Preterm VLBW Research Articles

Development at 8–12 months of an Alberta sample of preterm VLBW versus full term infants

Development at 8–12 months of an Alberta sample of preterm VLBW versus full term infants

Caregiving to Very Low Birthweight Infants: A Model of Stress and Immune Response

Mothers of preterm, very low birthweight (≤1500 g; VLBW) infants experience the stress of caring for small, fragile infants at the same time that they are recovering from the relative immunosuppression of pregnancy and when many health behavior changes (e.g., nutrition) occur which also may influence immune status. The purpose of this study was to examine changes in anxiety and depression and in health behaviors, as well as lymphocyte proliferation and natural killer cell activity in mothers of preterm, VLBW infants compared to mothers of healthy term infants. Mothers of preterm VLBW infants have decreasedin vitrolymphocyte response to mitogens compared to mothers of healthy term infants over time, and this difference could not be explained by anxiety, depression, or health behaviors. However, among mothers of VLBW infants, anxiety was related to decreased lymphocyte proliferation response at 1 month postpartum. There was no relationship between maternal depression and lymphocyte proliferative response in mothers of term infants. Natural killer cell activity did not differ between the two groups of mothers, nor was there a relationship between natural killer cell activity and maternal anxiety, depression, or health behaviors. Thus, lymphocyte proliferative response to mitogens may be an important biologic marker of increased stress in mothers of VLBW infants in the first couple of months postpartum.

FAMILY RESPONSE TO THE LOW BIRTH WEIGHT INFANT

Families of VLBW and LBW preterm infants are usually happy to have a new baby in the family, although they are anxious, depressed, and concerned about their infant's future health and well-being. During the first year of the infant's life, families of LBW and VLBW infants face many new challenges. They have infants with unique health-care needs who are often temperamentally difficult and who benefit enormously from excellent parenting. Preterm LBW and VLBW infants are often born to families who are poor and to mothers who are young. Families of VLBW and LBW preterm infants experience decreased employment possibilities at a time when they also have increased expenses. Families of LBW and VLBW preterm infants undergo a vulnerable period during which they may benefit greatly from receiving care from nurses who understand their needs.

Transcutaneous bilirubinometry in preterm very low birthweight infants.

Transcutaneous bilirubinometry using the Minolta Airshield TcB was performed on 40 preterm VLBW Chinese infants during the first 7 days of life; altogether 614 observations were made on the forehead and sternum, respectively. A positive correlation between the TcB index and plasma bilirubin concentration was obtained on the forehead and sternum. Positive plasma bilirubin-TcB index correlations were also observed for each individual day. The plasma bilirubin-TcB index (forehead) regressions were fairly similar for the individual days and the combined overall regression except for 2 days (days 5 and 7). A slight improvement was observed when only bilirubin concentrations less than or equal to 200 mumol/l were evaluated. The intercepts were however different for individual days requiring correction factors to the combined overall regression intercept if the regression is to be used for the respective days. However, the plasma bilirubin-TcB index (sternum) regression for the individual days were significantly different one from another, and from the overall combined plasma bilirubin-TcB index (sternum) regression. This significant difference was still observed when only plasma bilirubin concentrations less than or equal to 200 mumol/l were evaluated. Hence, transcutaneous bilirubinometry has major limitations in preterm VLBW infants.