| 1. |
- Duan, Rui-Dong, et al.
(author)
-
Human meconium contains significant amounts of alkaline sphingomyelinase, neutral ceramidase, and sphingolipid metabolites.
- 2007
-
In: Pediatric Research. - : Springer Science and Business Media LLC. - 1530-0447 .- 0031-3998. ; 61:1, s. 61-66
-
Journal article (peer-reviewed)abstract
- Intestinal alkaline sphingomyelinase (Alk-SMase) and neutral ceramidase may catalyze the hydrolysis of endogenous sphin-gomyelin (SM) and milk SM in human-milk fed infants. The enzymes generate sphingolipid metabolites that may influence gut maturation. Alk-SMase also inactivates platelet-activating factor (PAF) that is involved in the pathogenesis of necrotizing enterocolitis (NEC). We examined whether the two enzymes are expressed in both preterm and term infants and analyzed Alk-SMase, neutral ceramidase, SM, and sphingolipid metabolites in meconium. Meconium was collected from 46 preterm (gestational ages 23-36 wk) and 38 term infants (gestational ages 37-42 wk) and analyzed for Alk-SMase using C-14-choline-labeled SM and for neutral ceramidase using C-14-octanoyl-sphingosine as substrates. Molecular species of SM, ceramide, and sphingosine were analyzed by high-performance liquid chromatography mass spectroscopy. Meconium contained significant levels of Alk-SMase and ceramidase at all gestational ages. It also contained 16-24 carbon molecular species of SM, palmitoyl-and stearoyl-sphingosine, and sphingosine. There were positive correlations between levels of SM and ceramide and between ceramide and sphingosine levels. In conclusion, Alk-SMase and ceramidase are expressed in the gut of both preterm and term newborn infants and may generate bioactive sphingolipid messengers.
|
|
| 2. |
- Bengtsson, Jörgen, et al.
(author)
-
The influence of age on the distribution of morphine and morphine-3-glucuronide across the blood-brain barrier in sheep
- 2009
-
In: British Journal of Pharmacology. - : Wiley. - 0007-1188 .- 1476-5381. ; 157:6, s. 1085-1096
-
Journal article (peer-reviewed)abstract
- Background and purpose The effect of age on the distribution of morphine and morphine-3-glucuronide (M3G) across the blood-brain barrier (BBB) was studied in a sheep model utilizing intracerebral microdialysis. The effect of neonatal asphyxia on brain drug distribution was also studied. Experimental approach Microdialysis probes were inserted into the cortex, striatum and blood of 11 lambs (127 gestation days) and six ewes. Morphine, 1 mg.kg(-1), was intravenously administered as a 10 min constant infusion. Microdialysis and blood samples were collected for up to 360 min and analysed using liquid chromatography-tandem mass spectrometry. The half-life, clearance, volume of distribution, unbound drug brain : blood distribution ratio (K(p,uu)) and unbound drug volume of distribution in brain (V(u,brain)) were estimated. Key results Morphine K(p,uu) was 1.19 and 1.89 for the sheep and premature lambs, respectively, indicating that active influx into the brain decreases with age. Induced asphyxia did not affect transport of morphine or M3G across the BBB. Morphine V(u,brain) measurements were higher in sheep than in premature lambs. The M3G K(p,uu) values were 0.27 and 0.17 in sheep and premature lambs, indicating a net efflux from the brain in both groups. Conclusions and implications The morphine K(p,uu) was above unity, indicating active transport into the brain; influx was significantly higher in premature lambs than in adult sheep. These results in sheep differ from those in humans, rats, mice and pigs where a net efflux of morphine from the brain is observed.
|
|
| 3. |
- de Vries, LS, et al.
(author)
-
Role of cerebral function monitoring in the newborn
- 2005
-
In: Archives of disease in childhood. Fetal and neonatal edition. - : BMJ. - 1359-2998 .- 1468-2052. ; 90:3, s. 201-207
-
Research review (peer-reviewed)abstract
- For many years, newborn infants admitted to neonatal intensive care units have had routine electrocardiography and been monitored for respiratory rate, heart rate, oxygen saturation, and blood pressure. Only recently has it also been considered important to monitor brain function using continuous electroencephalography. The role of cerebral function monitoring in sick full term and preterm infants is reviewed.
|
|
| 4. |
|
|
| 5. |
- Elsmén, Emma, et al.
(author)
-
Fetal gender and gestational-age-related incidence of pre-eclampsia.
- 2006
-
In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 85:11, s. 1285-1291
-
Journal article (peer-reviewed)abstract
- Background. Male fetal gender is associated with an overall increased risk of pre-eclampsia. However, it was recently shown that the male: female birth ratio was decreased in pre-eclampsia associated with preterm delivery. The reason for this discrepancy is not known. Objective. To investigate whether the fetal and newborn gender is associated with the incidence of antenatal maternal pregnancy complications, and to investigate if gender-associated risk changes with gestational age at delivery. Methods. Population-based study including 1,158,276 infants born in Sweden 1990-2001. Five maternal diagnosis groups (pre-eclampsia, infection, preterm premature rupture of membranes, abruptio placentae, and polyhydramnios) were explored in relation to newborn infant gender and gestational age at delivery. Results. When all gestational ages were evaluated, male newborn gender was associated with increased odds ratios for all five diagnosis groups, and for preterm birth before 37 weeks gestation, M/F ratio 1.17. In very preterm births (gestational age below 32 weeks), male newborn gender was associated with a significantly lower risk for pre-eclampsia (OR 0.88, 95%CI 0.80-0.97), and a marginally lower risk for polyhydramnios (OR 0.74, 95%CI 0.54-1.01). Conclusion. The fetal gender seems to affect the occurrence of pre-eclampsia, and possibly also polyhydramnios. The finding could be due to an increased risk for spontaneous abortions in pregnancies with male fetuses, but could also be associated with the etiology of these conditions. Evaluation of antenatal pregnancy complications from a fetal/newborn gender perspective may contribute to new insights regarding their pathophysiological mechanisms.
|
|
| 6. |
- Elsmén, Emma, et al.
(author)
-
Umbilical Cord Levels of Interleukin-1 Receptor Antagonist and Neonatal Outcome.
- 2006
-
In: Biology of the Neonate. - : S. Karger AG. - 1421-9727. ; 89:4, s. 220-226
-
Journal article (peer-reviewed)abstract
- Background: Previous studies indicate that there may be infant gender differences in cytokine expression associated with differences in neonatal morbidity. Objective: We tested the hypothesis that umbilical cord interleukin-1 receptor antagonist (IL-1ra) correlates with infant gender and neonatal outcome in preterm infants. Study Design: IL-1ra was measured in cord blood taken from 58 preterm infants (33 males, 25 females) with gestational age less than 32 weeks. Receiver operating characteristics (ROC) curve were used for identifying IL-1ra values with high sensitivity and specificity for neonatal morbidity and adverse outcome, i.e., death or survival with severe intraventricular hemorrhage or periventricular leukomalacia. Results: In the female infants, but not the male infants, cord IL-1ra values correlated with postnatal depression, expressed as Apgar scores at 1 min (correlation coefficient, r(s); p value: -0.542; 0.005), 5 min (-0.571; 0.018), and 10 min (-0.442; 0.035); and postnatal age at intubation (-0.799; 0.001). The ROC area under the curve (AUC) was 0.735 for adverse outcome (p = 0.013), and 0.683 for bronchopulmonary dysplasia (p = 0.021) when all infants were included. However, there was a significant gender difference in the ROC curve for adverse outcome (p = 0.026), with AUC 0.640 (p = 0.240) in males and AUC 0.929 (p = 0.008) in females. Above a chosen cutoff at 13,500 ng/I for IL-1ra cord the sensitivity and specificity for predicting adverse outcome was 100 and 81%, respectively in females versus 50 and 84% in males. Conclusion: Increased levels of cord IL-1ra levels are associated with neonatal morbidity and adverse outcome in preterm infants. Comparable levels of IL-1ra have different predictive value depending on infant gender. Copyright (c) 2006 S. Karger AG, Basel.
|
|
| 7. |
- Fellman, Vineta, et al.
(author)
-
One-year survival of extremely preterm infants after active perinatal care in Sweden.
- 2009
-
In: JAMA : the journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 301:21, s. 2225-33
-
Journal article (peer-reviewed)abstract
- Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling.
|
|
| 8. |
- Forsblad, Kristina, et al.
(author)
-
Apgar score predicts short-term outcome in infants born at 25 gestational weeks
- 2007
-
In: Acta paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 96:2, s. 166-171
-
Journal article (peer-reviewed)abstract
- Aim: To identify early predictors of outcome in infants born at 25 gestational weeks. Material and Methods: Data from a regional perinatal database (time-period 1995-2001, total n = 108 000 births) were used. Apgar scores were available in 92 preterm infants, born at 25 + 0 to 25 + 6 gestational weeks, and analyzed in relation to short-term outcome (180-day survival with, or without, severe brain damage defined as intraventricular hemorrhage grade 3-4 or cystic periventricular leukomalacia). Based on multiple logistic regression analyses we constructed graphs of the estimated chance of survival. Results: Apgar scores at 1, 5 and 10 min correlated with survival without severe brain damage (p = 0.02, 0.006 and 0.006, respectively). Survival without severe brain damage was higher in singleton than in multiple births (p = 0.03); there was no association with infant gender or mode of delivery. The strongest model for prediction of survival without severe brain damage was based on 5-min Apgar score and the Clinical Risk Index for Babies (CRIB), (p < 0.001). Conclusion: Apgar score predicts short-term outcome in extremely preterm infants at 25 gestational weeks. The precision for prediction of outcome increases when Apgar score is combined with CRIB.
|
|
| 9. |
- Forsblad, Kristina, et al.
(author)
-
Short-term outcome predictors in infants born at 23-24 gestational weeks
- 2008
-
In: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:5, s. 551-556
-
Journal article (peer-reviewed)abstract
- AIM: Outcome is uncertain in infants born at 23-24 gestational weeks. The aim of the present study was to identify possible early predictors of outcome in these infants. MATERIALS AND METHODS: Data from the Swedish medical birth register (MBR) for live-born infants with gestational ages (GAs) 23 and 24 weeks, born during the time-period 2000-2002, were analysed in relation to short-term outcomes, that is survival and survival without severe brain damage (intraventricular haemorrhage [IVH] grades 3 and 4 and/or periventricular leukomalacia [PVL]). RESULTS: In 57 infants born at 23 gestational weeks, survival was associated with birthweight (BW) (p = 0.018) and 5-min Apgar score (p = 0.020) on univariate analyses. In 99 infants born at 24 weeks of gestation, survival without severe brain damage correlated with BW (p = 0.039), birth type (singleton/multiple) (p = 0.017) and Apgar score at 1, 5 and 10 min (p = 0.028, 0.014 and 0.030, respectively). The best model for predicting survival without severe brain damage in infants born at 24 gestational weeks was based on 5-min Apgar score and birth type. The small number of live-born infants at 23 weeks of gestation did not allow for multiple logistic regression analyses. CONCLUSION: The 5-min Apgar score is associated with short-term outcome in live-born infants at 23-24 gestational weeks. The association is stronger for infants born at 24 weeks of gestation.
|
|
| 10. |
|
|
