Herbert C. Miller

Birth weight, gestational age, and sex asdetermining factors in the incidence of respiratory distress syndrome of prematurely born infants

The incidence of respiratory distress syndrome among Negro infants of low birth weight (under 2,500 grams) appears to be affected independently by the infants birth weight, gestational age, and sex. Knowledge of how these factors affect the incidence of respiratory distress syndrome may have important bearing on the pathogenesis of this syndrome.

Maternal Smoking and Fetal Growth of Full Term Infants

Extract: Maternal smoking during pregnancy was associated with reductions in birth weights and crown-heel lengths, but not in ponderal indices of four groups of full term infants. The reductions in crown-heel lengths were statistically significant in three of the four groups of infants. The effects of smoking on fetal growth did not appear to be related to poor maternal nutrition. Mean weight gains during the last two trimesters of pregnancy were not significantly different in smoking and nonsmoking mothers and were above the mean weight gains recommended by the National Research Council.Speculation: The effects of smoking and poor maternal nutrition, as measured by low weight gains during the last two trimesters of pregnancy, are about the same with respect to linear growth of the fetal skeleton, but differ with respect to ponderal indices. Ponderal indices are not affected by smoking but tend to be markedly reduced if maternal weight gains during pregnancy are low.

Methemoglobinemia occurring in infants fed milk diluted with well water of high nitrate content

Summary 1. Two cases of proved methemoglobinemia in newborn infants probably caused by the ingestion of water with a high concentration of nitrate ion are reported. A third case of suspected methemoglobinemia from the same cause is also added. 2. The efficacy of methylene blue in the treatment of this condition iscorroborated. 3. It is suggested that special precautions be taken in rural areas to see that any water used in the feeding of infants is safe in respect to its nitrate content.

Respiratory distress syndrome of newborn infants. I. Diagnosis and incidence.

The respiratory distress syndrome (RDS) is a syndrome associated with a variety of anatomic changes, most of which cannot be diagnosed with certainty except by postmortem examination. New criteria have been developed in this clinic for the diagnosis of RDS. While the presence of any one of these criteria is sufficient for the diagnosis of RDS, the severity of the syndrome is determined by the presence or absence of generalized cyanosis. All infants with severe RDS have generalized cyanosis which persists beyond the first few minutes of life. When the criteria of this clinic are applied, the incidence of RDS ranges from 80 per cent in the weight group of 1,000 to 1,500 grams to 9 per cent in full-term infants born per vaginum.

Respiratory distress syndrome of newborn infants: II. Clinical study of pathogenesis

All deaths from the respiratory distress syndrome (RDS) during the first week of life occurred in the group initially diagnosed as having severe RDS. In half of the severely affected infants a continuum could be demonstrated which consisted of maternal complications capable of producing intrauterine asphyxia, unresponsiveness of the infant at birth, and severe RDS which often terminated in death. The anatomic changes noted at autopsy seemed to depend more upon the degree of maturation of the infant than on the type of maternal complication or the age of the infant at the time of death.

Maternal Factors in the Incidences of Low Birthweight Infants Among Black and White Mothers

Summary: Black mothers (1077) and white mothers (2333) were placed in one of three groups, depending on whether they had medical complications of pregnancy, one or more of seven behavioral conditions of pregnancy, or had no medical complications and no behavioral conditions. The seven behavioral conditions included 1) cigarette smoking or 2) low maternal weight gains in pregnancy, 3) being under 17 years or 4) over 35 years of age at delivery, 5) absence of any prenatal care, 6) being underweight for height at conception, and 7) use of addicting drugs or large amounts of alcohol during pregnancy. The incidences of low birth weight (LBW) infants (<2500 g) were not significantly higher in the lowest than in the highest of the socioeconomic groups of either black or white mothers when mothers were matched either for medical complications, for behavioral conditions, or for neither. The higher incidences of LBW infants in the lowest socioeconomic groups of black and of white mothers were most probably related to the higher incidences of mothers with behavioral conditions and the lower incidence of mothers who had neither medical complications nor behavioral conditions in the lowest socioeconomic groups. The incidences of LBW infants were low (1–3%) in both whites and blacks irrespective of socioeconomic status in the absence of medical complications and behavioral conditions of pregnancy. Socioeconomic status apparently had no significant effect on the incidence of medical complications of pregnancy, but was associated with an increasing incidence of mothers with behavioral conditions as socioeconomic circumstances worsened.Speculation: Data in the present study suggest that decisions women make with respect to seven specific behaviors in connection with their pregnancies are primary factors in determing the incidence of low birthweight infants and that specific social and economic factors are of secondary importance. Consideration should be given to reduce the incidence of low birthweight infants by making prospective parents aware of the importance of these seven behavioral conditions in determining pregnancy outcome for their offspring.

Use of bone age in predicting risk of incurring neonatal respiratory distress syndrome

Abstract Sixty per cent of infants with birth weights from 1,001 to 2,500 grams were found to have visible calcium in the secondary centers of ossification of their knees at birth. The incidence of the respiratory distress syndrome (RDS) in its severest form was 4 per cent in the group with visible centers, compared with 20 per cent in the group without visible centers. None of the former group died as a result of their RDS, compared to a fatality rate of 20 per cent in the group without visible centers.