Low-birth-weight children

Whitaker, A.H., Van Rossem, R., Feldman, J.F, Schonfeld, I.S., Pinto-Martin, J.A., Tore, C., Shaffer, D., and Paneth, N. (1997) Psychiatric outcomes in low-birth-weight children at age 6 years relation to neonatal cranial ultrasound abnormalities. Arch Gen Psychiatry 54 847-856. 

Robson AL, Pederson DR. 1997. Predictors of individual differences in attention among low birth weight children. J Dev Behav Pediatr 18 13-21. 

Pregnant women Children 6-24 months (normal birth weight) Children 6-24 months (low birth weight) Children 2-5 years Children 6-11 years Adolescents and adults 60 mg iron + 400 ng folic acid daily 12.5 mg lron +50ng folic acid daily 12.5 mg lron + 50ng folic acid daily 20-30 mg Iron dally 30-60 mg Iron dally 60 mg iron daily 6 months In pregnancy " 6-12 months of age" 2-24 months of age... 

The symptoms of vitamin E deficiency in animals are numerous and vary from species to species (13). Although the deficiency of the vitamin can affect different tissue types such as reproductive, gastrointestinal, vascular, neural, hepatic, and optic in a variety of species such as pigs, rats, mice, dogs, cats, chickens, turkeys, monkeys, and sheep, it is generally found that necrotizing myopathy is relatively common to most species. In humans, vitamin E deficiency can result from poor fat absorption in adults and children. Infants, especially those with low birth weights, typically have a vitamin E deficiency which can easily be corrected by supplements. This deficiency can lead to symptoms such as hemolytic anemia, reduction in red blood cell lifetimes, retinopathy, and neuromuscular disorders. 

Chronic exposure to Pb has been shown to cause anaemia, neurotoxic effects, such as reduced cognitive performance and reduced peripheral nerve conduction velocity, and nephrotoxicity. Children are more sensitive to exposure to Pb than adults, especially during the first 2 years of life [41], For children, exposure to lead can cause growth retardation, affect the neuropsychological development and cause encephalopathy [39]. Adverse reproductive effects due to lead exposure have been observed for both men and women. Exposure of pregnant women to low concentrations of lead is associated with miscarriages and low birth weights [40],... 

Most children born with HIV are asymptomatic. On physical examination, they often present with unexplained physical signs such as lymphadenop-athy, hepatomegaly, splenomegaly, failure to thrive, and weight loss or unexplained low birth weight, and fever of unknown origin. Laboratory... 

The risks of untreated depression in pregnancy should be considered. These included low birth weight, maternal suicidality, potential for hospitalization or marital discord, poor prenatal care, and difficulty caring for other children. 

Women who smoke marijuana during pregnancy may have low birth-weight babies who are at risk for developmental difficulties and are more susceptible to disease. Like other drugs, THC also crosses the placental barrier and affects the embryo as it grows some studies indicate that this may increase a baby s risk of developing leukemia. THC also passes into breast milk, where research has shown that it can affect a child s motor development. Toddlers whose parents smoke marijuana have been found to be angrier and to have more behavioral problems than children whose parents do not use marijuana. 

As indicated previously, adverse health outcomes from early exposures may become apparent at any point in the lifespan. In some instances, they may be apparent only after long latency periods. Chapter 6 addresses the various methodologies that can be used to assess health outcomes. Studies have shown that the effects of toxic exposures on developmental processes may result from different mechanisms of action, and the toxic exposures may produce different health outcomes compared with the same exposures in adults. Some examples of health effects resulting from developmental exposures include those observed prenatally and at birth (e.g. miscarriage, stillbirth, low birth weight, birth defects), in young children (e.g. asthma, neurobehavioural and immune impairment), in adolescents (e.g. precocious or delayed puberty), and in adults (e.g. diabetes and heart disease). 

Goldman LR, Paigen B, Magnant MM, et al. 1985. Low birth weight, prematurity and birth defects in children living near the hazardous waste site, Love Canal. Hazardous Waste and Hazardous Materials 2 209-223. 

The safety of midazolam in very low birth-weight neonates is being questioned. In 200 children weighing 3-15 kg premedicated with rectal midazolam 0.5 or 1.0 mg/ kg before minor surgery, the incidence of hiccups was 22% and 26% respectively (28). The mean age of children with hiccups was 6 months and of children without hiccups 20 months. Intranasal ethyl chloride spray was 100% successful in treating the hiccups. The incidence of hiccups was related to age but not dose. The effectiveness of... 

IGIV is used either for andbody replacement or immuno-moduladon. Some of the incUcadons as replacement therapy include general or specific immunodeficiency states e.g., hepadds A prophylaxis, chronic lymphocydc leukemia with hypogammaglobulinemia, muldple myeloma with specific andbody deficiency, low birth weight babies at risk for infecdon and infants/children with HIV. It is also used as an immune modulator in concUdons such as idiopathic thrombocytopenic purpura and acquired hemophilia (Krensky et ah, 2005 Shah, 2005). 

In a group of children with fever, neutropenia, and neoplastic disease, there was an increase in renal fluconazole clearance (45). In infants and children, the volume of distribution of fluconazole is significantly higher and falls with age. With the exception of infants, who have a slower clearance rate, children clear the compound more rapidly (61). However, a second larger study reported slower elimination in children under 1 year of age, requiring dosage adjustments (62). Low birth-weight neonates have a particularly low clearance rate, which increases within weeks (63). 

The use of fluconazole in 726 children under 1 year of age, reported in 78 publications, has been reviewed (64). They received a wide range of dosages for up to 162 days. Fluconazole was well tolerated and efficacious in the therapy of systemic candidiasis and candidemia in children under 1 year of age, including neonates and very low birth-weight infants. The daily dosage recommended by the manufacturers is 6 mg/kg, to be reduced in patients with impaired renal function in accordance with the guidelines given for adults. 

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