Marta Valcárcel

Early Mother-Infant Interaction and Somatic Growth.

This study tests the proposition that selected behaviors of both mother and infant during feeding are predictors of weight gain during the 1st mth of life. 40 normal mother--neonate pairs were studied, and the target behaviors were examined using an adaptation of the techniques developed by Brown and Bakeman [18]. Aggregate scores of 4 specific maternal and infant behaviors accounted for over 32% of the variance in total weight gain. These findings indicate that the availability of nutrients is not, in itself, a sufficient condition to meet the infants nutritional needs. Implicit in these findings are the possibilities that infants at risk of failure-to-thrive can be identified, and measures to prevent this syndrome can be introduced.

Chemotherapy during pregnancy and its effects on the fetus--neonatal myelosuppression: two case reports.

Cancer during pregnancy is infrequent. It presents an ethical dilemma—remission may be obtained with chemotherapy, but it has potential harmful effects to the fetus. We report a case of a very low birth weight preterm female infant born to a 21-year-old mother diagnosed with leukemia and given chemotherapy up to 1 week before delivery. In the laboratory, initial findings included severe pancytopenia, and bone marrow aspiration demonstrated complete aplasia. She was given blood product transfusions, erythropoietin, and granulocyte colony stimulating factor. The hematologic derangement was resolved without documented infections. The second case is a preterm male infant whose 30-year-old mother was diagnosed with lymphoma and had received chemotherapy during the third trimester. The infant presented with moderate leukopenia. He had an uneventful course without documented infection. Exposure of the fetus to transplacental chemotherapy must be considered when evaluating therapy options and timing of delivery in hematologic malignancies diagnosed during pregnancy.

Outcome of very-low-birth-weight infants who received epinephrine in the delivery room

BACKGROUND In recent years, there has been an increase in the number of very low birth weight (VLBW) infants and an improvement in their survival. However, there are no specific recommendations regarding the use of resuscitative efforts for VLBW infants, and there is scant data in the literature on morbidity and mortality in relation to epinephrine administration. Due to the vulnerability of VLBW infants, studies that examine the effects and consequences of cardiovascular resuscitation and epinephrine administration are needed. STUDY AIM The objective of this study is to determine the outcome of VLBW infants, who received epinephrine in the delivery room. METHODS Medical records of VLBW infants admitted to neonatal intensive care unit (NICU) from 1999 to 2007 were reviewed, and infants who received epinephrine in the delivery room were identified and included in the study. RESULTS Infants who received epinephrine are smaller in terms of gestational age and birth weight and have decreased survival. After adjusting for gestational age and birth weight, infants who received epinephrine presented lower 1 and 5 min APGAR (Appearance, Pulse, Grimace, Activity, Respiration) scores, more respiratory distress syndrome, lower survival (26% vs. 43%, p<0.01) and lower survival without severe brain injury (17% vs. 32%, p<0.01). CONCLUSIONS VLBW infants, who require epinephrine in the delivery room, are smaller in terms of gestational age and birth weight. The requirement of epinephrine in the delivery room during resuscitation may be associated to worst outcomes and decreased survival without severe brain injury. These findings lead to more questions on how aggressive resuscitation efforts should be for these infants.

The stability of sucking behavior and its relationship to intake during the first month of life

A study of forty full-term healthy infants showed that mean amplitude of sucking and amount of sucking time explained a significant percentage of intake of formula variance at two and at thirty days of age. Both parameters increased significantly with age, but both appeared stable across the 4-week period as indicated by significant correlations. At 2 days of age the mean amplitude of sucking was the best predictor of intake. At one month, sucking time was the best predictor. Mean amplitude of sucking was correlated with infants weight at a statistically significant level of both times.

Low Frequency of Rickets and Fractures among Very Low Birth Weight Infants Born in Puerto Rico 1558

Low Frequency of Rickets and Fractures among Very Low Birth Weight Infants Born in Puerto Rico 1558

GLUCOSE PRODUCTION RATES IN INFANTS WITH CONGENITAL HIV INFECTION. 702

Congenital human inmunodeficiency virus infection (HIV) can lead to brain damage in utero. Because the CNS utilizes the majority of circulating glucose in the normal infant, we explored the use of whole-body glucose production rate (GPR) to detect prenatal brain damage using (6,6-2H2) glucose tracer. We performed 20 studies in 16 patients, weight range 790-3714 g, between 2 and 35 days of age, born to mothers with HIV disease. Final HIV status is known in 14 patients, two are pending results. At follow up at 3 to 34 months, 2 infants have died, one of HIV and the other with severe brain damage not related to HIVinfection. The two infants who are HIV positive were premature; however, the HIV negative infants include 2 prematures (25%). The GPR of HIV positive babies was 5.4mg/kg/min, not significantly different from HIV negative infants, GPR 4.75mg/kg/min. One infant who developed hydrocephaly and spastic quadriparesis, not related to HIVstatus, had a low GPR of 3.5mg/kg/min. We conclude that GPR of infants exposed to HIV in utero is similar to that of normal babies.