Rate of weight gain in very-low birth weight Puerto Rican neonates

BACKGROUND: Small for gestational age neonates have a higher risk of growth delay. The purpose of the study is to determine if there are differences in their early weight gain patterns that persist after adjusting for confounding variables. METHODS: Two-hundred sixteen neonates born between 1999 and 2003 were included. The group for analysis was derived by matching all the SGA infants with AGA infants by sex, year of birth, and birth weight. The period of observation was from birth to date of discharge. Weight gain rate was defined as grams gained per kilogram of birth weight per day. Two sample T-test was used to determine the difference in growth rate between the groups. Simple regression was used to establish the effect of morbidities on weight gain rate. RESULTS: The total mean birth weight was 1105 g (+/- 223 g), the mean gestational age was 30 weeks (+/- 2.7 weeks), and the mean weight gain rate was 13.4 g/kg/d (+/- 6.8 g/kg/d). The mean weight gain rate for the adequate for gestational age group was lower (11.9 g/kg/d +/- 7.6g versus 14.9 g/kg/d +/- 5.5 g) (P < 0.001). When all variables were analyzed using the lineal regression model, only having a low APGAR score (P = 0.02) and being small for gestational age (P = 0.0004) were significant. CONCLUSIONS: We conclude that the growth patterns of very low birth weight neonates are different based on the adequacy of their birth weight, and that the disparity in growth rate is not explained by the differences in the incidence of morbidities that affect growth.

Respiratory syncytial virus-related bronchiolitis in Puerto Rico

BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of respiratory tract disease in infants and young children. Immunoprophylaxis is available for high-risk infants. This study reviews infants with bronchiolitis at three primary care hospitals to describe the epidemiology of RSV infection in Puerto Rico. METHODS: We analyzed data from 2 hospitals by obtaining the number of infants diagnosed with bronchiolitis and estimating the percentage of cases due to RSV. A third hospital included patients with confirmed RSV infection. RESULTS: There were 4,557 patients in the study. RSV infection occurred throughout the year. Data shows a progressive decrease in RSV-positive infections. CONCLUSIONS: Data confirms year-round incidence of RSV in Puerto Rico. A standardized surveillance system in Puerto Rico is imperative to determine RSV epidemiology. The decrease in positive RSV infections may be due to the introduction of immunoprophylaxis to high-risk patients.

Effect of prenatal T4 treatment in neonatal morbidity: preliminary findings

We report our experience with the use of intra-amniotic thyroxine to accelerate fetal maturation in preterm delivered infants. One hundred and fourteen infants who had received 500 micrograms of thyroxine weekly prenatally until an L/S ratio greater or equal to 2.0 was achieved, were compared to 113 premature infants who had not been given thyroxine or steroids prenatally. After stratification by weight, the relative incidence of respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC) and intraventricular hemorrhage (IVH) were compared. A decrease in the incidence of RDS was observed in the infants with birth weight between 1000 and 1500 g who had received more than one dose of intra-amniotic thyroxine. No difference in the incidence of RDS was observed in infants with birth weight of less than 1000 g or over 1500 g. One dose of thyroxine had no effect in decreasing the incidence of RDS, PDA, NEC, and IVH in any of the groups. We conclude intra-amniotic thyroxine seems to decreases the incidence of RDS in very low birth weight infants

Abnormal hemoglobins detected in screening of Puerto Rican population.

Cinco mil cuatrocientos setenta y tres personas, incluyendo neonatos, adolescentes, mujeres embarazadas y varones adultos de San Juan y pueblos cercanos fueron examinados para detectar hemoglobinopatias por electroforesis en 1977-78. Se encontraron 210 casos (3.90 por ciento) de hemoglobinas anormales, incluyendo 190 (3.5 por ciento) de Hb S y 20 (0.4 por ciento) de Hb C. La prevalencia de Hb S y C entre los adolescentes del area de San Juan fue de 4.2 por ciento. Pero la prevalencia en adolescentes del pueblo de Loiza fue de 8.7 por ciento. Los datos indican que la prevalencia de Hb AS y AC en la poblacion cercana, excluyendo a Loiza, es de 3.1 por ciento, la cual es claramente distinta a la prevalencia en la comunidad de Loiza (8.7 por ciento). El hallazgo de 210 casos de hemoglobinas anormales incluyendo dos de Hb SS entre 5,473 personas cernidas y 177 de Hb AS entre 512 personas referidas indican que hay una necesidad para continuar proveyendo educacion deteccion y consejeria sobre hemoglobinopatias en la poblacion puertorriquena