and optimal nutritive protein administration.
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PMID:Recombinant erythropoietin for prevention of anemia in preterm infants. 765 11

It has been well established that erythropoietin (EPO) in the dosage range of 500 units/kilo/week and perhaps slightly lower doses will produce a brisk reticulocyte response in infants with anemia of prematurity. Controlled clinical trials to demonstrate that this therapy can result in significant reductions in transfusion in these babies face several complex issues of experimental design. 1. Should the study population be relatively bigger, healthier babies (< 1500 grams birth weight, not on ventilatory support) who have lower transfusion requirements, or smaller sicker infants (< 1250 grams birth weight and on ventilators) who have higher transfusion requirements? These infants will need adequate nutrition and liberal supplementation with iron if they are to respond adequately, but the sicker smaller infants will take longer to meet these nutritional goals. 2. Timing is important because spontaneous recovery occurs at about 35 to 36 weeks of corrected gestational age, so to be effective, therapy must start before 33 weeks of gestational age and preferably earlier than that. 3. Since the end point is transfusion, the criteria used for transfusions become a critical issue. If liberal transfusion criteria are used, the study will be doubly biased in favor of EPO efficacy. There will be an increased number of transfusion events in the control population and spontaneous recovery from the anemia of prematurity will be overly suppressed in the control population. It's likely that the current transfusion criteria are too liberal thus introducing these biases to experimental design.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Erythropoietin therapy for extremely premature infants. 765 12

The prevelance of IDA in industrialized countries has declined in recent decades, but there has been little change in the worldwide prevalence. IDA is currently estimated to affect more than 500 million people. Recent studies have indicated that anemia per se, the most common manifestation of iron deficiency, is less important from a public health standpoint than liabilities associated with tissue iron deficiency. The most important of the latter are an impairment in psychomotor development and cognitive function in infants and preschoolers, a deficit in work performance in adults, and an increase in the frequency of low birth weight, prematurity, and perinatal mortality in pregnancy. There have been several recent advances in combatting nutritional iron deficiency. One of the major problems has been in distinguishing iron deficiency from other causes of anemia seen epidemiologically such as malaria, HIV infection, chronic inflammation, hemoglobinopathies, and protein energy malnutrition. When combined with serum ferritin and hemoglobin determinations, the serum transferrin receptor assay is a valuable addition in epidemiologic surveys because it provides a quantitative measure of functional iron deficiency and it distinguishes true IDA from the anemia of chronic disease. The most difficult challenge is to develop effective methods of supplying iron to large segments of a population. Supplementation with iron tablets is suitable for only brief periods of need such as during pregnancy. The poor compliance with existing supplementation programs is believed to be due mainly to the gastrointestinal side effects of oral iron which can be eliminated by the use of a gastric delivery system. The most effective long-term strategy is to increase the intake of bioavailable iron in the diet. The customary approach has been to fortify a food staple such as wheat, rice, sugar, or salt, and thereby increase the iron intake of the entire population. However, because of concerns about the risk of cancer and heart disease in individuals with high iron stores, there is an increasing reluctance to supply iron to individuals who do not require it. A more effective strategy is to fortify food vehicles that are targeted to segments of the population at greatest risk of iron deficiency such as infants and school children. Because of the strong inhibitory properties of diets in regions of the world where iron deficiency is most prevalent, the use of NaFeEDTA has important advantages for food fortification.
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PMID:Iron deficiency: the global perspective. 788 26

Risk factors for lactational failure in puerperium were investigated. Sixty mothers with inadequate daily milk supply for their babies were the lactational failure group, and 60 mothers with similar age having babies with similar age and weight were chosen as the control group. Low prolactin levels, low serum iron and low serum ferritin levels and low aldosterone values and birth in community hospitals were associated with significantly increased risk of deficient lactation. High income of the family, increase osmolality of breastmilk, high systolic blood pressure of the mother, birth by cesarean section were some of the variables that increased the risk that could not reach the level of significance. Prematurity of the baby was not among the risk factors if the gestational ages were more than 30 weeks. It is concluded that physicians awareness of the factors that may adversely effect the initiation and continuation of lactation is vital. Correcting iron deficiency even if it is not overt, sparing more time for the mothers discussing the benefits of breastmilk to their babies, and avoiding cesarean section if possible may help increase the incidence of breastmilk feeding.
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PMID:Lactational failure--study of risk factors in Turkish mothers. 796 1

One hundred eighty-four premature infants, < 1800 g at birth and < 36 wk gestation, were entered into a study investigating the role of additional folate and vitamin B-12 supplementation of the anemia of prematurity. All patients initially received vitamin E and iron in accordance with accepted standards. Patients were randomly assigned to four groups to receive orally 0.1 mg folate/d for 4 mo, 100 micrograms vitamin B-12 intramuscularly monthly for 4 mo, both supplements, or neither. All other activities including parenteral nutrition were carried out according to established practices, irrespective of study group. By 10-12 wk, infants treated with vitamin B-12 alone or combined with folate had higher hemoglobin values than the untreated (P < 0.0005) or solely folate-treated (P < 0.01) groups. These findings held true irrespective of wide variations in treatment and feeding practices. The only uncontrolled hematologic nutritional factor, selenium, showed a similar pattern of decline for 10-12 wk in all study patients, whether or not they received additional vitamin supplements.
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PMID:Premature infants require additional folate and vitamin B-12 to reduce the severity of the anemia of prematurity. 798 36


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