Kathleen Gifford

Outcome for survivors of mechanical ventilation weighing less than 1,250 gm at birth

We investigated the outcome in 28 survivors of mechanical ventilation weighing less than 1,250 gm at birth. Fifteen infants (54%) had neurodevelopmental sequelae, of whom eight had major handicaps. These eight infants differed significantly from the rest of the infants studied in the following manner: lower mean birth weight and gestational age, delay in transportation to our Neonatal Intensive Care Unit, and high incidence of bacterial sepsis. The remaining seven infants with NDS were functionally normal or minimally impaired at the time of the study, although significant problems may yet emerge with continued follow-up. Retrolental fibroplasia was diagnosed in 11 infants (39%) and resolved in two. The development of RLF was associated with prolonged oxygen exposure and the presence of bacterial sepsis. However, since major handicap, RLF, and sepsis were all problems observed in the smallest infants, a cause-and-effect relationship between sepsis and these sequelae remains speculative.

Positive Relationship of Cortisol Concentrations and Oral Nutrition to Epidermal Growth Factor Concentrations in Preterm Infants

We have suggested from previous studies that increases in early neonatal epidermal growth factor (EGF) concentrations were dependent on adequate glucocorticoid hormone concentrations. In order to examine this relationship, matched values for cortisol and EGF in 193 preterm infants on days 2 and 6 were compared. Gestational age had a significant positive effect on EGF concentrations for those infants receiving oral nutrition and there was also a positive relationship between nutrition and cortisol concentration. Cortisol was then used as an independent factor and was significantly (p = 0.01) related to EGF values such that as cortisol concentrations increased, EGF values also increased. In summary, we suggest that these results are consistent with a role for cortisol in the control of the EGF pattern in the newborn period.

PHARMACOKINETICS OF HYDROCORTISONE (HC) IN EXTREMELY LOW BIRTHWEIGHT (ELBW) INFANTS IN THE FIRST WEEK OF LIFE. † 1493

PHARMACOKINETICS OF HYDROCORTISONE (HC) IN EXTREMELY LOW BIRTHWEIGHT (ELBW) INFANTS IN THE FIRST WEEK OF LIFE. † 1493

779 PHYSIOLOGIC JAUNDICE

Maximum serum bilirubin (SB) levels and feeding methods were analyzed in 2388 infants (99% white) admitted to our well baby nursery in 1976-1980.The vast majority of breast feeding mothers had 24 hour rooming in and fed their babies on demand. Virtually all infants with SB>13 mg/dl received phototherapy which may have depressed the upper percentiles. The clear differences (for whatever reason) between these populations imply that our standards for non-physiologic jaundice should be modified. SB>13mg/dl might require evaluation in a bottle fed baby whereas SB>15.5mg/dl would be necessary to arouse similar concerns in a breast fed infant. This approach would save money, if nothing else.

Prophylaxis against Early Adrenal Insufficiency to Prevent Chronic Lung Disease in Premature Infants

Prophylaxis against Early Adrenal Insufficiency to Prevent Chronic Lung Disease in Premature Infants

EFFECT OF HYDROCORTISONE (HC) ON NEUTROPHIL CD14 EXPRESSION IN VERY LOW BIRTH WEIGHT(VLBW) INFANTS IN THE FIRST WEEK OF LIFE. 1735

EFFECT OF HYDROCORTISONE (HC) ON NEUTROPHIL CD14 EXPRESSION IN VERY LOW BIRTH WEIGHT(VLBW) INFANTS IN THE FIRST WEEK OF LIFE. 1735

780 THE “YELLOW BABY SYNDROME” (OR WHY WELL BABIES ARE JAUNDICED)

We obtained maximum serum bilirubin (SB) levels in 2421 new-borns in our well baby nursery. SB was >12.9mg/dl in 147 (6.1%) and these infants were compared with 147 with SB <12.9mg/dl.Method of delivery, apgar scores, transient respiratory distress and gestation showed no significant associations. Discrepancies between univariate and logistic results, particularly with regard to feeding, occur because many factors are closely related and, therefore, confounding. Only 14% of BF mothers smoke vs 42% bottle feeding. Eighty percent of babies with SB >12.9 are BF and 79% of diabetic mothers BF. Excessive weight loss is more common in BF. Nevertheless, the findings suggest a role for caloric ceprivation as a contributor to jaundice. Further studies are needed to evaluate more precisely the contribution of these factors to the development of neonatal jaundice.