The Causes of Neonatal Mortality. An Analysis of 501 Autopsies on Newborn Infants

Valdés-Dapena, Marie; Arey, James B.

doi:10.1097/00006254-197103000-00013

Cited by 15 publications

(17 citation statements)

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“…Major hemorrhage or thrombosis was found in 40% of neonatal deaths in a recent survey (9), and intraventricular hemorrhage was detected in 26% of 101 autopsies of newborn infants in another survey (25). Thus, problems related to hemorrhage and/or thrombosis play a major role in the mortality of newborn infants, particularly premature infants.…”

Section: Speculationmentioning

confidence: 98%

Development of Blood Coagulation—A Fetal Lamb Model

1981

Pediatr Res

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SummaryTo study the normal development of blood coagulation factor activities in a growing fetus while avoiding the effects of labor and delivery, a chronic fetal lamb model was developed in which serial blood samples from 10 fetuses were studied during the third trimester of pregnancy and 24 hr after birth. Under operating room conditions with sterile technique, a polyethylene catheter to which heparin had been bound to both internal and external surfaces was inserted into the femoral artery of the fetus. The catheter was brought out through a skin pouch to the side of the ewe and enclosed in a zip lock bag. Blood samples were withdrawn from the catheter three times each week for measurement of coagulation factor activities. Levels of coagulation factor activities at birth in noncatheterized animals were not different from those found in catheterized animals except for factor IX activity which was 12% higher in the catheterized animals (0.02 t P < 0.05). The patterns of development for each of the coagulation factors were similar in all 10 animals studied. Fibrinogen, prothrombin, and factor VII show a decrease in activity early in the last trimester of pregnancy whereas other factors V, VIII, IX, X, XI, XII, and XI11 show a gradual increase in activity throughout the last trimester of pregnancy. Both factors VIII and IX show a significant increase in activity (23% factor VIII and 12% factor IX) associated with the process of delivery. The levels of coagulation factor activities at birth in the lamb relative to adult sheep normals are similar to those found in humans with the exception of factor XIII. Factor XIII is at normal levels in the newborn lamb and is reported to be at levels approximately 50% of the adult level in human infants. SpeculationThe development of a chronic fetal lamb preparation has allowed the construction of developmental patterns for coagulation factor activities throughout the last trimester of pregnancy. Further studies into the biology of the changes in coagulation factor activities observed and the influences of such stresses as hypoxemia and premature delivery should enhance our understanding of the bleeding neonate.

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Section: Speculationmentioning

confidence: 98%

Development of Blood Coagulation—A Fetal Lamb Model

1981

Pediatr Res

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“…Birth weights of those that survived were not available. Of 14 babies, four survived the neonatal period. All deaths occurred during the perinatal period, the majority before the third postpartum day.…”

Section: Suimiri Sciweusmentioning

confidence: 99%

Simian Neonatology: I. Gestational Maturity and Extrauterine Viability

Price¹,

Anver²,

Garcia³

1972

Vet Pathol

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Abstract. In a 21-month period, 225 simians were born at the New England Regional Primate Research Center. Of these, 141 (63%) survived the neonatal period, and 84 (37%) were either born dead or died during the first 30 days of life. Sixty-two of the 84 neonatal deaths occurred during the perinatal period (0-7 days of life). In four macaque species studied, groups of infants that were high and low survival risks were established by examining weight-specific death rates. Criteria for establishing immaturity by birth weight were suggested in Suguinrrs oedipus and Suimiri sciuresrs.The newborn passes through a critical time, the neonatal period. The ability to adapt to its new environment depends on various factors, among which the length of in utero life plays a decisive role. Gestational age, birth weight, tissue maturity, and neonatal survival data are used to evaluate extrauterine viability in a newborn simian population. Materials and MethodsRecords of all births at the New England Regional Primate Research Center during a 21-month period from January 1969 through September 1970 were reviewed. Birth weights, gestational ages and numbers of stillborn, liveborn, neonatal deaths and survivors were evaluated. Six species of monkeys were studied (table 1). All infants from the four species of macaques were separated from their dams during the first 24 h of life and reared in a nursery. Squirrel monkey and marmoset infants were left with their dams. Each macaque species was divided into birth-weight groups of 50-g increments. Each group within the species was then analyzed for survivors and neonatal deaths. Weight-specific death rates were calculated for each group. Birth weight and degree of tissue maturity were used to evaluate immediate extrauterine viability in Suirniri sciureus and Suguinus oedipus.The neonatal period in this study included birth and the first 30 days of life. The perinatal period included events surrounding parturition and the first 7 days of life.

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“…Intrauterine aspiration was significant because it indicated intrauterine distress had occurred as a result of fetal hypoxia [18]. In human infants, fetal hypoxia is recognized as a clinical entity.…”

Section: Discussionmentioning

confidence: 99%

“…The species represented were Macaca muluttu (19 animals), M. arctoides (1 5), M.fuscicularis (13), M. cyclopis ( S ) , Suimiri sciureus (18), Saguinus oedipus (8), Cebus ulbifvons (2), Gulugo crussicaudatus (l), and…”

Section: Methodsmentioning

confidence: 99%

Simian Neonatology: II. Neonatal Pathology

Anver¹,

Hunt²,

Price³

1973

Vet Pathol

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Abstract. Spontaneous gross and microscopic lesions were studied in 82 perinatal and neonatal monkeys of various species. Ninety-seven lesions were found in the body systems examined. The system at greatest risk was the respiratory system (33 lesions), at the least risk, the cardiovascular system (four lesions). Lesions were inflammatory, degenerative, vascular, and of other types, such as intrauterine aspiration and congenital anomalies. Differences in the type and distribution of lesions in the various systems were found between premature and mature infants.The transition from an intrauterine to an independent existence is a miraculous but hazardous event. The vulnerability of the newborn exceeds that of any other point of life and, aside from old age, mortality rate is highest in the critical neonatal period. The causes of illness and death in the neonatal animal are multiple and depend to a large degree on the physiological status of the infant at birth. The ability to reduce neonatal mortality improves as our understanding of the physiology of the neonate expands and our knowledge of the prevalent disease of this period increases. Definitions of prematurity and maturity and the association of birthweight with survival in several simian species were the subjects of a previous report [15].Great demands have forced the establishment of nonhuman primate breeding programs. These stem from the fact that certain simian and ape species are endangered, that wild-caught animals are far from optimal experimental animals, and that newborn animals are required for certain studies. Knowledge of neonatal primate diseases, however, is limited. Although no systematic studies have been reported, it is well known that the mortality rate may be high.

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The Causes of Neonatal Mortality. An Analysis of 501 Autopsies on Newborn Infants

Cited by 15 publications

References 0 publications

Development of Blood Coagulation—A Fetal Lamb Model

Development of Blood Coagulation—A Fetal Lamb Model

Simian Neonatology: I. Gestational Maturity and Extrauterine Viability

Simian Neonatology: II. Neonatal Pathology

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