[Development of neonates at risk]. / Dalsí vývoj rizikových novorozencu.

From a group of 2542 children followed up for a prolonged period the authors selected several groups of risk neonates and compared their subsequent development with that of a control group from the same cohort. In the selected risk groups the authors evaluated anamnestic data of the mothers, somatic and neuropsychic development of the children. They compared also the psychomotor development of the children in the first years of life, their school attendance and progress, mean values of IQ and various mental deviations, as compared with children of the control group. By comparison with the incidence of analogous disorders the authors wanted to assess the ratic risks from early stages in later developmental disorders.

[Risk of morbidity in neonates in Prague 1980-1984]. / Riziková morbidita novorozencu v Praze v letech 1980-1984.

An epidemiological analysis of 3427 hospitalized neonates at four Prague intensive care and intermediary care units in 1980-1984 revealed that of the total neonatal risk morbidity, 5.6%, the greatest ratio is accounted for by non-inflammatory respiratory diseases, 3.3%, followed by infections, 1.5%, and serious congenital defects, 0.7%. The incidence of the above groups is higher in Prague, as compared with Scandinavian countries. The lethality of inflammatory diseases and serious congenital defects is the same, in the group of non-inflammatory disease it is markedly higher in particular in the sub-group of pulmonary maladaptation--early asphyctic syndrome. The perspective of reduction of neonatal mortality calls in particular for a reduced incidence of risk morbidity and better care of critically ill neonates.

[Perspectives on reducing morbidity and mortality in Prague]. / Perspektiva snizování morbidity a mortality v Praze.

From data obtained by means of a questionnaire from Prague neonatologists from seven maternity hospitals and four intensiv care units in Prague in 1980-1984 a detailed analysis was made of the specific morbidity and mortality of neonates during the first seven days after birth in a large neonatal population, incl. causes of morbidity and mortality. The analysis was focused on the morbidity of those nosological non-inflammatory and inflammatory units which threaten the life of neonates, which cause morbidity and where mortality is the extreme pole. Data and causes were compared with analogous data from countries with the highest standard of neonatal care--Sweden and Finland. The authors outline the procedure used for analysis of the necessary data in order to differentiate inevitable and evitable risks which damage the foetus and neonate and they analyzed the causes of different data from obstetric practice focused on prevention of hypoxia, immaturity, lethal congenital defects and factors from differentiated neonatalogical care.

Influence of intravenously administered intralipid on free fatty acid concentration and albumin binding capacity to bilirubin in newborn infants.

During a 24-hour interval, examination was carried out of 5 full-term and 4 preterm newborns in whom no disturbance of postnatal adaptation was found. The newborns received parenteral nutrition using infusates containing 20% Intralipid during 7 hours on the average. The mean daily dose of Intralipid was 1.2 g/kg, infusion rate was 0.17 g/kg/h. The concentration of FFA (n = 9) and ABC/Bi was examined three times in the course of 24 hours, and that prior to Intralipid administration, after one-hour infusion, and approximately 17 hours after the end of infusion. Before infusion and 24 hours after the first collection, blood bilirubin and glucose concentrations, and the values of pH, pCO2 and BE (= 9) were examined. One hour after the start of Intralipid infusion the mean FFA concentration was reduced and decreased again during the following 23 hours. The differences were mostly insignificant. One hour after the start of infusion the mean value of the ABC/Bi ratio decreased insignificantly, but returned to the initial value by the end of the follow-up period (24 hours). The mean concentration of bilirubin and blood glucose and the values of pH, pCO2 and BE did not change significantly. It may be reasonably assumed, that in newborns showing normal postnatal adaptation in the first days of life, the administration of 20% Intralipid (as parenteral nutrition) exerts no substantial effect on the plasma FFA concentration and ABC/Bi ratio in the course of 24 hours. General principles for the indication of parenteral Intralipid administration to the newborn are given.

Postnatal development of plasma FFA concentration and its influence of the separation of bilirubin from albumin binding in newborns.

The first part of the study gives data on the FFA concentrations, glycaemia and energy quotient in newborns with uncomplicated postnatal adaptation in the first 2 weeks of life. The study was carried out in a group of 69 full-term and 69 pre-term infants at the age of 24, 48, 72, 96 hours and 7 and 14 days. Although it is not the case of consecutive values of FFA concentrations in plasma, a certain developmental trend can be suggested. This is analogous in both groups with the only difference that in pre-term infants FFA culminate and decrease earlier (pre-term 48-72 hours, full-term infants 72-96 hours). The study shows that, in pre-term and full-term infants with satisfactory postnatal adaptation and above nutrition, stabilization of glucose-lipid metabolism occurs on the 3rd and 4th day after birth, respectively. In pre-term infants supplementary nutrition by the glucose system (glucose and amino acids) had a favourable effect. The second part of the study assesses the potential risk of increasing plasma FFA concentration for the separation of bilirubin from albumin binding. The means plasma FFA concentrations reached 25-48 and 49-72 hours after birth had no significant effect on the BCA/Bi ratio and, therefore, they are not dangerous as regards the possibility of displacing bilirubin from albumin binding.