Background Human immunodeficiency virus (HIV) sero-prevalence rate during pregnancy was 26% in 2009 in Gauteng. HIV exposure is associated with high morbidity and mortality in infants. Few studies have assessed the effect of HIV exposure on morbidity and mortality in very low birth weight (VLBW) infants. Aim To determine the infant characteristics at birth, morbidity during hospital stay and mortality at hospital discharge of VLBW infants according to maternal HIV status. Methods This was a retrospective cross sectional descriptive study. Hospital records of VLBW infants admitted at the Chris Hani Baragwanath Academic Hospital, Division of Neonatology from 1st January 2011 to 30th June 2011 were reviewed. Data were collected in an Excel spread sheet and imported to STATA version 12 for analysis. Results 302 hospital records of VLBW infants admitted from January to June 2011 were retrieved and reviewed. About a third (34.1%) of VLBW infants were born to mothers who were HIV positive. There were more babies who weighed <1000 grams in the HIV-exposed infants compared to HIV-unexposed infants (p-0.001). HIV exposed infants had a smaller head circumference (p-0.003), a shorter body length (p-0.006) and significantly more severe grades of IVH (p <0.001) compared to HIV unexposed infants. The overall mortality rate in VLBW infants was 27%, with HIV exposed infants having a mortality rate of 38.6% compared to 21% in the HIV-negative infants (p-0.002). Multivariate analysis showed that the main predictor of mortality was birth weight (p<0.001). Conclusion Though on univariate analysis maternal HIV status was associated with mortality in VLBW infants, this effect was not found on multivariate analysis. Therefore the final conclusion from this study is that maternal HIV status has no independent effect on outcomes to hospital discharge in VLBW infants. Birth weight was the predictor of survival in VLBW infants.

No description available.

No description available.

Long-term outcome of extremely preterm neonates depends on many endogenous and exogenous factors. Long-term follow-up of extremely preterm neonates during childhood and analyses of IGF1 gene polymorphisms may help to better understand the problems connected with delayed postnatal growth and the progression of cardiovascular diseases and diabetes mellitus type 2 in adulthood. The aim was the long-term follow-up of anthropometric parameters in children born at 22−25th and 26−27th week of gestation and to study the association between postnatal growth of extremely preterm children, children small for gestational age (SGA) and children born at term with appropriate birth weight/length (AGA) and IGF1 gene polymorphisms: (CA)10-24 repetitive polymorphism in promoter, microsatellite marker D12S318 and 185 bp in 3'UTR, (CT)n polymorphism (CA)n polymorphism 216 bp in the intron 2. Methods. 242 infants born at 22-27+6 weeks were enrolled. Anthropometric parameters were measured at the ages of 2 and 5 years in 72 children born at 22-25+6 week (group I) and 85 children born at 26-27+6 week (group II). Polymorphisms of IGF1 were analysed in 51 extremely preterm, 208 AGA and 59 SGA children using fragment analyses. The data of postnatal growth data in AGA children were obtained at 18 months, in SGA and extremely...

Long-term outcome of extremely preterm neonates depends on many endogenous and exogenous factors. Long-term follow-up of extremely preterm neonates during childhood and analyses of IGF1 gene polymorphisms may help to better understand the problems connected with delayed postnatal growth and the progression of cardiovascular diseases and diabetes mellitus type 2 in adulthood. The aim was the long-term follow-up of anthropometric parameters in children born at 22−25th and 26−27th week of gestation and to study the association between postnatal growth of extremely preterm children, children small for gestational age (SGA) and children born at term with appropriate birth weight/length (AGA) and IGF1 gene polymorphisms: (CA)10-24 repetitive polymorphism in promoter, microsatellite marker D12S318 and 185 bp in 3'UTR, (CT)n polymorphism (CA)n polymorphism 216 bp in the intron 2. Methods. 242 infants born at 22-27+6 weeks were enrolled. Anthropometric parameters were measured at the ages of 2 and 5 years in 72 children born at 22-25+6 week (group I) and 85 children born at 26-27+6 week (group II). Polymorphisms of IGF1 were analysed in 51 extremely preterm, 208 AGA and 59 SGA children using fragment analyses. The data of postnatal growth data in AGA children were obtained at 18 months, in SGA and extremely...

Objectives: The purpose of this thesis is to explore the associations between childhood cognitive abilities assessed at age 8 and health and socioeconomic outcomes at age 29-36 in extremely low birth weight survivors (ELBW, <1000g). Methods: Using data from the McMaster Extremely Low Birth Weight Cohort Study, Study 1 explores the influence of overall intelligence, fluid intelligence, and language abilities on the prevalence of lifetime major depressive disorder in ELBW survivors and normal birth weight comparison subjects. Study 2 examines the mediating role of overall intelligence, fluid intelligence, language abilities, quantitative reasoning, and academic achievement on the association between being born at ELBW and socioeconomic outcomes at age 29-36. The final study examines the moderating role of childhood cognitive functioning on links between postnatal psychosocial adversity and adult personal earnings in ELBW survivors. Results: Results from Study 1 suggest that childhood cognitive abilities do not influence the onset of major depressive disorder in ELBW survivors, but are protective against depression in normal birth weight individuals. Study 2 suggests that childhood cognitive abilities partially mediate the association between being born at ELBW and income attainment in adulthood, but not full time employment. Further, Study 2 suggests that this association is stronger in ELBW survivors who have neurosensory impairments. Results of Study 3 suggest that enhanced childhood cognitive functioning is not protective against postnatal psychological adversity in influencing income attainment, as those ELBW survivors with higher childhood intelligence and who suffered psychological adversity reported lower annual income at age 30. Conclusions: This thesis suggests that overall and specific cognitive abilities significantly influence adult outcomes in ELBW survivors and normal birth weight individuals. However, while cognitive reserve may not be protective against psychological adversity in ELBW survivors, early cognitive abilities are a critical indicator of socioeconomic attainment in this vulnerable population. / Thesis / Master of Science (MSc) / The following thesis explores the predictive role of childhood cognitive abilities on adult health and socioeconomic outcomes in extremely low birth weight survivors at age 29-36. Study 1 explores the influence of overall intelligence, fluid intelligence, and language abilities assessed at age 8 on the prevalence of lifetime major depressive disorder in extremely low birth weight survivors and normal birth weight comparison participants. Study 2 examines the mediating role of overall intelligence, fluid intelligence, language abilities, quantitative reasoning, and academic achievement on the association between being born at extremely low birth weight and socioeconomic outcomes at age 29-36. The final study examines the moderating role of childhood cognition on the association between postnatal psychosocial adversity and personal income attainment at age 30 in extremely low birth weight survivors. Overall, this body of work suggests that childhood cognitive abilities are an important contributor to adult outcomes in preterm survivors.

<p>Salivary cortisol and electrocardiogram data was collected at baseline and after a stress-anticipation task in extremely low birth weight (ELBW; < 1000 grams) survivors and normal birth weight (NBW) controls, in order to examine the moderating influence of emotion regulation on the relationship between being born at ELBW and internalizing problems in adulthood. The stress manipulation was an adapted Trier Social Stress Task. The participants were told they would have three minutes to create a speech on one of three predetermined topics (i.e., gun control, same sex marriage, or abortion). After three minutes passed, the particpants were told that there would be no speech. All participants showed a decrease in salivary cortisol levels throughout the day, and an increase in heart rate during the stress anticipation task. When a median split was used to create high and low stress reactive cortisol and heart rate groups, an interaction was found between birth status (ELBW vs. NBW) and group (High vs. Low Stress Reactive Cortisol) on self-reported internalizing problems (anxiety, depression, withdrawal). Those born at ELBW who had high stress reactive cortisol self-reported significantly higher levels of internalizing problems compared to ELBWs with low stress reactive cortisol. Those born at NBW did not differ on self-reported internalizing problems based on their stress reactive cortisol levels. When the moderating effect was probed with a linear regression analysis, the ELBW group was driving the relation between stress reactive cortisol levels and internalizing problems. Taken together, the results suggest that emotion regulation, as indexed by the neuroendocrine system, is moderating the relation between being born at ELBW and internalizing problems in adulthood. This is indicative of a differential susceptibility of risk and resilency in ELBW survivors depending on their ability to regulate their emotions, specifically during periods of stress.</p> / Master of Science (MSc)

Thesis (M.S.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-04, page: 2056. Adviser: Maureen Sanderson. Includes bibliographical references.

Neonatology is a branch of medicine which consists of the medical care not only of healthy newborn infants, but also of the ill or premature ones. The number of the premature born infants increases constantly worldwide. It might be caused by women postponing their pregnancies, and very likely also by the growing number of pregnancies achieved by the assisted reproductive technologies. Thanks to improvements in perinatal care of risk pregnancies, guiding preterm labour, and development of neonatal intensive care, it has become possible to save more infants born at the very margin of viability with an extremely low birth weight. The diagnostic, therapeutic and nursing techniques have been developing steadily. It's the methods providing maximum comfort for the child and ensuring the quality of their later life that have been put into forefront. They are a set of measures, which do not disturb the child's reflex behaviour; they support its physiological stability, and thus foster growth and development of the immature organism. The aim of this diploma work is to map the specific needs of the newborn infants with an extremely low birth weight, to find out how these needs are satisfied during the first days after birth, and to determine, how the nursing care supporting the development of the infants takes place in the real life. The theoretical part of the diploma work is based on the scientific papers and resources. The empirical part is based on an observation method, which was carried out at the Neonatal Intensive Care Unit of the University Hospital in Pilsen. The survey proved that the infants' needs are not only on the biological level, but also on the emotional level, and they need appropriate sensomotoric stimulation. The outcomes of the observation show that the greatest problem of the newborn infants with an extremely low birth weight is to satisfy the biological needs i.e. breathing, feeding and defecation. The need of safety and stimulation was satisfied only partly. Based on the information collected by observing the nursing staff, it was possible to lay out areas with a potential to improve the individualized care of the newborns with an extremely low birth weight. These are, above all, the increased level of noise at the unit and thus the sense of sleep and wakefulness of the infants. Furthermore, it's the stimulation of the children and the communication with the parents. The outcomes of the empirical part of this diploma work will be presented at the seminar of the perinatal centre.

No description available.