Infrared thermography in newborns: the first hour after birth.

OBJECTIVE: It was the aim of this study to investigate the surface temperature in newborns within the first hour after delivery. Furthermore, the influence of different environmental conditions with regard to surface temperature was documented. METHODS: Body surface temperature was recorded under several environmental conditions by use of infrared thermography. 42 newborns, all delivered at term and with weight appropriate for date, were investigated under controlled conditions. RESULTS: The surface temperature immediately after birth shows a uniform picture of the whole body; however, it is significantly lower than the core temperature. Soon after birth, peripheral sites become cooler whereas a constant temperature is maintained at the trunk. Bathing in warm water again leads to a more even temperature profile. Radiant heaters and skin-to-skin contact with the mother are both effective methods to prevent heat loss in neonates. CONCLUSIONS: Infrared thermography is a simple and reliable tool for the measurement of skin temperature profiles in neonates. Without the need of direct skin contact, it may be helpful for optimizing environmental conditions at delivery suites and neonatal intensive-care units.

Human cytomegalovirus load in various body fluids of congenitally infected newborns.

BACKGROUND: Congenital human cytomegalovirus (hCMV) infection is the most common intrauterine viral disease in western countries. Little is known about hCMV virus load in various body fluids of congenitally infected children. OBJECTIVES: To determine virus load in various body fluids. To assess the impact of hCMV virus load to predict the outcome of congenitally infected newborns and efficacy of antiviral therapy. STUDY DESIGN: Cord vein blood, urine, and cerebrospinal fluid (CSF) of congenitally hCMV-infected children were investigated and hCMV load was determined by quantitative polymerase chain reaction (PCR). Fourteen of 30 children had clinical symptoms and/or pathological laboratory results and 16 had none of them at birth. Ganciclovir was given to 21 children (10 of them with symptoms, 11 of them without symptoms). Viral load before and after therapy was measured. RESULTS: There was a significant difference between median virus load in cord vein blood (2.3 x 10(3) copies per ml) and in urine (4.2 x 10(5) copies per ml; P<0.001) at diagnosis of congenital hCMV infection. At that time, no significant difference of virus load was found between the various groups (symptomatic vs. asymptomatic; with therapy vs. without therapy), neither in serum nor in urine. Comparing median virus load in urine before (3.0 x 10(5) copies per ml) and after therapy (2.0 x 10(3) copies per ml), a significant decrease was observed (P<0.001). Virus load in CSF was always found to be less than 400 copies per ml, and only those children with symptoms showed a positive result. CONCLUSION: At birth, virus load in urine seems to be superior to that in cord vein blood to reflect the situation in the organs precisely. As predicting factor for the risk of developing symptoms, only hCMV detection in the CSF appears to be promising. The significant decrease of virus load in children with therapy may reflect the efficacy of therapy. Studies including a greater number of children are needed.