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The article presents description on the problems encountered by the King's College Hospital PLC from 1968 to 1976 on live-born infants whose diabetic mothers are treated with insulin and carbohydrate restriction during pregnancy and after delivery. These infants are found to have hyperinsulinism with evidence showing an increased insulin-like activity in the plasma. Severe congenital abnormalities were evident involving common systems including cardiac, neurological and skeletal systems.

Forty preterm infants suffering from respiratory distress syndrome were entered into a randomised controlled trial to assess the importance of the length of inspiratory time during weaning from high frequency positive pressure ventilation (HFPPV). Two weaning regimes were compared: in one (group A) inspiratory time was limited to 0.5 seconds throughout weaning, in the other (group B) ventilator rate was reduced by increasing both inspiratory and expiratory time (inspiration:expiration ratio constant) until inspiratory time reached 1.0 seconds. At ventilator rates of 20 and 40 breaths/minute an acute comparison was made in all 40 infants of the two inspiratory times; despite the lower mean airway pressure associated with the shorter inspiratory time blood gases were maintained. There was no difference in the incidence of pneumothoraces or need for reventilation between the two regimens but infants in group A had a shorter duration of weaning. We conclude limitation of inspiratory time to 0.5 seconds during weaning from HFPPV is advantageous to preterm infants with respiratory distress syndrome. [ABSTRACT FROM AUTHOR]

Neonatologists in 100 special care baby units in the United Kingdom and Ireland collaborated in a four year surveillance study of neonatal necrotising enterocolitis. The average overall annual reporting rate of necrotising enterocolitis for infants in England and Wales was 0.3/1000 live births, but ranged from 9.5/1000 live births in infants weighing less than 1000 g at birth to 0.2/1000 live births in infants weighing 2500 g or more. There were more deaths among girls, infants who weighed less than 1500 g at birth, those whose bleeding was abnormal or who had low peripheral platelet counts, infants with Gram negative bacteraemia, and very low birthweight infants who developed it during the first few days of life. In both boys and girls, and in all birthweight groups, operation was associated with increased mortality. [ABSTRACT FROM AUTHOR]

The effects of gender on mortality and morbidity of all neonates weighing less than 1500 g admitted to King's College Hospital Neonatal Intensive Care Unit during 1980-82 (n = 271) were examined. Very low birthweight boys had a significantly higher mortality and more postnatal complications than girls. The higher incidence of respiratory distress syndrome and pulmonary interstitial emphysema in boys was associated with increased mortality in the first year. Surviving boys had significantly more problems, including lower Apgar scores at five minutes, more frequent apnoeic attacks and bradycardic episodes, transient tachypnoea, neonatal anaemia, and lower blood calcium and phosphate concentrations. Surviving children were followed up at 1 and 2 years of age. Development of boys at 1 year was significantly delayed compared with girls in all fields save locomotor. Although at 2 years some of the differences had diminished, those in language and personal social skills were more pronounced. More than twice as many boys as girls had major neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

Forty six of 142 infants weighing less than 1500 g at birth, who had chest radiographs in the first 5 days of life, developed pulmonary interstitial emphysema (PIE) and in 19 this occurred in the first 24 hours. PIE was seen more frequently in infants weighing less than 1000 g at birth (24 of 57) than in those weighing 1000-1500 g (22 of 85). Ventilation for hyaline membrane disease was strongly associated with PIE, and only babies who were resuscitated, or ventilated, or had hyaline membrane disease developed the disorder. Most pneumothoraces were preceded by x-ray appearances of PIE (17 of 21). Mortality was increased in ventilated infants who developed PIE and was high in those with severe x-ray changes. [ABSTRACT FROM AUTHOR]

Seven very low birthweight (less than 1.3 kg) preterm infants, aged between 3 and 6 weeks were fed raw, pasteurised, and boiled human milk for 3 consecutive weeks. Serial metabolic balance techniques were used to assess the absorption and retention of calcium, phosphorous, sodium, and nitrogen, and the absorption of fat. Fat absorption was reduced by approximately one-third when raw milk was heated. It is suggested that the improved fat absorption from the raw milk may be related to the preservation of milk lipases. A reduction in the amount of N retained was also noted when the infants were fed boiled milk. There were no obvious differences in the absorption of N or the absorption and retention of Ca, P, and Na between the three milks. All infants gained weight most rapidly during the week in which they were fed raw milk. The mean weight gain during this time was approximately one-third greater than that during similar periods when pasteurised or boiled milk was administered [ABSTRACT FROM AUTHOR]