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Background: Hepcidin, an iron-regulatory hormone, plays a key role in preventing iron overload. Few studies have investigated the regulation of hepcidin in low-birth-weight (LBW) infants who are vulnerable to iron imbalance. Objectives: To identify perinatal factors associated with serum hepcidin levels in LBW infants. Methods: Ninety-two LBW infants with a median gestational age (GA) of 32.6 weeks and birth weight of 1,587 g were prospectively enrolled. Serum hepcidin-25 (Hep25) levels were measured from umbilical cord blood using liquid chromatography-tandem mass spectrometry. The relationship between Hep25 levels and prematurity or other possible hepcidin-regulatory factors was evaluated. Results: The median Hep25 level was 7.3 ng/mL (interquartile range: 2.85-16.38). log(Hep25) correlated with birth weight (r = 0.229, p = 0.028), log(interleukin-6 [IL-6]) (r = 0.408, p < 0.001), log(erythropoietin) (r = -0.302, p = 0.004), transferrin saturation (r = 0.29, p = 0.005), soluble transferrin receptor (r = -0.500, p < 0.001), and log(ferritin) (r = 0.696, p < 0.001). Serum iron and hemoglobin levels did not correlate with log(Hep25). Hep25 levels were higher among infants with chorioamnionitis and infants born vaginally and lower among infants born to mothers with pregnancy- induced hypertension than among infants without the respective characteristics. Stepwise multiple linear regression analysis confirmed the significant association of log(Hep25) with GA, log(IL-6), log(erythropoietin), and soluble transferrin receptor. Conclusions: Among LBW infants, GA, IL-6, erythropoietin, and soluble transferrin receptor were associated with Hep25 levels. Therefore, prematurity, inflammation, hypoxia, and erythropoietic activity may be important perinatal factors that affect hepcidin levels. [ABSTRACT FROM AUTHOR]

Background Extremely low-birthweight infants ( ELBWI) are at greater risk of developing hepatoblastoma than are normal-weight infants. Serum α-fetoprotein ( AFP) plays an important role as a tumor marker in the diagnosis of hepatoblastoma, therefore the aim of this study was to determine the changes in serum AFP concentration after birth in ELBWI. Methods Data were obtained for infants born between January 2005 and March 2008 with birthweight <1000 g who were followed up at Gunma Children's Medical Center with clinical examinations, including monitoring of the development of hepatoblastoma. The relationship between serum AFP concentration and age was analyzed up to 730 days after birth. Results Overall, 95 serum AFP measurements were obtained from 23 infants 30-730 days of age, with gestational age 24-32 weeks, and birthweight 498-982 g. Log10( AFP [ng/ mL]) was significantly correlated with log10(age [days]) ( r = −0.961, P = 0.000, n = 95), with the following regression formula: log10( AFP [ng/ mL]) = 11.063 − 3.752 log10(age [days]) (adjusted R2 = 0.923, n = 95). The standard error of the estimate, mean log10(age [days]), and the sum of squares for log10(age [days]) were 0.363, 2.503, and 10.579, respectively. Conclusions A correlation was found between serum AFP concentration and age in ELBWI, and the 95% CI of serum AFP concentration was determined for ELBWI up to 2 years after birth. [ABSTRACT FROM AUTHOR]

Background Despite the early use of phototherapy and exchange transfusion in premature infants based on total serum bilirubin ( TSB), the reemergence of kernicterus has been reported. The aim of this study was to assess the validity of using TSB as the criterion for phototherapy in extremely low-birthweight infants ( ELBWI). Methods We reviewed the medical charts of 43 ELBWI admitted to hospital between January 2009 and December 2010, and analyzed the relationship between TSB and unbound bilirubin ( UB). Results No infant underwent exchange transfusion or developed acute bilirubin encephalopathy. There was a significant correlation between TSB and UB measured immediately before phototherapy during the first 7 days of life ( r = 0.657, P < 0.001), but none thereafter ( r = 0.120, P = 0.213). Thirty-seven percent of infants who underwent phototherapy during the first 7 days of life had suprathreshold USB but subthreshold TSB, whereas this rose to 97% thereafter. Conclusions No correlation was observed between TSB and UB in ELBWI after the first 7 days of life, and almost all phototherapy sessions were initiated based on the UB criterion, even though TSB was below the accepted threshold. UB may be high if jaundice is evaluated solely on the basis of TSB. [ABSTRACT FROM AUTHOR]

Background: It is not known whether a moderate dose of oral iron supplementation would further enhance erythropoiesis in recombinant human erythropoietin (EPO)-treated very low-birthweight (VLBW) infants.Methods: In total, 24 preterm infants with birthweights 750–1499 g were enrolled at the age of 14–28 days to receive 400 IU/kg per week EPO subcutaneously for 8 weeks. The infants were randomly allocated either to receive oral iron supplementation 4 mg/kg per day or to serve as controls.Results: Hemoglobin and the absolute reticulocyte count in the iron supplementation and the control groups remained identical throughout the study period, whereas serum ferritin was significantly lower in the control group at study exit and follow up. Rates of treatment success (no need for transfusion and hemoglobin never below 8 g/dL) also did not differ between the groups.Conclusions: In this study we did not find a clear advantage in a moderate dose of oral iron supplementation on erythropoiesis in EPO-treated VLBW infants. Whether a higher dose would lead to enhanced erythropoiesis remains to be answered. [ABSTRACT FROM AUTHOR]

Abstract Background: There is a significant association between hepatoblastoma and low birthweight. A case-control study was conducted to reveal risk factors for hepatoblastoma in children of extremely low birthweight (<1000 g). Methods: Prenatal and postnatal histories, including parental histories, of 12 hepatoblastoma cases and 75 birthweight-matched controls were compared. Results: The gestational age of the hepatoblastoma cases (23–32 weeks; median 25 weeks), tended to be lower than that of the controls (23–36 weeks; median, 27 weeks; P=0.072). The time for an infant’s bodyweight to return to the same level as the birthweight also tended to be longer in hepatoblastoma cases than in controls (P=0.055). All hepatoblastoma cases received oxygen therapy for a period of 4–508 days (median 114 days), which was significantly longer than the 0–366 days (median 62 days) in the controls (P=0.022). Furosemide was given to all hepatoblastoma cases and was used for a significantly longer period in these infants (6–460 days; median 89 days) than in the controls (0–241 days; median 44 days P=0.027). A univariate Cox regression demonstrated that the time taken to regain bodyweight at birth and the duration of both oxygen therapy and furosemide treatment were significantly associated with the development of hepatoblastoma (hazard ratio (HR)=1.044, P=0.013; HR=1.006, P=0.001; and HR=1.007, P=0.001, respectively). Although there were significant correlations between the factors, a multivariate Cox regression analysis identified the duration of oxygen therapy as a significant independent risk factor (HR=1.006, P=0.001). Conclusions: Oxygen therapy and furosemide treatment, along with the rate of growth, are risk factors for the development of hepatoblastoma in children of extremely low birthweight, and the duration of oxygen therapy is the most important factor in predicting the development of hepatoblastoma. Further studies are necessary to determine the real reasons for the development of hepatoblastoma and to protect children of low birthweight from the development of cancer. [ABSTRACT FROM AUTHOR]

Describes a case of a low-birth weight infant with the rare disease of oromandibular-limb hypogenesis syndrome (OLHS) who died of respiratory failure due to pulmonary hypoplasia. Disorders included in OLHS; Anomalies of the limb; Abnormalities associated with pulmonary hypoplasia.

Describes a very low birth weight infant treated for a solitary liver abscess caused by methicillin-resistant Staphylococcus aureus. List of the etiologic agents of pyogenic liver abscess in infants; Therapies for a solitary liver abscess; Information on the clinical features of a solitary liver abscess.