Dissertations / Theses: 'Threat of premature birth'

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Haycock, Anna Cornelia. "Psychological functioning in children with low birth weight." Thesis, University of Limpopo, 2008. http://hdl.handle.net/10386/2573.

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Thesis (PhD. (Clinical Psychology)) --University of Limpopo, 2008 Low-birth-weight/premature children seem to be vulnerable to psychiatric, neuropsychological and other deficiencies. Limited research is available in the South African context about these ever-increasing phenomena. The aim of this study was to investigate the magnitude and characteristics of internalising (Separation Anxiety, Overanxious and Major Depressive Disorders) and externalising symptoms (Attention-Deficit/Hyperactivity, Oppositional Defiant and Conduct Disorders) among low-birth-weight children in comparison with normal-birth-weight children, as well as to establish neuropsychological deficiencies (motor, visual-spatial, memory and executive functioning) between the birth weight groups, analysed as a function of gender and age. The sample (158 children) was selected from nine urban mainstream primary schools in the Tshwane North and South districts by means of stratified random sampling. Low-birth-weight children (weighing below 2 000 g) (N=79) were matched with normal-birth-weight children (above 3 000 g) (N=79) according to age, gender, language and socio-economic status. The neuropsychological test battery and self-reporting questionnaire were individually administered to the sample at the selected schools during school hours. Teachers and parents of selected participants were requested to complete a rating scale. As expected, low birth weight is associated with a tendency towards increased internalising and externalising psychological symptoms, as well as poorer neuropsychological functioning. This was particularly significant in the domains of internalising symptoms (depression), externalising symptoms (hyperactivity/impulsiveness, inattention, Oppositional Defiant Disorder and Conduct Disorder) and neuropsychological impairments (motor, visual-spatial/visual-motor, memory and executive functioning). The neuropsychological impairments observed in this study among the LBW children probably increase the risk of subsequent externalising (conduct and oppositional behavioural problems) and internalising (depressive) psychological symptoms. These impairments are possibly exacerbated by inattention and hyperactivity/ impulsiveness. Reciprocal interaction seems to take place between the psychological symptoms andneuropsychological functions. Only a few gender differences were observed. Neuropsychological deficits were observed both in the 6 to 9 and 10 to 13 age groups, indicating deficient resolution of impairments with increasing age. Increased pre-, peri- and postnatal complications in the low-birth-weight group may predispose these children biologically to neuropsychological deficiencies and subsequent internalising/externalising symptoms. These impairments most probably affect academic, emotional, social and other significant areas of functioning, increasing public health cost.

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Jacobs, Salomi. "Referencing echocardiographic measurements for premature and low-birth weight infants." Thesis, Bloemfontein : Central University of Technology, Free State, 2012. http://hdl.handle.net/11462/212.

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Thesis (M. Tech. (Clinical Technology)) -- Central University of technology, Free State, 2012 Introduction: Reference ranges for cardiac measurement are available for adults, children and term infants but the same cannot be said for preterm or small for gestational age (SGA) infants surviving as a result of modern intensive care units. No published data of reference ranges for preterm infants exists for the South African population. Infants with congenital heart disease are twice as likely to be small for their gestational age and these reference ranges may affect clinical management decisions, therapeutic response and prognosis of these neonates. The aim was thus to establish reference ranges for cardiac dimensions and functional values for preterm and low birth weight infants for central South Africa and compare them with international standards. Methods: A total of 290 infants of less than 34 weeks of age and weighing less than 2500g at birth were examined during a twelve month period by echocardiography during the first 0-28 days of life. The study assessed normative cardiac measurements divided in M-Mode, 2-D and functional measurement for these infants in 3 weight groups. Exclusion criteria were applied to any condition affecting the size and functionality of the cardiac system. The following dimensions were measured: Standard M-Mode values for the left ventricle, 2D measurements of valve mitral and tricuspid orifices, as well as functional assessments including Shortening fraction (SF %), Ejection fraction (EF %), and Muscle performance Index (MPI)-index of the Left and Right ventricle. Measurements were done by the leading edge methodology following the ASE recommendations. A longitudinal study was also done to examine changes in these indices over the first month- on day 14 and day 28 of life. Interobserver differences were calculated for the variability between measurements of a single scan- 25 babies were re-measured and produced good repeatability. Results: 290 infants were included to produce Referance ranges of measurements (means and standard deviations) for 3 weight groups namely: <0.999g, 1000-1499g, and 1500g – 2500g. The gestational age’s ranges between 26-38 weeks with a median of 31 weeks, gender distribution was almost equal with a slight female preponderance. Body surface area ranged from a minimum from 0.076 m² and a maximum of 0.184 m², the body weight ranged between a minimum of 690g and a maximum of 2500g with a median of 1360g. Discussion: The left ventricular diastolic and systolic, interventricular septum, posterior wall, aortic and left atrium dimensions showed a proportionate increase in diameter with an increase in body weight There were no differences in cardiac dimensions between Small for Gestational age” (SGA) versus “Average for Gestational age” (AGA). Gender and race played no role in any functional measurements or with the cardiac sizes. Weight correlated well with BSA and the data suggest that weight only can be used to develop tables for clinical use. Cardiac chambers increased with BSA and weight and functional measurements stayed the same throughout the weight groups. Systolic and global functions were remarkably similar and constant throughout weight categories. . The longitudinal study also confirmed that the values are applicable to all low birth weight infants up to 28 days of age. Differences existed between some of the average South African infant’s cardiac chambers and international values. The Inter Ventricular Septum (IVS) and Posterior Wall (PW) measured thicker and the Left Atrium larger. This could be due to numerous factors that should be investigated further. Conclusion: The study emphasized the profound effect of growth and weight gain on the cardiac structure and that population specific reference values should therefore be developed and used.

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Björk, Adina. "Premature Birth & Postpartum Depression in Kosovo : Early Childhood Development." Thesis, Linnéuniversitetet, Institutionen för samhällsstudier (SS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-97976.

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Scholars around the world emphazise the value of more research within newborn health and maternal care until 2025, while some even express the need for more research whitin these topics in the specific case of Kosovo. Research about women`s postpartum depression (PPD) in Kosovo linked to the type of delivery was conducted by Obertinca & Dangellia, (2016), which demonstrate a research gap by asserting that current topic information within the country is scarce. This research objective was to focus on different expert perspectives in Kosovo, around linkages between a premature birth (PTB) and the mother`s PPD. Kosovo as a case presents an example of how low and middle income countries address their health policies within their national health-care system. The aim of the study was to understand what it is about PTB that seems to raise PPD amongst women in Kosovo. One important indication of further research value, is that research presented by Vigod et al, (2010) indicates strong linkages between prematurity and the mother`s PPD, while research according to Halbreich, (2005) claims that it is need for more conceptually integrated research and interdisciplinary approaches before one can establish possible linkages. An abductive logic of enquiry was used together with mixed methods within a multistage methodological approach, conducted remotely with representatives of United Nations Children`s Fund (UNICEF) and Action for Mother`s and Children (AMC) health-care staff, specialized on maternal and child health. It was found that different experts in Kosovo working with maternal and child health, shared the general perception around linkages between prematurity and the increased risk for the mother to develop PPD. Increased understanding about this topic is of highest importance since it can be linked to the country`s high numbers of infant mortality rate and performed caesarean sections, which directly affects maternal health and child development. The study used family systems theory and attachment theory in combination to develop a conceptual framework, which was useful during the thematic and content analysation process of the presented data. This study has contributed with new scientific knowledge to the on-going debate about prematurity and women`s postpartum depression, by triangulation of data from different key informants in Kosovo. This paper has provided conclusions with the basis for further research to be conducted.

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Hang, Thi Thu Le Sutthi Jareinpituk. "Maternal periodontal disease and preterm birth /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd401/4737317.pdf.

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Levin, Candyce. "HIV transmission to transmission to premature very low birth weight infants." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32779.

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There is sparse literature about HIV transmission in preterm infants. Eighty-two HIV-exposed preterm infants received birth polymerase chain reactions (PCRs). Five (6.1%) were HIV positive with all 5 mothers receiving inadequate antiretrovirals. Of the PCRnegative infants, 9 died and 87% of the survivors received further PCR testing which remained negative. With correct care, intrapartum transmission of HIV can virtually be eliminated.

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Ritson, Brenda. "Periodontal Disease and Preterm Delivery: Results of a Pilot Patient Education and Intervention Feasibility Study." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-141158/.

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Martin, Samantha Rochelle, and Nadine Rall. "Experiences of mothers relating to live premature birth and the premature infant at a private hospital in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/11482.

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Premature births, which are among the leading causes of neonatal mortality and morbidity in South Africa, often result not only in adverse effects on the infant due to the poorly developed organs and systems, but also affect the mother. Much literature exists about the causes of premature birth, clinical manifestations and management of premature infants; but healthcare practitioners, researchers and authors have not reported much on the mothers’ thoughts and feelings while going through the experience of premature labour and birth. This study deals with the experiences of mothers relating to live premature birth and the premature infant at a private hospital in the Nelson Mandela Metropolitan Municipality, an urban area within the Eastern Cape Province. The objectives of the study were to explore and describe the experiences of mothers relating to live premature birth and the premature infant at a private hospital in the Eastern Cape Province and to make recommendations based on the research findings which could be utilised by midwives when caring for mothers who had experienced a premature birth. This study, which is qualitative in nature, utilised an explorative, descriptive and contextual design. The population of the study was mothers between the ages of 18 and 38 years who had had a premature birth and were of a gestational age ranging from 28 to 34 weeks. Data collection took place at a private hospital in the Eastern Cape Province over a period of five months. A private room that was designated for the data collection and was not far from the unit where the neonate was kept, proved to be suitable for data-collection purposes. Semi-structured one-on-one interviews were conducted and recorded with an audio digital taperecorder, with a purposefully selected sample of 12 mothers including the pilot study. Data analysis followed formally after data saturation and the data collected was transcribed verbatim and analysed as recommended by Tesch, namely, data coding. An independent coder was used to verify and finalise the results. Two main themes with three sub-themes each and several categories emerged from the data analysis. The two main themes were that: 1. participants had experienced premature birth as an unexpected and traumatic occurrence; and 2. participants had experienced positive support as a coping mechanism throughout the premature birth. Direct quotations were used from the raw data collected to support the description of experiences and findings of this study. Trustworthiness of the study was maintained by using the criteria of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, beneficence, non-maleficence and justice were used to ensure that the research was conducted in an ethical manner. A summary of the study including limitations, recommendations and conclusions was provided.

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Marconi, Camila [UNESP]. "Interleucina 1β e interleucina 6 no líquido amniótico: relação com invasão microbiana da cavidade ammniótica em gestantes em trabalho de parto prematuro". Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/93614.

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Made available in DSpace on 2014-06-11T19:26:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-02-29Bitstream added on 2014-06-13T18:55:02Z : No. of bitstreams: 1 marconi_c_me_botfm.pdf: 320459 bytes, checksum: 2298744a701b431f9e2784f77b8120dc (MD5) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Fundação para o Desenvolvimento da UNESP (FUNDUNESP) O Trabalho de Parto Prematuro (TPP) é uma grave intercorrência obstétrica que acomete de 5-10% das gestações. Embora sua etiologia seja multifatorial, a infecção da cavidade amniótica (CA) é um importante fator associado ao seu desencadeamento. Objetivo: Comparar a freqüência de infecção na cavidade amniótica de gestantes em TPP em relação a gestantes fora de trabalho de parto e correlacionar com os níveis de citocinas pró-inflamatórias no líquido amniótico (LA). Material e Métodos: Foram incluídas neste estudo 20 gestantes em TPP e 20 gestantes fora de trabalho de parto, com idades gestacionais pareadas. No grupo TPP, amostras de LA foram obtidas no momento da resolução da gestação ou durante amniocentese transabdominal. O grupo de gestantes fora de trabalho de parto foi constituído de pacientes com indicação de amniocentese transabdominal. Para avaliação da infecção na CA foram realizadas reações em cadeia da polimerase (PCR) para a detecção de Mycoplasma hominis, Ureaplasma urealyticum e do gene bacteriano RNAr 16S. Os produtos de RNAr 16S foram seqüenciados para a identificação da espécie bacteriana. Os níveis das citocinas inflamatórias, interleucina (IL)-1β, IL-6, IL-8 e fator de necrose tumoral (TNF-α) no LA foram quantificados por ensaio imunoenzimático (ELISA). Resultados: A incidência de TPP no período do estudo foi de 5,8%. No grupo TPP, a pesquisa de invasão microbiana da CA foi positiva para M. hominis (35,0%), U. urealyticym (10,0%) e gene RNAr 16S (30,0%), sendo todas as freqüências superiores às encontradas no grupo fora de trabalho de parto (p<0,05). Quanto às citocinas, níveis aumentados de IL-1β (p=0,03), IL-6 (p<0,001) e IL-8 (p<0,001) foram detectados no LA das pacientes em TPP em relação às gestantes fora de trabalho de parto. Além disso, amostras de LA, com presença de infecção, apresentaram níveis... Preterm labor (PL) represents a serious obstetric complication whose rate is 5-10%. Although the PL etiology is multifactorial, intraamniotic infection is strongly associated to its occurrence. Objective: To compare the frequency of intraamniotic infection in women presenting PL with women not in labor and to correlate with inflammatory cytokines levels in amniotic fluid (AF). Material and Methods: Twenty women with PL and 20 women with same gestational age, but not in labor, were included in this study. AF samples of women in PL were collected at delivery or by amniocentesis. The control group was composed by women with indication for amniocentesis. The evaluation of intraamniotic infection was performed detecting Mycoplasma hominis, Ureaplasma urealyticum and the bacterial rRNA 16S gene using polymerase chain reaction (PCR). The PCR rRNA 16S products were sequenced for bacterial species identification. The IL-1β, IL-6, IL-8 and TNF-α levels in AF were measured by enzyme-linked immunoabsorbent assay (ELISA). Results: During the study period, PL rate was 5,8%. Intraamniotic infection in women with PL was positive for M. hominis (35,0%), U. urealyticum (10,0%) and bacterial rRNA 16S (30,0%). AF infection rates for all tested microorganism were superior in PL when compared to women not in labor (p<0,05). Regarding to the cytokine measurement, AF of PL women showed increased IL-1β (p=0,03), IL-6 (p<0,001) and IL-8 (p<0,001) levels in comparison to AF samples from women not in labor. Additionally, AF with infection presented increased levels of IL-1β e IL-6 (p=0,03). Conclusion: Women with PL present high frequency of intraamniotic infection when compared with women not in labor and such infection correlates with increased IL-1β e IL-6 AF levels.

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邱靜雯 and Ching-man Yau. "Use of occlusive wrap to prevent hypothermia in premature infants immediately after birth." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193042.

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Hypothermia at birth is strongly associated with mortality and morbidity in preterm infants. Unfortunately, infants are prone to hypothermia immediately after birth. A large proportion of preterm infants, especially those of gestational age at less than 30 weeks, experience different levels of hypothermia. A frequently used possible preventive measure is the application of an occlusive wrap immediately after birth. However, no systematic review on this preventive measure supports its translation into practice. This dissertation aimed to evaluate the current evidence on the application of occlusive warp for preterm infants. Four electronic databases, Cochrane Library, PubMed, CINAHL, and Medline, were searched. Eight studies met the inclusion criteria of this dissertation. Data were extracted and the quality of the included studies was evaluated by the Scottish Intercollegiate Guidelines Network (SIGN). Six studies were graded as high quality studies and showed that occlusive wrapping significantly prevented the incidence of hypothermia among the preterm infants smaller than 30 weeks. An evidence-based Superwarm guideline was developed, which was deemed to be transferable to the local setting of neonatal intensive care unit with similar target clients and philosophy of care as with those in the identified studies. Also, the proposed innovation was considered to be feasible after examination of staff competency, resources, and approval methods. The potential benefits to preterm infants, nurses, and also the hospital were high, and risks to the patient were minimal. The estimated set-up cost including manpower and consumable cost was $1,720, and the running cost was also $1,720 per year. A 12 -month implementation program scheduled including communication with stakeholders, training to the frontline nurses, and a pilot of the guideline. Patient outcomes will be measured by admission temperature, temperature one hour after admission, and mortality rate. Healthcare provider outcomes include compliance rate, workload, acceptance of the proposed guideline, job satisfaction, knowledge, and skill enhancement in thermoregulation of the preterm infants. The quality of patient care was also considered in the system outcomes. Guideline effectiveness will be evaluated by the increase in admission temperature, nurse and physician satisfaction, and controlled program expenditure. published_or_final_version Nursing Studies Master Master of Nursing

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Allin, Matthew. "The prevalence and significance of neurological abnormalities in a young premature birth cohort." Thesis, University of Oxford, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.427640.

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Wright, Karen L. "Factors related to birth transition success of late-preterm infants." Doctoral diss., University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/5085.

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Problem: Identifying the factors effecting birth transition success of late preterm infants may improve early recognition of newborn compromise. Multiple explanatory variables may be associated with birth transition success or failure. The purpose of the study was to determine the prevalence of, and clinical-epidemiological and demographic predictive factors for birth transition success of late preterm infants. Methods: A retrospective case-control chart review was used to compare the characteristics of successful and unsuccessful birth transition of 35 and 36 week gestational age late-preterm infants delivered in a large tertiary-care center during calendar year 2007. A mixture of categorical and numeric variables related to maternal, birth, and physiologic constructs were analyzed for their effects on birth transition as a binary outcome variable (success or failure). Results: Of 22 variables tested, four predictor variables were associated with birth transition failure: labor (OR = .42, p = .014), 5-minute Apgar score (OR = 1.79, p = .043), gender (OR = .47, p =.003), and respiratory rate (OR= 2.08, p = .001) as tested by logistic regression. The model was able to accurately assign transition failure and success at a rate of 66.7% and 74% respectively. The overall model was statistically significant (likelihood ratio chi square = 38.97(4), p less than].001). The Hosmer & Lemseshow test indicated that the model estimates fit the data at an acceptable level (chi]?? = 7.72, p = .358). Discussion/Implication: The absence of labor was identified as a risk factor for transition failure in this population. Male preterm infants were nearly twice as likely to fail transition as females in this population. The case group had a higher frequency of lower 5-minute Apgar scores, resulting in significantly lower mean scores. The failed transition group had more than twice the number of newborns with abnormally high respirations than the control group.; These findings indicate that identification infants at risk for birth transition failure begins with the recognition of the absence of labor as a significant risk factor for birth transition failure of late preterm infants. ID: 029809145; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2011.; Includes bibliographical references (p. 109-115). Ph.D. Doctorate Nursing

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Lindberg, Birgitta. "Fathers' experiences of having an infant born prematurely." Licentiate thesis, Luleå : Luleå university of technology, 2007. http://epubl.ltu.se/1402-1757/2007/60/.

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Samms-Vaughan, Maureen Elaine. "Factors associated with low birthweight growth retardation and preterm birth in Jamaica : an epidemiological analysis." Thesis, University of Bristol, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294549.

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Nyirati, Christina. "Profiles of risk for low birth weight, small for gestational age, and premature infants among Appalachian Ohio teenagers : a birth certificate study /." The Ohio State University, 1993. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487844105973922.

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Miller, Amanda M. "Injury and violence and the relationship to prematurity or low birth weight : a pilot study /." Connect to online version, 2009. http://minds.wisconsin.edu/handle/1793/38655.

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Mohanna, Magdi. "Preterm birth : evaluation of an intervention programme comprising risk factor scoring, fetal fibronectin testing and nifedipine tocolysis." Thesis, Keele University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341303.

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Introduction Neonatal mortality and morbidity from premature birth are still a major concern despite significant advances in perinatal medicine. Objective of the study The primary aim of the study was to establish the feasibility of accurately identifying a cohort of vvomen at increased risk of preterm birth using a modified risk assessment score and fetal fibronectin testing in order to undertake a pilot randomised placebo-controlled trial of nifedipine as a tocolytic. Methodology A population of pregnant women was screened prospectively between 24 and 34 weeks of gestation using a modified risk assessment system. Women identified as high-risk for preterm birth were then tested with fetal fibronectin. Those testing positive were randomised to either nifedipine or placebo. The study at this point was randomised, placebo-controlled and double-blind. Measures of outcome were compared for babies of trial vvomen with high-risk women who withheld consent. Main outcome measures Delivery before 34 weeks, neonatal death, admission to the Special Care Baby Unit (SCBU), chronic lung disease and major cerebral abnormality on ultrasound scan constituted the main measures of outcome. Results Five hundred and thirty four vvomen were identified as high-risk for preterm birth. One hundred and forty two women agreed to participate in the study. Forty nine women delivered before 37 weeks' gestation. The system was sensitive in predicting preterm birth before 34 weeks of gestation and within one week of testing for fetal fibronectin in symptomatic women. Babies of non-consenting mothers fared better overall than babies of the trial women. Conclusion Risk factor scoring and fetal fibronectin testing are useful screening tools that can predict preterm delivery. This sysytem can be clinically useful in the management of preterm labour or women at increased risk for preterm birth. There was no impact on the neonatal mortality or morbidity.

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Williams, Catherine. "The East London study of periodontal disease and preterm low birthweight." Thesis, Queen Mary, University of London, 2001. http://qmro.qmul.ac.uk/xmlui/handle/123456789/25127.

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Establishment of risk factors, and mechanisms involved in preterm (premature) birth is important for society. Despite efforts to find the cause(s), a significant proportion of preterm birth is of unknown aetiology. Maternal infection has been implicated and oral infection in the form of periodontal (gum) disease has also been suggested as a risk factor for preterm birth (OPenbacher et at, 1996). The aim of this study was to examine the possible relationship between maternal periodontal disease and the delivery of preterm infants with associated low birthweight in East London. This was an unmatched case-control study with 187 cases (mothers whose infant weighed < 2500g, gestational age < 37 weeks (preterm low birthwieght (PLBW)), and 532 controls (mothers whose infant weighed z 2500g, gestational age z 37 weeks). Risk factor information for prematurity and low birthweight were collected from Maternity notes and a structured questionnaire. Maternal periodontal disease levels were measured by: Community Periodontal Index, periodontal probing pocket depths and a bleeding index. Analysis was by logistic regression. The study population was derived from a multiethnic inner city population the predominant groups being Bangladeshi (51.9%) and white Caucasian (25.9%). No differences were found between the periodontal status of the case and control mothers for any of the periodontal indices. The risk for PLBW decreased significantly (p=0.02) with increasing mean periodontal probing pocket depth (crude OR 0.83[95% CI 0.68, 1.00]). After controlling for pre-pregnancy hypertension, smoking, alcohol consumption, maternal age, ethnic group and mother's education this risk decreased further (OR 0.78[95% CI 0.63, 0.96]). No evidence was found for increased risk of PLBW with maternal periodontal disease as measured in this study population. Promotion of oral health by healthcare workers is important, but these results did not support a specific drive to improve the periodontal health of pregnant women as a means of decreasing adverse pregnancy outcomes.

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Gaspardo, Claudia Maria. "Alívio de dor em neonatos pré-termo: avaliação da eficácia do uso continuado de sacarose." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/17/17148/tde-22112010-184812/.

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A trajetória de desenvolvimento do neonato pré-termo se inicia no contexto da Unidade de Terapia Intensiva Neonatal, permeado pela presença contínua de diversos estímulos dolorosos. As experiências iniciais e repetidas de dor podem ter efeito em longo prazo para os neonatos vulneráveis. A Academia Americana de Pediatria e a Sociedade Pediátrica Canadense recomendam o uso da solução de sacarose como intervenção não-farmacológica para alívio de dor em neonatos, entretanto, a eficácia e segurança do uso continuado da sacarose necessitam de investigação. O presente estudo randomizado controlado duplo-cego teve por objetivos avaliar a eficácia da administração via oral da solução de sacarose a 25%, em esquema de doses repetidas no alívio da dor em neonatos pré-termo e avaliar os possíveis efeitos colaterais advindos do uso continuado da sacarose para os neonatos. Trinta e três neonatos pré-termo com muito baixo peso ao nascer foram distribuídos em dois grupos: Grupo Sacarose (n = 17) e Grupo Água (n = 16). Os neonatos foram avaliados durante quatro dias consecutivos, durante procedimento de punção para coleta de sangue. Cada avaliação foi dividida em cinco fases: Linha de Base, Preparação para Punção (antissepsia), Punção, Recuperação com Manuseio (curativo) e Recuperação sem Manuseio. O indicador de dor foi avaliado pela atividade facial, mensurada pelo Neonatal Facial Coding System (NFCS). O nível de ativação dos neonatos foi mensurado pelo estado de vigília e sono e pela frequência cardíaca. Na primeira avaliação, os neonatos de ambos os grupos não receberam nenhuma substância antes do procedimento doloroso. Nos três dias seguintes, o Grupo Sacarose recebeu 0,5ml/kg de sacarose oral e o Grupo Água recebeu água estéril, dois minutos antes de cada procedimento doloroso. Foram obtidos dados de evolução clínica dos neonatos nos prontuários médicos. Os resultados encontrados revelaram que no primeiro dia de avaliação os neonatos de ambos os grupos anteciparam a reação ao estímulo doloroso de punção, apresentando elevação significativa do escore do NFCS, do estado de vigília e sono e da frequência cardíaca, já na antissepsia, sendo que durante a recuperação a frequência cardíaca continuou elevada em comparação à fase de Linha de Base. A partir do segundo dia de avaliação, o Grupo Sacarose apresentou menores escores do NFCS e do estado de vigília e sono, durante o procedimento, em comparação ao Grupo Água. O indicador fisiológico de frequência cardíaca não apresentou diferença significativa entre os grupos, entretanto, a sacarose reduziu o tempo necessário para o neonato se recuperar e atingir a estabilidade fisiológica após passar pelo procedimento doloroso de punção. Não houve diferença significativa na evolução clinica dos neonatos de ambos os grupos, o que demonstra que a sacarose não causou efeitos colaterais em curto prazo aos neonatos. Conclui-se que a dose de 0,5ml/kg de solução de sacarose a 25% administrada em esquema de doses repetidas foi eficaz para o alívio da dor em neonatos pré-termo e não trouxe efeitos colaterais imediatos para o estado de saúde dos neonatos. The development pathway of the preterm neonate begins in the context of the Neonatal Intensive Care Unit, permeated by the presence of several painful stimuli. Initial and repetitive pain may have long-term effect for vulnerable newborns. The American Academy of Pediatrics and Canadian Pediatric Society recommends the use of sucrose solution as non-pharmacological intervention for pain relief in neonates, however, the efficacy and safety of continued use of sucrose needs investigation. The present randomized controlled double-blind study aimed to assess the efficacy of oral administration of sucrose solution to 25% in repeated doses to relief pain in preterm neonates and to assess the possible side effects arising from the continued use of sucrose to newborns. Thirty-three preterm neonates with very low birth weight were divided into two groups: Sucrose Group (n = 17) and Water Group (n = 16). The newborns were assessed during four consecutive days during puncture procedure for blood collection. Each assessment was divided into five phases: Baseline, Antisepsis, Puncture, Dressing, and Recovery. The indicator of pain was assessed by facial activity, measured by the Neonatal Facial Coding System (NFCS). The level of activation of the neonates was measured by the sleep-wake states and heart rate. In the first assessment, the newborns of both groups did not receive any substance before the painful procedure. During the next three days, Sucrose Group received 0.5ml/kg of oral sucrose and Water Group received sterile water two minutes before each painful procedure. Clinical outcomes data of newborns were obtained in the medical records. The results showed that on the first day of assessment newborns of both groups have anticipated the reactivity to painful stimuli, with significant increase of NFCS score, sleep-wake states and heart rate as early as antisepsis, and during recovery heart rate remained increased in comparison to the Baseline phase. From the second day of assessment, the Sucrose Group had lower NFCS scores and sleep-wake states during the procedure, compared to the Water Group. The physiological indicator of heart rate showed no significant difference between groups, however, sucrose has reduced the time required for the infant to recover and achieve physiological stability after passing through the painful procedure of puncture. There was no significant difference in clinical outcome of newborn in both groups, demonstrating that sucrose did not cause short term side effects in neonates. The finding was that the dose of 0.5 ml/kg of sucrose solution to 25% administered in repeated doses was effective for pain relief in preterm and did not caused short term side effects to the health of newborns.

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Marconi, Camila. "Interleucina 1β e interleucina 6 no líquido amniótico: relação com invasão microbiana da cavidade ammniótica em gestantes em trabalho de parto prematuro /". Botucatu : [s.n.], 2008. http://hdl.handle.net/11449/93614.

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Orientador: Márcia Guimarães da Silva Banca: José Antonio Simões Banca: Maria Terezinha Serrão Peraçoli Resumo: O Trabalho de Parto Prematuro (TPP) é uma grave intercorrência obstétrica que acomete de 5-10% das gestações. Embora sua etiologia seja multifatorial, a infecção da cavidade amniótica (CA) é um importante fator associado ao seu desencadeamento. Objetivo: Comparar a freqüência de infecção na cavidade amniótica de gestantes em TPP em relação a gestantes fora de trabalho de parto e correlacionar com os níveis de citocinas pró-inflamatórias no líquido amniótico (LA). Material e Métodos: Foram incluídas neste estudo 20 gestantes em TPP e 20 gestantes fora de trabalho de parto, com idades gestacionais pareadas. No grupo TPP, amostras de LA foram obtidas no momento da resolução da gestação ou durante amniocentese transabdominal. O grupo de gestantes fora de trabalho de parto foi constituído de pacientes com indicação de amniocentese transabdominal. Para avaliação da infecção na CA foram realizadas reações em cadeia da polimerase (PCR) para a detecção de Mycoplasma hominis, Ureaplasma urealyticum e do gene bacteriano RNAr 16S. Os produtos de RNAr 16S foram seqüenciados para a identificação da espécie bacteriana. Os níveis das citocinas inflamatórias, interleucina (IL)-1β, IL-6, IL-8 e fator de necrose tumoral (TNF-α) no LA foram quantificados por ensaio imunoenzimático (ELISA). Resultados: A incidência de TPP no período do estudo foi de 5,8%. No grupo TPP, a pesquisa de invasão microbiana da CA foi positiva para M. hominis (35,0%), U. urealyticym (10,0%) e gene RNAr 16S (30,0%), sendo todas as freqüências superiores às encontradas no grupo fora de trabalho de parto (p<0,05). Quanto às citocinas, níveis aumentados de IL-1β (p=0,03), IL-6 (p<0,001) e IL-8 (p<0,001) foram detectados no LA das pacientes em TPP em relação às gestantes fora de trabalho de parto. Além disso, amostras de LA, com presença de infecção, apresentaram níveis... (Resumo completo, clicar acesso eletrônico abaixo) Abstract: Preterm labor (PL) represents a serious obstetric complication whose rate is 5-10%. Although the PL etiology is multifactorial, intraamniotic infection is strongly associated to its occurrence. Objective: To compare the frequency of intraamniotic infection in women presenting PL with women not in labor and to correlate with inflammatory cytokines levels in amniotic fluid (AF). Material and Methods: Twenty women with PL and 20 women with same gestational age, but not in labor, were included in this study. AF samples of women in PL were collected at delivery or by amniocentesis. The control group was composed by women with indication for amniocentesis. The evaluation of intraamniotic infection was performed detecting Mycoplasma hominis, Ureaplasma urealyticum and the bacterial rRNA 16S gene using polymerase chain reaction (PCR). The PCR rRNA 16S products were sequenced for bacterial species identification. The IL-1β, IL-6, IL-8 and TNF-α levels in AF were measured by enzyme-linked immunoabsorbent assay (ELISA). Results: During the study period, PL rate was 5,8%. Intraamniotic infection in women with PL was positive for M. hominis (35,0%), U. urealyticum (10,0%) and bacterial rRNA 16S (30,0%). AF infection rates for all tested microorganism were superior in PL when compared to women not in labor (p<0,05). Regarding to the cytokine measurement, AF of PL women showed increased IL-1β (p=0,03), IL-6 (p<0,001) and IL-8 (p<0,001) levels in comparison to AF samples from women not in labor. Additionally, AF with infection presented increased levels of IL-1β e IL-6 (p=0,03). Conclusion: Women with PL present high frequency of intraamniotic infection when compared with women not in labor and such infection correlates with increased IL-1β e IL-6 AF levels. Mestre

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20

Rogal, Shari. "The Effects of Posttraumatic Stress Disorder on Pregnancy Outcomes." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-141433/.

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The purpose of this study was to determine the effect of posttraumatic stress disorder (PTSD), diagnosed prospectively during pregnancy, on the occurrence of low birthweight (<2500 grams) and preterm delivery (<37 weeks gestational age). A cohort of 1362 women was recruited from prenatal care visits and screened for depression, panic disorder, posttraumatic stress disorder, and substance use. Current episodes of PTSD were assessed using the MINI International Neuropsychiatric Interview. Pregnancy outcomes were abstracted from hospital records after delivery, and the data were analyzed using logistic regression. Two hundred sixty two women (33%) were lost to follow-up due to unavailable medical records, leaving 1100 women in the final analyses. Among these 1100 women, 31 (3%) were found to have PTSD during pregnancy. Substance use in pregnancy, panic disorder, major and minor depressive disorders, and prior preterm delivery were significantly associated with PTSD in the sample, while age, language spoken, and race were not. Low birthweight (LBW) was present in 6.5% of sampled women and was not significantly associated with a diagnosis of PTSD in pregnancy when adjusting for potential confounders. However, LBW was significantly associated with minor depressive disorder OR= 1.82 (CI=1.01, 3.29). Preterm delivery occurred in 7.0% of those without and 16.1% of those with PTSD (p=0.055). Because prior preterm delivery data were not available for 33% of women with PTSD, this variable was included only in secondary analyses. However, the association between PTSD and preterm delivery depended on this variable, with OR= 2.82 (0.95, 8.38) before controlling for prior preterm delivery and OR=3.35 (1.04, 10.85) after controlling for prior preterm delivery. These data suggest that a possible association of PTSD and preterm delivery was limited by the low rates of PTSD in this cohort and the inability to control for all confounders. Taken together, these findings provide limited support for the hypothesized association between PTSD and preterm delivery and no support for an association of PTSD with LBW.

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Howard, Philip Hamilton. "Income inequality, air toxics and variation in adverse birth outcomes in Missouri counties /." free to MU campus, to others for purchase, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3052180.

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Lindmark, Emmy, and Lundqvist Jakob. "The Effects of a Premature Birth on Behaviour and Cognitive Ability in 4 - 8-Year Old Children : A comparative study over time." Thesis, Umeå universitet, Institutionen för psykologi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-114513.

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While previous studies have found that a preterm (PT) birth leads to a higher risk for numerous adverse outcomes, including neurodevelopmental and behavioural problems, few, if any, have investigated the consistency of conceivable behavioural problems over time. The aim of this study was to investigate the existence and the stability of behavioural problems from four to eight years of age in a group of 18 children born PT without diagnosed neurological or developmental morbidity, in comparison to a group of 19 children born full term (FT). Additionally, the effects of gestational age (GA) as well as possible associations between behavioural problems and cognitive ability were investigated. Also, differences related to parents’ level of education were observed. Behavioural problems were evaluated with Child Behavior Checklist (CBCL) and cognitive ability was assessed at eight years of age by using Wechsler Intelligence Scale for Children (WISC-IV). Results showed significant differences between the groups regarding cognitive ability where children born PT had lower scores. Contrary to most previous findings, no evident differences between the two groups regarding amount of behavioural problems were found. Children born PT increased in amount of anxiety problems from four to eight years of age, while children born FT decreased, and a lower GA was related to increasing oppositional defiant problems. Generally, the mothers of children born PT had a lower level of education than those of the FT group. Thus, interpretations with caution due to the relatively small number of participants, these initial findings reveal the need for further prospective follow-up studies on the relationship between birth status and the change of behaviour problems in relation to both inter- and intra-effectors over time. Tidigare forskning har visat att en för tidig födsel leder till en ökad risk för ett antal ofördelaktiga utfall, inklusive neuroutvecklingsrelaterade svårigheter och beteendeproblem. Få studier, om några, har undersökt stabiliteten av potentiella beteendeproblem över tid. Syftet med denna studie var att undersöka förekomst och stabilitet av beteendeproblematik mellan fyra till åtta års ålder i en grupp bestående av 18 barn födda för tidigt, utan neurologiska eller utvecklingsrelaterade störningar, jämfört med 19 barn födda fullgångna. Vidare undersöktes effekten av gestationsålder samt möjliga associationer mellan beteendeproblem och kognitiv förmåga. Skillnader i föräldrarnas utbildningsnivå mellan grupperna undersöktes också. Beteendeproblem skattades med Child Behavior Checklist (CBCL) och kognitiv förmåga bedömdes vid åtta års ålder med hjälp av Wechsler Intelligence Scale for Children (WISC-IV). Resultaten visade signifikanta skillnader mellan grupperna gällande kognitiv förmåga, där barn födda för tidigt hade lägre poäng. I motsats till vad flera tidigare studier funnit så visade vår studie inga signifikanta skillnader mellan grupperna gällande omfattning av beteendeproblem. Barn födda för tidigt uppvisade en ökning av ångestproblem från fyra till åtta års ålder medan barn fullgånget födda uppvisade en minskning, och lägre gestationsålder korrelerade med ökade trotsproblem. Generellt sett så hade mödrar till barn födda förtidigt en lägre utbildningsnivå än de i den fullgångna gruppen. Med försiktiga tolkningar på grund av det relativt låga antalet deltagare visar resultaten ett behov av vidare uppföljningsstudier av sambanden mellan födelsestatus och förändringen av beteendeproblem i relation till både inter- och intra-påverkande faktorer. The relation between sensory-motor, behaviour functioning and brain development in preterm born children

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Wilson, T. T. "Long term developmental and psychosocial outcomes following premature birth : has postnatal corticosteroid treatment been an over looked factor." Thesis, Queen's University Belfast, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.431442.

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24

Galea, George. "The incidence and consequences of cytomegalovirus transmission via blood transfusion to low birth weight premature infants in Aberdeen." Thesis, University of Aberdeen, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.257593.

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The acquisition of cytomegalovirus (CMV) infection following blood transfusion has been recognised for over 20 years. Prospective studies in the late 1960's and early 70's demonstrated that this infection was relatively frequent, particularly when patients were multitransfused. In assessing the clinical importance of CMV infection, critical distinctions must be made between infection and significant disease. This is primarily dependent on the immunocompetence of the invaded host. In the child or adult with a normal immune function, CMV infection usually results in asymptomatic seroconversion or is manifested as a mild heterophile-negative mononucleosis syndrome. There is minimal morbidity associated with these infections. Among healthy people the prevalence of CMV acquisition depends on age, socioeconomic conditions and the particular place where the investigations are carried out. In contrast, CMV may be associated with significant morbidity and mortality in immunocompromised patients eg, premature infants, children with immunodeficiency syndromes, patients on chemotherapy and transplant recipients. CMV infections in such patients may be either the result of reactivation of latent virus, since CMV frequently persists in the host after a primary infection or a de novo primary infection. In newborn infants, the role of blood transfusion in causing CMV infection is easier to ascertain, because reactivation of latent CMV is not a complicating factor. Premature infants, receiving blood transfusions (a very common practice) represent a special subpopulation in immunocompromised recipients. Numerous studies have identified 3 particularly high risk groups in this neonatal context: 1. maternal and neonatal seronegativity 2. transfusion of more than 50 mls of blood in toto per infant, particularly when the number of donors is high (&62 4) 3. very low birth weight; usually less than 1500 gms. Moreover these studies have convincingly shown that CMV infection can be significantly reduced by choosing seronegative blood for seronegative infants. However the provision of such blood would pose problems involving significant expense. Seronegative donors would have to be found from the routine donor panels and they would have to be tested prior to every blood donation, because of the possiblity of silent seroconversion. This involves the use of expensive reagents and requires organisational expertise regarding the appropriate timing of tests, keeping adequate stocks of such bloods, etc. Therefore before specific recommendations can be formulated with regard to the use of CMV seronegative blood for controlling CMV infections, it is necessary to study the local circumstances because the prevalence of CMV seronegativity varies in different populations. Moreover, recent studies have shown that the clinical consequences of CMV infection following blood transfusions seems to be diminishing. The reasons for this are not readily identifiable, but may be related to a number of factors, including the volume of blood transfused, the number of donor exposures and importantly a significant change in the make up of the blood donor population. Whatever the reason some centres have concluded, after local studies not to provide CMV screened blood for their sick nursery babies, even for the ones who are at highest risk of CMV infection. In fact a recent nationwide survey run by the American Association of Blood Banks and the College of American Pathologists in 1987 show that as many as 40% of community hospitals and 20% of children's hospitals do not provide blood or blood components with a reduced risk of CMV transmission for their neonates. With such conflicting policies on CMV screening it is therefore all the more important to evaluate the local clinical morbidity and/or mortality in at risk infants, induced by CMV infection via random (CMV unscreened) blood transfusions, which is current practice in our centre. Secondary to the main aims of this work, it was also possible to study: (a) the prevalence of CMV seropositivity amongst the blood donor population in the North East of Scotland and to study in some detail recent CMV infections both serologically and virologically in such donors. (b) the incidence of congenital CMV infection and CMV infection acquired during pregnancy in a select subpopulation of mothers. Since the data on CMV seroprevalence throughout different parts of the UK are scanty, the opportunity was taken to obtain some data on the subject. Although the information is of limited comparable value, the aim was to provide data both on the overall CMV donor carrier rate in different parts of the UK and also on the methodology used to detect it.

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Goolab, Deepika. "Outcomes and risk factors of very low birth weight infants with intraventricular haemorrhage who received respiratory support in a middle income country neonatal unit." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33698.

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Background: Prematurity is a major risk factor for intraventricular haemorrhage (IVH). Premature infants often require respiratory support. There is little information on neonates with IVH who require respiratory support in low and middle income countries. Objective: To describe the characteristics and short-term outcomes of very low birth weight (VLBW) infants with IVH who required respiratory support in a tertiary neonatal unit with resource limitations. Methods: This was a matched retrospective observational study. The population included VLBW infants with IVH, who received positive pressure respiratory support between January 2014 and December 2016. Outcomes of infants with severe IVH was compared to those with mild IVH. Outcomes were further analysed according to mode of ventilation. Results: 150 infants were included in the study, 56 (37%) received continuous positive airway pressure (CPAP) only and 94 (63%) mechanical ventilation. Severe IVH was associated with surfactant therapy across both ventilation groups (p=0.03). Oxygen requirement at 28 days was more frequent in infants with severe IVH compared to mild IVH (79% vs 38%, p=0.01) (OR 6.11 (95% CI 1.19-31.34), p=0.03). Severe IVH and the presence of coagulopathy were the strongest predictors of death in both ventilation groups (p <0.0001). Pulmonary haemorrhage was the commonest cause of death in those with severe IVH and blood culture confirmed sepsis in those with mild IVH. Periventricular leukomalacia (PVL) was associated with severe IVH in those receiving invasive ventilation (OR 6.67 (95% CI 1.11-40.17)). Conclusion: Mechanical ventilation, coagulopathy and pulmonary haemorrhage were strongly associated with death in VLBW infants with severe IVH in a resource-limited setting. These prognostic factors may have a role in end of life decisions.

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Маркевич, Віталій Едуардович, Виталий Эдуардович Маркевич, Vitalii Eduardovych Markevych та ін. "Роль нирок у мікроелементному забезпеченні передчасно народжених дітей". Thesis, Сумський державний університет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/42252.

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Метою роботи було за показниками концентрації у сечі дослідити стан ниркової регуляції мікроелементної забезпеченості організму новонароджених різного гестаційного віку протягом неонатального періоду.

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Deshpande, Girish. "Probiotics for Preterm Neonates for Prevention of Necrotising Enterocolitis." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21854.

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Necrotising enterocolitis (NEC) is a serious gastrointestinal emergency that is associated with high mortality and morbidly especially in extremely low birth weight neonates. The burden of NEC is very high due to prolonged hospitalisation, and cost of surgery. Since the treatment is mainly supportive, prevention is the only option. Probiotics are defined as live microorganisms which when administered in adequate amounts confer a health benefit on the host. Systematic reviews published by our group (Deshpande et al, Lancet 2007 & Pediatrics 2010) before commencing this doctorate research have shown the potential of probiotics in prevention of NEC and mortality. Aims of this research included 1) establish the evidence-based guidelines to use probiotics 2) introduce routine use of probiotics and perform before and after cohort study 3) evaluate the effect of routine probiotics on gut and tracheal microbiome in very preterm neonates (<30 weeks gestation). 4) to advance this field further, i) perform systematic review of RCTs probiotics in low and medium income countries ii) evaluate the role of para-probiotics in preterm neonates. This thesis by publications contains 8 chapters. Chapter 3 is a publication about evidence-based guidelines to use probiotics in preterm neonates. Chapter 4 presents a stepwise approach to introduce probiotics and results of before and after cohort study reporting significant reduction of NEC in probiotic cohort. Chapter 5 discusses the clinical evidence of benefits of probiotics in preterm neonates along with guidelines for clinicians in the context of the Australian regulatory framework. Chapter 6 presents significant results of tracheal and gut colonisation by probiotic bacteria. Chapter 7 incorporates the systematic review results that suggest benefits of probiotics in low and medium income countries in terms of reduction of NEC, sepsis and mortality. Chapter 8 discusses the possible role of para-probiotics in preterm neonates. In summary, this research has added significantly to the existing body of evidence in the area of probiotics for prevention of NEC in high risk preterm neonates, contributed in advancing this area further, evaluated the role of probiotics in low and medium income countries and the role of para-probiotics in preterm neonates.

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Paulukaitis, Jennifer J. "Risk factors in the prenatal environment and later cognitive abilities of very low birth weight premature infants in northern Nevada /." abstract and full text PDF (free order & download UNR users only), 2006. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1437659.

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Thesis (M.S.)--University of Nevada, Reno, 2006. "August, 2006." Includes bibliographical references (leaves 89-94). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2006]. 1 microfilm reel ; 35 mm.

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Santana, Ana Paula Canelas. "O nascimento prematuro: contributos do EESMO na preparação pré-natal e na transição para a parentalidade." Master's thesis, Universidade de Évora, 2021. http://hdl.handle.net/10174/29266.

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Com este projeto pretendeu-se contribuir para o desenvolvimento e aperfeiçoamento da intervenção do Enfermeiro Especialista em Saúde Materna e Obstetrícia, no processo de cuidar da mulher/família aquando do nascimento prematuro. Tornar-se mãe e pai gera uma fase de transição no ciclo familiar e o casal ambiciona a vinda de um filho perfeito. Porém, a prematuridade vem dissolver as fantasias e os desejos. Assim, o momento de transição para a parentalidade de um casal com um filho prematuro exige um cuidar específico e personalizado. Com o estudo qualitativo aqui realizado concluiu-se que os enfermeiros têm o dever de conhecer, na sua singularidade, a família de quem cuidam, atuando em parceria de forma a responder eficazmente às necessidades da mesma, conferindo-lhes informações e conhecimentos de modo a facilitar e a capacitá-los para o processo de transição para a parentalidade, começando a estimulação das competências parentais ainda durante a gravidez; ABSTRACT This project aimed to contribute to the development and improvement of the midwife intervention, in the process of caring for the woman / family at the time of premature birth. Becoming a mother and father creates a transition phase in the family cycle and the couple aspires to have a perfect child. However, prematurity comes to dissolve fantasies and desires. Thus, the moment of transition to the parenting of a couple with a premature child requires specific and personalized care. With the qualitative study conducted here, it was concluded that midwives have a duty to know, in their singularity, the family they care for, acting in partnership in order to respond effectively to their needs, providing them with information and knowledge in order to facilitate and qualify them for the transition to parenting, beginning the stimulation of parenting skills even during pregnancy.

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Sipola-Leppänen, M. (Marika). "Preterm birth and cardiometabolic risk factors in adolescence and early adulthood." Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526207957.

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Abstract About 11% of infants are born preterm (before 37 weeks of gestation) worldwide. Adults born preterm with very low birth weight show enhancement of cardiometabolic risk factors such as elevated blood pressure and impaired glucose regulation compared with their peers born at term. Not all the cardiometabolic risk factors related to preterm birth are known, or whether they apply to those born less preterm, although about 80% of premature infants are born late preterm. The association between preterm birth and cardiometabolic risk factors in adolescence and adulthood was investigated in three cohort studies: The Helsinki Study of Very Low Birth Weight Adults, the Northern Finland Birth Cohort 1986, and the ESTER study. Preterm birth over its whole range has a long-term impact on a child’s health in later life: adults born preterm with very low birth weight had lower resting energy expenditure, but higher resting energy expenditure per unit lean body mass than their peers born at term. Adolescent girls born before 34 weeks of gestation had higher blood pressure and boys have elevated levels of LDL cholesterol and apolipoprotein B. Adults born preterm were more likely to be obese and to have hypertension or metabolic syndrome than their peers born at term. In addition to conventional biomarkers of cardiometabolic disorders, they had alterations in other cardiometabolic biomarkers, such as uric acid and liver transaminases. Adolescents and adults born preterm are at greater risk of developing cardiometabolic disorders than their peers born at term. Most of the cardiometabolic risk factors related to preterm birth are modifiable. Favorable early life circumstances of premature infants, such as optimal nutrition and reduction of stress in neonatal intensive care units, might reduce the risk of later cardiometabolic disorders. In addition, children and adults born preterm might particularly benefit from primary prevention such as screening for additional risk factors and promotion of healthy lifestyles Tiivistelmä Noin joka yhdeksäs lapsi maailmassa syntyy ennenaikaisesti, ennen 37. raskausviikkoa. Keskosena syntyneillä aikuisilla on todettu enemmän joitakin sydän- ja verisuonisairauksien riskitekijöitä kuin heidän täysaikaisena syntyneillä ikätovereillaan. Näistä eniten on tutkittu etenkin kohonneen verenpaineen ja heikentyneen sokerin siedon esiintyvyyttä, mutta kaikkia myöhempien sairauksien riskitekijöitä ei tunneta. Suurin osa aiemmista keskostutkimuksista on tehty hyvin tai erittäin ennenaikaisesti syntyneillä, vaikka yli 80% keskosista syntyy lievästi ennenaikaisena. Ei ole juurikaan tutkimuksia siitä, ovatko sydän- ja verisuonitautien riskitekijät lisääntyneet myös tässä suuressa lievemmin ennenaikaisesti syntyneiden joukossa. Eriasteisen ennenaikaisen syntymän vaikutuksia nuoruus- ja aikuisiän sydän- ja verisuonitautien riskitekijöihin tutkittiin kolmessa kohorttitutkimuksessa: Helsingin Pikku-K -tutkimuksessa, Pohjois-Suomen syntymäkohortti 1986 -tutkimuksessa sekä ESTER-tutkimuksessa. Ennenaikaisella syntymällä sinänsä on pitkäaikaiset vaikutuksen syntyneen lapsen terveyteen myös nuoruudessa ja aikuisuudessa: Hyvin pienipainoisena ennenaikaisesti syntyneillä on korkeampi lepoenergian kulutus rasvatonta painoyksikköä kohden kuin täysiaikaisena syntyneillä ikätovereilla. Hyvin ennenaikaisena (ennen 34. raskausviikkoa) syntyneillä tytöillä on 16-vuotiaina korkeampi verenpaine, ja pojilla suuremmat LDL-kolesterolin ja apolipoproteiini B:n pitoisuudet. Keskosena syntyneet puolestaan täyttivät aikuisina todennäköisemmin lihavuuden, verenpainetaudin ja metabolisen oireyhtymän kriteerit. Perinteisten sydän- ja verisuonitautien riskitekijöiden lisäksi heillä oli muutoksia myös monissa muissa sydän- ja verisuonitautien merkkiaineissa, kuten uraatin ja maksa-arvojen pitoisuuksissa. Ennenaikaisesti syntyneillä nuorilla ja aikuisilla on suurentunut riski sairastua sydän- ja verisuonitauteihin myöhemmällä iällä. Näitä riskejä on mahdollista ennaltaehkäistä, minkä vuoksi ennenaikaisesti syntyneet nuoret ja aikuiset voivat hyötyä terveellisistä elämäntavoista erityisen paljon

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Oliver, Lawrence Tommy Victor. "Study on factors associated with low birth weight babies at Uitenhage Hospital." Thesis, University of the Western Cape, 2000. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The incidence of Low Birth Weight (LBW) babies born in the Uitenhage Provincial Hospital would seem to be a cause of concern from a public health of view. The incidence of 21% recorded during 1999 is markedly higher than the 7% recorded in the United States of America in 1998 and the average of 17% noted for developing countries. Some health concerns related to LBW babies are Sudden Infant Death Syndrome, scholastic performances later in life, and several chronic diseases in adults associated with them having been born as LBW babies.

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Morse, Shannon Leigh. "Exploring the Relationship Between Severity of Illness and Human Milk Volume in Very Low Birth Weight and Extremely Low Birth Weight Infants Over Six Weeks." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6329.

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Very low birth weight and extremely low birth weight neonates have tremendous risk of mortality. This is a grave concern; however, survival alone is not the goal of neonatal intensive care. Survival, along with a reduction or elimination of life long morbidity is the aim of neonatal intensive care. Human milk is known as the best nutrition for babies and a growing body of evidence supports that human milk is critical in helping these fragile neonates mitigate the overwhelming risks they face. Therefore, the purpose of this study was to examine the relationship between neonatal severity of illness and human milk, specifically mothers own milk (MOM), donor human milk (DHM), and total human milk (THM) intake in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants over the first six weeks of life. Although there is a growing body of evidence that supports the use of human milk in this fragile neonatal population, information is lacking about the relationship between human milk and neonatal illness severity. The current study was a secondary data analysis from a National Institutes of Health (NIH) funded R21 study in a level three NICU in Florida. Multilevel modeling was used for data analysis to examine relationships between maternal dyad characteristics and severity of illness, operationalized by the Score for Neonatal Acute Physiology-II (SNAP-II), at 12 hours of life and at the end of each week of life for six weeks. Growth models (linear, quadratic, piecewise) were examined to determine the best model fit for the data, then predictor variables were added and model fit was tested. Birth weight was added to final models as a control as it is seen as a proxy for severity of illness in the literature. Model six demonstrated a significant inverse relationship between MOM(mL) (γMOM(mL)) = -.000079, p < .05) and SNAP-II scores (Deviance = 287.862, Δχ2(df) = 31.38(1), p < .001, AIC = 303.862, BIC = 336.930). Model 11 demonstrated a significant inverse relationship between THM(mL) (γTHM(mL) = -.000127, p < .001) and SNAP-II scores (Deviance = 279.280, Δχ2(df) = 30.859(1), p < .001, AIC = 295.280, BIC = 328.347). No relationships were noted between severity of illness and DHM(mL), MOM(%), DHM(%), or THM(%). Therefore the relationships noted between MOM(mL) and THM(mL) and neonatal severity of illness should be interpreted with caution.

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Abelin, Törnblom Susanne. "Mediators of cervical ripening in preterm birth : experimental and clinical investigations /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-305-1/.

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Kyrklund-Blomberg, Nina. "Smoking and pregnancy : with special reference to preterm birth and feto-placental unit /." Stockholm : Karolinska Institutet, 2006. http://diss.kib.ki.se/2006/91-7140-580-1/thesis.pdf.

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Goldstein, Nicolas P. N. "Disproportionate Premature Birth in Women of Low Socioeconomic Status| A Psychological and Physiological Stress Explanation of Financial Risk Removal." Thesis, University of Rochester, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10824350.

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Objectives: Mothers of low socioeconomic status (SES) and of non-Hispanic black race deliver prematurely more often. The goal of my dissertation was to improve understanding of the mechanism of disproportionate premature birth in low SES women. I tested a psychological and physiological stress explanation of prematurity risk, estimated the effect of the Affordable Care Act (ACA) Medicaid expansion on gestational age (GA), and estimated how the ACA Medicaid expansion effect was influenced by race. Data and Methods: I developed a conceptual framework of how psychological and physiological stress increase premature birth risk utilizing Appraisal and pathophysiology theory. I generated hypotheses about how financial risk removal would impact GA and tested them utilizing variation in expansions in Medicaid eligibility for pregnant women in three matched state pairs and distribution of the Earned Income Tax Credit (EITC). I utilized data from the Pregnancy Risk Assessment Monitoring System and performed multivariate ordinal regressions. I also used national birth record data and exploited state variation in ACA Medicaid expansion status to estimate the impact on GA in non-Hispanic black and all other mothers using multivariate linear regressions and linear probability models. Results: Hypothesis testing based on two of the three Medicaid expansion for pregnant women state pairs and the EITC analyses resulted in significant evidence (one-sided p-values < 0.05) for a direct pathway between psychological stress concerning financial risk, physiological stress, and GA. The ACA Medicaid expansion was associated with an increase in GA for non-Hispanic black mothers (+34 hours), a decrease for all other mothers (–6 hours), and a 3% decrease (95% CI = –5% to –2%) in the incidence of early term or shorter gestation births for non-Hispanic black mothers. Conclusions: Decreasing financial risk for low SES women with Medicaid or the EITC is associated with increased GA. The higher premature birth risk in this population is likely the result of a direct pathway involving psychological and physiological stress. Other financial risk removal strategies should be investigated. The ACA Medicaid expansion did not meaningfully influence GA on a weekly scale but did moderately decrease overall preterm birth risk in non-Hispanic black mothers.

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Chapko, Dorota. "Life-course determinants of resilience to cognitive ageing : empirical evidence and policy implications." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=230978.

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Introduction: Understanding the life-course determinants of resilience to brain ageing could significantly reduce the burden of cognitive impairment and dementia on individuals, heath care providers, and societies. The focus of this work is the concept of cognitive reserve (CR), which implies that some individuals are able to remain cognitively healthy despite the accumulation of age-related neuropathology. Methods: The determinants of brain structure and function were statistically modelled using three ongoing ageing cohort studies [Aberdeen Birth Cohort of 1936 (ABC1936), Aberdeen Children of the 1950s (ACONF), The Three-City French Cohort (3C)]. First, I performed a systematic literature review to identify life-course determinants of CR. Then, I examined whether other potentially modifiable life-course factors such as birth weight, mid-life occupational profile, and late-life social relationships and technology use provided individuals with greater CR. I modelled data in STATA and SPSS/AMOS. Results: I found that the effects of low birth weight and pre-term delivery on cognitive functions persists into mid-life (ACONF). I showed that childhood intelligence at age 11 has almost twice the protective effect on cognitive ageing than mid-life occupation (ABC1936). The quantity and quality of social relationships (3C), and the aspects of technology use in latelife (ABC1936) did not provide greater CR. Conclusion: Early-life factors contribute to later-life brain health. A major implication of this work is that studies and/or programs should consider a life-course perspective (with a focus on early-life) to accurately assess and to improve the brain health of older adults.

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Ludvigsson, Jonas F. "Some epidemiological aspects of perinatal gastrointestinal disease /." Linköping : Univ, 2001. http://www.bibl.liu.se/liupubl/disp/disp2001/med707s.pdf.

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Van, Niekerk Evette. "The use of probiotics in the management of necrotising enterocolitis in HIV exposed premature and very-low birth weight infants." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/96020.

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Thesis (PhD)--Stellenbosch University, 2014. ENGLISH ABSTRACT: Introduction: An association between maternal human immunodeficiency virus (HIV) infection and Necrotizing Enterocolitis (NEC) in preterm infants has been reported. The impact of probiotics in an HIV-exposed very low birth weight (VLBW) infant on the occurrence of NEC is uncertain at present; however it is known that probiotics have protective effects against inflammation and prevent NEC. Postnatal growth restriction is a major issue in preterm, especially extremely-low-birth-weight (ELBW) infants and probiotics have been found to improve feeding tolerance in preterm infants. Human milk oligosaccharides (HMO) also known as the prebiotics of human milk, are known to have bifidogenic and anti-adhesive effects. Infants that receive human milk show a reduced incidence of NEC compared to those who receive infant formula. Very little is known about the composition of breast milk in the HIV-infected mother. Objective: The primary objective of the study was to assess the effect of probiotics on the incidence and severity of NEC in high-risk infants born to HIV-positive and HIV-negative women. The secondary objectives were to assess the effect of probiotic administration on feeding tolerance and growth outcomes of HIV-exposed but uninfected preterm infants, to describe the HMO composition of HIV-infected mothers breast milk and lastly to determine if HMO composition affects the incidence of NEC in HIV-exposed preterm very low birth weight infants. Patients and Methods: A randomized, double blind, placebo controlled trial was conducted for the period July 2011 to August 2012. HIV-exposed and HIV-unexposed premature (<34 weeks gestation) infants with a birth weight of ≥500g and ≤1250g were randomized to receive either a probiotic or a placebo. The probiotic consisted of 1x109 CFU, L. rhamnosus GG and B. infantis per day and was administered for 28 days. NEC was graded according to Bell’s criteria. Anthropometrical parameters and daily intakes were monitored. Breats milk samples were analysed for oligosaccharide content. Results: 74 HIV-exposed and 110 HIV-unexposed infants were enrolled and randomized (mean birth-weight, 987g; mean gestational 28.7 weeks). The incidence of death and NEC did not differ significantly between the HIV-exposed and unexposed groups but a significantly higher NEC incidence was found in the control group. There was no difference in the average daily weight gain for treatment groups or HIV exposure. The HIV-exposed group achieved significantly higher z-scores for length and head circumference at day 28 than the unexposed group (p<0.01 and p=0.03, respectively). There were no differences in the incidence of any signs of feeding intolerance and abdominal distension between the groups. Our results show significantly higher absolute concentrations of 2’-fucosyllactose, laco-N-tetraose and lacto-N-fucopentaose 1 and higher relative abundance of 3’-sialyllactose, difucosyl-lacto-N-tetraose and fucosyl-disialyllacto-N-hexaose in HIV-infected compared to -uninfected Secretor women. DSLNT concentrations were significantly lower in the breast milk of mothers whose infants developed NEC compared to infants without NEC. Conclusion: Probiotic supplementation reduced the incidence of NEC in the premature infants; however results failed to show a lower incidence of NEC in HIV-exposed premature infants. Probiotic supplementation did not affect growth outcomes or the incidence of any signs of feeding intolerance in HIV-exposure. The data confirms previous reports that HIV-infected mothers have higher 3’sialyllactose milk concentrations. Most intriguing though, the data also indicates that low levels of DSLNT in the mother’s milk increase the infant’s risk for NEC, which is in accordance with results from previously published animal studies and warrants further investigation. AFRIKAANSE OPSOMMING: Inleiding: ŉ Verwantskap tussen moederlike menslike immuniteitsgebreksvirus (MIV) en nekrotiserende enterokolitis (NEK) in premature babas is aangemeld. Die impak van probiotika in ŉ MIV-blootgestelde baie lae geboortemassa (BLGM) baba op die voorkoms van NEK is tans nog onseker, maar dit is wel bekend dat probiotika ŉ beskermende effek het teen inflammasie en die voorkoms van NEK. Nageboortelike groei beperkings is ŉ groot probleem in premature, veral ekstreme lae geboortemassa (ELGM) babas. Daar is gevind dat probiotika voeding toleransie in premature babas kan verbeter. Menslike melk oligosakkariede (MMO), ook bekend as die prebiotika van menslike melk, is bekend om bifidogeniese en anti-kleef effekte te hê. Babas wat moedersmelk ontvang toon ŉ verlaagde voorkoms van NEK in vergelyking met diegene wat baba formule melk ontvang. Baie min inligting is bekend oor die samestelling van borsmelk in die MIV-positiewe moeder. Doel: Die primêre doel van die studie was om die effek van probiotika op die voorkoms en die graad van NEK in hoë risiko babas van MIV-positiewe en MIV-negatiewe vroue te bepaal. Die sekondêre doelwitte was om die effek van probiotika op voeding verdraagsaamheid en groei uitkomste van MIV-blootgestelde, maar nie- geinfekteerde premature babas te evalueer sowel as die MMO samestelling van MIV-positiewe moeders se borsmelk te beskryf en laastens om die invloed van die MMO samestelling op die voorkoms van NEK in baie lae geboortegewig MIV-blootgestelde premature babas te beskryf. Pasiënte en Metodes: ŉ Gerandomiseerde, dubbelblinde, plasebo-beheerde studie is vir die tydperk Julie 2011 tot Augustus 2012 onderneem. MIV-blootgestelde en nie-blootgestelde premature (<34 weke) babas met 'n geboorte gewig van ≥500g en ≤1250g was ewekansig verdeel om probiotika of plasebo te ontvang. Die probiotika het bestaan uit 1x109 kolonie vormende eenhede, L. rhamnosus GG en B. infantis per dag en is toegedien vir 28 dae. NEK is gegradeer volgens Bell se kriteria. Antropometriese parameters en daaglikse inname is gemonitor. Borsmelk monsters is geanaliseer vir oligosakkaried inhoud. Resultate: 74 MIV-blootgestelde en 110 MIV-nie-blootgestelde babas is ingesluit en ewekansig ingedeel (gemiddelde geboorte gewig, 987g, gemiddelde gestasie 28,7 weke). Die voorkoms van die sterftes en NEK het nie beduidend verskil tussen die MIV-blootgestelde en nie-blootgestelde groepe nie, maar 'n beduidende verskil is gevind vir NEK voorkoms tussen die studie en die kontrole groep. Daar was geen verskil in die gemiddelde daaglikse gewigstoename tussen die behandelings groepe of MIV-blootstelling nie. Die MIV-blootgestelde groep het beduidend hoër z-tellings vir lengte en kopomtrek op dag 28 getoon teenoor die nie-blootgestelde groep (p <0.01 en p = 0,03, onderskeidelik). Daar was geen verskille in die voorkoms van voeding onverdraagsaamheid en abdominale distensie tussen die twee groepe nie. Ons resultate dui op aansienlik hoër absolute konsentrasies van 2'-fucosyllactose, laco-N-tetraose en lakto-N-fucopentaose 1 en hoër relatiewe voorkoms van 3'-sialyllactose, difucosyl-lakto-N-tetraose en fucosyl-disialyllacto-N-hexaose in MIV-positiewe vroue in vergelyking met-negatiewe Sekretor vroue. DSLNT konsentrasies was aansienlik laer in die melk van moeders wie se babas NEK ontwikkel het in vergelyking met babas sonder NEK. Gevolgtrekking: Probiotika aanvullings verminder die voorkoms van NEK in premature babas, maar die resultate kon nie ŉ laer voorkoms van NEK in MIV-blootgestelde premature babas bewys nie. Probiotiese aanvulling het geen invloed op groei uitkomste of die voorkoms van voeding onverdraagsaamheid in MIV-blootstelling getoon nie. Die data bevestig vorige verslae wat aandui dat MIV-besmette moeders hoër 3'sialyllactose borsmelk konsentrasies het. ŉ Interessante aspek is dat lae vlakke van DSLNT in die moeder se melk beduidend is van ŉ verhoogde risiko vir NEK, wat in ooreenstemming is met die resultate uit voorheen gepubliseerde dier studies en regverdig verdere ondersoeke.

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Ekholm, Selling Katarina. "Birth-characteristics, hospitalisations, and childbearing : Epidemiological studies based on Swedish register data." Doctoral thesis, Linköping : Faculty of Health Sciences, Linköping University, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9660.

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Esteves, Carolina Marocco. "A preocupação materna primária em mães de bebês nascidos pré-termo." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/23021.

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A preocupação materna primária é um estado psicológico muito especial da mãe, em que sua sensibilidade em relação ao filho torna-se exacerbada. Tal estado tem início ainda na gestação, sendo acentuado no seu final, estendendo-se até as primeiras semanas ou meses após o parto. O objetivo deste estudo foi o de investigar a preocupação materna primária em mães de bebês nascidos pré-termo. Participaram do estudo quatro mães de bebês nascidos pré-termo, com idades entre 22 e 28 anos, todas casadas. Os bebês estavam internados na UTINeo de um hospital universitário público e tinham nascido entre 30 e 37 semanas e com peso médio de 1000g a 2500g. Os bebês não apresentavam complicações clínicas sérias. Como parte de seu estágio de mestrado, a autora integrou a equipe de Psicologia do hospital e realizou atendimentos psicológicos com as mães, quando elas foram então convidadas a participar do estudo. Foram então realizadas duas entrevistas, uma sobre a gestação e outra sobre a maternidade no contexto da prematuridade. Para fins deste estudo, foi utilizado um delineamento de estudo de caso coletivo que buscou investigar semelhanças e diferenças nas respostas maternas com base em três categorias: Preocupação materna primária na gestação, Preocupação materna primária e o nascimento pré-termo e Preocupação Materna Primária no Puerpério. Análise de conteúdo qualitativa revelou diversas semelhanças entre os casos mostrando que o contexto da prematuridade parece ter agregado mais angústia e inseguranças às mães que estavam em processo de desenvolvimento da preocupação materna primária. No entanto, a presença de diversos indicadores sugerem que a prematuridade do bebê não impediu que estas conseguissem ingressar na preocupação materna primária. Nesse sentido, é plausível se pensar que apesar de a prematuridade e suas intercorrências, terem afetado inicialmente a preocupação materna primária após o choque inicial, as mães do presente estudo relataram fortes indicadores da presença deste processo, o que, com certeza, contribuiu para a qualidade da relação e desenvolvimento do filho/a. The primary maternal preoccupation is a special psychological state of the mother, when her sensitivity in relation to her baby becomes exacerbated. This state starts early in pregnancy but is marked on its end, extending through the first weeks or months after birth. The aim of this study was to investigate the primary maternal preoccupation in the mothers of preterm birth babies. Four mothers of preterm birth babies participated in the study. Their ages were between 22 and 28 years old and all of them were married. The babies were interned in the Neonatal Intensive Care Unit (UTINeo) of a public university hospital and were born with gestational age between 30 and 37 weeks, and with medium weight that varied from 1000g to 2500g. The babies did not present serious clinical complications. As part of the Master’s research, the author joined the Psychology’s Staff of the hospital and realized psychological treatment with the mothers, when they were invited to participate in the study. Two interviews were collected: one about gestation and another about motherhood in the prematurity context. Their answers were examined through content analysis. For this study, a collective case-study design was used to investigate the particularities and similarities of the answers, based on three categories: Primary maternal preoccupation in gestation, Primary maternal preoccupation and the preterm birth and Primary maternal preoccupation in the puerperium. Content analysis indicated similarities between the cases, showing that prematurity context brought more distress and insecurities to the mothers whom were in process of establishing primary maternal preoccupation. However, the presence of indicators suggests that the prematurity of the baby did not prevent the establishment of primary maternal preoccupation in the mothers. Accordingly, it’s plausible to think that, despite the prematurity and its intercurrences have affected the primary maternal preoccupation, after the initial shock, the mothers of the present study showed presence of the indicators of this process, which, of course, contributed to the quality of the relationship and development of the child.

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Gilfillan, Marlene. "Characteristics of black South African adult and adolescent women who gave premature birth to growth-restricted infants at Kalafong hospital, Gauteng." Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/2740.

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Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. INTRODUCTION: The objective of the study was to determine the prevalence of certain known risk factors for intra-uterine growth restriction (IUGR) in women who gave premature birth to growth-restricted infants at a large regional hospital (Kalafong) in the Gauteng province of South Africa and to investigate the possible associations between the presence of various risk factors and the severity of growth restriction found in these infants. METHOD: The study was designed as cross-sectional, descriptive and observational. The subjects included singleton growth-restricted premature infants (n=80), without congenital abnormalities and their mothers (n=80). Anthropometric data [weight, height, mid-upper arm circumference (MUAC) and triceps skinfold thickness (TSF)] were collected from these mothers three to four days post-partum. Infant birth weights were recorded at birth, while the lengths and head circumferences were recorded within 2 days post-partum. Additional information, such as birth spacing, maternal age, smoking habits and alcohol use, was collected by personal interview and blood pressure data and HIV status was obtained from medical records. Data capturing and descriptive statistics were done using Microsoft Excel and comparative analytical statistics were performed with the Statistical Package for the Social Sciences (SPSS), version 12.0. RESULTS: The study demonstrated a high prevalence (69%) of infants born with a birth weight <3rd percentile. In the sample, 81% of the mothers were aged 17-34 years and most (93%) had their children 18 months or longer apart. Malnutrition prevalence was moderate. In 58% of the mothers the BMI was normal (18.5-24.9 kg/m2) and in 47% the upper arm muscle area (UAMA) was between the 10th-85th percentile. Grade III overweight occurred in 3% and TSF ≤5th percentile occurred in 35% of the mothers. About half (51%) of the mothers in the sample population had hypertension during the second trimester of pregnancy. Smoking and alcohol use during pregnancy was rare (1% and 6% respectively) and the prevalence of HIV infection in the mothers was 26%. The prevalence (16%) of Grade II overweight among the mothers of symmetric growth-restricted (SGR) infants was higher than among the mothers of asymmetric growth-restricted (AGR) infants (7%). Of the hypertensive mothers, 55% had infants with SGR compared to 45% with AGR (p=0.47). Although rare, smoking occurred only in mothers with AGR infants (3%). No significant differences were found between the smoking and non-smoking group (p=0.21). Although the use of alcohol was more prevalent at 6% in mothers with SGA infants and 7% in mothers with AGR infants, no significant associations were found (p=0.95). Although not significant (p=0.76), there was a higher prevalence of HIV infection in mothers with SGR infants at 29%, compared to 23% of mothers of AGR infants. CONCLUSION: Although further studies are needed before intervention strategies can be planned and implemented, the findings of this study suggest that apart from the usual factors (maternal age and nutritional status, smoking and alcohol use during pregnancy and birth spacing) that may influence intra-uterine growth, hypertension may contribute greatly to IUGR in this study population.

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Massaro, Carla Regina. "Periodontite como fator de risco para parto prematuro e nascimento de bebês com baixo peso: Estudo de caso-controle." Universidade Estadual do Oeste do Paraná, 2018. http://tede.unioeste.br/handle/tede/4143.

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Submitted by Edineia Teixeira (edineia.teixeira@unioeste.br) on 2019-03-12T21:48:07Z No. of bitstreams: 2 Carla_Massaro_2018.pdf: 2100131 bytes, checksum: 49b8d75049eba84cd9747560262c9888 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Made available in DSpace on 2019-03-12T21:48:07Z (GMT). No. of bitstreams: 2 Carla_Massaro_2018.pdf: 2100131 bytes, checksum: 49b8d75049eba84cd9747560262c9888 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-04-03 Introduction: Periodontitis is considered a public health problem because of its high prevalence in the world and has been associated with preterm birth and low birth weight. Prematurity is one of the most serious perinatal problems, persisting as one of the major causes of perinatal mortality and morbidity. Objective: To evaluate the effect of periodontal disease on preterm birth and the birth of low birth weight babies. Materials and Methods: This is a study involving 45 mothers of newborn infants, assessed periodontally 48 hours postpartum, who presented mild to moderate / severe, localized or generalized chronic periodontitis with probing bleeding and gingival inflammation. Divided into DPL (mild periodontal disease) (n = 15) and DPMS group (moderate / severe periodontal disease) (n = 30). Data were collected from the current gestation and baby data. The variables were tested for normality and homogeneity (Shapiro-Wilk test) and submitted to the Student's T-test (p <0.05). The correlation between variables was analyzed using the Pearson Correlation Test. Results: The results showed that there was a moderate (-0.5388) and significant (p = 0.014) negative correlation between gingival crevicular fluid and gestational age, a moderate (-0.5026) and significant (p = 0.0046) negative correlation between the index of plaque and gestational age and a moderate (-0.4562) and significant (p = 0.0112) negative correlation between gingival index and gestational age in the DPMS group alone. Conclusion: From the results obtained, it was possible to conclude that the presence of inflammation due to moderate / severe periodontitis may represent a risk factor for the occurrence of preterm birth. Introdução: A periodontite é considerada um problema de saúde pública pela elevada prevalência no mundo, e tem sido associada ao parto prematuro e baixo peso ao nascer. A prematuridade constitui um dos problemas perinatais mais graves, persistindo como uma das maiores causas de mortalidade e morbidade perinatal. Objetivo: Avaliar o efeito da doença periodontal no parto prematuro e nascimento de bebês com baixo peso. Materiais e Métodos: Trata-se de um estudo envolvendo 45 mães de crianças recém-nascidas, avaliadas periodontalmente 48 horas pós-parto, que apresentaram periodontite crônica leve a moderada/severa, localizada ou generalizada, com sangramento à sondagem e inflamação gengival. Divididas em Grupo DPL (doença periodontal leve) (n=15) e Grupo DPMS (doença periodontal moderada/severa) (n=30). Foram coletados dados da gestação atual e dados do bebê. As variáveis passaram pelo teste de normalidade e homogeneidade (Teste de Shapiro-Wilk) e submetidas ao teste T-Student (p< 0.05). A correlação entre as variáveis foi analisada através do Teste de Correlação de Pearson. Resultados: Os resultados mostraram que houve uma correlação negativa moderada (-0.5388) e significativa (p=0.014) entre o fluido crevicular gengival e a idade gestacional, uma correlação negativa moderada (-0.5026) e significativa (p=0.0046) entre o índice de placa e a idade gestacional e uma correlação negativa moderada (-0.4562) e significativa (p=0.0112) entre o índice gengival e a idade gestacional somente no Grupo DPMS. Conclusão: A partir dos resultados obtidos, foi possível concluir que a presença de inflamação decorrente de uma periodontite moderada/severa pode representar um fator de risco para a ocorrência de parto prematuro.

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Silva, Eveline Franco da. "Condições de nascimento de recém-nascidos pré-termo tardios." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/114528.

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O nascimento de crianças antes de completar as 37 semanas de idade gestacional, ou seja, o nascimento prematuro, constitui-se em um evento de preocupação global. Os prematuros tardios, aqueles nascidos entre 34 semanas e 36 semanas e seis dias de gestação, representam uma parcela significativa na prematuridade. Entretanto, os recém-nascidos pré-termo tardios não podem ser considerados como recém-nascidos próximos ao termo, pois fisiologicamente são imaturos e em razão disso geram maiores ocorrências de internações hospitalares e morbidades. Essas consequências da prematuridade tardia geram impacto na saúde pública. Sendo assim, o objetivo do presente estudo foi conhecer as condições ao nascimento de recém-nascidos pré-termo tardios. Trata-se de um estudo qualitativo, do tipo exploratório, cuja coleta de dados realizou-se em três unidades de Estratégia de Saúde da Família, no período de novembro de 2011 a dezembro de 2012, na cidade de Porto Alegre/RS, com 13 informantes, mães desses recém-nascidos prematuros tardios. Os dados utilizados neste estudo foram obtidos do banco de dados da pesquisa “O cuidado leigo e profissional na prematuridade: fatores culturais relacionados ao período gestacional e pós-natal”, a qual teve registro na Comissão de Pesquisa da Escola de Enfermagem da Universidade Federal do Rio Grande do Sul e aprovação do Comitê de Ética em Pesquisa da Prefeitura Municipal de Porto Alegre, com Parecer registrado sob número 001.039956.11.3. A análise de dados foi fundamentada no referencial da Análise Temática e de Padrões, compondo dois temas: complicações decorrentes da prematuridade tardia; e repercussões no crescimento e desenvolvimento. O primeiro tema mostrou que as complicações decorrentes da prematuridade tardia foram relacionadas à sífilis congênita, ao baixo peso, à icterícia, à anemia, à hipoglicemia e à gemelaridade. Essa condição de nascimento exigiu cuidados específicos, desse modo reafirmando que os pré-termo tardios não podem ser considerados bebês a termo. O segundo tema apresentou a prematuridade tardia como um fator que pode comprometer o crescimento e desenvolvimento da criança. A partir do conhecimento das condições de nascimento desses recém-nascidos, ressalta-se a importância de desenvolver protocolos de atenção à saúde do pré-termo tardio, bem como a capacitação dos profissionais que atuam neste contexto para promover um cuidado diferenciado e de qualidade a esses bebês e suas famílias. Childbirth before achieving 37 weeks of pregnancy, which is known as premature birth, consists in an occurrence of global concern. The late-premature babies, those who are born between 34 weeks and 36 weeks and 6 days of pregnancy, represent a significant portion of prematurity. Nevertheless, the late-preterm newborns cannot be considered close to term newborns as physiologically they are immature and as a result of this, it has a higher incidence of hospital stays and deaths. These consequences of late prematurity give impact on the public health system. Thus, the aim of the present study was to get to know the birth conditions of late-preterm newborns. It refers to an explorative, qualitative study, which data was collected in three Family Health clinics in the period from November, 2011 until December 2012, in the city of Porto Alegre, RS, from 13 participants, mothers of the late-preterm newborns. The data used in this study were obtained from the databank of the investigation, ‘Lay and professional care in prematurity: cultural factors related to pregnancy and the post-natal period’, which was registered in the Investigation Committee of the Nursing School of the Federal University of Rio Grande do Sul and approved by the Investigations Ethical Committee of the Municipal Authority of Porto Alegre, appearing under the registration number 001.039956.11.3. The data analysis was founded in reference to Thematic Analysis and Patterns, composing of two topics: complications resulting from late prematurity and repercussions on growth and development. The first topic showed that the resulting complications of late prematurity were related to congenital syphilis, low weight, jaundice, anemia, hypoglycemia and multiple births. This birth condition demanded specific care, reaffirming those late-preterm babies cannot be considered as full-term babies. The second topic, presented late prematurity as a factor that can compromise the growth and development of the child. From the knowledge of the birth conditions of these newborns the importance of developing protocols to draw attention to the health of late pre-term babies is highlighted, as well as the abilities of these professionals perform in this area to promote differentiated good quality of care for these babies and their families. El nacimiento de niños antes de completar las 37 semanas de edad gestacional, o sea, el nacimiento prematuro, constituye un evento de preocupación global. Los prematuros tardíos, aquellos nacidos entre 34 semanas y 36 semanas y seis días de gestación, representan un grupo significativo de prematuridad. Entre tanto, los recién nacidos pre-término tardíos no pueden ser considerados como recién nacidos cercanos al término, pues filosóficamente son inmaduros y debido a eso generan mayores problemas de internaciones hospitalarias y morbilidades. Esas consecuencias de prematuridad tardía generan un impacto en la salud pública. Debido a esto, el objetivo del presente estudio fue conocer las condiciones del nacimiento del recién nacido pre-término tardío. Se trata de un estudio cualitativo, de tipo exploratorio, cuya recolección de datos se realizó en tres unidades de Estrategia de Salud de la familia en el periodo de noviembre 2011 hasta diciembre 2012, en la ciudad de Porto Alegre, Rio Grande del Sur, con 13 informantes, madres de esos recién nacidos prematuros tardíos. Los datos utilizados en este estudio fueron obtenidos del Banco de datos de la investigación ‘El cuidado lego y profesional en la prematuridad: factores culturales relacionados al periodo gestacional y postnatal’, la cual tuvo registro en la comisión de investigación de la Escuela de Enfermería de la Universidad Federal de Rio Grande del Sur y aprobación del comité de ética en investigaciones de la Prefectura Municipal de Porto Alegre con opinión registrada bajo el número 001.039956.11.3. El análisis de datos fue fundamentado en el referencial del Análisis Temático y de Patrones, compuesto de dos temas: complicaciones decurrentes de la prematuridad tardía y repercusiones en el crecimiento y desenvolvimiento. El primer tema mostró que las repercusiones decurrentes de la prematuridad tardía fueron relacionadas con la sífilis congénita, el bajo peso, la ictericia, la anemia, la hipoglicemia y los partos múltiples. Esa condición de nacimiento exigió cuidados específicos, de esa forma reafirmó que los pre-término tardíos no pueden ser considerados bebés de término. El segundo tema presentó la prematuridad tardía como un factor que puede comprometer el crecimiento y el desenvolvimiento del niño. A partir del conocimiento de las condiciones de parto de esos recién nacidos, se resalta la importancia de desenvolver protocolos de atención a la salud del pre-término tardío, al igual que la capacitación de profesionales que actúan en este contexto para promover un cuidado diferenciado y de cualidad a esos bebés y a sus familias.

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Baños, López Núria. "Cervical consistency index and quantitative cervical texture analysis by ultrasound to predict spontaneous preterm birth." Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/666980.

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INTRODUCTION: Preterm birth (PTB) remains a major contributor to perinatal morbidity and mortality being the second leading cause of death in children under 5 years of age. The rate of spontaneous preterm birth (sPTB) still accounts for approximately 5%-12% in USA and in most developing countries. Cervical length (CL) <25 mm measured with transvaginal ultrasound at mid-gestation is a known risk factor for sPTB. However, its value for screening a whole pregnant population consisting mainly of women without risk factors for sPTB remains controversial because of the low sensitivity of short CL in low-risk women. MAIN OBJECTIVE: To improve the identification of women at increased risk of sPTB in low and high sPTB risk asymptomatic pregnancies during mid-gestation with two innovative transvaginal ultrasound techniques, the Cervical Consistency Index (CCI) and the Quantitative Cervical Texture Analysis (CTx). The CCI is an ultrasound measurement that aims to estimate cervical softness by measuring maximal tissue compressibility with a vaginal ultrasound probe. The CTx, extracts information from the speckle pattern of the ultrasound image and identifies the patterns associated with SPTB. METHODS: Articles 1 and 2 are prospective cohort studies that compare the predictive capacity of the ICC with that of the CL. Article 3 is a cross-sectional study that analyzes the cervical texture along a term gestation. Article 4 is a case-control study, in which a CTx-score is obtained, which is compared with the CL. RESULTS: STUDY 1. Mid-trimester sonographic cervical consistency index to predict spontaneous preterm birth in a low-risk population: The cervix was significantly shorter (median CL 39.8 mm vs. 36.2 mm, p=0.004) and the CCI was significantly lower (median 73.0% vs. 58.1%, p<0.001) in the sPTB group. The area under the ROC curve (AUC) for CCI with regard to predicting sPTB <37+0 weeks was 0.84 (95% CI 0.75-0.93) and that for CL 0.68 (95% CI 0.56-0.81), P = 0.03. STUDY 2. Mid-trimester sonographic cervical consistency index to predict spontaneous preterm birth in a high-risk population: The CCI (%) was significantly inferior in women who had a preterm delivery compared to the term group. CCI adjusted OR, 0.91 (95% CI, 0.83-0.99; P=0.03). The AUC of the CCI to predict sPTB <37+0 weeks was 0.73 (95% CI, 0.61-0.85) while that of CL was 0.51 (95% CI, 0.35-0.67), P=0.03. STUDY 3. Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age: The correlation between the gestational age at which the images were obtained and the estimated gestational age by quantitative analysis of the cervical texture was R=0.88. Ce STUDY 4. Quantitative analysis of the cervical texture by ultrasound in the mid-pregnancy is associated with spontaneous preterm birth: The median CTx-based score obtained was significantly lower in cases compared to controls. The CTx-based crude OR 0.31 (95% CI 0.17-0.56; P<0.001) vs. adjusted OR 0.37 (95% CI 0.19-0.64; P=0.001). The AUC for the CTx-based score to identify women delivering < 37+0 weeks was higher (0.77; 95% CI 0.66-0.87) than for CL (0.60; 95% CI 0.47-0.72), P=0.02. DISCUSSION: The CCI and CTx have the potential to improve the identification of women at increased risk of sPTB compared to CL. The large number of scenarios in which these tools could be applied have demonstrated their potential impact on the current management of a large number of pregnancies. Cervical assessment is required in a wide range of clinical situations and the main reason why it is not yet universally implemented is the limited performance of the current cervical assessment techniques. Therefore, it is a healthcare priority to develop sPTB predictive tools with sufficiently improved performance to be used as screening tools. INTRODUCCIÓN: El parto prematuro representa la segunda causa de morbimortalidad infantil a nivel mundial. Las estrategias actuales de detección de las mujeres con un riesgo aumentado de parto prematuro espontáneo (SPTB), han demostrado ser insuficientes y el desarrollo de nuevas herramientas predictivas es una prioridad en el campo de la medicina materno-fetal. OBJETIVOS: Mejorar la identificación de las mujeres con riesgo de SPTB en el segundo trimestre, evaluando dos nuevas herramientas ecográficas: el Índice de Consistencia Cervical (CCI) y el análisis cuantitativo de la textura cervical (CTx). MÉTODOS: El CCI, evalúa la máxima compresibilidad del cuello del útero. El CTx, extrae información del patrón de moteado de la imagen ecográfica e identifica los patrones asociados con SPTB. Los artículos 1 y 2, son estudios prospectivos de cohortes que comparan la capacidad predictiva del CCI con la de la CL. El artículo 3 es un estudio transversal que analiza la textura cervical a lo largo de una gestación a término. El artículo 4 es un estudio de casos y controles, en el cual se obtiene un CTx-score, que se compara con la CL. RESULTADOS: Las curvas ROC para la predicción de SPTB <37 y <34 semanas del CCI (0.84 y 0.73), son significativamente mejores que las de la CL (0.68 y 0.51). El CTx-score en los casos de SPTB es significativamente inferior que en los controles. La curva ROC del CTx-score es mejor en comparación con la de la CL (0.77 vs 0.60). CONCLUSIONES: Los artículos 1 y 2, demuestran que el CCI es mejor predictor de SPTB que la CL en poblaciones de bajo y alto riesgo de prematuridad. El artículo 3 demuestra que la CTx puede identificar cambios a lo largo de la gestación normal. El artículo 4 demuestra que el CTx-score obtenido en casos y controles, se relaciona con el SPTB.

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Yetman, Marion. "Becoming a mother in the NICU : a grounded theory study /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0031/MQ47492.pdf.

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McCray, James. "Describing and Differentiating Pain Responses from Non-pain Responses in Low Birth Weight Pre-term Infants." University of Toledo Health Science Campus / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=mco1092411459.

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Roy-Matton, Naomé. "Profil psychosocial et issues de grossesse des femmes enceintes de l'Estrie une étude pilote prospective." Mémoire, Université de Sherbrooke, 2008. http://savoirs.usherbrooke.ca/handle/11143/3951.

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Objectif : Établir le profil psychosocial des femmes enceintes de l'Estrie et évaluer de façon préliminaire si ce profil diffère parmi les grossesses avec issues défavorables. Méthode. Cohorte prospective de 120 femmes enceintes, rencontrées à deux reprises (10-20 et 25-30 semaines), entre août 2004 et mars 2006. Il s'agit d'un questionnaire auto-administré des données démographiques, anthropométriques, des facteurs de risques biomédicaux, ainsi qu'un profil psychosocial comportant 6 dimensions: stress psychologique perçu, ennuis quotidiens, détresse psychologique, locus de contrôle, soutien social, traumatismes dans l'enfance. Les paramètres psychosociaux sont présentés en moyennes ou pourcentages. Le profil psychosocial est comparé entre les grossesses normales et anormales avec les tests t de Student ou le test de Mann Whitney, lorsque approprié. Résultats. Trente trois grossesses (27,5%) ont présenté des issues défavorables (prématurité, restriction de croissance intra-utérine, hypertension gestationnelle, diabète gestationnel). L'analyse du profil psychosocial révèle un score de stress psychologique perçu plus élevé entre 10-20 semaines chez les femmes avec issues défavorables de grossesse (score : 34,2 « 12,3 ; P < 0,01) et chez les femmes avec prématurité (score : 36,1 « 11,2 ; P < 0,02) comparativement à celui des femmes avec grossesses normales (score : 28,6 « 9,6). Par ailleurs, les 5 autres dimensions ne semblaient pas différentes selon les issues de grossesse. Conclusion. Ces résultats préliminaires suggèrent une piste possible reliant la perception de stress maternel durant la grossesse et certaines issues défavorables de grossesse, dont l'accouchement prématuré.

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Cassiano, Rafaela Guilherme Monte. "Avaliação do temperamento em crianças: metodologia combinada de heterorrelato e observação do comportamento em situação de interação." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/59/59137/tde-06052013-102556/.

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A abordagem de Rothbart demonstra a importância do temperamento infantil na formação da personalidade e no interjogo entre fatores de risco e mecanismos de proteção ao desenvolvimento. Novas questões surgiram sobre os instrumentos de avaliação do temperamento nessa abordagem com relação à necessidade de uma visão mais abrangente do comportamento da criança e de estudos que focalizem a avaliação em amostras vulneráveis. A presente pesquisa teve por objetivo elaborar e testar a aplicabilidade de um procedimento combinado de avaliação do temperamento de crianças, por meio de questionário e de observação da interação mãe-criança, em amostras de crianças com desenvolvimento típico e desenvolvimento em risco devido à prematuridade. A amostra incluiu 10 crianças, sendo cinco crianças nascidas a termo e cinco crianças nascidas pré-termo, com idade entre 18 a 36 meses, e suas respectivas mães. A coleta de dados foi realizada no domicílio da criança onde foram aplicados com a mãe: o The Early Childhood Behavior Questionnaire e um questionário semi-estruturado sobre o temperamento da criança. Além disso, foi realizada uma observação sistemática em situação lúdica-livre da interação mãe-criança. A análise de dados da interação mãe-criança incluiu três sistemas que avaliaram: a) inicio dos episódios de contato; b) dinâmica das atividades; c) natureza das atividades. Além de duas escalas que avaliaram: a) responsividade materna, sincronia, ritmo, intensidade, tom emocional e direcionamento da interação; b) entusiasmo, intrusividade, qualidade das direções, raiva ou frustração e qualidade do cuidado materno e oposicionismo da criança. As verbalizações das díades também foram analisadas. As observações foram analisadas por meio do programa Observer XT e os dados analisados em termos de estatística descritiva por meio do SPSS (versão 19.0). Os resultados mostraram que os escores dos fatores do temperamento das crianças nascidas a termo apresentaram a seguinte ordem crescente: Afeto Negativo, Extroversão e Controle com Esforço. Por outro lado, as crianças nascidas pré-termo apresentaram a seguinte ordem crescente: Afeto Negativo, Controle com Esforço e Extroversão. Com relação à interação mãe-criança, os intercâmbios iniciados pela mãe foram mais frequentes nos dois grupos. A atividade compartilhada pela díade obteve maior frequência nas díades a termo, enquanto que as atividades realizadas pela criança com participação parcial da mãe foi mais frequente no grupo de crianças prematuras em relação às demais dinâmicas. As mães das crianças nascidas a termo foram mais responsivas do que as mães das crianças prematuras. Houve maior intrusividade materna, raiva ou frustração e oposicionismo da criança nas díades de criança prematuras em relação às díades a termo. Os sistemas utilizados na avaliação da interação permitiram a análise dos comportamentos interativos das díades, além de mostrar as especificidades associadas ao temperamento da criança e comportamento materno. O modelo combinado de avaliação do temperamento foi capaz de identificar diferenças no padrão de comportamento das crianças com desenvolvimento típico e com a presença do risco biológico da prematuridade. A observação da interação mãe-criança foi fundamental para verificar a interação entre o temperamento da criança e os comportamentos maternos e consequentemente observar possíveis vieses no relato materno sobre o temperamento da criança. Rothbart\'s approach demonstrates the importance of child temperament in shaping the personality and the interplay between risk factors and protective mechanisms to development. New questions have arisen about the assessment temperament instruments in this approach concerning the need for a more comprehensive view of the child\'s behavior and the importance of studies that focus on the evaluation of vulnerable samples. The present study aimed to develop and test the applicability of a combined procedure for evaluating toddler temperament through questionnaire and observation of mother-child interaction in samples of children with typical development and development at risk concerning the prematurity. The sample included 10 toddlers, five toddlers were born full-term and five preterm toddlers, aged 18 to 36 months, and their mothers. Data collection was conducted in the child\'s home where were applied with the mothers: The Early Childhood Behavior Questionnaire and a semi-structured questionnaire about the child\'s temperament. Besides, a systematic observation in play-free mother-child interaction was performed. Data analysis of mother-child interaction included three systems that assessed: a) the early episodes of contact; b) dynamic activities; c) the nature of the activities. Besides two scales that assessed: a) maternal responsiveness, timing, rhythm, intensity, emotional tone, and direction of the interaction, b) enthusiasm, intrusiveness, quality of directions, anger or frustration, and quality of maternal care and oppositional defiant child. The verbalizations of the dyads were also analyzed. The observations were analyzed using the software Observer XT and analyzed in terms of descriptive statistics using SPSS (version 19.0). The results showed that the scores on temperament factors of the full-term toddlers presented the increasing following order: Negative Affect, Extroversion and Effortful Control. On the other hand, toddlers born preterm showed the increasing following order: Negative Affect, Effortful Control and Extroversion. Concerning the mother-child interaction, the episodes of contact initiated by the mother were predominant in both groups. The activity shared by the dyad was more frequently in full-term toddlers, while the activities performed by the toddler\'s with partial participation of mother was more frequent in the group of premature toddlers in relation to other dynamics. The mothers of full-term toddlers were more responsive than mothers of premature toddlers. The premature toddlers dyads had more intrusiveness mothers, anger or frustration and oppositional defiant toddlers than the full-term toddlers dyads. Systems used to evaluate the interaction allowed the analysis of interactive behaviors of dyads, besides showing the specifics associated with the toddler\'s temperament and maternal behavior. The combined model of temperament assessment was able to identify differences in the pattern of toddlers\' behavior with typical development and with the presence of biological risk of prematurity. The observation of mother-child interaction was essential to verify the interaction between the toddler\'s temperament and maternal behaviors and thereby observe possible biases in maternal report of child temperament.

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HAUCK, JULIE SWEENEY. "IDENTIFYING POSSIBLE SPEECH AND LANGUAGE DELAYS IN CHILDREN BORN PREMATURELY: ARE PARENTS INFORMED?" University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin997704793.

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Doverhag, Christina. "Inflammatory mechanisms in experimental neonatal brain injury and in a clinical study of preterm birth : involvement of galectin-3 and free radical formation /." Göteborg : Perinatal Center, Department of Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 2010. http://hdl.handle.net/2077/21479.

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Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2010. Härtill 3 uppsatser. På spikbladet med titel : Inflammation in experimental neonatal brain injury and in a clinical study of preterm birth : involvement of galectin-3 and free radical formation.

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