morphine and Body-Weight

A delayed passage of meconium is considered as a risk factor for feed intolerance in preterm neonates.. The aim of this study was to review the effects of different therapeutic agents for meconium evacuation on feed tolerance in preterm neonates.. A systematic review of randomised controlled trials (RCTs) of different therapeutic agents for meconium evacuation in preterm neonates (gestation <32 weeks and/or birth weight <1,500 g) using the Cochrane systematic review methodology was undertaken. Databases including Google Scholar were searched in January 2016. The primary outcome was the time to reach full feeds (TFF; ≥120 ml/kg feeds with stoppage of parenteral nutrition >24 h). Secondary outcomes included necrotising enterocolitis (NEC), weight at discharge and adverse effects. The results were summarised as per the GRADE guidelines.. Six RCTs (2 each of glycerine suppository and enema, 1 normal saline enema and 1 oral osmotic contrast agent; n = 442) with a low or unclear risk of bias were included. The pooled estimate (random effects model) showed no reduction in TFF [mean difference (MD) -0.03, 95% CI -2.47, 2.41, p = 0.98; level of evidence: low]. No differences in NEC [risk ratio (RR) 1.71, 95% CI 0.63, 4.65, p = 0.30; level of evidence: low] and weight at discharge (MD -0.08, 95% CI -0.30, 0.15, p = 0.50; level of evidence: low) were found. The trial assessing oral osmotic contrast agents reported a trend towards a higher incidence of NEC ≥ stage II. There were no other adverse effects.. Limited low-quality evidence indicates that prophylactic glycerine suppository, small volume glycerine/normal saline enema or oral osmotic contrast agents to evacuate meconium did not reduce TFF in preterm neonates. Large, well-designed trials are essential to study this clinically significant issue.

Topics: Body Weight; Defecation; Enema; Enterocolitis, Necrotizing; Feeding and Eating Disorders; Humans; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Meconium; Parenteral Nutrition; Physical Stimulation; Randomized Controlled Trials as Topic; Suppositories

Topics: Animals; Biomarkers; Body Weight; Brain; Esters; Fatty Acids; Female; Fetal Alcohol Spectrum Disorders; Male; Meconium; Organ Size; Placenta; Predictive Value of Tests; Pregnancy; Prenatal Exposure Delayed Effects; Rats, Sprague-Dawley; Sensitivity and Specificity

In this prospective cohort study, we investigated the association between fatty acid ethyl esters (FAEEs) in meconium as biomarkers of prenatal ethanol exposure and growth deficits, as birth outcomes, that constitute several of the key cardinal features of fetal alcohol syndrome.. A total of 157 meconium samples were collected from enrolled infants within 24 hours of birth, and nine FAEEs were quantified using liquid chromatography/tandem mass spectrometry. The relationships between cumulative concentrations of nine species of FAEEs in meconium and birth parameters of growth (age-sex-specific centiles of head circumference [HC], weight, and length) and respective and combined birth outcomes of growth deficits (HC ≤ 10th centile, weight ≤ 10th centile, and length ≤ 10th centile) were determined.. Multivariate logistic regression analysis demonstrated that higher cumulative concentrations of meconium FAEEs correlated with elevated risks for HC and length, both, 10th percentile or less (adjusted odds ratio [aOR], 2.94; 95% confidence interval [CI], 1.12-7.74;. The elevated cumulative FAEEs in meconium were associated with combined growth deficits at birth, specifically HC and length, both, 10th percentile or less, which might be correlated with detrimental alcohol effects on fetal brain and bone development, suggesting a plausible alcohol-specific pattern of intrauterine growth restriction.

Topics: Area Under Curve; Biomarkers; Body Weight; Chromatography, High Pressure Liquid; Cohort Studies; Esters; Fatty Acids; Female; Fetal Alcohol Spectrum Disorders; Head; Humans; Infant, Newborn; Logistic Models; Male; Meconium; Odds Ratio; Prospective Studies; ROC Curve; Tandem Mass Spectrometry

Very low birth weight infants (VLBWIs) are at risk of surgical intestinal disorders including necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI). We conducted this study to verify whether the timing of stoma closure and that of enteral nutrition establishment after stoma closure in VLBWIs differ among the most common disorders.. A retrospective multicenter study was conducted at 11 institutes. We reviewed the timing of stoma closure and enteral nutrition establishment in VLBWIs who underwent stoma creation for intestinal disorders.. We reviewed the medical records of 73 infants: 21 with NEC, 24 with FIP, and 25 with MRI. The postnatal age at stoma closure was 107 (28-359) days for NEC, 97 (25-302) days for FIP, and 101 (15-264) days for MRI (p = 0.793), and the postnatal age at establishment of enteral nutrition was 129 (42-381) days for NEC, 117 (41-325) days for FIP, and 128 (25-308) days for MRI (p = 0.855). The body weights at stoma closure were 1768 (620-3869) g for NEC, 1669 (1100-3040) g for FIP, and 1632 (940-3776) g (p = 0.614) for MRI. There were no significant differences among the three groups.. The present study revealed that the time and body weights at stoma closure and the postoperative restoration of bowel function in VLBWIs did not differ among the three diseases.

Topics: Age Factors; Body Weight; Enteral Nutrition; Enterocolitis, Necrotizing; Female; Humans; Ileus; Infant; Infant, Newborn; Infant, Very Low Birth Weight; Intestinal Perforation; Male; Meconium; Multicenter Studies as Topic; Retrospective Studies; Risk; Surgical Stomas; Time Factors; Treatment Outcome

In humans, the occurrence of prenatal exposure to ethanol is difficult to validate objectively. Increased concentration of fatty acid ethyl esters (FAEE) in the meconium of the newborn may be a biomarker of prenatal ethanol exposure. The validity of this proposed biomarker was tested in pregnant guinea pigs that received chronic oral administration of 4 g ethanol/kg maternal body weight/day (n=8), isocaloric-sucrose/pair-feeding (n=8) or water (n=2) throughout gestation. At gestational day 65 (term, gestational day 66 to 69), each dam and her offspring were euthanized, and meconium was collected from the term fetal large intestine. Eight individual FAEE (lauric, myristic, palmitic, palmitoleic, stearic, oleic, linolenic and arachidonic AEE) were measured by gas chromatography--flame ionization detection and confirmed by gas chromatography--mass spectrometry. The chronic maternal ethanol regimen decreased fetal body weight and brain weight. There was virtually no measurable FAEE in the meconium for the water group (n=3 fetuses). For meconium of the ethanol offspring (n=25 fetuses) compared with the sucrose offspring (n=23 fetuses), the total FAEE concentration was 8-fold higher; and lauric, palmitic, stearic and oleic AEE concentrations were at least 5-fold higher for the ethanol group. The data indicate that fetal meconium FAEE constitute a biomarker of prenatal ethanol exposure for a maternal ethanol regimen that restricts fetal development, with an inverse relationship between meconium total FAEE concentration and both body weight and brain weight.

Topics: Animals; Biomarkers; Body Weight; Brain; Ethanol; Fatty Acids; Female; Guinea Pigs; Maternal Exposure; Meconium; Organ Size; Pregnancy; Pregnancy Outcome; Prenatal Exposure Delayed Effects; Substance Abuse Detection

Our objective was to evaluate individualized growth assessment using the Rossavik growth model for detection of small-for-gestational-age (SGA) infants with a poor perinatal outcome.. Rossavik growth models derived from second-trimester ultrasound measurements were used to predict birth characteristics of 47 singleton SGA infants. Individual fetal growth curve standards for head and abdominal circumference, and weight were determined from the data of two scans obtained before 25 weeks' menstrual age and separated by an interval of at least 5 weeks. Comparisons between actual and predicted birth characteristics were expressed by the Growth Potential Realization Index (GPRI) and Neonatal Growth Assessment Score (NGAS). The proportions of perinatal outcomes [mechanical delivery, low Apgar score, abnormal fetal heart rate (FHR) patterns, neonatal acidosis, meconium staining of amniotic fluid, neonatal intensive care unit (NICU) admission and maternal complications] were compared between SGA infants with normal NGAS and those with abnormal NGAS.. Of the 47 fetuses studied, 27 had normal growth outcomes at birth and 20 showed evidence of intrauterine growth restriction, based on NGAS. There were significant increases in mechanical deliveries, abnormal FHR patterns and meconium staining of amniotic fluid in cases of growth-restricted neonates, determined using the NGAS classification, when compared with events related to normally grown infants. However, there were no significant differences in low Apgar score, neonatal acidosis, NICU admission and maternal complications between the 2 groups.. Individualized growth assessment should be useful for detection of SGA infants with poor perinatal outcomes.

Topics: Abdomen; Acidosis; Apgar Score; Body Weight; Cephalometry; Embryonic and Fetal Development; Female; Fetal Growth Retardation; Gestational Age; Heart Rate, Fetal; Humans; Infant, Newborn; Infant, Small for Gestational Age; Intensive Care, Neonatal; Meconium; Pregnancy; Pregnancy Outcome; Ultrasonography, Prenatal

Significant or highly significant differences were found between groups of breast and bottle-fed infants with respect to the incidence of jaundice, time to passage of first yellow stool and early weight changes. Experimental parameters were carefully defined, and a simple stool colour comparator has been designed and developed. Breast feeding should be encouraged for its incidence is low in many European countries and it is the responsibility of the attending midwife to ensure that correct suckling techniques are achieved by mothers and infants at the earliest possible time after delivery.

Topics: Body Weight; Bottle Feeding; Breast Feeding; Child Nutrition Sciences; Europe; Feces; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Jaundice, Neonatal; Job Description; Meconium; Mothers; Nurse Midwives; Rooming-in Care; Scotland; Sucking Behavior; Time Factors

This study was undertaken to determine the influences of increased maternal prepregnancy weight and increased gestational weight gain on pregnancy outcome.. This was a longitudinal retrospective study of 7407 term pregnancies delivered from 1987 through 1989. After excluding cases with multiple fetuses, stillbirths, fetal anomalies, no prenatal care, selected medical and surgical complications, and those with incomplete medical records, 3191 cases remained for analyses by determination of odds ratios for obstetric outcomes, by chi 2 tests for significant differences and by adjustment for risk factors with stepwise logistic regression.. Both increased maternal prepregnancy weight (body mass index) and increased maternal gestational weight gain were associated with increased risks of fetal macrosomia (p less than 0.0001), labor abnormalities (p less than 0.0001), postdatism (p = 0.002), meconium staining (p less than 0.001), and unscheduled cesarean sections (p less than 0.0001). They were also associated with decreased frequencies of low birth weight (p less than 0.001). The magnitude of the last was less than that of the other outcomes.. Increased maternal weight gain in pregnancy results in higher frequencies of fetal macrosomia, which in turn lead to increased rates of cesarean section and other major maternal and fetal complications. Because these costs of increased maternal weight gain appear to outweigh benefits, weight gain recommendations for pregnancy warrant careful review.

Topics: Apgar Score; Birth Weight; Body Weight; Cesarean Section; Female; Fetal Heart; Fetal Macrosomia; Heart Rate; Humans; Incidence; Infant, Low Birth Weight; Infant, Newborn; Meconium; Obstetric Labor Complications; Pregnancy; Pregnancy Outcome; Pregnancy, Prolonged; Resuscitation

Topics: Body Weight; Brain; Brain Edema; Humans; Hypoxia; Infant; Infant, Newborn; Inhalation; Meconium; Organ Size; Respiration; Spinal Cord

A geographically based population of 498 full term, appropriate for gestational age, healthy, singleton neonates was used to study the effect of obstetric and nursery practices on the occurrence of neonatal jaundice. At 3-4 days 56% of babies became visibly jaundiced (plasma bilirubin (PB) greater than 100 mumol/l) and 10% were hyperbilirubinaemic (PB greater than 200 mumol/l). Less mature babies, those slow to pass meconium and those who had lost weight at 4 and 7 days were more likely to be jaundiced. Obstetric practices, drugs given during labour, mother's or baby's blood group, natural illumination, plethora, extravasated blood or mode of feeding were found to have no effect. No benefit from giving supplementary milk or dextrose to breast fed babies was discovered. At 6-7 days at least 9% of babies, all but one of whom were breast fed, were visibly jaundiced. The frequency of prolonged jaundice (breast milk jaundice) was 3.8% of breast fed babies at 3 weeks and zero by 7 weeks. The proportion of babies receiving phototherapy was 2.2%.

Topics: Body Weight; Breast Feeding; Female; Gestational Age; Humans; Infant Food; Infant, Newborn; Jaundice, Neonatal; Male; Meconium; New Zealand; Nurseries, Hospital

Topics: Adolescent; Adult; Apgar Score; Body Weight; Female; Fetal Monitoring; Humans; Meconium; Placenta Diseases; Placental Insufficiency; Pregnancy

An animal model of meconium aspiration was developed to determine the efficacy of glucocorticoids in its treatment. Rabbit pups were made to aspirate either meconium or saline prior to the onset of respiration. Cortisol was administered in a random, blind fashion. Slight decrease in respiratory rate and less severe histopathologic changes in the lungs were seen in corticosteroid-treated animals. Survival was significantly decreased, without definite cause, in the glucocorticoid-treated animals whether or not they had aspirated meconium. Because of this decreased survival and the relatively insignificant improvement in clinical course and histopathology found with glucocorticoid treatment, we cannot recommend cortisol for the treatment of meconium aspiration.

Topics: Animals; Body Weight; Disease Models, Animal; Female; Humans; Hydrocortisone; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Lung; Meconium; Organ Size; Oxygen Consumption; Pregnancy; Rabbits; Sodium Chloride

Topics: Amniocentesis; Amniotic Fluid; Apgar Score; Blood Glucose; Body Weight; Estriol; Female; Gestational Age; Glucose; Glucose Tolerance Test; Humans; Hydrogen-Ion Concentration; Hypertension; Infant, Newborn; Meconium; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Hematologic; Pregnancy in Diabetics; Prenatal Diagnosis; Rh-Hr Blood-Group System; Statistics as Topic; Time Factors

Topics: Body Weight; Female; Fetal Death; Fetal Diseases; Gestational Age; Humans; Meconium; Nutrition Disorders; Pregnancy; Pregnancy Complications; Risk

Topics: Adolescent; Adult; Age Factors; Birth Weight; Body Height; Body Weight; Dysmenorrhea; Female; Germany, West; Gestational Age; Humans; Hyperemesis Gravidarum; Infant, Newborn; Infant, Premature; Maternal Age; Meconium; Menstruation; Obstetric Labor, Premature; Occupations; Placenta; Pregnancy; Psychotherapy

Topics: Anal Canal; Body Fluids; Body Water; Body Weight; Deuterium; Duodenum; Esophageal Atresia; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Jejunum; Meconium; Megacolon; Radioisotope Dilution Technique; Rectum; Tracheoesophageal Fistula; Water

Topics: Anemia; Body Weight; Chloramphenicol; Chlortetracycline; Cough; Cystic Fibrosis; Diabetes Mellitus, Type 1; Diet Therapy; Feces; Humans; Hunger; Hypoproteinemia; Infant; Infant, Newborn; Intestinal Obstruction; Meconium; Pancreatic Juice; Pancreatin; Physical Therapy Modalities; Prognosis; Rectal Prolapse; Sweat; Tooth Discoloration; Vomiting

Topics: Adult; Asphyxia Neonatorum; Birth Injuries; Body Weight; Brain Damage, Chronic; Delivery, Obstetric; Extraction, Obstetrical; Female; Fetal Heart; Gestational Age; Heart Rate; Humans; Hypertension; Infant, Newborn; Labor Presentation; Labor, Obstetric; Maternal Age; Meconium; Parity; Pregnancy; Prospective Studies; Respiration

Topics: Anti-Bacterial Agents; Body Weight; Cystic Fibrosis; Female; Humans; Infant; Infant, Newborn; Male; Meconium; Respiration; Respiratory Function Tests; Respiratory Therapy; Respiratory Tract Infections