J Korean Med Assoc.  2006 Nov;49(11):1003-1008. 10.5124/jkma.2006.49.11.1003.

The Disease Spectrum in Premature Infants and the Progress of Pharmacological Treatment

Affiliations
  • 1Division of Neonatology, Department of Pediatrics, Ulsan University College of Medicine, Korea. sypi@amc.seoul.kr

Abstract

Liveborn infants delivered before 37 week of postmenstrual age or less than 2,500g of birth weight are defined as premature infants. Recently, the unprecedented progress in neonatal practice has achieved remarkable improvements in the survival of extremely premature infants. However, immature organ function and the complication of therapy still contribute to the high mortality and morbidity from a spectrum of disease especially in extremely premature, low birth weight infants; respiratory distress syndrome, chronic lung disease, necrotizing enterocolitis, intraventricular hemorrhage, nosocomial infection, and prolonged hospitalization consist of the spectrum of disease in premature infants. To achieve further progress in neonatal-perinatal practice, randomized clinical trials should be employed not just to test the effectiveness of new therapies but also to evaluate competing strategies toward evidence-based, better clinical practice.

Keyword

Premature infant; Immaturity; Morbidity; Pharmacological treatment

MeSH Terms

Birth Weight
Cross Infection
Enterocolitis, Necrotizing
Hemorrhage
Hospitalization
Humans
Infant
Infant, Extremely Premature
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature*
Lung Diseases
Mortality

Reference

1. Muraskas J, Hasson A, Besinger RE. A girl with a birth weight of 280g, now 14 years old. New England Journal of Medicine. 2004. 351:836–837.
2. Fujiwara T, Konishi M, Chida S, Okuyama K, Ogawa Y, Nakamura H, et al. The Surfactant-TA Study Group. Surfactant replacement therapy with a single postventilatory dose of a reconstituted bovine surfactant in preterm neonates with respiratory distress syndrome: final analysis of a multicenter, double-blind, randomized trial and comparison with similar trials. Pediatrics. 1990. 86:753–764.
Article
3. NIH Consensus Development Panel: Effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA. 1995. 273:413.
4. Tooley J, Dyke M. Randomized study of nasal continuous positive airway pressure in the preterm infant with respiratory distress syndrome. Acta Paediatrica. 2003. 92:1170–1174.
Article
5. Dani C, Bertini G, Pezzati M, Cecchi A, Caviglioli C, Rubaltelli FF. Early extubation and nasal continuous positive airway pressure after surfactant treatment for respiratory distress syndrome among preterm infants <30 weeks' gestation. Pediatrics. 2004. 113:e560–e563.
Article
6. Kinsella JP, Cutter GR, Walsh WF, Gerstmann DR, Bose CL, Abman SH, et al. Early inhaled nitric oxide therapy in premature newborns with respiratory failure. New England Journal of Medicine. 2006. 355:354–364.
Article
7. Field D, Elbourne D, Truesdale A, Grieve R, Hardy P, Normand C, et al. INNOVO Trial Collaborating Group. Neonatal Ventilation With Inhaled Nitric Oxide Versus Ventilatory Support Without Inhaled Nitric Oxide for Preterm Infants With Severe Respiratory Failure: the INNOVO multicentre randomised controlled trial. Pediatrics. 2005. 115:926–923.
8. Yeh TF, Lin YJ, Lin HC, Huang CC, Hsieh WS, Tsai CH, et al. Outcomes at school age after postnatal dexamethasone therapy for lung disease of prematurity. New England Journal of Medicine. 2004. 350:1304–1313.
Article
9. Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Tin W, et al. Caffeine for Apnea of Prematurity Trial Group. Caffeine therapy for apnea of prematurity. New England Journal of Medicine. 2006. 354:2112–2121.
Article
10. Bandstra ES, Montalvo BM, Goldberg RN, Pacheco I, Ferrer PL, Bancalari E, et al. Prophylactic indomethacin for prevention of intraventricular hemorrhage in premature infants. Pediatrics. 1988. 82:533–542.
Article
11. Fowlie PW, Davis PG. Prophylactic intravenous indomethacin for preventing mortality and morbidity in preterm infants. Cochrane Database of Systematic Reviews. 2002. 3:CD000174.
Article
12. Koch J, Hensley G, Roy L, Brown S, Ramaciotti C, Rosenfeld CR. Prevalence of spontaneous closure of the ductus arteriosus in neonates at a birth weight of 1000 grams or less. Pediatrics. 2006. 117:1113–1121.
Article
13. Cotton RB, Haywood JL, Fitzgerald GA. Symptomatic patent ductus arteriosus following prophylactic indomethacin. A clinical and biochemical appraisal. Biology of the Neonate. 1991. 60:273–278.
14. Gersony WM, Peckham GJ, Ellison RC, Miettinen OS, Nadas AS. Effects of indomethacin in premature infants with patent ductus arteriosus: results of a national collaborative study. Journal of Pediatrics. 1983. 102:895–906.
Article
15. Seri I. Hydrocortisone and vasopressor-resistant shock in preterm neonates. Pediatrics. 2006. 117:516–518.
Article
16. Section on Ophthalmology American Academy of Pediatrics. American Academy of Ophthalmology. American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2006. 117:572–576.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr