Fat trajectory after birth in very preterm infants mimics healthy term infants

2018 ◽  
Vol 14 (3) ◽  
pp. e12472 ◽  
Author(s):  
N. A. Al-Theyab ◽  
T. J. Donovan ◽  
Y. A. Eiby ◽  
P. B. Colditz ◽  
B. E. Lingwood
Keyword(s):  
Preterm Infants ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm

Body Composition in Very Preterm Infants: Role of Neonatal Characteristics and Nutrition in Achieving Growth Similar to Term Infants

Neonatology ◽  
2016 ◽  
Vol 111 (3) ◽  
pp. 214-221 ◽  
Author(s):  
Geneviève Tremblay ◽  
Christine Boudreau ◽  
Sylvie Bélanger ◽  
Odette St-Onge ◽  
Etienne Pronovost ◽  
...  
Keyword(s):  
Body Composition ◽  
Preterm Infants ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Stereophotogrammetric head shape assessment in neonates is feasible and can identify distinct differences between term-born and very preterm infants at term equivalent age

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Petra Santander ◽  
Anja Quast ◽  
Johanna Hubbert ◽  
Laura Juenemann ◽  
Sebastian Horn ◽  
...  
Keyword(s):  
Body Weight ◽  
Preterm Infants ◽  
Total Duration ◽  
Neurodevelopmental Outcome ◽  
Small Sample ◽  
Head Shape ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm

AbstractThe development of head shape and volume may reflect neurodevelopmental outcome and therefore is of paramount importance in neonatal care. Here, we compare head morphology in 25 very preterm infants with a birth weight of below 1500 g and / or a gestational age (GA) before 32 completed weeks to 25 term infants with a GA of 37–42 weeks at term equivalent age (TEA) and identify possible risk factors for non-synostotic head shape deformities. For three-dimensional head assessments, a portable stereophotogrammetric device was used. The most common and distinct head shape deformity in preterm infants was dolichocephaly. Severity of dolichocephaly correlated with GA and body weight at TEA but not with other factors such as neonatal morbidity, sex or total duration of respiratory support. Head circumference (HC) and cranial volume (CV) were not significantly different between the preterm and term infant group. Digitally measured HC and the CV significantly correlated even in infants with head shape deformities. Our study shows that stereophotogrammetric head assessment is feasible in all preterm and term infants and provides valuable information on volumetry and comprehensive head shape characteristics. In a small sample of preterm infants, body weight at TEA was identified as a specific risk factor for the development of dolichocephaly.

scholarly journals Remifentanil Degradation in Umbilical Cord Blood of Preterm Infants

2011 ◽  
Vol 114 (3) ◽  
pp. 570-577 ◽  
Author(s):  
Lars Welzing ◽  
Sabine Ebenfeld ◽  
Verena Dlugay ◽  
Martin H. J. Wiesen ◽  
Bernhard Roth ◽  
...  
Keyword(s):  
Cord Blood ◽  
Preterm Infants ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Pharmacokinetic Data ◽  
Serum Samples ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Cord Serum ◽  
Very Preterm

Background No pharmacokinetic data about remifentanil in preterm infants exist, although remifentanil is increasingly used in this especially vulnerable subgroup of pediatric patients. Unfortunately, ethical restrictions in the volume of blood that can be withdrawn for kinetic sampling nearly prohibit pharmacokinetic studies in preterm infants. Methods Because remifentanil is rapidly metabolized by nonspecific blood esterases, we collected umbilical cord serum of preterm and term infants to investigate whether the activity of nonspecific blood esterases depends on gestational age. Umbilical cord serum, buffer solution, ascorbic acid, and remifentanil were mixed in a glass vial placed in a shaking water bath at 37°C. Subsequently, serum samples were subjected to liquid chromatography-mass spectrometry-based analysis of remifentanil and its metabolite GR90291 after 0, 30, 60, 100, and 150 min. Results We analyzed umbilical cord serum samples of 34 preterm infants (24-36 gestational weeks) and six term infants. The degradation rates of remifentanil to its major metabolite GR90291 were comparable in preterm and term infants. The overall median degradation half-life of remifentanil was 143 ± (interquartile range) 47 min (minimum, 76 min; maximum, 221 min) without significant differences between very preterm infants (less than 28 gestational weeks) and term infants. The remifentanil concentration remained stable in control runs without serum. Conclusions Our study demonstrates that very preterm infants exhibit a high nonspecific esterase activity in umbilical cord blood that is comparable with that of term infants. These results support clinical experiences that remifentanil is rapidly metabolized by preterm infants without prolonged side effects.

Very preterm infants displayed similar imitation skills to full‐term infants at term equivalent age

2021 ◽  
Author(s):  
Claire Koenig‐Zores ◽  
Mathilde Davy‐Monteil ◽  
Véronique Vincent ◽  
Dominique Astruc ◽  
Nicolas Meyer ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Full Term ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Equivalent Age ◽  
Very Preterm

scholarly journals To Characterize Standard Laboratory Coagulation Parameters and Plasma Thrombin Generation in Very Preterm Infants and to Investigate Their Relationship to Clinical Outcomes

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2827-2827
Author(s):  
Elaine Neary ◽  
Naomi McCallion ◽  
Barry Kevane ◽  
Melanie Cotter ◽  
Karl Egan ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Protein C ◽  
Thrombin Generation ◽  
Published Data ◽  
Advisory Committees ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Risk Of Bleeding ◽  
Coagulation Tests

Abstract Very premature infants are at risk of bleeding complications and are frequently given plasma because of a perception that coagulation test results are abnormal. However, “abnormal” clotting times may simply be due to physiological immaturity. We hypothesized that prospective characterization of coagulation tests alongside assessment of thrombin generation would provide information on overall haemostatic balance in this vulnerable patient cohort. In a prospective observational study, blood was drawn into citrated tubes from cord blood of neonates <30/40 and subsequently on day 1, 3 and fortnightly until 30/40 corrected gestational age from non-heparinised lines. Exclusion criteria included antenatal intraventricular haemorrhage and lack of informed consent. Platelet poor plasma was obtained by centrifugation of whole blood. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, procoagulant and anticoagulant factor activity were measured and tissue factor (TF)-stimulated thrombin generation was characterized in a calibrated automated thrombography assay with a 1pM TF stimulus using Thrombinoscope™ software. Control plasma was obtained from cord blood of term neonates. Between April 2013 and June 2014, 92 patients <30/40 were admitted. Six infants were excluded and 86 recruited. Mean gestational age and birth weight were 27 (23.7-29.9) weeks and 1019 (530-1590) g respectively. Median (5th-95thpercentile) Day 1 PT, APTT, and fibrinogen were 17.5 (12.9-26.7) s, 82.9 (53.4-139.8) s and 1.4 (0.7-3.7) g/L respectively which were significantly prolonged compared with published results of term infants; p<0.001. Serial analysis revealed correction of PT, APTT and fibrinogen with increasing postnatal age; p<0.001. Further analysis of procoagulant and anticoagulant mechanisms was performed in a subset of infants (N=16) where sufficient plasma was available from umbilical cord samples. Despite apparent “prolongations” in clotting times, we found that preterm peak thrombin generated was similar to term infants (94.3 (33.4-149.8) nM vs. 93.5 (74.3-133.8) nM; p=0.94). Minor, non-significant differences in the area under the thombin generation curve (endogenous thrombin potential) were observed (88 (37.1-126.3) nm/min vs. 101.3 (76.8-139.7) nm/min; p=0.09). Alpha-2-macroglobulin (α2M)-bound thrombin cleaves the fluorogenic thrombin substrate utilized in this assay and contributes to measured thrombin generation. However, in keeping with published data in a more mature cohort, α2M activity was lower in preterm vs. term infants. Consequently, we speculate that true ETP in preterm infants may be higher, undermining the current perception that these infants are at risk of bleeding due to “abnormal” clotting times. In keeping with published data in a more mature cohort, mean activity of procoagulant factors II, VII, IX and X were reduced in preterm vs. term infants (0.33 (0.18-0.5) IU/ml vs. 0.45 (0.35-0.6) IU/ml, p=0.003; 0.38 (0.14-0.57) IU/ml vs. 0.42 (0.31-0.59) IU/ml, p=0.29; 0.19 (0.09-0.50) IU/ml vs. 0.28 (0.19-0.37) IU/ml, p=0.004 and 0.33 (0.13-0.52) IU/ml vs. 0.43 (0.32-0.58) IU/ml, p=0.02) respectively. Conversely, activity of anticoagulant factors Protein C (0.14U/ml (0.06-0.24) IU/ml vs. 0.27 (0.18-0.39) IU/ml; p=0.002), free protein S (0.39 (0.28-0.55) IU/ml vs. 0.47 (0.36-0.59) IU/ml; p=0.02), antithrombin (0.22 (0.06-0.36) IU/ml vs. 0.52 (0.38-0.69) IU/ml; p=0.0001) and tissue factor pathway inhibitor (7.7 (2.6-16.9) vs. 10 (4.2-15.6) ng/ml; p=0.14) was lower in preterm vs. term infants. No differences in attenuation in thrombin generation in response to the anticoagulant activated protein C were observed in preterm vs. term infants, p=0.92. In conclusion, in the largest prospective study to date of very preterm infants, we describe typical ranges for widely available coagulation tests. We also demonstrate differences in both procoagulant and anticoagulant pathways, to which standard clotting tests may have limited sensitivity. Finally, we show for first time that thrombin generation is similar in very preterm and term infants. These findings call into question the current practice of exposing infants to plasma products based on standard laboratory parameters, a practice which is associated with enormous potential harm and is not evidence based. These findings have the potential to impact on neonatal practice worldwide. Disclosures Ní Áinle: LEO Pharma: Research Funding; Bayer Healthcare Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees.

scholarly journals 2902. Pertussis Antibody Levels in Preterm Infants After Maternal Tdap Immunization During Pregnancy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S83-S83
Author(s):  
C Mary Healy ◽  
Marcia Rench ◽  
Laurie Swaim ◽  
Gowrisankar Rajam ◽  
Fiona Havers ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Geometric Mean ◽  
Late Preterm ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Luminex Assay ◽  
Very Preterm ◽  
Maternal Immunization ◽  
Specific Igg ◽  
Antibody Levels

Abstract Background Maternal immunization with tetanus, diphtheria, acellular pertussis vaccine (Tdap) in the third trimester reduces infant pertussis, but data are lacking on how this strategy impacts pertussis antibody levels in large cohorts of preterm infants Methods We collected paired maternal delivery-cord sera from infants of women who received Tdap ≥7 days before birth. IgG to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by Luminex assay (IU/mL). Geometric mean concentrations (GMC) with 95% confidence intervals (CI) for pertussis antibodies were calculated. Four infant groups were compared by weeks of gestation: very (<32), moderate (32–33) and late preterm (34–36), and term (≥37). Results 344 preterm and 688 term mother-infant pairs were included. Among preterm infants, mean maternal age was 31.2 years (range 15.1–39.3); 37% were white, 37% Hispanic, 17% Black, 8% Asian and 1% other. Fifty-six were very preterm infants (16%, mean gestation 30.5 weeks), 82 moderate (24%, 33.1 weeks), and 206 late (60%, 35.4 weeks); 17 (5%) were born at <30 weeks. For preterm infants, Tdap was administered at a mean gestation of 29.9 weeks (very 27.9; moderate 29.7; late 30.4; [P < .001]), and at a mean interval of 29.3 days before delivery (very 17.9; moderate 24; late 34.5 [P <.001]). Eleven (3%) women received Tdap during the second trimester (8 very, 2 moderate, 1 late). GMCs (95% CI) of pertussis-specific IgG at birth varied by gestation (table). Infant antibody levels as a proportion of maternal antibodies increased from 24 to 32% in infants < 30 weeks to 117 to 132% in those ≥37 weeks (P<.001). Conclusion Although levels are lower than in term infants, maternal immunization with Tdap results in substantial pertussis-specific antibodies in most preterm infants, especially late preterm infants. Disclosures All Authors: No reported Disclosures.

Very preterm infants show earlier emergence of 24-hour sleep–wake rhythms compared to term infants

2015 ◽  
Vol 91 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Caroline Guyer ◽  
Reto Huber ◽  
Jehudith Fontijn ◽  
Hans Ulrich Bucher ◽  
Heide Nicolai ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Preterm birth alters the maturation of the GABAergic system in the human prefrontal cortex

2021 ◽  
Author(s):  
Helene Lacaille ◽  
Claire-Marie Vacher ◽  
Anna A Penn
Keyword(s):  
Prefrontal Cortex ◽  
Preterm Infants ◽  
Gene List ◽  
Gabaergic System ◽  
Developmental Changes ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Maturation Index ◽  
The Impact

Developmental changes in GABAergic and glutamatergic systems during frontal lobe development have been hypothesized to play a key role in neurodevelopmental disorders seen in children born very preterm or low birth weight, but the associated cellular changes have not yet been identified. Here we studied the molecular development of the GABAergic system specifically in the dorsolateral prefrontal cortex, a region that that has been implicated in neurodevelopmental and psychiatric disorders. The maturation state of the GABAergic system in this region was assessed in human post-mortem brain samples, from term infants ranging in age from 0 to 8 months (n=17 male, 9 female). Gene expression was measured for 47 GABAergic genes and used to calculate a maturation index. This maturation index was significantly more dynamic in male than female infants. To evaluate the impact of premature birth on the GABAergic system development, samples from one-month-old term (n=9 male, 4 female) and one-month corrected-age (n=8 male, 6 female) very preterm infants, were compared using the same gene list and methodology. The maturation index for the GABAergic system was significantly lower in male preterm infants, with major alterations in genes linked to GABAergic function in astrocytes, suggesting astrocytic GABAergic developmental changes as a new cellular mechanism underlying preterm brain injury.

scholarly journals Hospitalizations for respiratory syncytial virus bronchiolitis in preterm infants at <33 weeks gestation without bronchopulmonary dysplasia: the CASTOR study

2012 ◽  
Vol 141 (4) ◽  
pp. 816-826 ◽  
Author(s):  
J.-B. GOUYON ◽  
J.-C. ROZÉ ◽  
C. GUILLERMET-FROMENTIN ◽  
I. GLORIEUX ◽  
L. ADAMON ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Full Term ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
Country Specific

SUMMARYThis study was conducted during the 2008–2009 respiratory syncytial virus (RSV) season in France to compare hospitalization rates for bronchiolitis (RSV-confirmed and all types) between very preterm infants (<33 weeks' gestational age, WGA) without bronchopulmonary dysplasia and full-term infants (39–41 WGA) matched for date of birth, gender and birth location, and to evaluate the country-specific risk factors for bronchiolitis hospitalization. Data on hospitalizations were collected both retrospectively and prospectively for 498 matched infants (249 per group) aged <6 months at the beginning of the RSV season. Compared to full-term infants, preterm infants had a fourfold [95% confidence interval (CI) 1·36–11·80] and a sevenfold (95% CI 2·79–17·57) higher risk of being hospitalized for bronchiolitis, RSV-confirmed and all types, respectively. Prematurity was the only factor that significantly increased the risk of being hospitalized for bronchiolitis. The risk of multiple hospitalizations for bronchiolitis in the same infant significantly increased with male gender and the presence of siblings aged ⩾2 years.

scholarly journals Postnatal Serum Total Thyroxine of Very Preterm Infants and Long-Term Neurodevelopmental Outcome

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1055
Author(s):  
Yung-Chieh Lin ◽  
Chen-Yueh Wang ◽  
Yu-Wen Pan ◽  
Yen-Ju Chen ◽  
Wen-Hao Yu ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Congenital Hypothyroidism ◽  
Brain Injuries ◽  
Neurodevelopmental Outcome ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Total Thyroxine ◽  
Tsh Levels

Primary congenital hypothyroidism is a disease associated with low serum thyroxine and elevated thyroid-stimulating hormone (TSH) levels. The processes of screening and treating congenital hypothyroidism, in order to prevent neurodevelopmental impairment (NDI) in newborns, have been well investigated. Unlike term infants, very preterm infants (VPIs) may experience low thyroxine with normal TSH levels (<10.0 μIU/mL) during long-stay hospitalization. In the current literature, thyroxine treatment has been evaluated only for TSH-elevated VPIs. However, the long-term impact of low thyroxine levels in certain VPIs with normal TSH levels deserves more research. Since July 2007, VPIs of this study unit received screenings at 1 month postnatal age (PNA) for serum TSH levels and total thyroxine (TT4), in addition to two national TSH screenings scheduled at 3–5 days PNA and at term equivalent age. This study aimed to establish the correlation between postnatal 1-month-old TT4 concentration and long-term NDI at 24 months corrected age among VPIs with serial normal TSH levels. VPIs born in August 2007–July 2016 were enrolled. Perinatal demography, hospitalization morbidities, and thyroid function profiles were analyzed, and we excluded those with congenital anomalies, brain injuries, elevated TSH levels, or a history of thyroxine treatments. In total, 334 VPIs were analyzed and 302 (90.4%) VPIs were followed-up. The postnatal TT4 concentration was not associated with NDI after multivariate adjustment (odd ratios 1.131, 95% confidence interval 0.969–1.32). To attribute the NDI of TSH-normal VPIs to a single postnatal TT4 concentration measurement may require more research.

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