Prenatal diagnosis of congenital cytomegalovirus infection.

Objective: To assess prospectively the diagnostic reliability and prognostic significance of prenatal diagnosis of cytomegalovirus (CMV) infection.

Methods: One hundred ten pregnant women (four with twin pregnancies) with a risk of congenital CMV infection were investigated. Prenatal diagnosis was carried out by amniocentesis and fetal blood sampling (n = 75) or amniocentesis alone (n = 35).

Value of the comparative enzyme-linked immunofiltration assay for early neonatal diagnosis of congenital Toxoplasma infection.

Background: The transplacental transfer of specific maternal IgG antibodies makes the diagnosis of congenital Toxoplasma infection quite difficult in the neonate. The enzyme-linked immunofiltration assay (ELIFA), comparing at delivery the immunologic profile of the mother's antibody response and that of her child, allows discrimination between IgG antibodies of maternal origin and IgGs synthesized by the fetus.

Objective: To evaluate the diagnostic reliability of the comparative ELIFA for diagnosing congenital Toxoplasma infection as well as the reliability of testing for IgM- and IgA-specific antibodies in cord blood.

Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants.

Objective: To investigate the effects of neonatal hypoglycemia on physical growth and neurocognitive function.

Study Design: A systematic detection of hypoglycemia (<2.6 mmol/L or 47 mg/dL) was carried out in 85 small-for-gestational-age preterm neonates.

[Intrauterine and postnatal transfer of high risk newborn infants. Swiss Society of Neonatology].

Unlabelled: The centralisation of high risk deliveries in perinatal centres has become standard practice in most developed countries over the last 20 years. The goal of this study was to assess to which extent this practice has been implemented in Switzerland as well. In addition, we compared standard morbidity outcome measurements between outborn and inborn infants, as well as the frequencies of postnatal interhospital transfers.

[The prognosis of premature infants: from the viewpoint of gynecologists-obstetricians and results from Lausanne].

Aim Of The Study: To assess the views of obstetricians concerning the survival rate in neonates on the basis of gestational age and birth-weight, rate of severe handicap, and minimum gestational age for preventive and curative measures (steroids for foetal lung maturation and caesarean section in the event of acute foetal distress). Then, to compare these results with the outcomes observed in the referral centre for these obstetricians.

Method: We circulated an anonymous questionnaire (two mailings between October 1995 and February 1996) to obstetricians in the Lausanne area.

Impact of infertility treatments on the health of newborns.

Objective: To measure the use of infertility treatments in the general population and their association with neonatal health.

Design: Cross-sectional, population-based study.

Setting: Canton of Vaud, Switzerland; Etude du Developpement des Nouveau-nés (EDEN), a prospective study of chronic childhood conditions.

Enrollment of a population-based cohort of newborns at higher risk of developing a chronic condition: the EDEN study. Etude du Developpement des Nouveau-nés Study.

Objective: To describe the methods used at birth to recruit a population-based cohort of newborns of all birthweights at higher risk of having a chronic condition, and to present baseline results.

Methods: Screening of all newborns at hospital discharge for five non-exclusive criteria: (1) low birthweight (LBW), (2) congenital anomalies or genetic disease, (3) specified conditions associated with a high probability of chronicity, (4) referral to a neonatal intensive care unit (NICU), (5) or defined social problems. Calculation of Hobel risk scores for children satisfying > or = 1 criterion.

Risk factors of sensorineural hearing loss in preterm infants.

Among 547 preterm infants of < or = 34 weeks gestation born between 1987 and 1991, 8 children (1.46%) developed severe progressive and bilateral sensorineural hearing loss. Perinatal risk factors of infants with hearing loss were compared with those of two control groups matched for gestation and birth weight and for perinatal complications.

Haemodynamic changes during high frequency oscillation for respiratory distress syndrome.

In a crossover trial left ventricular output (LVO), cerebral blood flow velocity (CBFV), and resistance index (RI) of the anterior cerebral artery were compared using Doppler ultrasonography, in eight preterm infants with respiratory distress syndrome (RDS) during conventional mechanical ventilation and high frequency oscillation. LVO was 14% to 18% lower with high frequency oscillation. There were no significant changes in CBFV.

Influence of perinatal, developmental and environmental factors on cognitive abilities of preterm children without major impairments at 5 years.

The relative role of perinatal factors (birthweight, gestational age, gender, asphyxia, mechanical ventilation and cerebral lesions), developmental factors (neuromotor development during the first 18 months of life) and environmental factors (socio-economic status and bilingualism) on cognitive abilities was evaluated in a cohort of preterm children who had been prospectively examined for haemorrhage (PVH) and periventricular leucomalacia (PVL) and followed-up to 5 years of age. Standardized neurological examinations and development assessment including tests of cognitive function were carried out. Major impairments could be ascribed to the presence of large PVL changes.

[Extremely premature infants: what is their future? Lausanne experience 1982-1992].

This study describes neonatal mortality and morbidity as well as the neuropsychological outcome of extremely-low-birth-weight infants (less than 1000 grams) born between 1/1/1982 and 12/31/1992. The number of preterm infants admitted to the neonatal unit has increased over the last ten years. If neonatal mortality remains high, the prognosis of these immature children is favourable and depends on close collaboration between obstetricians and neonatologists and on the quality of perinatal care.

Cytomegalovirus fetal infection: prenatal diagnosis.

We report the results of prenatal diagnosis in 15 cases of primary cytomegalovirus infection during pregnancy. Sixteen fetuses (one twin pregnancy) were examined by ultrasonography, amniocentesis, and fetal blood sampling. Prenatal diagnosis was positive in eight cases as evidenced by positive amniotic fluid cultures in eight, positive immunoglobulin M (IgM) in six, and abnormal ultrasound in two.

Significance of ultrasound appearances in the neurological development and cognitive abilities of preterm infants at 5 years.

The developmental outcome at 5 years of age was studied in 93 preterm infants who had been prospectively examined for peri-ventricular leucomalacia (PVL). Standardised neurological examination and developmental assessment, including tests of cognitive function, were carried out. Major sequelae (n = 10) could be ascribed in most cases to the presence of large PVL lesions.