Intrapartum synthetic oxytocin reduce the expression of primitive reflexes associated with breastfeeding.

AIM: Several synthetic peptide manipulations during the time surrounding birth can alter the specific neurohormonal status in the newborn brain. This study is aimed at assessing whether intrapartum oxytocin administration has any effect on primitive neonatal reflexes and determining whether such an effect is dose-dependent. MATERIALS AND METHODS: A cohort prospective study was conducted at a tertiary hospital. Mother-infant dyads who received intrapartum oxytocin (n=53) were compared with mother-infant dyads who did not receive intrapartum oxytocin (n=45). Primitive neonatal reflexes (endogenous, antigravity, motor, and rhythmic reflexes) were quantified by analyzing videotaped breastfeeding sessions in a biological nurturing position. Two observers blind to the group assignment and the oxytocin dose analyzed the videotapes and assesed the newborn's state of consciousness according to the Brazelton scale. RESULTS: The release of all rhythmic reflexes (p=0.01), the antigravity reflex (p=0.04), and total primitive neonatal reflexes (p=0.02) in the group exposed to oxytocin was lower than in the group not exposed to oxytocin. No correlations were observed between the dose of oxytocin administered and the percentage of primitive neonatal reflexes released (r=0.03; p=0.82). CONCLUSIONS: Intrapartum oxytocin administration might inhibit the expression of several primitive neonatal reflexes associated with breastfeeding. This correlation does not seem to be dose-dependent.

Mode of delivery may influence neonatal responsiveness to maternal separation.

INTRODUCTION: Maternal-infant separation (MIS) is a highly stressful situation for the neonate. MATERIALS AND METHODS: A study was conducted to observe and describe the reactions of term neonates to brief maternal separation and restoration of skin contact within the first 48 h of life, and to assess whether the mode of delivery influences neonatal responsiveness. A brief maternal-infant separation situation was videotaped to observe the reactions of the newborns within the first 12-48 h of life. Characteristics observed in the newborns were: the Moro reflex, spreading out arms and feet, looking at the mother, presence/lack of crying, and some dichotomous variables (present or lacking); in mothers: adult speech, "motherese" speech, speaking to another adult present in the room, singing, clicking, tapping on the diaper, rocking, kissing the baby, touching toes, touching hands, changing position, making loving comments, calling the newborn by his/her name and touching his/her back. Crying on restoration of contact was measured. RESULTS: Ten neonates born by planned C-section and 21 neonates born by oxytocin-induced vaginal delivery were included. No behavioral differences were observed according to the mode of delivery. Neonates born by vaginal delivery took longer (64.8±8.6 s) to calm down than those born by C-section (0.9±1.4 s) (p=0.004). A correlation was observed between cortisol concentrations at birth and the time required to calm the baby down (r=0.41; p=0.02). CONCLUSION: Neonates born by a planned C-section cried much less on maternal separation, which might indicate an altered attachment behavior and altered response to stress. Further studies are needed to determine the potential long-term implications of variations in mother-infant attachment during the first days of life.

[Analysis of Spanish scientific production in rare diseases: 1990-2000]. / Análisis de la producción científica española sobre enfermedades raras: 1990-2000.

BACKGROUND AND OBJECTIVE: To analyze the Spanish scientific production in a group of rare diseases selected during the period 1990-2000. MATERIAL AND METHOD: Analysis of the following disease groups: congenital anomalies, metabolism inborn errors and primary immunodeficiencies. Bibliometric tools were used to assess and analyze the evolution of research in this area. The MEDLINE database was utilized for references search. RESULTS: Total references recovered for the study were 2978: 82.5% original articles and 17.3% reviews. The number of authors was 14,752 and the mean author/article was 4.9%. Seven types of institutions were coded with hospitals being the most productive with 78% of articles published. The Bradford nucleus was formed by 1,288 articles and 43.2% of the total had been published in 12 journals (2.1%). CONCLUSIONS: Despite rare diseases research is still scarce, important efforts have been made at a national level focused on the development and strengthening of research in this field. Nevertheless, it is necessary to join efforts in this field to facilitate an appropriate research policy making that may help improve the current status.