Effects of nasal CPAP therapy on respiratory and spontaneous arousals in infants with OSA.

Obstructive sleep apnea (OSA) in infants has been shown to resolve frequently without a cortical arousal. It is unknown whether infants do not require arousal to terminate apneas or whether this is a consequence of the OSA. We studied the apnea and arousal patterns of eight infants with OSA before and after treatment with nasal continuous positive airway pressure (CPAP). These infants were age matched to eight untreated infants with OSA and eight normal infants. Polysomnographic studies were performed on each infant. We found that the majority of central and obstructive apneas were terminated without arousal in all OSA infants. After several weeks of nasal CPAP treatment, the proportion of apneas terminating with an arousal during rapid-eye-movement sleep increased in treated infants compared with untreated infants. Spontaneous arousals during rapid-eye-movement sleep were reduced in all OSA infants; however, during CPAP treatment, the spontaneous arousals increased to the normal control level. We conclude that OSA in infants possibly depresses the arousal response and treatment of these infants with nasal CPAP partially reverses this depression.     

The intestinal microflora of infants: fecal flora of infants with vitamin K deficiency

The fecal flora of 10 infants with vitamin K deficiency (VKD) and 10 healthy infants was examined. All the infants were breast-fed. In the infants with VKD, the total counts (P less than 0.01) and the numbers of bifidobacteria (P less than 0.001) were lower than in the healthy infants, whereas bacteroides, veillonella and enterococci were present in greater numbers in the feces of infants with VKD. The incidence of the Bacteroides fragilis group was higher (P less than 0.05) in the infants with VKD than in the healthy infants. A significant reduction (P less than 0.05) in Bifidobacterium breve was shown in the infants with VKD. The data emphasize the abnormal flora in infants with VKD.     

脑脊液检查在早产儿及足月儿细菌性脑膜炎的诊断价值

目的:评价脑脊液检查在早产儿及足月儿细菌性脑膜炎诊断中的价值。方法:选取2014年6月1日至2016年12月31日上海市儿童医院新生儿科收治的行腰椎穿刺检查的447例新生儿,回顾性分析新生儿的一般资料、脑脊液常规生化、培养等指标,根据胎龄将患儿分为早产儿167例与足月儿280例,再根据有无患发细菌性脑膜炎分为早产儿细菌性脑膜炎27例(早产儿观察组)、早产儿非细菌性脑膜炎140例(早产儿对照组)、足月儿细菌性脑膜炎38例(足月儿观察组)、足月儿非细菌性脑膜炎242例(足月儿对照组),采用受试者工作特征(ROC)曲线评估蛋白定量、白细胞计数、葡萄糖对早产儿及足月儿细菌性脑膜炎的诊断价值。结果:与同组对照组相比,足月儿观察组和早产儿观察组蛋白定量和白细胞计数均明显升高,而葡萄糖含量显著下降,且差异均具有统计学意义(P0.05);本研究65例细菌性脑膜炎患儿脑脊液培养分离出11株细菌(16.9%)。足月儿脑脊液白细胞计数、蛋白定量以及葡萄糖诊断细菌性脑膜炎的ROC曲线下面积分别为0.995、0.846、0.703。早产儿脑脊液白细胞计数、蛋白定量以及葡萄糖诊断细菌性脑膜炎ROC曲线下面积分别为0.970、0.711、0.705。结论:脑脊液白细胞计数、蛋白定量在足月儿和早产儿细菌性脑膜炎中具有较高的诊断价值。     

百日咳鲍特菌感染婴幼儿口咽部的菌群变化

摘要：目的 通过比较健康婴幼儿与百日咳鲍特菌感染婴幼儿口咽部的菌群相对丰度,探讨百日咳鲍特菌感染对婴幼儿口咽部的菌群影响。方法 采用高通量测序技术,对53例百日咳鲍特菌感染婴幼儿和21例健康婴幼儿口咽标本进行16S rDNA测序,对测序序列进行分析,比较两组间的菌群多样性及在门、属水平上菌群结构差异。结果 健康婴幼儿与百日咳鲍特菌感染患儿在性别和年龄方面差异没有统计学意义。百日咳鲍特菌感染婴幼儿比健康婴幼儿口咽部菌群多样性显著增加。变形菌门（Proteobacteria）作为主要的门在百日咳鲍特菌感染患儿组中相对丰度显著高于健康婴幼儿组;两组排在相对丰度前15位的属,共有3个主要的属在百日咳鲍特菌感染患儿中显著增加,分别为盐单胞菌属（Halomonas）、嗜血杆菌属（Haemophilus）和鲍特菌属（Bordetella）;而罗氏菌属（Rothia）显著减少。结论 百日咳鲍特菌感染婴幼儿口咽部的菌群发生了显著的变化,百日咳鲍特菌感染患儿口咽部的菌群多样性比健康婴幼儿显著增加,在门和属水平百日咳鲍特菌感染患儿与健康婴幼儿主要组成方面均有显著性不同。     

Maternal Infant Monitoring in a Free-ranging Group of Japanese Macaques (<Emphasis Type="Italic">Macaca fuscata</Emphasis>)

In nonhuman primates, females with infants visually monitor their infants from a distance to detect and consequently avoid potential threats to their infants. We recorded maternal visual monitoring of infants (infant monitoring) ages 7–18 wk in a free-ranging, provisioned group of Japanese macaques (Macaca fuscata). The infant monitoring rate declined as a function of infants’ ages in weeks and increased when the infants were beyond their mother’s reach, indicating that infant monitoring reflects the vulnerability of infants. Females with infants increased infant monitoring when their infants were handled by other group members but not when their infants moved alone. This suggests that intragroup threats (harassment/mishandling or kidnapping) have a relatively stronger influence on infant monitoring than external threats (predation or infanticide) under the condition of this study. Infant monitoring of middle-/low-ranking females was more frequent than that of high-ranking females when their infants were handled by other individuals. This may reflect greater intragroup threats to infants of middle-/low-ranking females; however, further study is needed to confirm this. During important activities (feeding or grooming), the infant monitoring rate was lower than that during other activities (resting or self-directed behavior). However, even during important activities, females with infants increased infant monitoring when infants were handled. This indicates that females with infants face a trade-off between infant monitoring and other important activities, and even if females have to reduce the time spent on important activities, they increase infant monitoring when their infants face greater potential intragroup threats.     

Natal Attraction in Adult Female Baboons (Papio cynocephalus ursinus) in the Moremi Reserve, Botswana

Mammalian females are strongly attracted to infants and interact regularly with them. Female baboons make persistent attempts to touch, nuzzle, smell and inspect other females’ infants, but do not hold them for long periods, carry them, or provide other kinds of care for them. Mothers generally tolerate these interactions, but never initiate them. The function of these brief alloparental interactions is not well understood. Infant handling might be a form of reproductive competition if females’ interest in infants causes distress to mothers or harm to their infants. Alternatively, infant handling might be the product of selection for appropriate maternal care if females who are highly responsive to infants are the most successful mothers. We test several predictions derived from these hypotheses with data collected in a free‐ranging group of baboons (Papio cynocephalus ursinus) in the Moremi Reserve of Botswana. Infants were most attractive when they were very young. Mothers of young infants were approached by other adult females on average once every 6 min, and other females attempted to handle their infants approximately once every 9 min. By the time infants were a year old, their mothers were being approached only once every 30 min and infants were being handled only once every 5 h. Females were more strongly attracted to other females’ infants when they had young infants of their own, and their interest in other females’ infants declined as their own infants matured. Females seemed to be equally attracted to all infants, but had greater access to offspring of their relatives and subordinate females. Females nearly always grunted as they handled infants. As in other contexts grunts are a reliable predictive signal that non‐aggressive behavior will follow, the use of grunts before handling suggests that these interactions were not a form of deliberate harassment.     

Triadic interactions among Macaca radiata: Passports and buffers

Male members of a group of captive Macaca radiata at the California Primate Research Center held and carried infants as they approached or were approached by higher-ranking males and as they were threatened by other males. Male infants between the ages of 25 and 84 weeks were involved in triadic interactions more frequently than were female infants of any age or male infants of other ages. That males were less likely to be harassed while huddling with or embracing infants suggested that infants provided an effective buffer against aggression.     

Spectrophotometric Analysis in Umbilical Cords of Infants with Meconium Aspiration Syndrome

We compared spectrophotometric analysis of the umbilical cords of infants with meconium aspiration syndrome (MAS) or with meconium-stained amniotic fluid (MSAF) and healthy infants. In a prospective study, 15 infants with MAS and 37 infants with MSAF were enrolled. Twenty healthy infants formed a control group. The absorption peak of umbilical cords with meconium was significantly higher in the infants with MAS or MSAF than in controls. Spectrophotometric analysis of the umbilical cords with meconium may be useful to identify developed neonates with MAS or MSAF.     

Actigraphic monitoring of the activity-rest behavior of preterm and full-term infants at 20 months of age

Differences in the activity-rest behavior of preterm and full-term infants provide an important contribution to the analysis of the ontogeny of circadian rhythms. In this study, we recorded the activity-rest behavior of 17 preterm and 8 full-term infants at the approximate age of 20 months over an average of 10 days by means of actigraphic monitoring (Actiwatch, Cambridge Neurotechnology Ltd.). At the same time, the parents of the infants kept a daily diary. The activity-rest rhythm, the nighttime sleep duration, the daytime rest duration, as well as the sleep quality of the infants were analyzed. Preterm and full-term infants at the age of 20 months show a circadian rhythm with a period length between 23 h 32 min (23:32 h) and 24 h 23 min (24:23 h). It can be concluded that the preterm and full-term infants all reached a vital developmental step by showing the dominant circadian rhythm in the spectrum. The daytime rest duration of preterm infants is significantly shorter than that of full-term infants. The sleep quality of preterm infants is significantly lower than that of full-term infants, which means that the preterm infants have a larger percentage of less restful nighttime sleep. In other studies preterm infants show an over-proportional frequency of attention deficit hyperactivity disorder (ADHD). For this reason, future analyses should reveal whether or not actigraphic monitoring is a suitable means for an early identification of activity-rest behavior in children who may develop ADHD.     

新生儿凝血指标及部分生化指标检测参考区间调查

目的:调查分析新生儿凝血指标及部分生化指标检测参考区间。方法:以十所三甲医院2012年1月~2014年6月收治的新生儿2683例为研究对象,其中足月儿1700例,早产儿983例,选择同期十所医院职工健康体检1000例为对照组,通过全自动血凝仪、全自动生化分析仪测定所有对象凝血指标及12项生化指标,并建立相关指标参考区间。结果:足月新生儿PT、TT、APTT凝血指标较对照组延长,Fib较对照组降低,差异均有统计学意义(P=0.000);早产儿PT、TT、APTT较足月儿延长(P=0.000),Fib(P=0.001)降低;足月新生儿Glc水平较对照组低(P=0.000),早产儿Glc水平较足月新生儿更低(P=0.000);足月新生儿血钙水平低于对照组,血清TC、Cr、BUN、ALT含量均在对照组之下(P=0.000),早产儿相对更低(P均0.05);足月新生儿LDH、CK酶活性及K+水平均高于对照组(P均0.05),早产儿水平更高(P0.05);足月儿血清Alb、TP及Na+水平低于对照组(P0.05),早产儿更低(P均0.05)。结论:新生儿凝血表达与成人不同,凝血及部分生化指标参考区间的变化与年龄有联系,有必要为新生儿建立与年龄相关的凝血、生化指标参考区间。     

Actigraphic Monitoring of the Activity-Rest Behavior of Preterm and Full-Term Infants at 20 Months of Age

Differences in the activity-rest behavior of preterm and full-term infants provide an important contribution to the analysis of the ontogeny of circadian rhythms. In this study, we recorded the activity-rest behavior of 17 preterm and 8 full-term infants at the approximate age of 20 months over an average of 10 days by means of actigraphic monitoring (Actiwatch®, Cambridge Neurotechnology Ltd.). At the same time, the parents of the infants kept a daily diary. The activity-rest rhythm, the nighttime sleep duration, the daytime rest duration, as well as the sleep quality of the infants were analyzed. Preterm and full-term infants at the age of 20 months show a circadian rhythm with a period length between 23 h 32 min (23:32 h) and 24 h 23 min (24:23 h). It can be concluded that the preterm and full-term infants all reached a vital developmental step by showing the dominant circadian rhythm in the spectrum. The daytime rest duration of preterm infants is significantly shorter than that of full-term infants. The sleep quality of preterm infants is significantly lower than that of full-term infants, which means that the preterm infants have a larger percentage of less restful nighttime sleep. In other studies preterm infants show an over-proportional frequency of attention deficit hyperactivity disorder (ADHD). For this reason, future analyses should reveal whether or not actigraphic monitoring is a suitable means for an early identification of activity-rest behavior in children who may develop ADHD.     

Patterns of low birth weight in the Bengali newborns

This paper examines the distribution of low birth weight (2500 g or less) by gestation time, sex, maternal age, parity (birth order), socioeconomic conditions, and season of birth among 5117 single live births born to Bengali mothers at the Ramakrishna Mission Seva Pratisthan Hospital in Calcutta, India. Preterm infants have low birth weight significantly more often than their full term counterparts. Female infants have low birth weights significantly more often than male infants. The infants of poor mothers have lower birth weights in higher order births more often than infants of higher orders born to well-off mothers. Teenaged mothers produce low birth weight babies significantly more often than older mothers. Although the relationship is not significant, low birth weight infants occur more often among 1st and late born infants and less often among 2nd born infants. The season of birth is not significantly associated with birth weight. Less than 10% of low birth weight infants are pre-term, while the rest are full term. The great majority of low birth weight infants are small-for-gestational-age; the minority are small due to curtailed gestational age. The proportion of infants weighing less than 2001 g is only 9%; this figure tallies closely with earlier studies of India.     

0～3岁婴幼儿超声骨密度现状调查及影响因素分析

目的:了解0~3岁婴幼儿的骨密度现状,并分析其相关影响因素,为婴幼儿骨密度不足的预防工作提供依据。方法:选取2016年1月-2018年10月期间于我院进行健康体检的0~3岁婴幼儿860例为研究对象。采用超声骨密度测量仪对入选婴幼儿左腿胫骨中段骨密度进行检测,并对婴幼儿的骨密度现状进行分析。采用问卷调查方式收集所有婴幼儿的性别、年龄、喂养方式、是否补充维生素D、户外活动时间等资料,并采用单因素和多因素Logistic回归分析0~3岁婴幼儿骨密度的影响因素。结果:860例婴幼儿中,骨密度正常婴幼儿336例,轻度骨密度不足婴幼儿196例,中度骨密度不足婴幼儿179例,重度骨密度不足婴幼儿149例,骨密度不足发生率为60.93%。单因素分析结果显示,不同年龄、性别、是否补充维生素D及不同户外活动时间婴幼儿之间的骨密度不足发生率比较差异有统计学意义(P0.05),而不同喂养方式婴幼儿之间的骨密度不足发生率比较差异无统计学意义(P0.05)。多因素Logistic回归分析结果显示,年龄(0~6个月,7~12个月)、性别(女)、补充维生素D(否)、户外活动时间(1 h)为0~3岁婴幼儿骨密度的危险因素(P0.05)。结论:0~3岁婴幼儿的骨密度不足发生率较高,年龄、女性、未补充维生素D、户外活动时间过少均是0~3岁婴幼儿骨密度的危险因素,可通过适量补充维生素D、增加户外活动时间以提高婴幼儿骨密度值。     

Population surveillance of multimalformed infants--experience with the Swedish Registry of Congenital Malformations. First Part

The paper discusses the principles of an analysis of infants with multiple malformations, recorded in a birth defect registry. It is illustrated with 973 multimalformed infants recorded in the Swedish Registry of Congenital Malformations, 1965-1984. The detection and delineation of patterns of associated malformations is described and exemplified with the VATER association pattern. There is no time trend for the rate of infants with this association; they represent about 4% of all registered multimalformed infants; and their prevalence at birth is 2.7 per 100,000 births. The rate of infants probably representing unidentified trisomy 13 shows a decrease after 1977 indicating an increased access to cytogenetic services. A similar decrease is seen in infants probably representing unidentified Meckel's syndrome. Using 28 multimalformed infants registered in 1985, the technique for surveillance of multimalformed infants in a population is discussed.     

Identification of infants destined to die unexpectedly during infancy: evaluation of predictive importance of prolonged apnoea and disorders of cardiac rhythm or conduction.

Twenty four hour tape recordings of electrocardiogram and breathing movement were made prospectively in 6914 full term and 2337 preterm infants or infants of low birth weight during their first six weeks of life. These recordings included 40 obtained in 29 infants who subsequently suffered the sudden infant death syndrome and 13 obtained in 10 other infants who died suddenly and unexpectedly. None of the recordings obtained in the infants who suffered the sudden infant death syndrome showed prolonged apnoea (cessation of breathing movement for 20 seconds or more) or pre-excitation. One infant had multiple ventricular premature beats (38/hour). Compared with recordings obtained in 211 control infants who did not die none of the recordings obtained in the infants who suffered the syndrome showed abnormal prolongation of the QT interval.     

Preference for Cute Infants Does Not Depend on Their Ethnicity or Species: Evidence from Hypothetical Adoption and Donation Paradigms

Results of previous work suggest a preference of adult observers for cute compared to less cute infants. In Study 1 we investigated whether the preference for cute infants depends on the ethnicity and species of the infant. We simultaneously presented two faces (one cute and one less cute) and asked Caucasian participants to choose the infant to whom they would rather give a toy (Task 1) and which infant they would rather adopt (Task 2). The infants were Caucasian or African human babies or dog puppies. For all face categories and in both tasks we found a strong preference for cute infants. A possible reason for preferring cute infants may be that cute infants look healthier than less cute infants. To investigate whether cuteness is associated with the assessment of health we conducted Study 2. Faces of Caucasian and African infants and dog puppies were rated for cuteness and health. The findings revealed a significant relationship between health and cuteness evaluation across all stimuli. We suggest that one reason why cute infants are preferred might be because they are perceived as being healthier.     

Responses of foster-mothers and troop members to adopted newborns in a captive group of rhesus monkeys

Two rhesus monkey males and two females, born to females caged singly, were exchanged with same-sex infants born to females in a large troop which was held in an enclosure in a different building. The ages of the infants were between 24 and 120 hr. The selected foster mothers (FMs) immediately accepted the foreign infants, allowed them to suckle and treated them as their own offspring. Compared with interactions with previous offspring, the FMs initially tended to be more possessive and restrictive of their foster infants: generally they took longer before they allowed the infants to sit at a distance from them and more readily retrieved them. The foster infants tended to be more active (‘fidgety’) than natural (control) offspring born to the troop. Non-related members of the troop, differentiated between foster and control groups. These troop animals more frequently approached and sat in proximity, often in fur-contact with, touched, groomed, and lipsmacked to, foster infants than control infants. The attractiveness of the fostered infants seemed to be slightly associated with the FMs' dominance rank. The foster infants were therefore viewed by others as having assumed the role afforded by the FMs' rank. Thus both FMs and other troop members recognized the unfamiliarity and novelty of the foster infant but the infants were still accepted into the group. We suggest that the different treatment of the foster infants by the troop may have consequences on the infants' future social development.     

Development in Japanese macaques (Macaca fuscata): Sexually dimorphic behavior during the first year of life

We have documented several sexually dimorphic patterns of behavior that develop during the first year of life in infant Japanese macaques and their mothers. Mothers treated their infants differently by sex—mothers of males broke contact with them and retrieved them more frequently than did mothers of females. And mothers of male infants moved more frequently than did mothers of female infants. Male infants played more, played in larger groups, and mounted more frequently; female infants groomed and spent more time close to other monkeys in larger social groups than did males. Female infants were also punished by other group members more frequently than were male infants. We conclude that male and female Japanese macaque infants receive differential treatment early in life by both their own mothers and other animals, and males and females in turn treat their mothers and other animals differently. There appears to be a reciprocal relationship between the behavior of infants, mothers and other social partners that contributes to the development of sexually dimorphic patterns of behavior.     

Variation in early neonatal mortality for different types of fetal growth retardation

Birth and first-48-hr death records were analyzed for 10,024 liveborn infants in Mexico City and 12,786 liveborn infants in Santa Cruz, Bolivia. The objective of the analysis was to characterize the early postnatal mortality rates for different types of fetal growth retardation and prematurity. Infants who were delivered prior to 37 weeks of gestation had 23-100 times the mortality risk of infants born at full term and normal weight. Light-for-gestational-age infants (birth weight less than 2,900 g) were further divided into proportionately growth-retarded with normal Rohrer's index (weight/height) and disproportionately growth-retarded with low Rohrer's index. The proportionately growth-retarded infant had nearly twice the mortality of the full-term, appropriate-weight infants, whereas the disproportionately growth-retarded infants had 2.9-5.7 times the mortality rate of the full-term, appropriate-weight infants. There were some differences between samples in mortality rates and prevalence of the different classes of small infants, but the pattern of mortality within samples was consistent between samples.