Pathogenesis and Prognosis of Prematurity

Abramowicz, Mark; Kass, Edward H.

doi:10.1056/nejm196610202751605

Cited by 51 publications

(9 citation statements)

References 44 publications

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“…Ross [ 19831, comparing Many factors can induce prematruity : toxemia, placenta previa, incompetent cervix, and undernutrition, anemia, smoking, high altitude, excessive work, hormonal imbalance, infections, and psychological factors [Abramowicz and Kass, 1966;O'Connell, 1948;Urrusti et al, 19721.…”

Section: Prematuritymentioning

confidence: 99%

Introduction to the study of pre‐and postnatal growth in humans: A review

Mendez

Opitz²,

Reynolds³

1985

Am. J. Med. Genet.

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This review is divided in several items. A brief introduction on the characterization of the growth processes is made; the ways of assessing fetal development and well-being, the factors acting on fetal growth and birth weight, the causes and post-natal consequences of prematurity and intrauterine growth retardation are discussed in the first part. The following items deal mainly with: the normal pattern of growth from birth to puberty according to sex, race, and nutritional status, with special mention to pubertal changes; methods for predicting adult height from skeletal age; the effect of hormones during pre- and post-natal life; and the genetics of adult stature. The remainder of this review deals with genetic causes of growth abnormalities. Constitutional delay of growth, familial short stature, hypothalamic-pituitary dwarfism, skeletal dysplasias and many genetic syndromes presenting intrauterine growth retardation are listed. Aneuploidy effects on human growth are extensively reviewed, and usual growth patterns in Down and Ullrich-Turner syndrome patients as well as other sex aneuploid individuals and mosaics are fully described. The influences of X and Y chromosomes on growth and maturation are also discussed. Finally, some remarks are made about overgrowth syndromes.

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Section: Prematuritymentioning

confidence: 99%

Introduction to the study of pre‐and postnatal growth in humans: A review

Mendez

Opitz²,

Reynolds³

1985

Am. J. Med. Genet.

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“…The impact of neonatal intensive care in lowering birthweight-specific mortality, especially in low birthweight infants, is attested to by numerous reports of declining rates in hospitals that have instituted such care.8 2232 These improvements contrast sharply with mortality rates by birthweight reported from hospitals prior to the 1960s.24 44 Many studies have associated maternal education, income, age, parity, race, prepregnant weight and smoking status with neonatal mortality. [11][12][13][14][15][16][17][18][19][20][45][46][47] Most of these studies have also shown a relationship between these factors and birthweight, the latter being a factor that far outweighs all others as a determinant of neonatal mortality.…”

Section: Components Of the Change In Neonatal Mortalitymentioning

confidence: 99%

Neonatal mortality: an analysis of the recent improvement in the United States.

Lee¹,

Paneth²,

Gartner³

et al. 1980

Am J Public Health

185

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To test the hypothesis that the recent substantial decline in the United States neonatal mortality rate (20.0/1000 in 1950 to 11.6/1000 in 1975) is associated with improvements in perinatal medical care, we examined this change in relation to the two primary components which determine neonatal mortality: birthweight distribution and birthweight-specific mortality.No improvement in the weight distribution of U.S. live births has occurred during this 25-year period, indicating that the change in neonatal mortality isIn the early 1960s considerable national attention was focused on the lack of improvement in United States infant and neonatal mortality rates.'3 This lack of improvement stood in contrast to steady declines in these mortality rates during the preceding decade.' 5 In recent years, however, the picture has changed and a resumption in the decline in these rates has occurred. In the 15 years from 1950 to 1965 neonatal mortality declined only 12 per cent; in the 10 years from 1965 to 1975, it declined 35 per cent. The improvement in neonatal mortality in the latter period amounts to an elimination of 6.1 deaths per 1000 live births, and accounts for 76 per cent of that period's decline in infant mortality rate.Neonatal mortality is inversely related to birthweight, with the proportion of low birthweight (.2500 grams) and particularly very low birthweight (<1500 grams) live births in the newborn population tending to be the major determi- attributable to improved survival for one or more birthweight groups. Decline in the mortality rate in the first 15 years was slow; three-fourths of the decline in the entire 25-year period occurred since 1965. With the exception of perinatal medical care, factors known to affect survival at a given birthweight have not changed in prevalence in the 25-year period. It is a plausible hypothesis that improved perinatal medical care is a major factor in declining neonatal mortality in the U.S. (Am JPublic Health 70:15-21, 1980.) nant of overall neonatal mortality.6-'0 Birthweight-specific mortality rates are the second major determinant of overall neonatal mortality. It is useful, therefore, to view the neonatal mortality rate as the sum of birthweight-specific neonatal mortality rates multiplied by the proportion of live births in each birthweight category. Comparing neonatal mortality rates from different time periods or different geographic areas is of limited utility unless account is taken of these two components of neonatal mortality. Factors intimately associated with neonatal mortality, such as socioeconomic status, parity, and medical complications of pregnancy, powerfully affect the birthweight distribution."-20 There is little evidence that they similarly affect birthweight-specific mortality rates.9' 10 17-21 On the other hand, immediate perinatal care8' 22-32 the infant's sex 7-20 33 34 and appropriateness of birthweight in relation to gestational age33 [35][36][37] are factors associated with differences in birthweight-specific mortality rates, whil...

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“…I t is difficult to make direct comparisons between the current study and results of other follow-up studies of low-birthweight infants (Drillien 1961(Drillien , 1967Abramowicz and Kass 1966;Janus-Kukulska and Lis 1966;Fitzhardinge and Ramsay 1973;Francis-Williams and Davies 1974;Davies and Tizard 1975;Drillieri et a/. 1980;Kitchen ef a/.…”

Section: Discussionmentioning

confidence: 79%

Neurological ‘Soft’ Signs in Low‐birthweight children

Hertzig

1981

Develop Med Child Neuro

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SUMMARY Sixty‐six longitudinally studied prematurely born children who had weighed between 1000 and 1750g at birth were examined neurologically at eight years of age. 13 of these children had localizing neurological findings and another 20 were found to have two or more non‐localizing (‘soft’) signs of CNS dysfunction. These 33 children were significantly more likely to have sustained perinatal complications than were children whose neurological examinations were normal. However, a history of prenatal complications was significantly more frequent among children who subsequently developed ‘soft’ signs, while children with localizing findings were significantly more likely to have experienced postnatal complications. No significant differences in IQ or reading and arithmetic achievement test‐score levels were found between children with ‘soft’ signs and those who were neurologically normal. Nevertheless, children with ‘soft’ signs were significantly more likely to have received special education and to have been referred for psychiatric consultation than were children who were neurologically normal. RÉSUMÉ Signes neurologiques ‘légers’ chez les enfants nés prématurément 66 enfants nés prématurément avec un poids de 1000 à 1750g à la naissance et suivis ensuite longitudinalement ont été examinés neurologiquement à l'âge de huit ans. 13 de ces enfants présentaient des troubles neurologiques locaux et 20 autres enfants présentaient deux signes au moins de dysfonction non localisée (‘légère’) du SNC. l'existence de complications périnatales était significativement plus fréquente chez ces 33 enfants que chez les enfants dont l'examen neurologique était normal. Par ailleurs, une histoire de complications prénatales était significativement plus fréquente parmi les enfants ayant présenté des signes neurologiques ‘légers’, tandis que les enfants présentant des troubles neurologiques localisés avaient eu significativement davantage de complications postnatales. Aucune différence significative en terme de QI, de niveau de lecture ou de calcul n'a été trouvée entre les enfants avec signes ‘légers’ et les enfants neuro‐normaux. Néanmoins, les enfants avec signes ‘légers’ avaient reçu de facon statistiquement significative plus souvent une education spécialisée et avaient été adressés plus souvent en consultation psychiatrique que les enfants neurologiquement normaux. ZUSAMMENFASSUNG ‘Leichte’ neurologische Befunde bei frühgeborenen Kindem 66 frühgeborene Kinder einer Langzeitstudie, die bei der Geburt 1000 bis 1750g wogen, wurden im Alter von acht Jahren neurologisch nachuntersucht. 13 dieser Kinder hatten lokalisierte neurologische Befunde, weitere 20 hatten zwei oder mehr nicht lokalisierte (‘leichte’) Befunde einer ZNS Dysfunktion. Diese 33 Kinder hatten mit größerer Wahrscheinlichkeit perinatale Komplikationen durchgemacht als die Kinder, deren neurologische Untersuchung normal war. Jedoch waren bei den Kindem mit ‘leichten’ neurologischen Befunden in der Anamnese häufiger praenatale Komplikationen, während bei den Kind...

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Pathogenesis and Prognosis of Prematurity

Cited by 51 publications

References 44 publications

Introduction to the study of pre‐and postnatal growth in humans: A review

Introduction to the study of pre‐and postnatal growth in humans: A review

Neonatal mortality: an analysis of the recent improvement in the United States.

Neurological ‘Soft’ Signs in Low‐birthweight children

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