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This study aimed to explore healthy, term neonates’ behavioural and physiological responses to music using frame-by-frame analysis of their movements (Experiment 1; N = 32, 0–3 days old) and heart rate measurements (Experiment 2; N = 66, 0–6 days old). A ‘happy’ and ‘sad’ music was first validated by independent raters for their emotional content from a large pool of children’s songs and lullabies, and the effect of the emotions in these two music pieces and a control, no-music condition was compared. The results of the frame-by-frame behavioural analysis showed that babies had emotion-specific responses across the three conditions. Happy music decreased their arousal levels, shifting from drowsiness to sleep, and resulted in longer latencies in other forms of self-regulatory behaviour, such as sucking. The decrease in arousal was accompanied by heart rate deceleration. In the sad music condition, relative ‘stillness’ was observed, and longer leg stretching latencies were measured. In both music conditions, longer latencies of fine motor finger and toe movements were found. Our findings suggest that the emotional response to music possibly emerges very early ontogenetically as part of a generic, possibly inborn, human musicality.

Összefoglaló. Bevezetés: A szakirodalomban számos felmérés született az újszülöttkori bőrelváltozások előfordulási gyakoriságának vizsgálatára. Az epidemiológiai vizsgálatok eredményei azonban nem mindig adaptálhatók, hiszen jelentős különbségeket találunk az egyes népcsoportok bőrmanifesztációi között, emellett kevés és ellentmondásos adat áll rendelkezésre arról, hogy milyen tényezők befolyásolják ezen bőrtünetek kialakulását. Célkitűzés: Prospektív kohorszvizsgálatunk fő célkitűzése az volt, hogy felmérjük az alapvetően egészséges, érett újszülöttek bőrgyógyászati elváltozásainak előfordulási gyakoriságát, illetve megvizsgáljuk az ezen elváltozások kialakulásában szerepet játszó tényezőket. Módszer: Vizsgálatunkat a Szegedi Tudományegyetem Szülészeti és Nőgyógyászati Klinikájának Újszülött Osztályán végeztük 2014 áprilisa és 2015 áprilisa között. Az újszülöttek bőrgyógyászati vizsgálatát követően az édesanyák 50 kérdést tartalmazó, standardizált kérdőívet töltöttek ki. Az újszülöttekre, illetve a szülés körülményeire vonatkozó adatokat a hivatalos betegdokumentáció adatainak felhasználásával elemeztük. Eredmények: A vizsgálatban összesen 1629, kaukázusi típusú újszülött vett részt. 88,15%-uknál diagnosztizáltunk legalább egyfajta bőrgyógyászati eltérést. Vizsgálatunkban számos esetben szignifikáns korrelációt találtunk az újszülöttek neme, gestatiós kora és súlya, valamint az újszülöttkori bőrelváltozások előfordulási gyakorisága között. Emellett a szociodemográfiai tényezők, a szülők fenotípusos jellegzetességei, az édesanya betegségei, gyógyszerszedési szokásai, káros szenvedélyei is hatást gyakorolhatnak a laesiók kialakulására. Következtetés: Az irodalmi adatok áttekintését követően elmondhatjuk, hogy vizsgálatunk rendkívül átfogó, új adatokat szolgáltat a neonatalis bőrtünetek előfordulási gyakoriságáról és a kialakulásukban potenciálisan szerepet játszó tényezők kapcsolatáról hazánkban és világviszonylatban is. Orv Hetil. 2022; 163(13): 513–522. Summary. Introduction: Cutaneous lesions are very frequent in neonates. Despite the fact that the incidence of neonatal skin disorders has been reported in several studies, very few reports address the factors that influence the appearance of birthmarks. Objective: In this cross-sectional study, we aimed to record cutaneous findings in essentially healthy, term and late preterm neonates, and to use this data to assess the associations between various factors and the appearance of birthmarks. Method: The study was conducted on consecutive neonates born between April 2014 and April 2015 at the Department of Obstetrics and Gynecology at the University of Szeged. After the whole-body skin examination, a standardized questionnaire consisting of 50 questions was completed by the mothers. Data relating to the neonatal history of the participating neonates were obtained from the official neonatal medical charts. Results: A total of 1629 Caucasian neonates were included in the study. Of these, 88.15% exhibited at least one skin manifestation. Significant correlations were found between the newborn gender, gestational age and weight and the presence of many skin manifestations. Furthermore, sociodemographic factors, parental phenotypic characteristics, maternal diseases and medicine-taking habits also have impact on the development of certain cutaneous lesions. Conclusion: By examining a large number of newborns and by providing detailed analysis of several neonatal, perinatal and parental factors, our study contributes to a deeper understanding of the development of the examined cutaneous lesions. Orv Hetil. 2022; 163(13): 513–522.

The relationship between smoking and human health has been investigated mostly in adults, despite the fact that the chemicals originating from sustained maternal smoking disrupt the carefully orchestrated regulatory cascades in the developing fetus. In this study, we followed molecular alterations in the umbilical cord (UC) vessels and fetal red blood cells (RBCs), which faithfully reflect the in vivo status of the fetus. We showed evidence for the decreased level of DNA-PKcs-positive nuclei in samples with smoking origin, which is associated with the impaired DNA repair system. Furthermore, we pointed out the altered ratio of MMP-9 metalloproteinase and its endogenous inhibitor TIMP-1, which might be a possible explanation for the morphological abnormalities in the UC vessels. The presented in vivo dataset emphasizes the higher vulnerability of the veins, as the primary target for the toxic materials unfiltered by the placenta. All these events become amplified by the functionally impaired fetal RBC population via a crosstalk mechanism between the vessel endothelium and the circulating RBCs. In our ex vivo approach, we looked for the molecular explanation of metal-exposure-induced alterations, where expressions of the selected genes were upregulated in the control group, while samples with smoking origin showed a lack of response, indicative of prior long-term in utero exposure.

To learn the association between sociodemographic and obstetric factors and lifestyle characteristics of pregnant women, and to identify factors that can influence pregnant women's health consciousness.A cross-sectional, questionnaire-based study was performed among women who gave birth in Szeged in 2014-2015. Data collection was based on a self-administered questionnaire and health documentations. Overall maternal health promoting behavior (MHPB) index was defined by summarizing the scores obtained from diet, physical activity, smoking status, and alcohol consumption.The final analysis included 1548 mothers; 41.3% (n = 602) of the sample had healthy diet, 9.0% (n = 134) were physically active and attended special pregnancy exercise classes, 84.4% (n = 1279) did not drink alcohol, and 93.5% (n = 1447) were nonsmokers. Regarding the MHPB index, 0.8% (n = 11) of the women reached the maximum score (20), while the average was 14.8 (SD = 2.58). Advanced maternal age (p 0.001), having a spouse or partner (p 0.001), higher educational level (p 0.001), planned pregnancy (p 0.001), and early visit at pregnancy care (p = 0.046) were significantly associated with higher MHPB index.The lifestyle of pregnant women can have a great impact on the developing fetus, either in a positive or negative way. In order to evaluate maternal lifestyle, overall health behavior should be considered. Lifestyle of the included women was not satisfactory, an improvement in health consciousness is needed at every social level; however, the differences between the various social classes may suggest the importance of further promotion and improvement of pregnancy planning and pregnancy care among younger and lower educated women.

BACKGROUNDAdvanced maternal age is traditionally described to be 35 years of age or over. In recent years, new trends have suggested that it may be 40 years of age or over; this occurs in Hungary.AIMThe aim of this study was to determine the association between advanced maternal age and various adverse maternal and neonatal outcomes.METHODSA retrospective analysis was performed among women who delivered between 2015 and 2017. All women aged 40 years or over (cases) were involved into the analysis (n = 374). The controls (n = 378) were randomly selected from women aged 25 to 29 years who delivered during the same period considering the number of previous gestations and previous deliveries. The data collected from the medical records comprised the mothers’ demographic and obstetric characteristics and neonatal data. To assess the contribution of maternal age to various maternal and neonatal outcomes, multiple logistic regression analyses were used.RESULTSThe logistic regression analyses showed higher odds of gestational diabetes (AOR, adjusted odds ratio: 2.81), preeclampsia (AOR: 13.05), threatened preterm delivery (AOR: 3.62), and cesarean section (AOR: 3.31) in mothers of higher age. The odds of low birth weight (AOR: 2.56) and intensive care (AOR: 2.03) were significantly higher in older vs. younger mothers, while no significant associations were between maternal age and fetal macrosomia and congenital malformations.CONCLUSIONSConsidering our results, it is important to educate women about the consequences of delayed childbearing and the need of continuous observation within prenatal care.

Összefoglaló. Bevezetés: A szakirodalomban számos felmérés született az újszülöttkori bőrelváltozások előfordulási gyakoriságának vizsgálatára. Az epidemiológiai vizsgálatok eredményei azonban nem mindig adaptálhatók, hiszen jelentős különbségeket találunk az egyes népcsoportok bőrmanifesztációi között, emellett kevés és ellentmondásos adat áll rendelkezésre arról, hogy milyen tényezők befolyásolják ezen bőrtünetek kialakulását. Célkitűzés: Prospektív kohorszvizsgálatunk fő célkitűzése az volt, hogy felmérjük az alapvetően egészséges, érett újszülöttek bőrgyógyászati elváltozásainak előfordulási gyakoriságát, illetve megvizsgáljuk az ezen elváltozások kialakulásában szerepet játszó tényezőket. Módszer: Vizsgálatunkat a Szegedi Tudományegyetem Szülészeti és Nőgyógyászati Klinikájának Újszülött Osztályán végeztük 2014 áprilisa és 2015 áprilisa között. Az újszülöttek bőrgyógyászati vizsgálatát követően az édesanyák 50 kérdést tartalmazó, standardizált kérdőívet töltöttek ki. Az újszülöttekre, illetve a szülés körülményeire vonatkozó adatokat a hivatalos betegdokumentáció adatainak felhasználásával elemeztük. Eredmények: A vizsgálatban összesen 1629, kaukázusi típusú újszülött vett részt. 88,15%-uknál diagnosztizáltunk legalább egyfajta bőrgyógyászati eltérést. Vizsgálatunkban számos esetben szignifikáns korrelációt találtunk az újszülöttek neme, gestatiós kora és súlya, valamint az újszülöttkori bőrelváltozások előfordulási gyakorisága között. Emellett a szociodemográfiai tényezők, a szülők fenotípusos jellegzetességei, az édesanya betegségei, gyógyszerszedési szokásai, káros szenvedélyei is hatást gyakorolhatnak a laesiók kialakulására. Következtetés: Az irodalmi adatok áttekintését követően elmondhatjuk, hogy vizsgálatunk rendkívül átfogó, új adatokat szolgáltat a neonatalis bőrtünetek előfordulási gyakoriságáról és a kialakulásukban potenciálisan szerepet játszó tényezők kapcsolatáról hazánkban és világviszonylatban is. Orv Hetil. 2022; 163(13): 513-522.Cutaneous lesions are very frequent in neonates. Despite the fact that the incidence of neonatal skin disorders has been reported in several studies, very few reports address the factors that influence the appearance of birthmarks.In this cross-sectional study, we aimed to record cutaneous findings in essentially healthy, term and late preterm neonates, and to use this data to assess the associations between various factors and the appearance of birthmarks.The study was conducted on consecutive neonates born between April 2014 and April 2015 at the Department of Obstetrics and Gynecology at the University of Szeged. After the whole-body skin examination, a standardized questionnaire consisting of 50 questions was completed by the mothers. Data relating to the neonatal history of the participating neonates were obtained from the official neonatal medical charts.A total of 1629 Caucasian neonates were included in the study. Of these, 88.15% exhibited at least one skin manifestation. Significant correlations were found between the newborn gender, gestational age and weight and the presence of many skin manifestations. Furthermore, sociodemographic factors, parental phenotypic characteristics, maternal diseases and medicine-taking habits also have impact on the development of certain cutaneous lesions.By examining a large number of newborns and by providing detailed analysis of several neonatal, perinatal and parental factors, our study contributes to a deeper understanding of the development of the examined cutaneous lesions. Orv Hetil. 2022; 163(13): 513-522.

Background Dietary supplements are recommended for pregnant women who cannot meet the daily dose through food intake, or who are at higher risk of deficiencies because of a substance abuse (e.g. smoking). Today, the preventive effect of folic acid (FoA) in the periconceptional period is evidence based, and there are studies about the positive effects of omega-3 fatty acids (n-3 FAs) during pregnancy. The aim of this study was to determine the association between FoA and n-3 FAs supplementation and health behavior - diet, physical activity, smoking - of pregnant women. Methods The cross-sectional study was conducted among women having their babies at the Department of Obstetrics and Gynecology (N = 1548). Data collection was based on self-administered questionnaire and health documentation. Uni- and multivariable logistic regression analyses were performed with IBM SPSS 26.0; the results are expressed in odds ratios (OR) and 95% confidence intervals (CI). Results Mean age of women was 31 years, most of them had university degree, nearly 90% of them lived in partnership. The prevalence of smoking during pregnancy was 6.5%, 39.8% did not consume fruits/vegetables daily, 58.5% ate fish less than weekly, 47.9% were physically inactive; 67.6% took FoA, and 30.6% n-3 FAs. FoA and n-3 FAs taking were more likely among those who ate fruits and vegetables every day (OR/CI: 1.30/1.01-1.66; 1.47/1.15-1.89) and among non-smokers (OR/CI: 1.73/1.06-2.83; 4.80/1.69-13.61), while FoA consumption associated with physical activity (OR/CI: 1.37/1.07-1.74) and n-3 FAs with fish consumption (OR/CI: 1.35/1.06-1.72). Conclusions Our results showed that a high proportion of pregnant women did not follow a healthy lifestyle, and the unhealthy behavior was significantly associated with the less frequent use of dietary supplementation. The results call the attention for the importance of counseling on healthy lifestyle and appropriate supplement use before and during pregnancy. Key messages Use of dietary supplementation is higher among pregnant women following a healthy way of lifestyle. The results reinforce the importance of lifestyle counseling during pregnant care.

Curvularia lunata is an ascomycete filamentous fungus causing local and invasive phaeohyphomycoses in both immunocompromised and immunocompetent patients. Neutrophils are crucial participants of the first line host defense against fungal infections. They migrate to the infected site and eliminate the infectious agents by various mechanisms including phagocytoses, oxidative damage, or formation of neutrophil extracellular trap (NET). Neutropenia may be a risk factor for phaeohyphomycoses, and restoration of the neutrophil function can improve the outcome of the infection. In the present study, interaction of primary human neutrophil granulocytes with the hyphae C. lunata was examined and compared to that with the well characterized filamentous fungal pathogen Aspergillus fumigatus. Neutrophils could recognize the serum opsonized hyphae of C. lunata and attach to them. Myeloperoxidase release was also activated by a soluble factor present in the culture supernatant of the fungus. Induction of the oxidative burst was found to depend on serum opsonization of the hyphae. Although extracellular hydrogen peroxide production was induced, the fungus efficiently blocked the oxidative burst by acidifying the reaction environment. This blockage also affected the NET forming ability of the neutrophils.

Cutaneous lesions are very common in neonates. Although a number of studies have reported on their incidence, very little is known about the factors that influence them. We set out to investigate a large population of neonates with the aims of achieving an overall picture of neonatal skin manifestations, and examining their relationships with various maternal, neonatal and perinatal factors. This study was conducted on neonates born at the Department of Obstetrics and Gynaecology at the University of Szeged between June 2013 and July 2015. A total of 4658 consecutive infants underwent a whole-body skin examination within the first 72 hours of extrauterine life. The official neonatal medical charts were used to collect data on the history of the participating neonates and on maternal factors. 74.35% of the neonates exhibited at least one skin manifestation. The major diagnosis groups were transient, benign cutaneous lesions; vascular lesions; traumatic, iatrogenic, congenital or acquired disorders with skin injuries; pigmented lesions; and developmental abnormalities or benign skin tumours. The relationships between the skin findings and six neonatal or maternal factors were examined: gender, gestational age and birth weight of the neonates; maternal age and the number of previous pregnancies of the mothers, and mode and circumstances of the delivery. We found several significant correlations between the examined maternal/neonatal factors and the occurrence of birthmarks and neonatal skin disorders. Of course, further studies are required to confirm and better understand these associations.

An understanding of the basic pathophysiological mechanisms of neonatal diseases necessitates detailed knowledge about the wide range of complications in the circulating fetal RBCs. Recent publications on adult red blood cells (RBCs) provide evidence that RBCs carry an active nitric oxide synthase (NOS3) enzyme and contribute to vascular functioning and integrity via their active nitric oxide synthesis. The aim of this study was to determine the effect of maternal smoking on the phenotypical appearance and functionality of fetal RBCs, based on morphological and molecular studies. We looked for possible links between vascular dysfunction and NOS3 expression and activation and its regulation by arginase (ARG1). Significant morphological and functional differences were found between fetal RBCs isolated from the arterial cord blood of neonates born to nonsmoking (RBC-NS,n=62) and heavy-smoking (RBC-S,n=51) mothers. Morphological variations were quantified by Advanced Cell Classifier, microscopy-based intelligent analysis software. To investigate the relevance of the newly suggested “erythrocrine” function in fetal RBCs, we measured the levels of NOS3 and its phosphorylation in parallel with the level of ARG1, as one of the major influencers of NOS3 dimerization, by fluorescence-activated cell sorting. Fetal RBCs, even the “healthy-looking” biconcave-shaped type, exhibited impaired NOS3 activation in the RBC-S population, which was paralleled with elevated ARG1 level, thus suggesting an increased redox burden. Our molecular data indicate that maternal smoking can exert marked effects on the circulating fetal RBCs, which could have a consequence on the outcome of in utero development. We hypothesize that any endothelial dysfunction altering NO production/bioavailability can be sensed by circulating fetal RBCs. Hence, we are putting forward the idea that neonatal RBC could serve as a real-time sensor for not only monitoring RBC-linked anomalies but also predicting the overall status of the vascular microenvironment.

The aim of this study was to analyse the factors associated with caesarean section (CS) at the Department of Obstetrics and Gynaecology, University of Szeged, Hungary.Data collection was based on self-administered questionnaire and medical records related to the deliveries in the year of 2014. Maternal age, education level, marital status, pre-gestational body mass index (BMI), infertility treatment, previous CS, gestational diabetes mellitus (GDM), pre-pregnancy hypertension and pregnancy-induced hypertension (HT/PIH) were examined. The participation rate was 67.3%, multiple pregnancies and questionnaires with missing data were excluded (n = 1493). Univariate and multivariate comparisons were performed.There were 1125 (45.4%) CSs out of 2479 deliveries. CS rate: 40.0%. Underweight 109 (7.1%), normal 921 (60.2%), overweight 320 (20.9%) obese 181 (11.8%).7.6% (n = 117), GDM: 10.1% (n = 155). The odds of CS were significantly higher among obese mothers (OR: 1.81) compared with the normal weight group. Increasing maternal age (OR: 0.97) and being underweight (OR: 0.59) significantly decreased, previous CS (OR: 12.19), infertility treatment (OR: 1.91) and HT/PIH (OR: 1.87) significantly increased the probability of CS.Pre-gestational obesity, infertility treatment, previous CS and HT/PIH had significant effect on the mode of delivery.

Most of the skin disorders that occur in neonatal intensive care units are due in part to the immaturity and vulnerability of the neonatal skin. Various iatrogenic diagnostic and therapeutic procedures are also conducive to iatrogenic damage. This study was to review the neonates admitted to our neonatal intensive care unit who needed wound management, and to assess the most common skin injuries and wounds, and their aetiology. Data were extracted from medical records of neonates who needed wound management in our Neonatal Intensive Care Unit between January 31, 2012 and January 31, 2013. Information about gestational age, sex, birth weight, area of involvement, wound aetiology, and therapy were collected. Among the 211 neonates observed, wound management was required in 10 cases of diaper dermatitis, 7 epidermal stripping, 6 extravasation injuries, 5 pressure ulcers, 1 surgical wound and infection, 1 thermal burn, and 5 other lesions. International guidelines in neonatal wound care practice are not available, and further research concerns are clearly needed. Dressings and antiseptic agents should be chosen with great care for application to neonates, with particular attention to the prevention of adverse events in this sensitive population. Team work among dermatologists, neonatologists and nurses is crucial for the successful treatment of neonates.

Summary Pregnancy is a state associated with an enhanced metabolism and demand for O2, which may lead to the overproduction of reactive oxygen species (ROS) and hence to oxidative stress. An elevated ROS level may result in delayed development and a low birth weight. The aim of this study was to reveal the consequences of multiple pregnancies on the redox status of neonatal human red blood cells (RBCs) and evaluate the role of endothelial nitric oxide synthase (NOS3) – expressing RBCs in the generation of oxidative stress. The study presents evidence of higher levels of production of hydrogen peroxide, peroxynitrite and nitrate content in the RBCs of twin neonates, clearly reflected by an elevated level of protein and lipid damages. This phenotype appears to be a consequence of multiple pregnancies, regardless of the level of maturity or the birth weight of the twins. Besides the higher level of ROS, there was a general decrease in the expression of genes coding for antioxidants. The first data are presented on NOS3-expressing neonatal human RBCs. The number of RBCs producing NOS3 was more than twice as high in twin neonates compared to singletons, with no correlation to maturity.

OBJECTIVE To determine the risks of adverse perinatal outcomes of teenage mothers. MATERIAL AND METHODS A retrospective analysis was performed on teenage mothers (under 20 years of age) who delivered in the period of 2010-2014 at the Department of Obstetrics and Gynecology, University of Szeged (study group). All mothers who delivered in Hungary during the same period were studied as a control group. The following parameters were analyzed: demographic data of the mothers, maternal complications, perinatal outcome and congenital malformations of the newborns. The binominal test, Student's t-test and Poisson's regression were applied using STATA 9.0 (StataCorp, College Station, TX, USA) statistical software (p

The study employed four gestural models using frame‐by‐frame microanalytic methods, and followed how the behaviours unfolded over time. Forty‐two human newborns (0–3 days) were examined for their imitation of tongue protrusion, ‘head tilt with looking up’, three‐finger and two‐finger gestures. The results showed that all three gesture groups were imitated. Results of the temporal analyses revealed an early and a later, second stage of responses. Later responses were characterized by a suppression of similar, but non‐matching movements. Perinatal imitation is not a phenomenon served by a single underlying mechanism; it has at least two different stages. An early phase is followed by voluntary matching behaviour by the neonatal infant., Positive evidence for imitation of four gestures in the first week of life: possible mechanisms and models.

Objective: Multiple pregnancy is associated with an enhanced metabolism and demand for O2, which may lead to the overproduction of reactive oxygen species and the development of oxidative stress. The degree of oxidative damage depends on the level of the antioxidant protection system of the foetus. The objective of the study was to identify the relationship between the state of the maturity and the antioxidant status of twin neonates. Investigations of the umbilical cord blood were carried out to detect differences in the antioxidant defence system between mature and premature twin neonates. Methods: The activities of the superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) enzymes, the levels of reduced glutathione (GSH), protein carbonyls and oxidized lipids and the total antioxidant capacity of the plasma were determined. Results: The level of lipid peroxidation was significantly higher in the premature neonates. An increase in the total antioxidant capacity was accompanied by a decrease in the damaged protein concentration. Significantly elevated activities of GPx alone were observed in the premature twins, though the GSH content too tended to be increased. The activity of SOD was decreased in the premature neonates. Discussion: The antioxidant status of twin neonates are mainly influenced by maturity. We suggest that the level of lipid peroxidation might be of clinical value as a marker of pre- and perinatal distress in twins.

SUMMARY. Background:Lungfunctiondatainhealthynewborninfantsarescarcelargelydueto lack of suitable techniques, although data for developmental and prenatal exposure studies are much needed. We have modified the forced oscillation technique (FOT) for the measurement of respiratory mechanical impedance (Zrs) in unsedated sleeping infants in the first 3 days of life. Methods: Zrs was measured during 30-s epochs of quiet sleep in term neonates born via spontaneous vaginal delivery with a non-invasive FOT between 8 and 48Hz. Total respiratory resistance (R), compliance (C) and inertance (I) were obtained by fitting Zrs spectra. Cluster analysis was used to determine a set of minimal Zrs spectra representing optimal respiratory mechanics for each infant. Results: Successful measurements were obtained in each of the first 3 days in 30/38 (78.9%) neonates. Group mean (� SD) values of R, C, I, and resonant frequency pooled for the 3 days were 45.9 � 16.6hPasL � 1 , 0.97 � 0.21mlhPa � 1 , 0.082 � 0.031hPas 2 L � 1 and 19.2 � 3.2Hz, respectively. Within-session variability represented by coefficient of variation was 5.34 � 3.18% for R and 13.80 � 8.57% for C. Greater between-session variability was observed for the individual infants; however, the only statistically significant change over time was a 13% increase in R from day 1 to day 2. Parameter interdependence was significant (r 2 ¼0.63) between R and I reflecting thelarge contribution of theupper airways to the total Zrs. Conclusions: Noninvasive measurement of Zrs can be made in neonates during natural sleep with a high success rate, even in the first hours of life. Pediatr Pulmonol. 2014 Wiley Periodicals, Inc.

Records of metric data of birth, serve not only the medical needs of the newborn baby, but are also indicators to assess the status of public health.This is a retrospective study of 4946 newborns (singleton: 2508 boys and 2365 girls) born in 1989 and in 2009 at the Department of Obstetrics and Gynaecology of the University of Szeged. We aimed as to compare and map the metrical changes over 20 years, and to describe the averages of four body parameters of the normal birth weight (2500-4000 g) subgroup (3993 singleton babies) in both years. Statistical analysis was performed with SPSS 17.0.In 1989, the mean birth weight was 3223.770 ± 559.595 g, birth length 49.551 ± 2.729 cm, chest circumference 32.181 ± 2.231 cm, and head circumference 34.122 ± 1.688 cm. In 2009, the birth weight was 3309.673 ± 582.630 g, birth length 49.515 ± 2.658 cm, chest circumference 32.736 ± 2.392 cm and head circumference 33.854 ± 1.768 cm. The mean birth weight, chest circumference and the maximum value of birth weight have thus increased. The mean maternal age shifted to 30.21 ± 4.863 years, which is an increase of 3.57 years in 20 years.The body parameters of newborns changed significantly between 1989 and 2009. As underlying causes changes in eating habits and lifestyle of the mother are to be mentioned.

Epidural analgesia (EA) is a widely accepted, safe, and reliable method of labour pain relief; it has proved to be beneficial to both mother and child. However, it can be associated with a longer s...

Although a large body of evidence has accumulated on the young human infant's ability to imitate, the phenomenon has failed to gain unanimous acceptance. Imitation of tongue protrusion, the most tested gesture to date, was examined in a sample of 115 newborns in the first 5 days of life in 3 seating positions. An ethologically based statistical coding system that coded all mouth and tongue movements regardless of whether they were imitative was employed. In order to assess the role of arousal, all arm and finger movements, as well as the infants' states, were coded. Neonates selectively increased the frequency of the strong, but not the weak, tongue protrusions; did not change their states; and did not increase the frequencies of the arm and general finger movements from the baseline to the modeling period, and the position of the baby significantly affected the outcome measures. The results confirm the human neonate's imitative ability, provide evidence that neonatal imitation is not an arousal response, and demonstrate that methodological factors affect the results.

Objective To assess the neonatal outcome of macrosomic neonates in uncomplicated, singleton, term deliveries. Study design A retrospective analysis was performed on 5738 live-born term neonates born in the period 2008–2009. The neonatal outcomes were compared between two birth weight (BW) groups: the macrosomic neonates born with BW ≥ 4000 g and a control group: 2500–3999 g. There were 410 (7.1%) neonates in the macrosomic group, 4757 (82.9%) in the control group, while 571 (10.0%) were less than 2500 g at birth. A correlation analysis of two subgroups of the macrosomic neonates (4000–4499 g vs. ≥4500 g) was also carried out. Results The rate of caesarean section (CS) was significantly higher in the macrosomic group as compared with the control group (49.3% vs. 39.9%), as were the prevalences of hypoglycaemia (6.1% vs. 2.9%), adrenal haemorrhage (0.98% vs. 0.15%) and the male to female ratio (2.15 vs. 0.95). The rate of icterus was significantly higher in the control group (30.4% vs. 18.5%). The macrosomic subgroups were similar in many aspects, but we found significantly more neonates in the higher weight subgroup as regards a low Apgar score, clavicle fracture and the need for intensive care. Conclusions The macrosomic infants were born in good general condition, although those with BW ≥4500 g more frequently had an adverse outcome. The macrosomic and control groups’ data revealed significant differences in the rate of CS, the male to female ratio, hypoglycaemia and adrenal haemorrhage.

Newborns are exposed to mechanical and oxidative stress during labor and to relative hyperoxia thereafter during the course of adaptation to the extrauterine conditions. Part of the adaptation mechanism is the rapid degradation of fetal hemoglobin and the oxidation of its heme moiety by heme oxygenases (HOs). Heme oxygenase-1 enzyme (HO-1) is the inducible isoform, which is induced by and protective against oxidative stress. We hypothesized that HO-1 may play a role in the physiological adaptation of newborns. We therefore measured the HO-1 mRNA expression with cRT-PCR during the first week after birth in healthy mature and premature newborns. We found that HO-1 was induced until day 2 or 3 after birth, but its level had dropped below the birth HO-1 mRNA level by the end of the first week. HO-1 levels and inducibility were similar in mature newborns and premature newborns. The fact that HO-1 was inducible even in gestation week 26 suggests that HO-1 plays an important role in the early adaptation processes.

Socio-emotional behaviour is in part sex-related in humans, although the contribution of the biological and socio-cultural factors is not yet known. This study explores sex-related differences during the earliest communicative exchange, the neonatal imitation in 43 newborn infants (3–96 hours old) using an index finger extension imitative gesture. Results showed that although the experimenter presented comparable stimuli to both sexes, and the total number of movements was similar in boys and girls, girls showed more fine motor movements, a higher number of specific imitative gestures, responded faster during the imitation and showed a higher baseline heart rate during the experiment. Newborn girls, with their faster and more accurate imitative abilities, may create a more responsive and interactive social environment, which in turn may lead to differences in socio-emotional and cognitive development between girls and boys. Copyright © 2007 John Wiley & Sons, Ltd.

Imitation of a fine motor movement, index finger protrusion, was examined in 39 neonates using an ethologically based objective coding system. Results confirmed that imitation of finger movements exists, and infants demonstrated "learning" as imitation developed through an incomplete imitation stage. Neonatal imitation was more frequently left-handed, an early sign of laterality in motivation to be investigated further. The existence of index finger imitation in human neonates indicates that volitional control of individuated finger movements develops much earlier than previously thought. The differential increase of index finger protrusion movements during the imitation periods suggests that this behavior is not an automatic response triggered by general arousal but instead is a true indicator of purposeful neonatal imitation.

Purpose: To compare the rate of birth weight discordance and perinatal outcome of twin pregnancies after assisted reproduction with that of spontaneous twins. Method: A total of 12,920 deliveries were analyzed retrospectively. Seventy-five twin pregnancies after ART were compared to the 94 spontaneous counterparts. Birth weight discordance was defined as a difference of 20% or more. Results: Discordance rate was elevated (25.3% vs. 17.0%) among ART twins. SGA was increased and NICU admission was more frequent in discordant group. Unlike-sexed twins were more prevalent (73.7% vs. 37.5%) among discordants after ART. Conclusions: ART can increase discordance rate which can elevate perinatal risk.

Background. The aim of the study was to evaluate the obstetric and neonatal outcome of pregnancies after assisted reproduction technology (ART) in comparison with matched controls from spontaneous pregnancies. Methods. A total of 12 920 deliveries at the Department of Obstetrics and Gynecology, University of Szeged, from 1 January 1995 to 31 December 2001 were subjected to retrospective analysis. Two hundred and eighty-four singleton, 75 twin and 17 triplet pregnancies after ovulation induction ( n = 114; 30.3%), intrauterine insemination ( n = 33; 8.8%) and in vitro fertilization ( n = 229; 60.9%) were evaluated. The pregnancy outcome of the singleton and twin pregnancies was compared with that for controls matched with regard to age, gravidity and parity and previous obstetric outcome after spontaneous pregnancies. Results. Twenty-four percent of the assisted reproductive pregnancies were multiple pregnancies. The incidences of singleton intrauterine growth retardation (IUGR) and preterm birth were reas...

Purpose : To determine the rates of pregnancy complications following in vitro fertilization in comparison with those in a matched control group. Methods : A total of 13,543 deliveries at the Department of Obstetrics and Gynecology, University of Szeged, between January 1, 1995 and February 28, 2002 were subjected to retrospective analysis. The 230 (1.7%) pregnancies following IVF-ET were evaluated and matched with spontaneous pregnancies concerning age, parity, gravidity, and previous obstetric outcome. Demographic and selected maternal characteristics, pregnancy and labor complications, and neonatal outcome were compared in the two groups. Results : The pregnancy complication rate was partly significantly higher among the singleton IVF-ET pregnancies. The obstetric risk was elevated, though not significantly concerning twin pregnancies. Conclusions : IVF-ET presents an additional obstetric risk. The neonatal outcome displays a significant difference only concerning an increased premature birth rate of singleton pregnancies. Triplet IVF-ET pregnancies involve a much higher risk of both pregnancy complications and neonatal outcome.

Acta Obstet Gynecol Scand 2002; 81: 313-316. © Acta Obstet Gynecol Scand 81 2002 Background. To determine the perinatal outcome of pregnancy in primiparous women over 35 years of age and to evaluate determinants predicting cesarean delivery in these women. Methods. Two hundred and seven mothers aged at least 35 years (1.8% of the total deliveries) delivered in the Department of Obstetrics and Gynecology between 1995 and 2000. These women were matched with women aged 20-29 years according to gravidity. Multiple logistic regression analysis was used to evaluate the risk of cesarean delivery, with controls for possible confounding factors. Results. Cesarean section was 2.09-fold more prevalent among the older than among the younger women; the difference being significant (odds ratio, OR=3.36, 95%CI 2.22-5.09; p

Objective: To determine the utility of the first-trimester fetal nuchal translucency (NT) thickness in the prediction of fetal cardiac malformations. Design: Retrospective study. Setting: Department of Obstetrics and Gynecology and Medical Genetics, University of Szeged. Methods: The pre- and postnatal course and outcome, and the relationship between the first-trimester fetal NT thickness and fetal congenital heart defects (CHDs) in 4309 pregnancies ended up with birth or therapeutic abortion between January 1998 and June 2000 were registered. Prenatal care included first- and second-trimester fetal sonography at weeks 10–13 and 18–20, respectively. Results: 4251 births and 58 first- and second-trimester therapeutic abortions due to lethal congenital malformations or chromosomal abnormalities were recorded. Altogether 209 (4.9%) congenital malformations were detected, 39 (18.7%) of which were heart defects with normal karyotype. At birth, 151 congenital malformations were diagnosed, 34 of them were known prenatally. The prevalence of CHDs was 9 per 1000 pregnancies. The measurement of fetal NT thickness was available in 35 of the 39 fetuses with heart defects: it was ≥3 mm in 18 (51.4%) and

Objectives: To compare the neonatal and maternal morbidity data associated with induced or naturally conceived pregnancies of primiparous women aged 35 years and older. Methods: We recruited primiparous women aged 35 years and older, who delivered between January 1995 and December 2000. The outcomes of the induced ( n =62) and naturally conceived ( n =132) pregnancies were compared. The Fisher exact test was used for univariate analysis in order to compare the delivery and pregnancy characteristics in the two groups. Results: Cesarean section featured with a 0.76 times lower prevalence among the induced pregnant women, than among the spontaneous ones, but the difference was not significant statistically. The induced pregnancies were not associated with a significantly higher rate of perinatal complications. Conclusions: Induced pregnancy does not involve a higher risk of maternal complications. The incidence of premature newborns and intrauterine growth retardation was high in both subgroups, but without a statistically significant difference.

To assess the incidence, risk factors and clinical presentations of neonatal adrenal haemorrhage (NAH) in uncomplicated, singleton and term deliveries.A retrospective analysis of 26,416 term neonates delivered between 2001 and 2013, and screened with abdominal ultrasonography.Of the 26,416 neonates, 74 (0.28%) displayed NAH; the male/female ratio was 1.55:1. Vaginal delivery was significantly more frequent than caesarean section among them (71 versus 3; 95.9% versus 4.1%). Unilateral bleeding occurred on the right side in 36 (48.7%), and on the left in 34 (45.9%), without a significant difference; bilateral haematomas were found in four cases (5.4%). The most common risk factors were macrosomia (16, 21.6%) and fetal acidaemia (23, 31%), while four (5.4%) neonates exhibited pathological acidaemia. Clinical presentations included jaundice in 37 (50%), anaemia in six (8.1%) and an adrenal insufficiency in only one (1.3%) case. In three cases, neuroblastoma was diagnosed.Vaginal delivery, macrosomia and fetal acidaemia are the most important risk factors for NAH. The adrenal glands on both sides were similarly involved. In the healthy neonates with NAH, the clinical presentations were mild, with spontaneous regression. Differentiation of NAH from tumours is of considerable importance.

Intrauterine growth restriction (IUGR) is a pleiotropic complication of pregnancy. Prematurity and growth abnormalities are common risk factors for perinatal morbidity and mortality. Free radical damage has been recognized as a common pathogenic mechanism of many neonatal diseases. The aim of the present study was to characterize the possible links between the level of maturity, the birthweight and the antioxidant status of neonates born with IUGR. Our data suggest that the stress markers measured on the cord blood of neonates with IUGR and mature, healthy neonates do not necessarily reflect the extent of oxidative stress. However, significant correlations were found between the maturity of the neonates with IUGR and the oxidative damage. The mature IUGRs exhibited ONOO − accumulation and increased lipid peroxidation more frequently as compared with the pre-term group. The results suggest that the oxidative injury in IUGR may depend on the level of maturity and the birthweight.

At present there are no exact epidemiologic data on the prevalence of neonatal skin disorders and birth marks in Hungary.The aim of the authors was to investigate the prevalence of skin disorders in mature healthy neonates after birth.The survey was carried out in the Neonatal Care Unit at the Department of Obstetrics and Gynaecology at the University of Szeged between April, 2012 and May, 2013.A total of 2289 newborn infants underwent whole-body screening skin examinations. At least one skin manifestation was found in 63% of the neonates. The major groups of skin disorders were transient benign cutaneous lesions, vascular lesions, pigmented lesions, traumatic, iatrogenic, congenital or acquired disorders with skin injuries, developmental abnormalities and benign skin tumours. The most frequent transient cutaneous lesions were erythema toxicum neonatorum, sebaceous hyperplasia and desquamation. The most common vascular lesions were naevus simplex, haemangioma and haemangioma precursor lesion, while the most frequently observed pigmented lesions were congenital melanocytic naevi and Mongolian spot.In the vast majority of cases, special treatment was not necessary, but 5.27% of the neonates required local dermatologic therapy, and in 9.2% of neonates follow up was recommended.Bevezetés: Magyarországon nincsenek pontos epidemiológiai adatok a születési jegyek, újszülöttkori bőrelváltozások prevalenciáját illetően. Célkitűzés: A szerzők az egészséges újszülöttek körében a születést követően észlelhető bőrgyógyászati kórképek, bőrtünetek előfordulási gyakoriságának felmérését tűzték ki célul. Módszer: A vizsgálatot a Szegedi Tudományegyetem Szülészeti és Nőgyógyászati Klinikájának Újszülött Osztályán végezték. Összesen 2289 gyermek bőrgyógyászati szűrővizsgálatára került sor. Eredmények: A vizsgált gyermekek 63%-ánál diagnosztizáltak legalább egyfajta bőrgyógyászati eltérést. A főbb diagnóziscsoportok a következők voltak: újszülöttkori tranziens benignus bőrelváltozások, vascularis laesiók, pigmentált laesiók, sérülések, traumák, veleszületett vagy szerzett bőrsérülésekkel járó elváltozások, illetve fejlődési rendellenességek, jóindulatú bőrdaganatok. A tranziens bőrelváltozások közül az erythema toxicum neonatorum, a sebaceus hyperplasia, a száraz bőr, a vascularis laesiók közül a naevus simplex, a haemangioma és haemangioma prekurzor laesiók, a pigmentált laesiók közül a congenitalis anyajegyek és a mongolfolt fordult elő leggyakrabban. Következtetések: Az esetek túlnyomó többségében speciális kezelésre nem volt szükség, azonban az újszülöttek 5,27%-ában speciális bőrgyógyászati helyi kezelést alkalmaztak, emellett az esetek 9,2%-ában rendszeres obszervációt tartottak indokoltnak. Orv. Hetil., 2014, 155(13), 500–508.

Lung function data in healthy newborn infants are scarce largely due to lack of suitable techniques, although data for developmental and prenatal exposure studies are much needed. We have modified the forced oscillation technique (FOT) for the measurement of respiratory mechanical impedance (Zrs) in unsedated sleeping infants in the first 3 days of life.Zrs was measured during 30-s epochs of quiet sleep in term neonates born via spontaneous vaginal delivery with a non-invasive FOT between 8 and 48 Hz. Total respiratory resistance (R), compliance (C) and inertance (I) were obtained by fitting Zrs spectra. Cluster analysis was used to determine a set of minimal Zrs spectra representing optimal respiratory mechanics for each infant.Successful measurements were obtained in each of the first 3 days in 30/38 (78.9%) neonates. Group mean (± SD) values of R, C, I, and resonant frequency pooled for the 3 days were 45.9 ± 16.6 hPa s L(-1), 0.97 ± 0.21 ml hPa(-1), 0.082 ± 0.031 hPa s(2) L(-1) and 19.2 ± 3.2 Hz, respectively. Within-session variability represented by coefficient of variation was 5.34 ± 3.18% for R and 13.80 ± 8.57% for C. Greater between-session variability was observed for the individual infants; however, the only statistically significant change over time was a 13% increase in R from day 1 to day 2. Parameter interdependence was significant (r(2) = 0.63) between R and I reflecting the large contribution of the upper airways to the total Zrs.Noninvasive measurement of Zrs can be made in neonates during natural sleep with a high success rate, even in the first hours of life.

Background. A prospective screening study was carried out at the regional genetic and perinatal center in South Hungary in order to determine the efficiency of first-trimester nuchal translucency screening for fetal aneuploidies, following augmentation of the availability of nuchal translucency screening in the region by the inclusion of newly-trained hospital sono-graphers. Methods. Nuchal translucency thickness was measured by transvaginal sonography in 7,044 women with singleton or multiple pregnancies at weeks 10-12. Fetal karyotyping was performed when the nuchal translucency was ≥2.5 mm, and in women with fetuses at high cytogenetic risk. Results. Follow-up was performed in 6,841 of the 7,044 screened women. An abnormal karyotype was found in 33 cases (0.48%). The level of increased nuchal translucency was 4.5% at a cutoff of ≥2.5 mm, and 2.8% at a cutoff of ≥3 mm. Seventeen cases of trisomy 21, eight of trisomy 18, four of trisomy 13, one of 45,X, one of triploidy and two cases with other chromosom...

This study examined the emergence of fear expressions, based on survey reports from a quasi-representative sample of 957 Hungarian mothers. Infant girls showed fear expressions significantly earlier (3.48 weeks) than boys (4.28 weeks). Results indicate a possible gender-related development of facial expressions of fear in human infants.