Background:The early postnatal cardiovascular consequences of intrauterine growth restriction (IUGR) have not been completely elucidated. This study aimed to evaluate the effect of IUGR on neonatal myocardial function and cardiovascular adaptation to extrauterine life. Methods: Conventional and tissue Doppler echocardiographic parameters were compared on the second and fifth postnatal day between 30 IUGR and 30 appropriate-forgestational age (AGA) neonates. results: IUGR neonates presented relative interventricular septum (IVS) hypertrophy (IVS to left ventricular (LV) posterior wall diastolic ratio: median IUGR-AGA difference of 0.05 (interquartile range: 0.04-0.06); P = 0.020), relative LV dilatation (wall thickness to end-diastolic LV dimension difference of 0.12 (0.06-0.16); P = 0.012), and increased left myocardial performance index (MPI difference of 0.19 (0.05-0.28); P = 0.012). Repeated measurements ANOVA revealed a different pattern of change in LV stroke volume (LVSV; P < 0.001), LV cardiac output (LVCO; P < 0.001), MPI (P < 0.001), and heart rate (HR; P = 0.025) between AGA and IUGR infants. From the second to the fifth postnatal day, AGA neonates presented a decrease in MPI and HR with an increase in LVSV and LVCO. IUGR neonates failed to achieve similar changes in MPI, HR, and LVSV, whereas their LVCO decreased. conclusion: IUGR neonates present changes in cardiac morphology and subclinical myocardial dysfunction, which may result in an altered pattern of cardiovascular adaptation to extrauterine life. i ntrauterine growth restriction (IUGR), defined as the inability of a fetus to achieve its genetically determined potential size, is associated with increased risk of perinatal complications and neonatal morbidity (1). Epidemiological evidence also suggests a strong relationship between IUGR and cardiovascular disease in adulthood (2), supporting the existence of a maladaptive programming process in utero, which affects cardiovascular system in the long term (3). Previous studies have shown that chronic intrauterine substrate deprivation is associated with changes in ventricular geometry and "cardiomyopathy-like" myocardial dysfunction in the fetus (4-7). Alterations in cardiovascular adaptation to extrauterine life have also been reported in neonates exposed to IUGR, but these findings were only hypothetically related to an impairment in myocardial function (8).Traditionally, the assessment of cardiac performance in infants relies on conventional echocardiographic indexes (9). Tissue Doppler imaging (TDI) is a relatively new echocardiographic technique, which enables assessment of ventricular mechanics by providing information on myocardial motion and timing of cardiac events with high temporal and spatial resolution (10). Accumulating evidence from studies in neonates (11-15) and children (16)(17)(18) suggests that specific TDI parameters, such as peak myocardial velocities and myocardial performance index (MPI) (19), are more sensitive markers of ventricular dysfunction than those derived from con...

BackgroundInfections by a variety of pathogens are a significant cause of morbidity and mortality during perinatal period. The susceptibility of neonates to bacterial infections has been attributed to immaturity of innate immunity. It is considered that one of the impaired mechanisms is the phagocytic function of neutrophils and monocytes. The purpose of the present study was to investigate the phagocytic ability of neonates at birth.MethodsThe phagocytic ability of neutrophils and monocytes of 42 neonates was determined using the Phagotest flow cytometry method, that assesses the intake of E. Coli by phagocytes, in cord blood and in peripheral blood 3 days after birth. Fifteen healthy adults were included in the study as controls.ResultsThe phagocytic ability of neutrophils in the cord blood of neonates was significantly reduced compared to adults. The 3rd postnatal day the reduction of phagocytic ability of neutrophils was no longer significant compared to adults. The phagocytic ability of monocytes did not show any difference from that of adults either at birth or the 3rd postnatal day.ConclusionsOur findings indicate that the intake of E. Coli by phagocytes is impaired at birth in both preterm and full term neonates compared to adults. This defect is transient, with the phagocytic ability in neonates reaching that of the adults 3 days after birth.

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We provide a predictive TcB tool that could allow for a noninvasive, risk-based approach to neonatal hyperbilirubinemia.

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We provide data on TcB levels for the first 120 postnatal hours from a large population of white, healthy, term and near-term neonates. We also present a percentile-based TcB nomogram designated for noninvasive and hour-specific evaluation of neonatal hyperbilirubinemia.

Normal children and adults show diurnal variation of plasma Cortisol levels reaching peak values around 08.00 h and lower values around 24.00 h. Despite numerous studies on diurnal variation of plasma Cortisol levels in children, the age of appearance of a circadian rhythm has not been definitely established. The purpose of this study was to investigate the development of Cortisol circadian rhythm in infancy. In seventy healthy, full-term infants, less than six months old, plasma Cortisol was measured at 10.30 h and 22.30 h. The mean ± SEM values of daytime plasma Cortisol at one to four weeks of life were 159 ± 41, 116 ± 43, 240± 54 and 456 ± 95 nmol/1 and the night-time values were 129 ± 40, 99 ± 44, 131 ± 78 and 430 ± 105 nmol/1, respectively. No statistically significant differences were found between daytime and night-time Cortisol values during the first four weeks of life. In contrast, the daytime values of plasma Cortisol were 295 ± 62 at the age of 2-3 months, 211 ± 43 at 4-5 months and 291± 31 nmol/1 at 6 months of life, and night-time values were 166 ± 52, 119 ± 35 and 109 ±21 nmol/1, respectively, which were statistically significant (p < 0.05). These data clearly indicate that Cortisol circadian rhythm starts between the second and third month of life.