Premature Group Research Articles

L’utilisation des courbes de poids personnalisées en anténatal améliore-t-elle le diagnostic des fœtus petits pour l’âge gestationnel à haut risque de morbidité néonatale ?

ObjectivesTo assess the accuracy of customized growth charts for the ultrasound antenatal diagnostic of fetus small for gestational age in a high-risk population of preterm. MethodsAll premature infants born in a French university maternity center for a year and classified as small for gestational age at birth by using customized growth charts developed by Ego et al. were included in this retrospective study. At the ultrasound performed closest to the term, customized growth charts and population growth curves were compared for the antenatal diagnosis of a premature infants group classified small for gestational age in post-natal by customized growth charts and more at risk of perinatal complications. ResultsSixty-seven newborns were included in the study. Fifty-one (76.1%) were secondarily classified as small for gestational age although they were eutrophic on the basis of population growth curves and 16 (23.9%) were small for gestational age on both curves. The average time between the last ultrasound and birth was 2.2 weeks. On the threshold of the tenth percentile, the sensitivities of customized growth charts and curves in population were not significantly different (29.85% versus 41.79% P=0.05) for antenatal detection of fetus small for gestational age. ConclusionIn our study, the use of customized growth charts does not improve the antenatal detection of most at-risk children.

The role of serial measurements of serum insulin-like growth factor 1 levels in the development of retinopathy of prematurity.

To determine the role of serum insulin-like growth factor-1 levels in the development of retinopathy of prematurity, which is a major cause of childhood blindness worldwide. We prospectively studied newborn infants born at a postmenstrual age of <32 weeks and birth weights <1 500 gr, between January 1st, 2015, and December 31st, 2015. A total of 40 infants were enrolled in the study. The retinal examination time was determined in accordance with the American Academy of Pediatrics recommendations for retinopathy of prematurity screening and follow-up. Retinopathy of prematurity was classified according to the international classification of retinopathy of prematurity. Serum Insulin like growth factor 1 levels were measured serially in blood samples on the 1st, 3rd, 7th, 21st, and 28th day. Among the 40 infants, 11 (27.5%) constituted the retinopathy of prematurity group and 29 comprised the non-retinopathy of prematurity group. In the retinopathy of prematurity group, the mean gestational age and birth weight was significantly lower. The demographic features of the study cohort were similar. The duration of mechanical ventilation was significantly greater in the retinopathy of prematurity group compared with the non-retinopathy of prematurity group (p=0.036). In terms of neonatal morbidities such as respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, patent ductus arteriosus, and necrotizing enterocolitis, no differences were detected between the groups. The mean serum insulin-like growth factor-1 levels in retinopathy of prematurity group were significantly lower than those in the non-retinopathy of prematurity group at each time point (1st, 3rd, 7th, 21st, and 28th day of postnatal life) (p=0.001). This study demonstrated the low serum insulin-like growth factor-1 levels was associated with retinopathy of prematurity development.

Avaliação hematológica e hemogasométrica de potros nascidos de éguas com placentite ascendente

RESUMO A placentite é a principal causa de partos prematuros, aborto e nascimento de potros comprometidos, podendo causar hipóxia e septicemia. A hematologia e a gasometria venosa fornecem informações importantes para o monitoramento da saúde de potros nascidos de éguas com placentite. O objetivo deste trabalho foi descrever os valores hematológicos e hemogasométricos durante as primeiras 24h de vida em potros nascidos de éguas mestiças Crioulas submetidas à indução experimental de placentite, com diferentes graus de maturidade. Foram utilizados 16 potros nascidos de éguas submetidas à indução experimental de placentite, divididos em três grupos de acordo com o grau de maturidade: prematuro (n=8), dismaturo (n=4) e a termo (n=4). Foram realizadas coletas sanguíneas nos momentos 0h, 12h e 24h para realização de hemograma completo e gasometria venosa. No eritrograma, foi observada anemia normocítica normocrômica no grupo prematuro em relação ao grupo dismaturo nas 12h e 24h. O grupo prematuro apresentou menor contagem de leucócitos totais nas 24h em relação ao grupo a termo (P=0,01). Os valores de pH, cHCO3 e SO2 não diferiram entre os grupos, porém os animais prematuros apresentaram acidose respiratória (pH=7,28). A PCO2 nos prematuros foi maior na 0h (P=0,02). Nos três grupos, a PCO2 apresentou uma curva adaptativa com redução dos valores durante as 12h e 24h. Os potros prematuros mostraram menores valores de excesso de base (BE) no nascimento (P=0,02), confirmando o quadro de acidose respiratória. Concluiu-se que as respostas hematológicas e hemogasométricas diferem entre potros com diferentes graus de maturidade. A acidose observada no grupo prematuro ao nascimento, com estabilização e resposta compensatória durante as 12h e 24h, demonstra a necessidade de avaliação hemogasométrica sequencial em potros de risco, o que permite a identificação da resposta clínica ao processo e, assim, auxilia no estabelecimento do tratamento e prognóstico para esses potros.

胎膜早破孕妇GBS、VVC、BV感染及对妊娠结局的影响

目的：探讨胎膜早破孕妇GBS、VVC、BV感染及其对妊娠结局的影响，预防和治疗胎膜早破，改善妊娠结局，促进母儿健康。方法：收集最近三年湘雅二医院和湖南省财贸医院产科妊娠晚期胎膜早破孕妇283例作为研究组，另收集302例同期未胎膜早破正常孕妇作为对照组，所有收集孕妇均进行GBS、VVC、BV感染率检测，比较两组妊娠结局。结果：1) 研究组GBS、VVC及BV感染率高于对照组，两组比较差异有统计学意义(P 0.05)；4) 研究组GBS不良妊娠结局之早产的发生率明显高于VVC、BV感染的不良妊娠结局发生率(P 0.05)；5) 对照组GBS，VVC及BV感染患者不良妊娠结局发生率组内两两比较结果显示差异无统计学意义(P > 0.05)；6) 两组病例中，胎膜早破组的各项炎症指标显著高于未胎膜早破组(如：N%、CRP及PCT均升高)，两组比较有统计学意义(P 0.05). 4) Team of GBS and incidence of adverse pregnancy outcomes of preterm birth was obviously higher than that of VVC, BV infection incidence of adverse pregnancy outcomes (P 0.05). 5) In the control group, GBS, VVC and BV patients with adverse pregnancy outcomes showed no statistically significant difference (P > 0.05). 6) In the two groups, the inflammatory markers of the premature rupture group were significantly higher than those in the premature rupture group (e.g., N %, CRP and PCT), and the two groups were statistically significant (P < 0.05). Conclusion: 1) GBS, VVC and BV infections are important causes of premature rupture of membranes, especially the important pathogenic factors of premature rupture of the membrane. 2) Premature rupture of pregnant women’s GBS, VVC and BV infection will lead to increased incidence of adverse pregnancy outcomes.

Observation on neonatal apnea in relation to aetiopathogensis and their outcome

Background: Apnea is nearly universal among preterm infants, but neither the apnea burden nor its clinical associations have been systematically studied. This study was aimed to estimate the frequency of apnea in newborn, at different gestational age and birth weight and establish different etiological factors of apnea in newborn and their outcome. Methods: The present study was conducted on neonates admitted in Special Newborn Care Unit, Department of Pediatrics, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India between April, 2014 to September, 2016. All neonates at risk of apnea ( 2500 gm was 38.88, 15.09, 6.45 and 0.49 per 100 live births respectively (statistically significant, p value < 0.001). In our study commonest causes of apnea was infection (51.02%) and apnea of prematurity (29.59%) (Statistically significant, p value < 0.001). The mean birth weight and gestation were 1434.34gm and 31.6 weeks for the infection group and 1117.41gm and 30.34 weeks for the apnea of prematurity group in our study. The survival rate in babies with apnea of prematurity was 72.41% (p <0.001) as compared to 32% (P <0.001) in apnea due to infection group. The percentage of survival in < 1000 gm, 1000-1499 gm, 1500-2499 gm and 2500gm was 22.85,55,60 and 100 percent respectively (p value < 0.001). Conclusions: Infection and apnea of prematurity are common causes of apnea in newborn. All babies ≤ 32 weeks gestation needs to be closely monitored for apnea. Apneic spells occurring in infants at or near term are always abnormal and are nearly always associated with serious causes. Apnea due to sepsis carries a poor prognosis.

A new strategy of management for newborns in a neonatal care unit: A succesful experience from Morocco

Aim of the study: To evaluate if the readmission rates of newborns treated in our unit has been affected by the introduction of new protocols. Materials and Methods: two groups were compared: Group A: newborns readmitted during the period from January 2010 to May 2011, Group B: newborns readmitted during the period from June 2011 until December 2012. Epidemiological data and settings of rehospitalization were collected on a standardized form, the reasons for rehospitalization, and evolution. Results: 105 were readmitted during the first four months of life , the rate of readmission was 1.8%. The difference is not significant between the two periods. The main reasons for readmission are nosocomial infection in 77% and 65% of premature groups A and B respectively, feeding difficulties with dehydration and weight loss, and viral infections in 31% and 21% of premature groups A and B respectively. The death rate was reduced in premature infants in group B (5.8%) compared to preterms of group A (23%). Conclusion: In our study the introduction of a new protocol support has a considerable gain in the number of patients treated, and the mortality reduction without affecting the rates of rehospitalisation.

Prospective Study on Factors Related to Development in Premature Infants at Six-Months

Purpose: This study was conducted to monitor the development of Korean premature infant at six-month age and to explore factors related to developmental status of the premature infants. Methods: Participants were 58 premature infants whose corrected age was six-months old and their mothers. The developmental states of infants were followed-up with the Korean Prescreening Developmental Questionnaire (KPDQ-II). Clinical characteristics of the infants were identified from the medical records. Other characteristics including Edinburgh Postnatal Depression Scale, husband’s support, social support, and mother-infant attachment were assessed using self-report questionnaires from the mothers. Results: Forty three percent of the infants were in the group of questionable status of development on the KPDQ-II. There were significant differences between the premature infants with normal developmental status and those with questionable developmental status depending on gender (χ2 = 5.03, p = .034), gestational age (t = 2.59, p = .012), hospital stay (p = .013), revised Neurobiologic Risk Score (p = .005) and mother-infant attachment score (t = 2.12, p = .040). Conclusion: Mother-infant attachment, as well as physiological state of premature infants, is an important variable in early development. Therefore, early monitoring for the development has to be done for physiologically vulnerable premature groups. Also, providing proper nursing support to improve maternal attachment needs to be considered. Key words: 미숙아; 발달; 어머니; ì• ì°© Key words: Premature infant; Development; Mothers; Attachment

Health, Wealth, Social Integration, and Sexuality of Extremely Low-Birth-Weight Prematurely Born Adults in the Fourth Decade of Life.

Although it has been previously reported that the transition of extremely low-birth-weight survivors (≤1000 g) in their mid-20s was similar to that of normal-birth-weight controls (>2500g), there was uncertainty as to whether this positive pattern would persist. To compare the social functioning of low-birth-weight prematurely born adults aged 29 to 36 years with that of normal-birth-weight term controls. A population-based longitudinal cohort study was conducted in Ontario, Canada, between March 14, 2011, and August 13, 2013, among 100 of 165 low-birth-weight survivors (60.6%) prematurely born between January 1, 1977, and December 31, 1982, and 89 of 144 sociodemographically matched normal-birth-weight term controls (61.8%) recruited at age 8 years. Neurologic impairments were present in 20 premature participants (20.0%). Extremely low birth weight. Information on health, educational level, employment, social integration, sexuality, and reproduction was obtained through standardized questionnaires completed by the participants. Participants included 100 (39 males) extremely low-birth-weight survivors and 89 (33 males) normal-birth-weight term controls. The groups did not differ in the highest educational level achieved or in family and partner relationships. However, a lower proportion of premature adults was employed (odds ratio [OR], 0.37; 95% CI, 0.15 to 0.93) and fewer were employed full time (OR, 0.49; 95% CI, 0.24 to 0.98). The premature group had a mean total personal income of $20 000 less than controls, and more required social assistance (OR, 4.16; 95% CI, 1.13 to 15.33). Compared with the control group, more members of the premature group remained single (OR, 1.95; 95% CI, 1.08 to 3.50), had never had sexual intercourse (OR, 11.30; 95% CI, 2.56 to 49.91), did not have children (OR, 0.52; 95% CI, 0.27 to 0.99), reported more chronic health conditions (β, 1.54; 95% CI, 0.79 to 2.30), had lower self-esteem (β, 8.40; 95% CI, 1.68 to 15.12), and were less likely to have current drug abuse or dependence (OR, 0.29; 95% CI, 0.90 to 0.92) or lifetime alcohol abuse or dependence (OR, 0.30; 95% CI, 0.15 to 0.59). A higher proportion of premature adults without neurosensory impairments identified themselves as nonheterosexual (OR, 4.87; 95% CI, 1.01 to 23.69). After exclusion of individuals with neurosensory impairments, differences in employment, social assistance, marital status, and reproduction were no longer significant. In the fourth decade of life, extremely low-birth-weight survivors achieved similar educational levels and family and partner relationships, and reported fewer risky behaviors compared with controls. However, they had lower levels of employment, income, and self-esteem, and fewer were married and had children. It is therefore essential that these individuals receive necessary support and continued monitoring throughout life.

Erken ve normal menopoz: stres, evlilik uyumu ve cinsiyet rolleri açısından bir karşılaştırma

Objective: Middle age period brings about particular difficulties for some women, because of the physiological and psychological changes. The physiological changes occuring in this period is called andropause for males and menopause for females. While it starts about 40-50 years of age in general, it might be at an earlier stage of life for some women which is called premature menopause, indicating the climacterium. The main aim of this study is to compare two groups of women with premature menopause and normal menopause in terms of stress reactions, ways of coping, marital adjustment, and sex roles. Method: Data were collected from a total of 224 women, 82 of which had premature menopause (under age 40), and 142 had normal menopause (above age 40). The participants were given Demographic Information Form (DIF), Stress Reactions Scale (SRS), Ways of Coping Inventory (WCI), Marital Adjustment Scale (MAS), and Bem Sex Roles Inventory (BSRI) to obtain data. Results: The t-test analysis has revealed that the premature menopause group had higher scores in stress reactions, lower scores in self confident and optimistic ways of coping with stress, and lower scores in marital adjustment, compared to the normal menopause group. The predictive variables for both groups were found to be “degree of agreement in marriage”, “helpless style”, and “searching for social support” by regression analysis. The “masculine sex role” was the predictor of only the premature menopause group. Discussion: When we review the related literature, we see that most of the studies are about women who entered menopause around 40 years of age and the problems they face in the process. There is very little research on women who enter menopause earlier (premature menopause). For this reason, it is felt that the current study will add to our knowledge on the premature manapause phenomenon, which challenges women physically and psychologically. We feel it is important to raise awareness in women on the issue in order to prevent and alleviate stress-related problems. We also feel the results of the study might be important in the areas of psychotheraphy and psychological counselling. For example during psychological counselling or psychotheraphy for premature menopause, it might be important to measure the sex roles, marital satisfaction levels and the levels of satisfaction of these women with their close interpersonal relationships, and try to design interventions accordingly. Additionally it might be helpful to teach new coping strategies to manage their stress levels.

Diagnostic value of non-invasive cardiac output parameters in premature infants with patent ductus arteriosus

Objective To investigate the diagnostic value of non-invasive cardiac output parameters: cardiac index (CI) and minute distance (MD), in premature infants with patent ductus arteriosus (PDA) and determine the cut-off value. Methods Clinical data of 98 premature infants admitted to the neonatal intensive care unit from January 2015 to June 2015 were collected. These premature infants were divided into the treated PDA group (n=30), the untreated PDA group (n=28) and the normal premature group (n=40) based on the results of echocardiogram in the first three days after birth and the use of drugs. Non-invasive cardiac output parameters were measured in the first three days after birth. The data were analyzed by t test, analysis of variance and SNK-q test. The diagnostic value of CI and MD for PDA was analyzed by the receiver operating characteristic curve. Results By preliminary analysis of the ROC curve, CI and MD were the most representative parameters for the diagnosis of PDA which need to be treated clinically, we thus chose CI and MD in this study. The aortic and pulmonary arterial CI and MD in the treated PDA group were significantly higher than in the untreated PDA group and the normal premature group (all P 0.05). The cut-off value of the aortic CI and MD was 2.95 L/(min·m2) and 21.50 m/min, respectively, while that of the pulmonary arterial CI and MD was 4.55 L/(min·m2) and 26.50 m/min, respectively. The sensitivity and specificity of the combined aortic CI and MD for the treated PDA group were 0.90 and 0.82, and those of combined pulmonary arterial CI and MD were 0.87 and 0.82; and those of combined aortic and pulmonary arterial CI and MD were 0.80 and 0.88, respectively. Conclusions The non-invasive cardiac output parameters CI and MD have good diagnostic value for the PDA needing clinical treatment, and the combined use of the two parameters can improve specificity, and help formulate the early treatment strategy for premature infants with PDA. When aortic CI was ≥2.95 L/(min·m2) and MD was ≥ 21.50 m/min, a preliminary diagnosis of the PDA needing clinical treatment, can be made, and simultaneously when the pulmonary arterial CI was ≥ 4.55 L/(min·m2) and MD was ≥ 26.50 m/min, the arterial duct should be closed timely. Key words: hemodynamics; premature infants; PDA; non-invasive cardiac output parameters

Interactions between environmental factors and maternal–fetal genetic variations: strategies to elucidate risks of preterm birth

ContextPreterm birth (PTB) is a complex disease in which medical, social, cultural, and hereditary factors contribute to the pathogenesis of this adverse event. Interactions between genes and environmental factors may complicate our understanding of the relative influence of both effects on PTB. To overcome this, we combined data obtained from a cohort of newborns and their mothers with multiplex analysis of inflammatory-related genes and several environmental risk factors of PTB to describe the environmental–genetic influence on PTB. ObjectiveThe study aimed to investigate the association between maternal and fetal genetic variations in genes related to the inflammation pathway with PTB and to assess the interaction between environmental factors with these variations. Study designWe conducted a case–control study at the Pereira Rossell Hospital Center, Montevideo, Uruguay. The study included 143 mother–offspring dyads who delivered at preterm (gestational age<37 weeks) and 108 mother–offspring dyads who delivered at term. We used real-time PCR followed by a high-resolution melting analysis to simultaneously identify gene variations involved in inflammatory pathways in the context of environmental variables. The genes analyzed were: Toll-like receptor 4 (TLR4), Interleukin 6 (IL6), Interleukin 1 beta (IL1B) and Interleukin 12 receptor beta (IL12RB). ResultsWe detected a significant interaction between IL1B rs16944 polymorphism in maternal samples and IL6 rs1800795 polymorphism in newborns, emphasizing the role of the interaction of maternal and fetal genomes in PTB. In addition, smoke exposure and premature rupture of membranes (PROM) were significantly different between the premature group and controls. IL1B and IL6 polymorphisms in mothers were significantly associated with PTB when controlling for smoke exposure. TLR4 polymorphism and PROM were significantly associated with PTB when controlling for PROM, but only in the case of severe PTB. ConclusionsInteractions between maternal and fetal genomes may influence the timing of birth. By incorporating environmental data, we revealed genetic associations with PTB, a finding not found when we analyzed genetic data alone. Our results stress the importance of studying the effect of genotype interactions between mothers and children in the context of environmental factors because they substantially contribute to phenotype variability.

Outer Retinal Structural Alternation and Segmentation Errors in Optical Coherence Tomography Imaging in Patients With a History of Retinopathy of Prematurity

To evaluate retinal anatomy and segmentation errors from spectral-domain optical coherence tomography (SD-OCT) imaging in school-aged children. A prospective cohort study in a referral medical center. One hundred thirty-three eyes of 133 patients were enrolled. Patients were grouped as those who were treated for retinopathy of prematurity (ROP) (ROP-Tx group); those with spontaneously regressed ROP (ROP-non-Tx group); other premature patients (premature group); and full-term age-matched children (full-term group). Anatomy and segmentation errors of retina were evaluated by SD-OCT. The mean age at assessment was 9.5 years (range, 4-16 years). The external limiting membrane (ELM) and the cone outer segment tips (COST) line were least frequently identified in patients of the ROP-Tx group (65.2% and 47.8%, P= .002 and P < .001, respectively). The visual acuity of the patients did not correlate significantly with the absence of COST line (P= .140) but correlated with the absence of ELM (P< .001). The presence of artifacts, including misidentification of the inner retina, misidentification of the outer retina, out-of-register artifacts, off-center scans, and degraded scan images, was observed to range from 0.6% to 50.0% in 4 groups of patients. All types of errors occurred more frequently in the ROP-Tx group than in the full-term group (all P < .05). Outer retinal abnormalities were commonly observed in the ROP-Tx group. The higher segmentation errors in the ROP-Tx group might be related to fine structural abnormalities in the outer retina. Future studies are needed to investigate the mechanisms for these structural changes.

Lipopolysaccharides and Prematurity: Effect on the Activity of Respiratory Chain Enzymes in Human Umbilical Venous Endothelial Cells

Fetal infection is associated with considerable perinatal morbidity. Dysfunction of human umbilical venous endothelial cells (HUVEC) may compromise fetal blood supply from the placenta. HUVECs were incubated with one of the key inflammatory mediators, lipopolysaccharides (LPS), and activities of respiratory chain enzymes were measured. Based on gestational age, HUVEC were divided into a mature and two premature groups from otherwise uncomplicated pregnancies (four patients each) and incubated for 1, 6, or 12 hours with LPS (100 ng/mL), respectively, incubation without LPS served as a control. We analyzed the activities of respiratory chain enzymes and citrate synthase as a mitochondrial marker spectrophotometrically. No significant differences in respiratory chain activities between the LPS-incubated cells and internal controls could be observed. However, we were able to demonstrate significant differences depending on gestational age: respiratory chain complex IV (p

Ophthalmological follow-up of prematurely born children in preschool age: prospective study of visual acuity, refractive errors and strabismus

Background. Preterm birth is a very relevant problem. Retinopathy of prematurity in its severe forms causes visual impairment or can lead to blindness. The aim of the present study was to describe the visual outcome in prematurely born and full-term children at the preschool age and to evaluate the effects of prematurity per se, ROP, and treatment on visual acuity and refractive errors. Materials and methods. A prospective study on the incidence of ROP during 2006–2008 included 103 preterm infants. 81 had ROP and 22 had no history of ROP; 40 were age-matched healthy children. All underwent a complete ophthalmic examination. Results. Significant myopia (≤ –0.50D) in prematurely born children differed from full-term ones. The ROP treated group had the highest prevalence of myopia (P 2D) was dominant in the premature group (39%) as compared with the control group (0%) (P

Evaluation of isometric force in lower limbs and body composition in preterm infants

Abstract Introduction Strength is a physical quality with a clear influence on quality of life. It is determined by the structure of the musculoskeletal system, and depends on the muscular structure. It has been described that prematurity conditions both qualities. The aims of this study are to determine whether prematurity is associated with strength or body composition and to evaluate the relationship between prematurity, strength and muscle mass. Material and methods Case–control study. Participants were premature 7-to-11-year-old children and full-term birth controls. Strength was measured by a strength gauge and body composition from DEXA (duel-energy X -ray absorptiometry) scans. A total of 89 subjects were included and divided into three groups: 30 prematures with birth weight ≤1500 g, 29 prematures with birth weight 1500–2000 g, and 30 controls. Results Weight and BMI z-score was lower in the premature group. No differences were found in muscular mass or strength between groups. A ratio was established between strength and weight or muscular mass. It was observed that it was possible for them to move four times their weight, without finding any differences between groups or a relationship with birth weight. Conclusions Between 7 and 11 years of age, children who were premature have lower weight and BMI than the rest of the children. However, there were no differences in body composition or strength between preterm children and controls.

Electronic Poster Presentations, Maternal Fetal Medicine

Electronic Poster Presentations, Maternal Fetal Medicine

Safety Analysis for Pentavaccine Used in Premature Infants: Family Vaccination Centre’s Experiment

Combined vaccines containing non-cellular pertussis component and having low reactogenicity, increase vaccination coverage against controllable infections. However, the safety of vaccination in children dealing with health issues, as well as those having a history of premature infancy, requires additional research. The article presents reactogenicity analysis for the DTP-IPV/HIB pentavaccine during primary vaccination and revaccination of premature infants (n = 85), as well as vaccination of mature newborns (n = 1433) inoculated in accordance with the national Vaccination Calendar behind the schedule. The occurrence of post-vaccinal reactions in the premature infant group was the same as in the mature infant group and amounted to 41.2% and 45.0%; the occurrence of common reactions was 18.8% and 22.4%; local effects measured 25.8% and 27.9% respectively. Post-vaccinal reactions were either weak or moderate, not requiring treatment, and they would completely disappear by the end of the third post-vaccinal day. Simultaneous injection of pentavaccine and Hepatitis B vaccine and pneumococcal conjugate vaccine in children with a history of premature infancy, showed no influence during the post-vaccinal period. The reactogenicity of pentavaccine increased along with the vaccination ratio during the primary series of vaccinations.

Causes of prematurity in the Bloemfontein Academic Complex

Background: Prematurity is globally the leading cause of neonatal mortality, morbidity and long-term disability. The Millennium Development Goals (MDG) of the United Nations, and specifically MDG 4, address child mortality. Neonatal mortality rates contribute to 37% of all under-five mortality, with the largest proportion (30%) due to prematurity. The overall purpose of this study was to determine factors associated with prematurity and to identify treatable and preventable causes at the Bloemfontein Academic Complex in order to decrease the morbidity and mortality associated with prematurity in line with MDG.Methods: A case control study design was used including all premature babies referred to the Kangaroo Care Unit of the National District Hospital between December 2010 and March 2011. Each baby was included with his/her mother as a pair. For each premature baby and mother pair a term baby and mother pair was included as a control. Data were collected on a data sheet from the mothers’ antenatal records, and from maternal notes as well as the neonatal follow-up and discharge notes. Data gathered included baseline characteristics, habits, diseases and medication of the mother during the antenatal period and delivery as well as baseline demographics of the babies. Results: A total of 194 mothers and 198 babies were included in the study with 109 case mothers and 85 control mothers . Pre-existing medical conditions were more prevalent in the premature group (69%) compared with the control group (27%) with p 0.0001. These conditions included hypertension, HIV disease and syphilis. Possible causes for prematurity identified in this study included teenage mothers and premature rupture of membranes.Conclusion: Risk factors identified for prematurity were: teenage mothers, pre-existing medical conditions in the mother, and preterm rupture of membranes. Smoking and alcohol consumption during pregnancy could not be identified as risk factors for prematurity. It is recommended that patients with any of the above-mentioned identified risk factors be classified as high risk for the development of prematurity and shorter follow-up intervals and more aggressive management of pre-existing medical conditions should be practised.

Can Oral Anaerobic Bacteria cause Adverse Pregnancy Outcomes?/ Дали Оралните Анаеробни Бактерии Можат Да Доведат До Лоши Опстетрички Исходи?

Maternal periodontal infection has been recognized as a risk factor for premature and low birthweight infants. It is suspected that pathogens causing periodontal disease may translocate to the amniotic cavity and so contribute to triggering an adverse pregnancy outcome. The aim of this study was to evaluate whether the presence of specific periodontal pathogens may influence the incidence of preterm labor and premature birth. This study was designed as a hospital-based case-control study. A total of 70 pregnant women, aged 18-40 with single live pregnancy were recruited from the Departement of Gynecolgy and Obstetrics at a General hospital in Sibenik, Croatia, between March 2013 to March 2014. The case group: 30 pregnant women who were hospitalised with signs of premature labor. 40 patients with normal pregnancy post-delivery up to 48 hrs, who had given birth at term, and the baby had a weight of more than 2500 gr. These women had undergone microbiological examination at the time of recruitment, microbial samples, paper point subgingival swabs were obtained in both groups and processed by anaerobic culturing. Standard procedures were used for culture and identification of bacteria. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may have influence the premature delivery. The levels of periodontal pathogens tended to be higher in the premature (case group) labor compared to the term deliveries (control group). Levels of Porphyromonas gingivalis, Fuscobacterium nucleatum, Actinomyces actinomycetecomitans were statistically significantly higher in premature births as compared to term deliveries, adjusting for baseline levels. The joint effects of red and orange microbial clusters were significantly higher in the premature group compared to the term group. The study shows a significant association betwen periodontal anaerobic infection and adverse pregnancy outcome. High levels of periodontal pathogens during pregnancy are associated with an increased risk for preterm delivery. Further studies elucidating the role of the microbial load and maternal immune response as related to pregnancy outcome seem merited.

Burkholderia gladioli infection isolated from the blood cultures of newborns in the neonatal intensive care unit.

Burkholderia gladioli was described as a plant pathogen, and it is a rare cause of infection in humans that is primarily associated with human pulmonary infections, such as chronic granulomatous disease and cystic fibrosis. The neonatal respiratory system is not fully developed and cannot expel bacterial aerosol properly. A total of 2,676 newborns in the neonatal intensive care unit were retrospectively analysed in Putian City, Fujian Province, China, from 2011 to 2014. All of the blood samples were tested for C-reactive protein (CRP), procalcitonin (PCT) and white blood cell (WBC). B. gladioli infections were determined and analysed using a blood culture system. Antibiotic susceptibility testing was performed using the K-B method. Of the 2,676 participants, 87 (3.25%) had a positive B. gladioli blood culture that occurred >72h after birth, including a premature group (54.0%, asphyxia [vs. 9.20%], fever [vs. 13.80%], pneumonia [vs. 6.90%] and hyperbilirubinaemia [vs. 8.05%]) and newborns with necrotising enterocolitis (NEC) (vs. 5.75%). The mean ± standard deviation (SD) of the CRP level was 12.31 ± 0.26mg/L and that of the PCT level was 1.53 ± 0.21ng/ml in the 87 B. gladioli-infected newborns. Most of the B. gladioli isolates were sensitive to many antimicrobial agents and did not lead to serious consequences. All of the B. gladioli-infected newborns were unhealthy, especially the premature infants. B. gladioli might be a causative bacteraemia agent in neonates, it appears to have pathogenic potential in newborns and its sensitivity to antibiotics may be a beneficial factor.