This study compared concentrations of total protein, lysozyme, and immunoglobulins (IgA, IgG, IgM) in samples of colostrum (n=101) obtained from mothers of infants<32 weeks, 32 to 36(6) 7 weeks, and >or=37 weeks gestational age, both before and after pasteurization. Total protein was measured by refraction index, lysozyme by the lysoplate method, and immunoglobulins through the radial immunodiffusion technique. The total protein concentration was greater in colostrum of the <32 weeks and 32 to 36(6) 7 weeks categories compared to full-term (P<.001), while concentrations of lysozyme and IgM were similar. IgA concentrations were higher in the <32 weeks group compared to the full-term and similar to the 32 to 36(6) 7 weeks group (P<.05). The IgG was higher in the <32 weeks category compared to 32 to 36(6) 7 weeks, and both were similar to the full-term (P<.05). Pasteurization significantly decreased all of the factors analyzed.

More than half of the VLBW infants born at public university level 3 Brazilian hospitals either die or survive with major morbidities.

The performance of very low birth weight preterm infants, in terms of cognition and expressive language, was analyzed and compared with that of term infants with the Protocol for Expressive Language and Cognition Development Observation (PELCDO). The study involved 12 very low birth weight preterm infants and 20 term infants, all of whom were evaluated monthly. Sessions were videotaped, and data were analyzed according to this specific protocol. Our results suggest that cognition and expressive language develop significantly later in very low birth weight preterm infants than in the term. We found positive correlations for cognitive and expressive language development, the delay becoming more evident after 6 months of age, persisting through the sensorimotor period, and continuing into the beginning of preoperational period, indicating the importance of follow-up evaluation, defining the true needs of such infants and identifying the ideal moment for speech-language intervention.

The objectives of this study were to determine the incidence of infection by respiratory viruses in preterm infants submitted to mechanical ventilation, and to evaluate the clinical, laboratory and radiological patterns of viral infections among hospitalized infants in the neonatal intensive care unit (NICU) with any kind of acute respiratory failure. Seventy-eight preterm infants were studied from November 2000 to September 2002. The newborns were classified into two groups: with viral infection (Group I) and without viral infection (Group II). Respiratory viruses were diagnosed in 23 preterm infants (29.5%); the most frequent was respiratory syncytial virus (RSV) (14.1%), followed by influenza A virus (10.2%). Rhinorrhea, wheezing, vomiting and diarrhea, pneumonia, atelectasis, and interstitial infiltrate were significantly more frequent in newborns with nosocomial viral infection. There was a correlation between nosocomial viral infection and low values of C-reactive protein. Two patients with mixed infection from Group I died during the hospital stay. In conclusion, RSV was the most frequent virus in these patients. It was observed that, although the majority of viral lower respiratory tract infections had a favorable course, some patients presented a serious and prolonged clinical manifestation, especially when there was concomitant bacterial or fungal infection.

This study is the first that highlights the effectiveness of T-piece resuscitator ventilation in improving relevant outcomes in preterm neonates.