Sexual steroid levels and their clinical significance in the early neonatal age.

Serum concentrations of progesterone (P) and estradiol (E2) in the umbilical cord blood were measured in healthy full term newborn infants and were related to the serum levels of indirect bilirubin at 72 hr postpartum in the same group of neonates. In those having higher concentration of bilirubin than 204 mumol/l at 72 hr after birth, cord P and E2 levels were significantly higher than in the rest of the group. Furthermore, strong correlation was found between serum levels of progesterone at 24 hr after birth and that of bilirubin at 72 hr postpartum in the same subjects. According to the authors' conclusion serum progesterone levels 24 hours after birth prognosticate the occurrence of neonatal hyperbilirubinaemia.

Antenatal corticosteroid increases serum ceruloplasmin activity in premature neonates.

Serum ceruloplasmin activity in full term and premature neonates was measured on the first day of life. Preterm newborns were born more than 24 hours after antenatal corticosteroid treatment, had enzyme activity equivalent to that of the full term babies. Little or no ceruloplasmin activity was found in those prematures who were born without steroid prophylaxis. Highly significant correlation was observed between the initial ceruloplasmin activity and the morbidity and mortality of respiratory distress syndrome.

Beta-adrenergic sensitivity--imminent premature delivery.

In order to determine individual sensitivity, 0.4 microgram/kg/min of fenoterol was in fused to 95 pregnant women prior to institution of tocolytic treatment against premature delivery. Changes of maternal heart rate during this test was recorded and analysed retrospectively. The following conclusions were drawn: Even in a carefully prescreened pregnant population, 4.2% of gravidas proved to be hypersensitive to fenoterol: the irreversible commencement of premature delivery was accompanied by a significant decrease of beta sensitivity: to avoid complications due to tocolytic therapy, it is necessary to stop sympathomimetic medication in a stepwise manner: there was no pathologic consequences of fenoterol treatment to the newborn babies.

Relationship of maternal and newborn (cord) serum ferritin concentrations measured by immunoradiometry.

Serum ferritin concentration was determined by immunoradiometry in venous blood samples of 45 pregnant women at term, in their babies' cord blood samples, and blood specimens obtained from 43 infants aged 3-12 months. The concentration of ferritin was higher in cord serum than in respective maternal samples and infant specimens. Low values were found in more than half of the maternal venous samples. Iron stores of newborns delivered by mothers with low serum ferritin concentration were lower than in newborns of mothers having normal ferritin levels. Serum ferritin measurement is a sensitive method to determine iron deficiency in pregnancy.

Effect of oxytocin infusion during labor: indocyanin green elimination and serum bilirubin levels.

The elimination of indocyanin green (IGG) in selected mature newborn babies (n = 50) was investigated on the first postnatal day. The IGG dose was 2 mg/kg body weight. The half time (t1/2), the elimination constant (K2), the dye distribution volume (ml/kg), as well as the level of serum indirect bilirubin on the third postnatal day were measured and calculated. Healthy, mature newborns from spontaneous labor served as controls (n = 14): the two study groups consisted of either growth-retarded (n = 8) or acidotic (n = 8) neonates. According to the management of deliveries, they were spontaneous, assisted by oxytocin drop infusion (n = 10) or under lumbal peridural anaesthesia + oxytocin drop infusion (n = 8). In the acidotic neonates the elimination constant was significantly lower and the half time significantly longer. In the growth retarded newborn babies the difference was not significant. The increase of the level of indirect bilirubin in serum appearing in the acidotic group on the third postnatal day was significantly greater.

Comparative study of transition temperature in adult and newborn human red blood cells.

Hypotonic haemolysis of newborn and adult human red blood cells (RBC) is more intensive at 4 than at 37 degrees C. Newborn RBC are more resistant to the decrease of temperature than adult RBC. Transition temperature of the RBC membrane can well be determined by illustrating osmotic haemolysis as a function of temperature. This parameter characterizes well the microviscosity of the membrane. The inclination point of Arrhenius curves representing transition temperature occurred always at 25 degrees C both in the case of adult and newborn RBC. The similarity of the transition temperature indicates the similarity of membrane microviscosity of newborn and adult human RBC.

[Variation in cellular immunity - its bearings on effectiveness of steroids used during labour (author's transl)]. / Veränderung der zellulären Immunität auf die Wirkung der während der Geburt verwendeten Steroide.

Thirty-five mothers and their newborns were examined for immunosuppressive effects of dexamethasone administered during labour (0.5 mg/kg body weight). Decline of both active and total t-cells was recorded from the mothers (p < 0.5; p < 0.01). No deviation was recordable from b-cells. The ratio of t-cells, b-cells, and O-cells in premature and full-term newborns was reduced to something below the values obtained from control groups. The difference, however, was not significant.

[Studies into aetiology of hyaline membrane disease (author's transl)]. / Untersuchungen zur Atiologie des Hyalinmembran-Syndroms.

The courses of gestation were re-examined of 171 newborns who had died of hyaline membrane disease. Premature births accounted for 91.81 per cent of the cases reviewed, while 73.24 per cent had undergone gestation between 28 and 32 weeks of pregnancy. Premature placental detachment, hydramnion, and twin pregnancy were among the major factors contributive to gestational complications. Perinatal asphyxia played a substantive role in 53.21 per cent of all cases under review. In newborns delivered on term the development of RDS was in almost all cases attributable to acidosis. Early complications were analysed for newborns involved in steroid prophylaxis. The frequency of cerebral haemorrhage was nearly identical with findings recorded from a control group. A significant difference was not even recorded from cases of inflammatory complications.

D-penicillamine therapy of neonatal jaundice: comparison with phototherapy.

A total 330 newborns suffering from haemolytic disease of the newborn and hyperbilirubinaemia was treated with D-penicillamine. The therapy resulted in a significant decrease in the frequency of exchange transfusions and of high serum bilirubin levels among preterm and fullterm babies with or without sensitization. Concerning the drug's mechanism of action, reduction of the bilirubin level is achieved by means of the copper stored in the liver. The intravenous route is suggested for application of the drug. In preterm infants D-penicillamine treatment proved more effective than phototherapy.

Trace elements in the serum of mothers and their children.

The serum copper, zinc and iron levels, iron binding capacity and coeruloplasmin activity were determined in 28 maternal and cord bloods and in 50 infants and children. At the end of the gestation period the serum copper level increased, iron concentration remained unchanged while the level of zinc decreased significantly as compared to the values for healthy, non-pregnant women. Iron and zinc concentrations at birth were significantly higher in the newborn than in the mother, whereas the copper level amounted only to 20% of the maternal value. Subsequently, the copper level increased to reach the lower limit of healthy adults in the first to second year of life. The remarkably high neonatal zinc concentration fell significantly in the first 2 to 4 weeks of life and decreases to the normal adult level at one year of age. The changes in the trace element concentrations may be due to quantitative differences in the transporting proteins, variations in placental permeability and in the function of transfer proteins.

Immunoglobulin E in the sera of infants and children.

The serum IgE level has been studied from birth up to 14 years of age. The mean serum IgE concentration was found to be correlated with age. Parallel measurements in cord blood and maternal blood yielded a mean of 25 I.U./ml (range, 0--90 I.U.) for the former and one of 124 I.U./ml (range, 50-600 I.U.) for the latter. The normal IgE level ranged from 20 to 100 I.U./ml in infants and from 100 to 200 I.U./ml in children, but even values of 400 to 600 I.U. did not necessarily reflect a pathological condition. In the majority of patients with eczema, urticaria and spastic bronchitis, high IgE levels were measured. The highest individual and mean values were obtained in children harbouring intestinal helminths, though a normal IgE level also occurred in such patients. In coeliac disease the values were within normal limits.