RESUMEN
The growth and development of 15 patients with VATER association were prospectively followed for 1-4 years. Prenatal growth retardation was frequent but at least 50% of children with early growth deficiency demonstrated long-term catch-up growth. Mental development was normal in 12 of 15 children but 8 of 13 children had delayed motor skill development. Early postnatal growth deficiency was an indicator of children at risk for developmental problems. Parents should be reassured that most children with VATER association display normal development.
Asunto(s)
Anomalías Múltiples/fisiopatología , Crecimiento , Estatura , Peso Corporal , Desarrollo Infantil , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Masculino , Destreza Motora , Estudios ProspectivosRESUMEN
This study determined the incidence of retinopathy of prematurity (ROP) in 2,958 admissions to the Newborn Intensive Care Unit of the James Whitcomb Riley Hospital for Children, Indianapolis, between January 1976 and December 1979. Among 2,484 survivors, acute ROP developed in 72 (2.9%); 60 (83%) of these newborns had birth weights of less than 1,500 g. The incidence of acute ROP among survivors with birth weights of less than 1,000 g (28%) was approximately three times that of the survivors with birth weights between 1,001 and 1,500 g (10.1%). The overall incidence of blindness was 4.5% of surviving infants less than 1,000 g and 1.2% of those surviving with birth weights of 1,000 to 1,500 g. Evidence of the strong influence of immaturity and low birth weight on the risk of development of ROP is reaffirmed. Increasing survival of the most susceptible infants may be the factor contributing most to the overall incidence of ROP.
Asunto(s)
Retinopatía de la Prematuridad/epidemiología , Peso al Nacer , Edad Gestacional , Humanos , Indiana , Mortalidad Infantil , Recién Nacido de Bajo Peso , Recién Nacido , Unidades de Cuidado Intensivo NeonatalRESUMEN
The authors evaluated 89 infants who had had computed tomography of the head and who were followed-up for a minimum of one year. In a large proportion with moderate ventriculomegaly spontaneous stabilization or regression occurred, with normal developmental outcome in a high percentage of cases. However, there was a statistically significant trend toward lower developmental scores as ventricular size increased. Many infants with ventricular enlargement will not develop progressive hydrocephalus, but their cognitive and psychomotor development may be affected.
Asunto(s)
Encefalopatías/fisiopatología , Ventriculografía Cerebral , Encefalopatías/complicaciones , Encefalopatías/diagnóstico por imagen , Humanos , Recién Nacido , Riesgo , Hemorragia Subaracnoidea/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
All infants of less than 1,500 g birth weight who required a ventriculo-peritoneal shunt were followed for developmental problems over the 1st year of life. There were 19 infants; 2 died within the 1st postoperative week. At 1 year of age corrected for prematurity the mean Bayley Mental Developmental Index was 62 +/- 23.0, and the mean Psychomotor Developmental Index was 61 +/- 19. Only 2 infants attained scores greater than 85 on both scales, while an additional 2 infants attained a score of greater than 85 on one scale. It is concluded that ventriculo-peritoneal shunting procedures performed after progressive ventricular enlargement has taken place are not likely to result in normal development of the infant less than 1,500 g birth weight.
Asunto(s)
Derivaciones del Líquido Cefalorraquídeo , Desarrollo Infantil , Hidrocefalia/cirugía , Recién Nacido de Bajo Peso , Femenino , Estudios de Seguimiento , Humanos , Hidrocefalia/psicología , Recién Nacido , Masculino , PeritoneoRESUMEN
There were 47 seriously-ill neonates with medical causes of respiratory distress and 10 infants with severe respiratory distress secondary to a congenital diaphragmatic hernia treated with tolazoline according to a strict protocol designed to manage persistent fetal circulation (PFC). Of the 47 infants, 28 (60%) had a positive response defined as an increase in the pO2 greater than or equal to 24 mm Hg within 4 hr of beginning the drug. Of 7 infants, 4 with congenital diaphragmatic hernia had a positive response. The mean increase in the pO2 for the 47 infants was statistically significant (p less than .05). Of the 47 infants with medical disorders, 27 survived (survival 57%), whereas only 2 of the 10 infants with congenital diaphragmatic hernia and severe persistent fetal circulation survived (survival 28%). Erythema (60%), hematest positive gastric aspirates (55%), thrombocytopenia (45%), hyponatremia (40%) and increased gastric aspirates (36%) were the most common adverse effects occurring during tolazoline infusion. Hypotension occurred in nine cases, but was transient. Of the 27 survivors, 20 with medical causes of persistent fetal circulation were evaluated at age 1 yr. Eighty percent of these infants studied were considered normal as defined by an MDI and PI of the Bayley Scales of greater than or equal to 70. These data suggest that tolazoline is a useful adjunct in the management of neonates with PFC. In addition, tolazoline was more effective in mechanically ventilated neonates treated with respiratory paralytic agents. Although tolazoline resulted in a significant improvement in the paO2 in 4 infants with congenital diaphragmatic hernia, it did not appear to improve mortality in these infants.