Diagnosis of iron deficiency: mean corpuscular hemoglobin (MCH) as a predictor of iron deficiency in infants.

Hematologic variables were measured in 240 apparently healthy infants ranging from 1-12 months of age attending a well baby clinic. There were 20 infants for each month of age. Hematologic parameters were measured in each infant by Coulter Counter Model S. Serum iron, total iron binding capacity, free erythrocyte protoporphyrin (FEP) and serum ferritin levels were measured in most infants. Their weights together with their serum iron, total iron binding capacity, and serum ferritin were judged to be independent variables of iron status, whereas the hematologic variables were considered to be response variables indicative of iron status. The correlation coefficients among these variables, after excluding redundant variables and transforming to logarithms, were computed. Canonical correlation analysis was applied to the matrix of correlation coefficients to yield the linear function of the independent variables most highly correlated with a linear function of the response variables. The linear function of the response variables was found to be well approximated by the logarithm of the mean corpuscular haemoglobin, which was highly correlated with each of the independent variables.

Chloramphenicol levels in cerebrospinal fluid in meningitis.

Chloramphenicol was found to cross the blood-brain barrier into the cerebrospinal fluid of children with pyogenic meningitis effectively both at days 2 and 10 of therapy. It is recommended as the drug of choice in the treatment of children with Haemophilus influenzae meningitis.

The site of placental insertion and fetal growth.

A simple method of examining the placenta and its attached membranes after vaginal delivery was used to assess the site of placental insertion in utero. The placental site was determined in 187 term infants. Birth weight and length were not influenced by the position of the placenta, but infants with placentas situated at the fundus had significantly larger heads. Infants with low-lying placentas were at no growth disadvantage.

Infant size and relative placental weight at birth.

In 811 unselected term infants, the ratios of placental weight to (a) body weight, (b) head circumference and (c) body length were assessed as possible determinants of infant size at birth. Unlike the placentofetal weight ratio, the ratio of placental weight to either head circumference of body length proved an excellent predictor of infant size, ponderal index and skinfold thickness. Infants with a relatively small placenta at term were growth-retarded when compared to infants with relatively large placentas. It is suggested that the ratio of placental weight to either head circumference or body length at term reflects not only relative placental size but also the functional capacity of the placenta to meet the nutritional demands of the fetus.

The bacteriological environment of preterm infants.

Bacteria were cultured in the intra-uterine environment in 72% of 56 preterm infants studied. Placental tissue yielded the greatest number of positive cultures, with anaerobic organisms accounting for one-quater of these. Bacterial growth was obtained in the specimens of 4 out of 5 infants who died, and in 5 clinically infected babies. The incidence of bacterial infection was not increased by rupture of membranes for more than 18 hours, by amniocentesis or by administration of dexamethasone to the mother.

Maternal size and fetal growth.

In a population characterized by short and underweight mothers, weight gain during the third trimester and post-delivery weight were found to be more important determinants of birth weight than was maternal height. These findings suggest that maternal energy stores during pregnancy, rather than genetic factors or childhood nutrition as reflected by height, influence fetal growth in undernourished communities.