Elsa J. Sell

Platelet counts, fibrinogen concentrations, and factor V and factor VIII levels in healthy infants according to gestational age

Platelet counts and the level of the non-vitamin K-dependent coagulation factors fibrinogen, factor V, and factor VIII were measured in 106 normal newborn infants of four different gestational age groups. For comparison, the vitamin K-dependent factors were studied. It was found that the numbers of platelets and levels of factor V were similar in the several age groups as they were to those of older children. Fibrinogen values were similar in the four age groups but were significantly lower than those in older children. The level of factor VIII increased with gestational age, as did that of factor II, but in contrast to that of factor II was always within or above the values found in older children.

LATE PULMONARY OUTCOMES POORLY PREDICTED BY EARLY RISK FACTORS IN VERY LOW BIRTH WEIGHT INFANTS • 1566

LATE PULMONARY OUTCOMES POORLY PREDICTED BY EARLY RISK FACTORS IN VERY LOW BIRTH WEIGHT INFANTS • 1566

68 BRAZELTON BEHAVIOR TESTING IN THE HIGH RISK NEWBORN

The Brazelton Scale was administered to 204 high risk infants; 366 tests were given. 88% were <2500g and 90% were <36 weeks gestation. 42% had assisted ventilation, and 19% were small for gestational age. Gestational age at test time was 35-43 weeks in 92%. Deviant reflexes (scored as 0, 1 or 3 except for passive movements) were: crawling (20%), standing (39%), placing (23%) Moro (27%), walking (79%), and passive movements of arms (77%) & legs (82%). Mean scores on decrement and orientation items wereSignificant correlations were: 1) Infants with ventilatory support were less able to self quiet or to be consoled; 2) The longer the ventilatory support the poorer the self quieting, consolability and response to animate stimuli, but the better the use of postural changes to self quiet; 3) Gestational age at birth and/or test time influenced dominant states, alertness, consolability, pull to sit, activity, and response to inanimate auditory stimulus.Conclusion: gestational age and perinatal events influence high risk infant responses to the Brazelton test so that their behavior is not accurately described by term newborn standards.

985 INFLUENCE OF VARIOUS MATERNAL FACTORS ON FETAL OUTCOME

A 5-year retrospective study of 4,430 deliveries assessed the influence of maternal obesity, pre-pregnant weight, weight gain, age, and diabetes on fetal outcome. Male babies were heavier than females (p<.05). Thus different curves may be needed to determine the designation “LGA” in some populations. Obese mothers, mothers who gained > 30 1bs. during their pregnancy, and Class A diabetics all had heavier babies and increased numbers of LGA births compared to controls (p<.01). When obesity and diabetes were present, 66.7% of the births were LGA vs. 12.1% for controls (p<.01).The prevalence of major malformations correlated only with maternal diabetes, where there was a 4-fold increase over controls (11.3% vs. 2.7%, p<.05). Perinatal mortality was affected by maternal factors only insofar as they adversely affected birthweight or gestational age. Diabetes however, resulted in increased mortality at all birthweights and gestational ages, and gave an overall perinatal mortality rate of 143/1000 births, which was almost 4 times greater than controls (p<.01).Maternal obesity, pre-pregnant weight, weight gain and diabetes are significant determinants of birthweight and the percentage of LGA births, whereas only maternal diabetes was found to directly increase the prevalence of major malformations or the perinatal death rate.

69 NEONATAL BEHAVIORAL ASSESSMENT AND PSYCHOLOGICAL OUTCOME AT 1 YEAR IN HICH RISK INFANTS

33 infants requiring ICU nursery care had Brazelton Behavioral Testing prior to discharge and were followed for 1 year. At birth 91% were <2500 g. and 37 wks. gestation; 61% were caucasian, 30% Mexican-American; 64% had birth asphyxia; 15% were SGA; 58% had IRDS with 70% of those ventilated. The Brazelton Test was performed at 35-42 weeks in 88%. At 1 year the Bayley test was administered. The results were corrected for gestational age and the percent achieving each score are below:Complete tests were not achieved in all children because of fatigue or failure to cooperate. Significant correlations found were: 1) SGA babies did more poorly on fine motor tasks, 2) Infants who had better self organization on the Brazelton had better scores on gross motor tasks, and 3) Infants with better passive resistance to arm movement on the Brazelton scored better on both motor and mental parts of the Bayley.Conclusion: Two items in the Brazelton test correlated with good performance on the Bayley test in high risk infants.