Early human development
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To clarify the situation of the incidence of the sudden infant death syndrome (SIDS) in Japan to provide the basis for health administration training. ⋯ To lighten the trauma suffered by a SIDS family, it is necessary that we pay adequate attention to giving consideration to the family through general informed consent including giving thoughtful consideration in advising an autopsy.
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Early human development · Nov 2003
Prenatal maternal cortisol levels and infant behavior during the first 5 months.
Research on both animals and humans is providing more and more evidence that prenatal factors can have long-term effects on development. Most human studies have examined the effects of prenatal stress on birth outcome (i.e. shorter pregnancies, smaller infants). The few studies that have looked at the infants' later development have found prenatal stress to be related to more difficult temperament, behavioral/emotional problems and poorer motor/cognitive development. In this paper, we have examined links between late pregnancy cortisol levels and infant behavior during the first 5 months of life. ⋯ The infants were divided into two groups based on their mothers' late pregnancy cortisol values: high and low prenatal cortisol groups. A trend was found for the high cortisol infants to be delivered earlier than the low cortisol group. Furthermore, the behavioral observations showed the higher prenatal cortisol group to display more crying, fussing and negative facial expressions. Supporting these findings, maternal reports on temperament also showed these infants to have more difficult behavior: they had higher scores on emotion and activity. The differences between the infants were strongest at the youngest ages (weeks 1-7).
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Early human development · Aug 2003
Pregnancy termination following prenatal diagnosis of serious heart disease in the fetus.
The fetal diagnosis of complex congenital heart disease (CHD) leads to a crisis for the affected couple. How much more so when a decision is made to terminate the pregnancy? In making that decision do the parents understand the anomaly, its consequences and possible outcome and does that information influence their decision process? ⋯ Although the numbers were small, it would appear that the above approach used by an obstetric ultrasonologist and cardiologist, working together, explaining complex congenital heart disease in lay terms and focusing on the need for intervention, functional outcome and quality of life issues, provided the parents with a reasonable understanding of the anomaly. Nevertheless, the decision to terminate, very difficult for nearly all the couples, seemed to be based on the perceived distress of the affected infant/child, the siblings and parents themselves. While three couples were grateful for an opportunity to respond, two refused, suggesting the need for more detailed follow up and support for those parents who decide to terminate an apparently wanted pregnancy.
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Early human development · Jun 2003
Comparative StudyAre there developmentally distinct motor indicators of pain in preterm infants?
The aims of this study were to examine preterm infant reactions to pain in detail over prolonged time periods using multiple measures, and to assess the value of including specific body movements of the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) system to evaluate pain. Ten preterm infants born at 31 weeks mean gestational age (GA) and mean birth weight 1676 g were studied during a routine blood collection in a Level III neonatal intensive care unit (NICU). At 32-week post-conceptional age, computerized physiologic and video recordings were obtained continuously for 60 min (prior to, during and after lance). ⋯ HR increased and oxygen saturation decreased post-lance. Infants with more prior pain exposure, lower Apgar, and lower GA at birth, displayed more motor stress cues but less facial activity post-lance. Extension of extremities and finger splay, but not twitches and startles, from the NIDCAP, appear to be stress cues and show promise as clinical pain indicators to supplement facial and physiological pain measures in preterm infants.
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Early human development · Jun 2003
Cardiac adaptation in small for gestational age neonates after prenatal hemodynamic disturbances.
Small for gestational age neonates with prenatal hemodynamic disturbances are at increased risk for neonatal morbidity. Investigations of fetal cardiac function have proved some functional impairments. The aim of the study was to investigate postnatal cardiac adaptation in these neonates in comparison with neonates without prenatal hemodynamic impairments. ⋯ The described findings could be signs of persistent hemodynamic impairments in growth-retarded neonates with prenatal disturbed hemodynamics. The neonates revealed a reduced ability to compensate the prenatal hemodynamic disturbances. This aspect should be included in the discussion of perinatal management in cases of severe growth retardation.