New fetal growth cur ye^ for Japanese. Acta Paediatr Scand, Suppl. 319 62. New fetal growth curves for Japanese have been made with the moperation of 37 major medical centers throughout Japan by the sponsorship of the Mwstry of Health. They are reliable in regard to the adequacy of the sample number, the accuracy of the data on gestatkmd age and tbe proper processes of composing growth curves. Effect of sex and parity are signUlcant on wight but not on length and head circumference growth curves. The light-for-dates infant is deflned as below mean -1.5 SD by the statistic analysis of their morbidity. Tbepo new offMel fetal growth curves will solve current confusion of sweral fetal growth c u m from different institutions in Japan. Key words: Fetal growth c u m , s d -f o r -&a& infant.
An epidemiological survey was carried out to examine the present situation with respect to sudden infant death syndrome (SIDS) in Kanagawa Prefecture. Questionnaires on sudden unexpected death of infants aged < 1 year in 1990‐91 were sent to the hospitals and clinics in Kanagawa Prefecture which may take care of such infants. By analysing information from 10 485 replies, 48 out of 73 reported sudden infant deaths were confirmed to be SIDS, although autopsy was not performed in 13 cases (27%). The incidence of SIDS per 1000 live births in Kanagawa Prefecture was 0.29 in 1990 and 0.31 in 1991; and if limited to autopsy cases 0.19 and 0.25, respectively. Sudden infant death syndrome cases in Japan were found to occur more frequently when infants were < 6 months old, at home and sleeping alone, but less in the winter and between midnight and early morning. There was little difference between the numbers in prone and supine sleeping positions at discovery. It was not clear whether SIDS occurred more often to babies sleeping prone than supine, because there were no controls matched with the SIDS cases. In future, continuous epidemiological surveys of SIDS in Japan should be carried out.
We studied the efficacy of mediumchain triglyceride (MCT) as an energy source in premature infants. Infants who were given 3 g/kg/day of MCT oil gained body weight better than the control group in spite of a smaller water intake. This is advantageous to premature infants who need water restriction due to patent ductus arteriosus (PDA), bronchopulmonary dysplasia (BPD), etc. We also proved that MCT oil is rapidly absorbed and digested, by means of the '3C-trioctanoin breath test. Jpn 1988;30: 564 -568)
(Acta Paediatr
The main metabolic alterations in the hypothalamus of SHRSP that the endogenous vaso-dilating prostaglandin I2 biosynthesis was not so enough adaptively enhanced as in SHRSR and that not only the vaso-constricting thromboxane A2 biosynthesis but also the edema-causative leukotriene C formation elevated much higher than in SHRSR would reasonably contribute to a cause of malignant hypertension prior to stroke.
Changing patterns of instantaneous heart rate associated with apnea were analysed in 22 neonates; ten sleepy infants due to analgesic agents used during delivery, five preterm infants with favourable outcome and seven sick neonates with major medical complications. Patterns of heart rate change were classified into five types: type I deceleration, which is a sharp drop of heart rate synchronized with apnea; type II deceleration, which is a gradual decrease of heart rate during apnea; type III decerelation, which is a bradycardic spell without consistent relation with apnea; acceleration, which is a rapid increase of heart rate associated with respiration change; and a non‐reactive type, in which there is no appreciable heart rate change during apnea. Type II deceleration, type III deceleration and the absence of acceleration were strongly related with poor clinical conditions. Type I deceleration was frequently observed in most neonates with apnea and was not necessarily regarded as an ominous finding. The non‐reactive type was seen in both cases, with favourable and unfavourable outcome. Application of the knowledge of fetal heart rate monitoring to neonatal monitoring is possible and is rather promising.
In 1984, Peter Dunn postulated that infants from 28 weeks' gestation till 18 weeks' postnatal age who grow normally have almost identical poteptial growth velocities, regardless of racial and geographic differences. He suggested that the straight line growth curve in this period could be used as a perinatal growth chart for international reference. We composed biological growth curves for Japanese fetuses by eliminating data with risk factors for fetal growth, and compared them with the curves of Dunn. Our conclusions are as follows: 1 ) Japanese population fetal growth curves correspond with the curve of Dunn between 28 and 38 weeks' gestation. 2) Even in ideal conditions, flattening of fetal growth after 38 weeks' gestation always occurs. 3) In the early postnatal period, infants grow with the same straight line velocity as during fetal growth between 28-38 weeks' gestation. Infants from 28 weeks' gestation to 18 weeks' postnatal age have an almost identical growth potential in spite of some degree of growth constraint in utero after 38 weeks' gestation.
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