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Background/objectives: To quantify the rate of progressive failure of very-low-birth-weight (VLBW) infants over time in the neonatal intensive care unit to meet growth milestones., Subjects/methods: In a prospective longitudinal study, 114 VLBW preterm infants (1500 g) of both sexes, with normal and/or low weight for gestational age were included. At the start, weight, length, mid-upper arm (MUAC), thigh and cephalic circumferences were measured. Weight/age (W/A), length/age and weight/length (±2 z-score) indices were calculated. All measurements were taken at inclusion, at 7, 15 and 30 days of hospitalization. Chi-square test, analysis of variance and repeated-measures tests were estimated., Results: Thirteen cases (14%) died and were excluded soon after the first determinations. In all, 9 (8.9%) died during the study, 12 (11.9%) were discharged before 30 days of life and 80 (79.2%) completed the study. At 7 days, the percentage of preterm infants with an index of W/A <-2 z-scores increased from 44 to 67% (44-68 subjects; P<0.01), with no changes afterwards; the indicator MUAC <-2 z-scores increased at 7 days from 23 to 49% (23-49 subjects); at 15 from 23 to 65% (23-61 subjects) and at 30 days from 23 to 79% (23-63 subjects; P<0.001)., Conclusions: Clinicians could use these indicators for earlier detection of growth failure in VLBW infants in order to target more aggressive nutrition early.

Background: Late-onset sepsis (occurring after 3 days of age) either cross-infection (CI) or perinatal is the first cause of morbidity and mortality in neonatal intensive care units (NICU) around the world. Our objective was to determine the current incidence of CI risk factors in neonates admitted to the NICU of the Hospital Civil de Guadalajara during a 9-month period., Methods: A case-control study with 114 newborns; 38 with CI and 76 controls. Odds ratio with 95 % confidence interval were calculated., Results: Associated risk factors were total parenteral nutrition (OR = 16.54, CI = 6.30-43.39, p < 0.001); weight < 1000 g (OR = 7.33, CI = 2.15-25.01, p < 0.001); intravascular catheter (OR = 6.79, CI = 2.68-17.00, p < 0.001); gestational age < 30 weeks (OR = 4.54, CI = 1.61-12.81, p < 0.003); intratracheal intubation and mechanical ventilation with (OR = 6.98, CI = 2.94-16.5, p < 0.001)., Conclusions: Total parenteral nutrition and weight < 1000 g showed the greatest association with cross-infection; in this study, male gender was not a risk factor.

Background: Laboratory test used in the diagnosis of neonatal sepsis have a low specificity. Recently, procalcitonin has been proposed as a marker to identify the presence of systemic infections. The objective of the study was to evaluate the sensibility and specificity of procalcitonin as a marker of systemic infection in newborn with a suspicion of neonatal sepsis using a blood culture as a gold standard., Methods: 21 newborn with a suspicion of neonatal sepsis were included in the study, postnatal age 8.3 +/- 5.2 days in a period from October 2003 to a January 2004. Procalcitonin, were measured at the moment of clinical diagnosis and after 24 and 48 hours and twice blood culture were done., Results: Seven blood cultures were positive at the moment of diagnosis as well as 21 determinations of procalcitonin, sensibility 85.7%, specificity 21.7%; (OR = 1.63, 95% CI = 0.14-19.4); determinations after 24 hours showed procalcitonin sensibility and specificity of 85.7% and 28.5% (OR = 2.4, 95% CI = 0.22-26.6) and after 48 hours 100% of sensibility and 42.8% of specificity (OR = 1.75, 95% CI = 1.11-2.75])., Conclusions: Positive procalcitonin has a good sensibility and moderate specificity 48 hours after clinical diagnosis of neonatal sepsis.

Objective: To identify maternal and neonatal risk factors associated with hyaline membrane disease and its mortality., Patients and Method: A case-control study with 41 newborns with hyaline membrane disease and 123 controls was made between September 2001 and February 2002 in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. The diagnosis of hyaline membrane disease was done with clinical and radiographic data. Maternal risk factors were obtained by direct interview with the mother; the newborn data were obtained of the clinical files. The association was measured with the odds ratios (OR) and the confidence interval of 95%., Results: The frequency of hyaline membrane disease was of 6.8 per 1,000 live births. Mortality rate was of 2.8 per 1,000 live births. There were 17 deaths (41%). The risk factors associated with hyaline membrane were: illness during the first and second trimester of pregnancy, (OR: 3.28 [1.16-9.31]; OR: 8.88 [3.56-22.50], respectively), Apgar score lower than seven at the first minute (OR: 18.57 [4.50-88.67]), and masculine gender (OR: 2.58 [1.15-5.83])., Conclusions: Frequency and mortality were similar to the reported by other studies made in population samples. The exposure to illnesses during pregnancy and the low Apgar score were associated with the increased frequency of hyaline membrane disease.

Objective: To identify the obstetrics and neonatal risk factors associated with transient tachypnea of the newborn., Patients and Methods: Case-control study of 110 neonates with transient tachypnea and 110 newborns controls, between May and October 2000, in the Hospital Civil de Guadalajara Dr. Juan I. Menchaca. The diagnosis of transient tachypnea was done by clinical and radiology data and exclusion of the other causes of respiratory distress. The exposure was documented by a direct interview to the mother and clinical information of the clinical expedient. The association was measured with the odds ratios and confidence interval of 95%., Results: The frequency of transient tachypnea was of 2 percent newborn alive. The risk factors that were associated with transient tachypnea was: low Apgar score at minute (OR: 33.74, CI 95%: 4.73-681.52), premature rupture of amniotic membranes (OR: 3.65, CI 95%: 1.53-8.90), cesarean section (OR: 2.01, CI 95%: 1.14-3.57) and masculine gender (OR: 2.02, CI 95%: 1.14-3.60). It was more frequent in the cases the antecedent of diabetes mellitus and bronchial asthma., Conclusions: The results suggest that it's necessary to improve the obstetrics surveillance to diminish the frequency of low Apgar score and risk factors associated with transient tachypnea of the newborn.

We analyzed prenatal history of 277 live low birth weight infants (less than 2,500 g). We tried to determine some perinatal factors that may be associated with good prognosis in this group of babies. The variables analyzed were: maternal age, number of prenatal visits, complication of pregnancy, mode of delivery, birth weight, sex, gestational age. Apgar score at 1 minute and the neonatal morbidity. The population was divided in 3 groups: 1. Less than 1,000 g, (3).2. 1,000-1,499 g, (37) and 3. 1,500-2,499 g (237). Each group was also divided in appropriate for gestational age (AGA) and small for gestational age (SGA). We found that morbidity and the risk of death, is less in the SGA compared with AGA, associated with better prenatal care, higher birth weight and gestational age.