SummaryProthrombin of newborns was investigated by means of the quantitative immunoelectrophoresis and the two-dimensional immunoelectrophoresis. The plasma of 10 of 24 healthy term newborns and of 5 preterm infants taken immediately after birth showed one prothrombin precipitate in the a-2-fi-globulin position when a buffer containing 25 mM calcium lactate was used. No differences in the mobility and form of the precipitate could be observed as compared to healthy adults. The plasma of the other 14 term newborns and one small-for-date infant showed two precipitates, one in the a-2-&globulin position and a second in the a-1-globulin position. Twenty-four hr after the injection of vitamin K, the precipitate in a-1-globulin position was no longer evident.When a buffer without calcium was used in the two-dimensional immunoelectrophoresis, only one precipitate in the a-1-globulin position was found in all newborns. In the quantitative immunologic determination, the prothrombin was found to be decreased as compared to that of adults. The quantitative immunologic determination and the activity assay gave equal results in those infants who had only one precipitate in the two dimensional immunoelectrophoresis. In those newborns, who had two precipitates, the quantitative immunologic determination gave higher results than the measurement of the activity assay.From this study, no evidence of differences between the prothrombin of newborns and that of adults could be derived. Vitamin K deficiency, as judged from the appearance of a second peak in a-1-globulin position in the two dimensional immunoelectrophoresis was a frequent finding in term newborns, even on the 1st day of life. small for date. Five were prematures with a gestational age of 3 1-35 wk. None of these five prematures had perinatal problems, in spite of their prematurity. All but two children received 1 mg/kg vitamin K (Konakion) im shortly after birth.Immediately after birth, blood was drawn from the umbilical vein and again 24 hr afterwards by puncturing a peripheral vein. Blood samples were collected in plastic tubes containing 1/10 volume of 0.1 M trisodium citrate. The plasma was stored at -20' C until the determinations were carried out.Prothrombin activity was determined by the one stage assay (20) using a test kit of the Behring Co.Prothrombin was quantified immunologically according to Laurel] (1 I), using a monospecific rabbit antiserum against prothrombin (Behring Co): 1% agarose, barbital buffer of a pH of 8.6, 6-7 V/cm.Calibration curves for the activity and for the quantitative immunologic determination were done with a pooled plasma of 20 healthy adults and the results were expressed in percent of this pooled piasma. Two-dimensional immunoelectrophoresis (4, 5) was done, using rabbit antiserum against human prothrombin 1) with a barbital buffer of a pH of 8.6 and 2) with a barbital buffer of a pH of 8.6 and 25 mM calcium lactate. Agarose, 1%, first dimension 6-7 V/ cm for 4 hr, second dimension 2-3 V/cm for 12-14 hr.Plasma of healthy adults a...

Based on the results from semistructured interviews with parents of fifty SIDS victims and of fifty matched controls we developed a SIDS risk questionnaire, the so-called SRFB Graz. In a retrospective study this questionnaire was applied to 65 SIDS victims and 195 comparable controls. By statistical analysis a cut point was computed, which discriminates SIDS cases from controls with a sensitivity of 86% and a specificity of 95%.

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Severe neonatal acidosis, defined in this study as a pH of 7,00 or less in the blood of the umbilical artery occurred in 0,4% of 8 992 life born term babies between 1980 and 1981. Analysis of high risk factors during pregnancy showed no difference between acidotic and non acidotic newborns, whereas in all newborns with severe acidosis there were more or less unexpected acute complications during delivery, such as abrutio placenta or cord complications or else. 60% of infants were born by cesarian section or forceps. Resuscitation was performed in an aggressive manner by starting IPPV within one minute post partum, correcting the acidosis and by attempting to stabilize circulation by administration of glucose and human albumin. 6 babies required prolonged ventilatory support over 24 hours. 27 newborns received parenteral solutions of glucose and amino-acids for 6 or more days. Severe acidosis was followed in 8 babies by abnormal neurologic symptoms. In infants with severe acidosis Apgar-score at one minute was not found to be significantly related to subsequent outcome. A NapH of less than or equal to 6,90 and/or Apgar-score of less than or equal to 4 at five minutes, especially in connection with additional risk factors, is an ominous finding.