Biomaterial Database

Antecedents of clinically significant pulmonary hemorrhage among newborn infants. 2000

T M Berger, and E N Allred, and L J Van Marter

Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA. thomas.berger@ksl.gsd.lu.ch

OBJECTIVE To evaluate risk factor profiles associated with clinically significant pulmonary hemorrhage (PH) in preterm (PT) and term infants. METHODS Case-control study of all infants with PH cared for in three Harvard-affiliated neonatal intensive care units between 1987 and 1994. RESULTS A total of 50 cases of PH occurred in PT infants (gestational age (GA) of < or = 34 weeks), and 26 cases occurred in near-term/full-term (NT/FT) infants (GA of > 34 weeks). The median age at the time of PH was 46 hours among PT infants compared with 6 hours among NT/FT infants. For PT infants, four factors best predicted PH: a GA of between 24 and 26 weeks and antenatal glucocorticoid treatment reduced the risk (odds ratios (ORs) of 0.7 and 0.3, respectively), whereas requirement for resuscitation with positive pressure ventilation and thrombocytopenia were associated with increased risk (ORs of 4.3 and 4.0, respectively). Among the NT/FT infants, the model included three variables: meconium aspiration (OR 4.9), requirement for resuscitation with positive pressure ventilation (OR 2.9), and hypotension (OR 3.5). CONCLUSIONS Antecedent factors and timing of PH differ between PT and NT/FT infants, suggesting that the mechanisms contributing to PH are influenced by developmental maturity as well as perinatal and neonatal medical conditions and interventions.

UI	MeSH Term	Description	Entries
D007022	Hypotension	Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.	Blood Pressure, Low,Hypotension, Vascular,Low Blood Pressure,Vascular Hypotension
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234	Infant, Premature	A human infant born before 37 weeks of GESTATION.	Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D008171	Lung Diseases	Pathological processes involving any part of the LUNG.	Pulmonary Diseases,Disease, Pulmonary,Diseases, Pulmonary,Pulmonary Disease,Disease, Lung,Diseases, Lung,Lung Disease
D008471	Meconium Aspiration Syndrome	A condition caused by inhalation of MECONIUM into the LUNG of FETUS or NEWBORN, usually due to vigorous respiratory movements during difficult PARTURITION or respiratory system abnormalities. Meconium aspirate may block small airways leading to difficulties in PULMONARY GAS EXCHANGE and ASPIRATION PNEUMONIA.	Aspiration, Meconium,Meconium Aspiration,Meconium Inhalation,Aspiration Syndrome, Meconium,Syndrome, Meconium Aspiration
D011175	Positive-Pressure Respiration	A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange.	Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D011295	Prenatal Care	Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality.	Antenatal Care,Care, Antenatal,Care, Prenatal
D012151	Resuscitation	The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)	Resuscitations
D005865	Gestational Age	The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination.	Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D005938	Glucocorticoids	A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system.	Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid