Neonatology

Article Abstract:

Neonatology, celebrating its 25th birthday in 1990, is devoted to increasing survival for newborns (neonates) in high-risk categories. Respiratory distress syndrome remains a prime focus of study because of the high mortality and morbidity associated with it. Surfactant, a substance that lines the lung's chambers, is deficient in infants with this condition. Although it can now be manufactured, surfactant therapy has not brought about the anticipated decrease in mortality. Other causes of respiratory distress syndrome must exist. It appears that pain can induce a condition of hypoxia (too little oxygen) in newborns. Monitoring of heart and lung function is now performed via pulse oximetry, a method whereby a probe, attached to the infant's palm or sole, measures the oxygen saturation of the blood. This method is entirely painless and requires no calibration. Computerized monitoring of infants in neonatal intensive care units can allow computation of trends over time as well as calculation of complex variables, such as lung compliance and resistance. Maternal drug abuse affects infants; these children are at risk for developmental disabilities, which are not yet fully understood. HIV (human immunodeficiency virus, which is associated with AIDS, acquired immunodeficiency syndrome) can be transmitted from mother to fetus. Reports indicate that, on average, 2 of every 1000 pregnant women has HIV infection, and several thousand infected babies will be born each year. Since up to 80 percent of infants weighing between 750 and 1,000 grams (approximately 1.6 to 2.2 pounds) are surviving, average stays in neonatal intensive care units are longer, with many very-low-birth-weight infants having a favorable prognosis. Although infants who weigh less than 750 grams (about 1.6 pounds) rarely live, in-hospital survival of these infants has lengthened, raising questions about the justification of routine intensive care for such premature infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Patient outcomes, Mortality, Complications and side effects, Demographic aspects, Drug therapy, HIV (Viruses), HIV, Birth weight, Low, Low birth weight, Infant mortality, Disease transmission, AIDS (Disease) in children, Pediatric AIDS (Disease)

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Neonatology

Article Abstract:

Many women requested early discharge after childbirth as an alternative to standard deliveries. However, managed care programs have adopted this strategy for every pregnant woman as a way to cut costs. But the American Academy of Pediatrics issued guidelines in 1995 stating that mothers and their newborn infants should not be discharged until certain criteria were met, and that these criteria probably could not be met in fewer than 48 hours. However, a 1995 study found that discharging medically stable premature infants from a neonatal intensive care unit saved $2.7 million at a large university hospital. The use of corticosteroids has been shown to reduce the incidence of respiratory distress syndrome in premature infants, but they are not widely used. The use of thyroid hormones in addition to corticosteroids is controversial. Infants born at 23 or 24 weeks may survive, but many will have severe disabilities. However, infants born at 25 or 26 weeks will most likely survive with few disabilities.

Management, Prevention, Corticosteroids, Adrenocortical hormones, Childbirth, Delivery (Childbirth)

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Neonatology

Article Abstract:

Improvements in ventilators may reduce the incidence of lung disease in premature infants in neonatal intensive care units. Most children acquire HIV infection in the uterus or during delivery. New diagnostic techniques allow these infants to be diagnosed as early as three months after birth. Many very-low-birth-weight infants require blood transfusions, but this puts them at risk of contracting hepatitis and cytomegalovirus, as well as HIV. Human erythropoietin, which is a hormone involved in red blood cell formation, has been produced by genetic engineering. It could reduce these babies' need for blood transfusions. Cocaine use by pregnant women remains between 3% to 50%, depending on the medical center reporting the statistics. 'Crack babies' will not necessarily grow up to be a burden on society. More research is needed on the social conditions that cause pregnant women to abuse drugs.

Care and treatment, Innovations, Diagnosis, HIV infection in children, Pediatric HIV infections, Ventilators, Ventilators (Medical equipment)

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