IL-1 beta and IL-3-like activity in preterm infants.

The capacity of peripheral blood mononuclear cells (PBMC) of preterm neonates to release IL-1 beta and IL-3-like activity (IL-3-LA) has been investigated. In the present study it was found that this capacity is significantly lower than that of their mothers and of control adults. In addition, the results showed that preterm serum has a lower stimulatory effect on IL-1 beta production and an inhibitory effect on IL-3-LA secretion by PBMC of adult controls, in comparison with maternal and adult sera. These findings suggest an additional feedback mechanism for control of haematopoiesis in premature neonates. It is possible that the lower production of IL-1 beta and IL-3-LA may be involved in the increased susceptibility to infections of preterm newborns.

Sialic acid level in maternal and neonatal lymphocytes and sera correlated to birth order and sex of the neonate.

Sialic acid (N-acetylneuraminic acid) was determined 1 h after normal term deliveries on peripheral blood lymphocytes from 42 mother-neonate pairs and in 29 maternal and neonatal sera. Results were evaluated according to maternal parity and sex of the neonate. The cases were divided into two groups: primiparae, and secundi- and multiparae. In primiparae the sialic acid level on lymphocytes from male neonates and from their mothers was by 23-30% decreased as compared to female neonatal and maternal cells. In the higher parity group, a significantly increased sialic acid level was found on lymphocytes from male as compared to female neonates, and maternal serum sialic acid concentration, unrelated to the newborns' sex, was by 17-20% increased as compared to primiparae. The results suggest that with increasing parity higher levels of sialic acid on male neonatal cells may possibly contribute to mask fetal male-specific histocompatibility antigens. Increased sialic acid levels in maternal sera from secundi- and multiparae suggest its possible contribution to an increased serum blocking effect.

Beta glucuronidase and hyperbilirubinaemia in breast fed infants of diabetic mothers.

A prospective study was performed comparing bilirubin concentrations in 10 breast fed term infants of diabetic mothers (IDM) to those of 10 breast fed normal term infants. The beta-glucuronidase concentrations in serum and breast milk were assayed in the respective mothers. Significantly higher bilirubin concentrations were noted in the IDM group. Serum and breast milk beta-glucuronidase concentrations were significantly higher in diabetic mothers as compared with those of non-diabetic mothers. We suggest that the high concentration of beta-glucuronidase in breast milk of diabetic mothers is an additional important cause leading to hyperbilirubinaemia in their breast fed infants.

Normal ranges of hip motion of preterm infants.

The hip motion of 158 preterm infants with gestational ages between 25 and 36 weeks was measured. The results of this study, compared with those of previous studies of term infants, show that hip motion changes with increasing gestational age above 25 to 27 weeks.

Expression of transferrin receptor on human maternal and neonatal peripheral blood lymphocytes.

The levels of peripheral blood lymphocytes expressing the receptor for transferrin (TSR) on untreated and phytohemagglutinin (PHA)-stimulated cell samples from maternal-neonate pairs were evaluated 4-12 h postpartum. Significantly increased levels of TSR+ cells were observed on fresh, unstimulated neonatal and maternal cells, as compared to control cells from young adult males and females, and the values seemed to correlate with the sex of the neonate and with birth order. The level of TSR+ cells in culture was found to be increased on neonatal cells and decreased on maternal cells.

Changes in maternal and newborn lymphocyte reactivity in reciprocal mixed lymphocyte cultures during the postpartum period.

Reciprocal one-way mixed mother-newborn lymphocyte cultures (MMNLC) containing alternatively maternal or newborn responding (R) or stimulating (S) cells were investigated in both directions in primiparae at three different times: a few hours after delivery, and at 4 and at 16 weeks. Cultures were grown in the presence of maternal and pooled control serum prepared from the blood of five to eight unrelated healthy donors. Four weeks after delivery in maternal and in control serum a significant increase in MMNLC reactivity could be observed, which disappeared at 16 weeks when a pronounced decline in MMNLC values in both directions was found. The suppressive effect of maternal serum was more pronounced at delivery, still evident 4 weeks later, and insignificant after 16 weeks. The results of this study suggest that 4 weeks after delivery, maternal sensitization to fetal histocompatibility antigens can be detected in primiparae with MMNLC; and that 16 weeks later, this was no longer detectable with the same test.

Time trends (1978-86) of anencephaly and spina bifida in four hospitals affiliated with the International Clearinghouse: a warning.

The prevalence and time trends of spina bifida and anencephaly in the central area of Israel have been studied using data derived from four hospitals affiliated with the International Clearinghouse for Birth Defects Monitoring Systems. Spina bifida rates show a continuous increase from 1978 (1.1/10,000) to 1986 (7.4/10,000) with a peak in 1984 (7-fold increase compared with 1978). The logistic regression analysis of proportion of cases revealed a significant linear trend over time (P less than 0.005). Anencephaly rates increased from 1978 to 1981 but later decreased continuously until 1986 when the prevalence returned to the initial level of 1978. This time trend of spina bifida may represent a real alarm; the implications of this observation are discussed.

Role of the newborn's sex in mixed maternal-newborn lymphocyte culture reactivity.

One-way-stimulated mixed mother-newborn lymphocyte cultures (MMNLC) from male and female newborns were evaluated and compared shortly after delivery. Newborn sex-correlated differences were observed in the strength of the MMNLC reactivity with responding maternal as well as newborn cells. The reactivity of MMNLC with responding maternal cells from male as compared to female newborns was significantly less inhibited in maternal and newborn serum. The inhibitory effect of maternal serum on maternal and male newborn lymphocytes in MMNLC seems to be correlated to the sex of the previous child delivered and was significantly lower when the present as well as the previous baby were of the same sex, e.g. 2 boys. The results suggest that fetal-male-specific Y-chromosome-correlated histocompatibility antigens may specifically influence the maternal immune response to her fetus.

Lymphocyte subpopulations in mother and newborn: correlation with sex of the newborn and number of pregnancies.

T cell subsets were defined with monoclonal antibodies of the OKT series, OKT3, OKT4 and OKT8, in 23 male and 22 female newborns and in their mothers 4-10 h after delivery. The data were compared and statistically evaluated between mother and newborn, between male and female newborns as well as between parity groups. The results indicate that the distribution of OKT4 and OKT8+ cells is different in mother and newborn and a significantly increased percentage of OKT4+ cells and a significantly decreased percentage of OKT3+ cells was observed in newborns as compared to their mothers after the first and second delivery. For maternal cells from male as compared to female newborns the percentage of OKT4+ was significantly decreased after the second delivery. OKT8+ cells in the mother were significantly decreased after the second as well as after three or more deliveries of male as compared to female newborns. With increasing parity the percentage of OKT3+, OKT4+ and OKT8+ cells decreased slowly for both sexes and the difference was significant between primi- and multiparae. The present findings suggest a possible role of the newborn sex and of parity in the distribution of specific T cell subsets in mother and newborn shortly after delivery.

Teratoma of the mastoid region in a newborn.

Teratomas are congenital tumours arising from pluripotent cells and usually consisting of tissue arising from all 3 embryonic germ layers. Teratomas are quite uncommon in head and neck sites and to date only 150 such cases have been reported. A rare case of teratoma of the mastoid region in a newborn is reported. The method of diagnosis and treatment are discussed and the literature is reviewed.

X-ray microanalysis of the fingernails in term and preterm infants.

The element content of the fingernails of 10 term and 14 preterm infants, clipped for the first time after delivery, was determined by x-ray microanalysis. The results showed a decrease in sulfur and aluminum, and a higher chlorine content in term infants in comparison with preterm ones, the difference being statistically significant. Sodium, potassium, calcium, and zinc content did not differ in the two groups. Copper, iron, magnesium, aluminum, and phosphorus were detected in trace amounts only. Cobalt was not detected in the fingernails of newborns in either group. The elevated content of aluminum in the fingernails of preterm infants may be a clue to the osteopenia observed in these infants.

Breast milk jaundice in preterm infants.

A retrospective study was performed comparing bilirubin levels in 40 preterm newborns with uncomplicated courses fed a combination of premature breast milk and formula to those of 60 comparable preterm newborns fed formula only. A significantly higher bilirubin level was noted in the group fed the combined diet on the 6th day of life and on the day of discharge. Seventy-six and seven tenths percent of the preterm infants fed breast milk and formula met the criteria for phototherapy, whereas only 45 percent were treated in the group fed formula alone. Our findings indicate that premature breast milk might cause early and late increase in bilirubin levels in healthy preterm newborns.

Fracture of the clavicle in the newborn. An ultrasound diagnosis.

Forty-one cases of clavicle fracture in newborn babies were examined by both radiographic and ultrasonic methods. No substantial difference has been found between these two modalities. It is suggested that ultrasound should be the procedure of choice in the diagnosis of clavicle fracture. This is especially true in those cases where impaired movement of the arm is the only clinical sign.

In vivo and in vitro effects of theophylline on the peripheral blood mononuclear cells from preterm infants.

The in vivo effect of aminophylline (theophylline ethylenediamine) on cAMP levels and the mitogenic response of peripheral blood mononuclear cells (PBMC) from preterm infants were investigated. Increased cAMP levels and reduced response of these cells to concanavalin A (Con A) were found in preterm newborns who received intravenous aminophylline. No inhibitory effect of the drug on phytohemagglutinin (PHA)-induced proliferation was observed. cAMP levels of PBMC derived from preterm infants were significantly lower than those of term newborns. The in vitro effect of theophylline on the mitogenic response of PBMC from adults, term and preterm infants was also compared. It was found that PBMC from adults were significantly more sensitive to the inhibitory effect of theophylline on Con A-induced proliferation than were PBMC from either term or preterm infants, whereas the effect of the drug on the mitogenic response to PHA was similar in the three groups. These data suggest differences either in the sensitivity to increased cAMP concentration between PBMC from adults and newborns or in their lymphocyte subpopulations.

An infant with multiple deformations born to a myasthenic mother.

An infant with multiple deformations born to a mother with untreated myasthenia gravis presented with arthrogryposis multiplex, craniofacial dysmorphism, kyphoscoliosis of the thoraco-lumbar spine, severe hypotonia, absence of the sucking reflex, and other neurological deficits. The neurological state of the infant supported the diagnosis of congenital myasthenia gravis, but the negative Tensilon test and the lack of clinical improvement after prolonged Mestinon treatment ruled out this diagnosis. We believe that the multiple deformations and reduced fetal movements are related to the maternal myasthenic environment associated with mild polyhydramnion.

Difference in the placental ferritin levels measured by a specific monoclonal antibody enzymoassay in preterm and term delivery.

The use of a new monoclonal antibody (MoAb) enzymoassay for the specific measurement of placental ferritin (PLF) enabled it to be quantitatively determined in the sera of pregnant women, women at full-term and preterm delivery, and in their newborns. High levels of PLF were measured in the sera of pregnant women at 17 weeks of gestation up to full-term delivery as compared with normal adult women who mostly lack PLF. The level of PLF in the serum was irrespective of the total ferritin level. In full-term newborns, PLF concentration was lower than that found in their mothers although it increased compared to healthy adults. It was further found that in the blood of women who delivered at 29-36 weeks, PLF was undetected or was very low. Accordingly their preterm infants also exhibited very low or undetectable PLF in their serum. These results suggest the possible use of PLF as a prognostic indicator in pregnancy.