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.     

低出生体重儿肠道微生态构建影响因素的 动态监测

目的动态监测低出生体重儿肠道菌群,分析不同体重、不同喂养方式及疾病状态等因素对患儿肠道微生态的影响,为规范临床低出生体重儿宫外营养支持措施及治疗手段提供依据。方法应用16SrRNA荧光定量PCR技术检测正常新生儿和低出生体重儿生后第1、3、7天粪便中大肠埃希菌、肠球菌、乳杆菌及双歧杆菌的含量。结果 (1)在生后7d内,无论正常新生儿还是低出生体重儿,其粪便中大肠埃希菌、肠球菌、乳杆菌和双歧杆菌的含量均随日龄的增加而增加,且生后7d内正常新生儿的粪便中大肠埃希菌、肠球菌、乳杆菌和双歧杆菌的含量均显著高于低出生体重儿(P0.05),正常新生儿生后7d内粪便中各细菌的增长率均高于低出生体重儿。(2)体重2 000~2 500g的低出生体重儿粪便中大肠埃希菌和肠球菌在各日龄中的含量明显高于体重2 000g的新生儿(P0.05);同时其粪便中双歧杆菌和乳杆菌含量在3日龄和7日龄阶段明显高于体重2 000g的新生儿(P0.05)。(3)3日龄和7日龄母乳喂养组的低出生体重儿粪便中双歧杆菌和乳杆菌含量明显高于乳制品喂养组(P0.05);且母乳喂养组新生儿生后7日内粪便中大肠埃希菌、乳杆菌和双歧杆菌含量的增长率均高于乳制品喂养组,尤其是双歧杆菌的增长率(126.49%vs 54.81%)。(4)合并并发症的3日龄和7日龄的低出生体重儿,粪便中乳杆菌和双歧杆菌含量均明显低于无合并症的低出生体重儿(P0.05);且无并发症组的低出生体重儿其粪便中肠球菌、乳杆菌和双歧杆菌的增长率均高于有并发症组的低出生体重儿,大肠埃希菌增长率则低于有并发症组。结论低出生体重儿肠道菌群的定植时间晚且数量少,体重、喂养方式及有无并发症是影响新生儿肠道菌群丰度的重要因素。母乳喂养可促进低出生体重儿肠道中益生菌的定植。疾病因素会导致肠道菌群丰度的降低,使肠道菌群紊乱,其程度可能与病情的严重程度相关。     

Effects of iron therapy on blood lead concentrations in infants

To determine whether blood lead concentration is elevated in iron-deficient infants, blood lead and serum ferritin concentrations, serum iron/transferring iron-binding capacity (Fe/TIBC) and complete blood counts were measured in 30 iron deficient and 35 control infants, aged 6–24 months. All 30 iron-deficient infants received iron supplementation (ferric hydroxide-polymaltose complex, 6 mg/kg Fe³⁺/day) for 1–6 months. Blood lead concentrations were measured in 18 of the iron deficient infants after their ferritin levels returned to the normal range. The geometric mean blood lead concentration was higher in iron deficient than in control infants (1.846 vs. 1.416 μg/dL). After iron therapy, the blood lead levels of iron-deficient infants decreased significantly compared with pre-treatment levels (1.785 vs. 2.386 μg/dL), and the hemoglobin and ferritin concentrations increased significantly. These findings indicate that iron deficiency increases blood lead concentrations in infants with very low blood lead concentrations.     

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.     

Effects of solid foods on growth of bottle-fed infants in first three months of life.

We studied 821 infants who were bottle-fed from birth to determine whether non-milk solids begun within the first 3 monts of life affect early growth. The infants were seen seven to 10 days and three months after birth. They were divided into three groups-those who had started solids before 6 weeks of age (657 infants); those who had started solids between the ages of 6 weeks and 3 months (124 infants); and those given cow''s milk formulae alone during the first three months (40 infants). The infants were weighed and measured seven to 10 days after birth and at three months. Mean weekly rates of weight and length gain over the 3 months were calculated and did not differ significantly between the three groups. As no record was made of quantities of food taken we cannot explain the failure of solid foods to affect growth. Studies of how young infants utilise these foods are needed.     

Influence of postconceptual age on the electromyographic characteristics in newborns

The purpose of the study was to investigate the neuromuscular state in the preterm infants using surface electromyography (EMG). Ten preterm (gestational age, 31–32 weeks) and ten term infants (gestational age, 38–39 weeks) participated in the study in the second, fourth and sixth postnatal weeks. Linear and novel nonlinear parameters were used for the treatment of the interference EMG (iEMG) in four muscles (mm. bic. br. dext., trie. br. dext, tib. ant. sin., and gastr. sin.). In the preterm infants aged 33–37 weeks, both linear and nonlinear iEMG parameters were significantly lower in comparison to the term infants. Thus, the iEMG of the preterm infants was characterized by a more primitive time-domain structure and lower amplitude and spectrum frequency. In addition, unlike in term newborns, the lifetime dynamics of the iEMG parameters in the preterm infants was retarded. Thus, the motor system of a preterm infant is likely to be less prepared for postnatal life due to the shorter stay in utero. Nonetheless, the iEMG of the preterm infants may be characterized as more complex in comparison to the term newborns of the same postconceptual age. This may be attributed to the new postnatal sensory stimuli.     

兰州市婴幼儿艰难梭菌带菌状况

在兰州市随机采集的２１６名健康婴幼儿粪标本经分离并对其培养特性、菌落菌体形态特征、生化反应特性以及毒素原性等进行一系列检查,检出了３７人的粪便含有艰难梭菌（１０４─１０８／ｇ）,检出总阳性率为１７．１％,新生儿、婴儿及幼儿各年龄组的检出阳性率分别为１３．５％（１９／４１）、３３．３％（１３／３９）、１３．９％（５／３６）。３７株分离菌中毒素原性阳性者仅有８株（２１．６％）,均分布于婴儿与幼儿两组。新生儿１４１人中２７人的粪标本为胎粪,只有１人（３．７％）含艰难梭菌（２×１０６／ｇ）,但不产毒素。所有婴幼儿中有２２人因各种原因曾用过抗菌药物,但仅有２人的粪便含艰难梭菌,而且均为非产毒株,表明艰难梭菌检出率与药物服用之间似无显著的相关性。     

Individual and group effects on early caregiver-infant relationships in red-bellied tamarin monkeys

The relationship between changes in caregiver-caregiver and caregiver-infant behaviour was studied during the infants' first month in 10 family groups of red-bellied tamarins, Saguinus labiatus, with twin infants. With infants of a given age, fathers generally spent a higher proportion of time carrying per infant than did mothers, but in most cases these differences were not significant. Mothers and fathers carried significantly more than older siblings did at the beginning and end of the infants' first month. With older infants, caregivers started to rub off infants they were carrying, so that infants started to spend some time off all caregivers. Each caregiver initiated carrying by retrieving an infant from another caregiver, and sometimes retained an infant against a retrieve attempt by another caregiver in order to continue carrying it. Before infants started to spend some time off, time spent carrying by mothers, fathers and older siblings was positively correlated with the percentage of retrieve attempts by other caregivers that they retained against, and, more strongly, with the value of their own number of retains minus the number of retains by other caregivers against them. These results indicate that competition to care for infants has a direct effect on the early development of each caregiver-infant relationship within the family group.     

A preliminary investigation on the relationship between gut microbiota and gene expressions in peripheral mononuclear cells of infants with autism spectrum disorders

Fecal and blood samples of infants with autism spectrum disorders (ASD) and healthy infants were analyzed to investigate the association of altered gut microbiota and ASD development. 16S rRNA gene-based sequencing found that, unlike those of healthy infants, feces of ASD infants had significantly higher and lower abundance of genera Faecalibacterium and Blautia, respectively. Moreover, DNA microarray analysis of peripheral blood mononuclear cells (PBMC) detected more highly than low expressed genes in ASD infants than in healthy infants. Gene Ontology analysis revealed that differentially expressed genes between ASD and healthy infants were involved in interferon (IFN)-γ and type-I IFN signaling pathways. Finally, strong positive correlations between expression of IFN signaling-associated genes in PBMC and fecal abundance of Faecalibacterium were found. Our results strongly suggested that altered gut microbiota in infants resulted from ASD development and was associated with systemic immunity dysregulation, especially chronic inflammation.     

儿童保健对早产儿生长和智力发育的影响及相关性研究

为了探究正常的儿童保健对早产儿生长和智力发育的影响,并明确早产儿的生长和智力发育分别与儿童保健的影响,本研究选取40例早产儿,随机分为对照组和观察组,每组20例。对照组进行常规育儿管理,观察组采用儿童保健管理。统计分析两组早产儿在0.5岁、1岁、1.5岁和2岁的生长(头围,体重和身高)和智力(智力和心理活动)发育情况及相关性。研究发现,儿童保健可明显促进早产儿的生长和智力发育,且正规儿童保健与早产儿的生长和智力发育呈正相关关系,均具有显著性差异。本研究结果说明,儿童保健可明显促进早产儿的生长和智力发育,具有重要的临床应用价值。     

脑电图与早产儿脑损害的相关性研究

脑电图（Electroencephalography EEG）是观察早产儿（premature infants）脑损害的敏感方法。急性和慢性EEG的改变与早产儿以后的神经和认知功能异常有相关性,应用神经生理学的方法诊断早产儿脑损害,早期持续在ICU病房的EEG监测和在以后阶段的EEG检查相结合是比较理想的手段。     

Effects of White Matter Injury on Resting State fMRI Measures in Prematurely Born Infants

The cerebral white matter is vulnerable to injury in very preterm infants (born prior to 30 weeks gestation), resulting in a spectrum of lesions. These range from severe forms, including cystic periventricular leukomalacia and periventricular hemorrhagic infarction, to minor focal punctate lesions. Moderate to severe white matter injury in preterm infants has been shown to predict later neurodevelopmental disability, although outcomes can vary widely in infants with qualitatively comparable lesions. Resting state functional connectivity magnetic resonance imaging has been increasingly utilized in neurodevelopmental investigations and may provide complementary information regarding the impact of white matter injury on the developing brain. We performed resting state functional connectivity magnetic resonance imaging at term equivalent postmenstrual age in fourteen preterm infants with moderate to severe white matter injury secondary to periventricular hemorrhagic infarction. In these subjects, resting state networks were identifiable throughout the brain. Patterns of aberrant functional connectivity were observed and depended upon injury severity. Comparisons were performed against data obtained from prematurely-born infants with mild white matter injury and healthy, term-born infants and demonstrated group differences. These results reveal structural-functional correlates of preterm white matter injury and carry implications for future investigations of neurodevelopmental disability.     

Influence of recombinant human erythropoietin on neutrophil function in premature neonates

The in vivo influence of recombinant human erythropoietin (rhEpo) and iron on human neutrophil (PMN) antimicrobial function was assessed. A total of 21 preterm infants were randomized to receive either 200 U/kg/other day of rHuEPO+12 mg/kg/day of iron (EPO+high Fe, seven infants) or 200 U/kg/other day of rhEPO+4 mg/kg/day of iron (EPO+standard Fe, 9 infants) or 4 mg/kg/day of iron only (standard Fe, five infants). PMNs were isolated from blood of these infants 60+/-5 days after birth and from eight healthy adults. No differences between infants and adults were found in PMN random migration and chemotactic activity to N-formylmethionyl leucyl phenylalanine (FMLP), superoxide anion production in response to FMLP and phagocytosis of Staphylococcus aureus. In contrast, percentage phagocytosis was significantly lower in EPO+standard Fe as compared to both EPO+high Fe and standard Fe groups (P<0.01). This modest impairment of phagocytic activity of neonatal PMNs found in association with administration of rhEPO and standard iron may be related to consumption of iron during rhEPO-enhanced erythropoiesis.     

Effect on Neonatal Jaundice of Oestrogens and Progestogens Taken before and after Conception

Study of 182 newborn babies has shown that among bottle-fed infants the mean plasma bilirubin concentration was slightly but significantly higher (P <0·01) in those whose mothers had previously used steroid contraceptives. A similar finding was not noted among breast-fed infants.A further 16 infants whose mothers had received progestogen therapy during their pregnancy had a mean plasma bilirubin concentration which was significantly higher than each of the four other groups of infants studied (P <0·01). Icterus occasionally reached clinically important levels in these babies.     

A Commentary on Multiple Screening for Aminoacidopathies in the Newborn Infant

Multiple screening for aminoacidopathies has been attempted with a simple micromethod (Lancet, 2: 230, 1964) requiring only 10 μl. of plasma collected in a capillary tube and processed by a chromatographic technique. In a survey of 1250 infants, two newborn infants with phenylketonuria, two older infants with hypermethioninemia-tyrosinemia and hepatic cirrhosis were found, and approximately 10% of the premature infants had marked hypertyrosinemia. Multiple screening therefore has the advantage of multiple diagnosis over other techniques which screen specifically for a single disease. Pilot screening projects with this and other techniques could improve our knowledge of heritable metabolic disease so that mass screening for such problems may eventually be justifiable.     

Effect of night and day on preterm infants in a newborn nursery: randomised trial.

The effect of alternating night and day on sleep, feeding, and weight gain in 41 healthy preterm infants was examined in a randomised controlled trial. Twenty infants from a night and day nursery, where the intensity of light and noise was reduced between 7 pm and 7 am, spent longer sleeping and less time feeding and gained more weight than 21 infants from a control nursery, where the intensity of light and noise was not reduced. Differences were significant and became apparent only after discharge home; they were still present three months after the expected date of delivery, when infants from the night and day nursery were an average of 0.5 kg heavier (p less than 0.02). These findings suggest that physical environment has an effect (either direct or indirect) on the subsequent behaviour of preterm infants and that exposure to night and day is beneficial.     

Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth.

In a double-blind trial of vitamin D supplements in pregnant Asian women calciferol (ergocalciferol, 1000 IU/day) was administered to 59 women and placebo to 67 controls during the last trimester. The two groups had similar distributions of maternal age, height, parity, number of vegetarians, countries of origin, and sex and gestation of the infants. At entry to the trial maternal serum 25-hydroxy vitamin D (25-OHD) concentrations were low in both treatment and control groups and significantly lower in vegetarians than non-vegetarians. Mothers in the treatment group gained weight faster in the last trimester than those in the control group, and at term they and their infants all had adequate plasma 25-OHD concentrations, Mothers and infants in the control group, however, had low plasma concentrations of 25-OHD and calcium and raised plasma alkaline phosphatase (bone isoenzyme) activity. Five of these infants developed symptomatic hypocalcaemia. Almost twice as many infants in the control group were small for gestational age (29% v 15%), but there were no significant differences between the two groups of infants in antropometric measurements. Infants in the control group, however, had larger fontanelles, suggesting impaired ossification of the skull. Because of the benefits to mothers and infants in the treatment group and the absence of side effects, vitamin D supplements should be given to all pregnant Asian women in the United Kingdom.     

早期干预对早产儿脑损伤预后的临床观察

目的：探讨早期联合干预对脑损伤早产儿智能及运动发育的影响。方法：80例存在脑损伤的早产儿随机分为干预组与对照组,每组各40例,对照组给予常规治疗与保健指导,干预组在此基础上联合神经节苷脂治疗与早期康复训练,定期随访两年,观察比较患儿纠正胎龄40周时神经行为评分（NBNA）,智力及运动发育情况。结果：干预组患儿纠正胎龄40周NBNA评分为33．04±1．12．对照组NBNA评分为30．95±0．88,两组间差异有统计学意义（P〈0．05）;干预组MDI与PDI指数分别于9月龄始和6月龄始显著高于对照组（P〈0．01或0．05）;1岁时进行Gesell智力发育检查,干预组大运动、精细动作、适应性、语言、个人一社会交往等五个能区情况均明显好于对照组（P〈0．01）;干预组17．5％的后遗症发生率显著低于对照组32．5％的发生率（P〈0．01）。结论：联合旱期干预治疗可有效促进脑损伤早产儿神经系统功能修复,改善智能及运动发育,减少后遗症发生。     

Effects of Preterm Birth on Intrinsic Fluctuations in Neonatal Cerebral Activity Examined Using Optical Imaging

Medical advancements in neonatology have significantly increased the number of high-risk preterm survivors. However, recent long-term follow-up studies have suggested that preterm infants are at risk for behavioral, educational, and emotional problems. Although clear relationships have been demonstrated between preterm infants and developmental problems during childhood and adolescence, less is known about the early indications of these problems. Recently, numerous studies on resting-state functional connectivity (RSFC) have demonstrated temporal correlations of activity between spatially remote cortical regions not only in healthy adults but also in neuropathological disorders and early childhood development. In order to compare RSFC of the cerebral cortex between preterm infants at term-equivalent ages and full-term neonates without any anatomical abnormality risk during natural sleep, we used an optical topography system, which is a recently developed extension of near-infrared spectroscopy. We clarified the presence of RSFC in both preterm infants and full-term neonates and showed differences between these groups. The principal differences were that on comparison of RSFC between the bilateral temporal regions, and bilateral parietal regions, RSFC was enhanced in preterm infants compared with full-term neonates; whereas on comparison of RSFC between the left temporal and left parietal regions, RSFC was enhanced in full-term neonates compared with preterm infants. We also demonstrated a difference between the groups in developmental changes of RSFC related to postmenstrual age. Most importantly, these findings suggested that preterm infants and full-term neonates follow different developmental trajectories during the perinatal period because of differences in perinatal experiences and physiological and structural development.     

Influence of common non-synonymous Toll-like receptor 4 polymorphisms on bronchopulmonary dysplasia and prematurity in human infants

Bronchopulmonary dysplasia (BPD) is a common chronic lung disease and major risk factor for severe respiratory syncytial virus (RSV) infection among preterm infants. The Toll-like receptor 4 (TLR4) is involved in oxidative injury responses in the lungs. Two non-synonymous single nucleotide polymorphisms in the TLR4 gene have been associated with RSV infection in children. However, it is unclear to what extent this association is confounded by BPD or prematurity. In this study, we analyzed two population-based cohorts of preterm infants at risk for BPD as well as ethnicity-matched infants born at term, to test whether the TLR4 polymorphisms Asp299Gly (rs4986790) and Thr399Ile (rs4986791) are independently associated with BPD or premature birth. In a Canadian cohort (n = 269) composed of a majority of Caucasian preterm infants (BPD incidence of 38%), the TLR4-299 heterozygous genotype was significantly under-represented in infants without BPD (1.6% of infants versus 12% in infants with severe BPD) after adjusting for twins, ethnicity, gestational age, birth weight and gender (p = 0.014). This association was not replicated in a Finnish cohort (n = 434) of premature singletons or first-born siblings of Caucasian descent, although the incidence of BPD was substantially lower in this latter population (15%). We did not detect a significant association (>2-fold) between TLR4 genotypes and prematurity (p>0.05). We conclude that these TLR4 genotypes may have, at best, a modest influence on BPD severity in some populations of high-risk preterm infants. Further studies are warranted to clarify how clinical heterogeneity may impact genetic susceptibility to BPD.