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Murguia-Peniche T.,National Center for Child and Adolescent Health
Journal of Pediatrics | Year: 2013

Vitamins A and D are essential nutrients that play important roles in growth and development. Preterm and low birth weight infants have low levels of these nutrients and are at risk for developing detrimental health consequences associated with vitamin A and vitamin D deficiencies. Preliminary data suggest that vitamin A and D supplementation is needed to prevent deficiency. More work is needed to define optimal doses, timing, and modes of administration to ensure that an adequate supply of these vitamins is available to meet the critical needs during pregnancy and in high-risk neonates. Source


Murguia-Peniche T.,National Center for Child and Adolescent Health | Mihatsch W.A.,Munich Municipal Hospitals | Zegarra J.,Hospital Nacional Cayetano Heredia | Supapannachart S.,Mahidol University | And 2 more authors.
Journal of Pediatrics | Year: 2013

The interplay between microorganisms and the intestine of newborn infants is associated with diverse functional and clinical outcomes that result from the specific interactions among microbial communities, their products, and the unique characteristics of the gastrointestinal tract. Multiple mechanisms of action for infant formula ingredients with probiotic activity appear to exist. These mechanisms are thought to protect the host not only from intestinal diseases but also from systemic infection. However, questions about the safety of probiotics for preterm infants remain unanswered, particularly with regard to sepsis, immunomodulatory effects, and microbial resistance. Few well-designed studies have been conducted to evaluate the effects of probiotic, prebiotic, and synbiotic ingredients on relevant clinical outcomes in preterm infants. Although existing data are encouraging, there is insufficient evidence to recommend the routine use of these ingredients in all preterm infants. Source


Neu J.,University of Florida | Mihatsch W.A.,Munich Municipal Hospitals | Zegarra J.,Hospital Nacional Cayetano Heredia | Supapannachart S.,Mahidol University | And 2 more authors.
Journal of Pediatrics | Year: 2013

When microbial communities colonize in the developing intestinal tract after birth, microrganisms interact with specific apical surface receptors on the enterocytes. This interaction triggers a response that prevents overexpression of inflammatory cytokines, thus providing protection from pathogen-induced mucosal damage. Multiple immune modulatory factors in human milk and innate humoral factors also control inflammatory responses, providing additional protective effects. Our understanding of the role of the luminal microbial communities or microbiota is growing rapidly as novel technologies provide new insights into their taxonomy, function during early development, and impact on life-long health. Multiple studies have evaluated the effects of the specific nutrients, glutamine, arginine, nucleotides, polyunsaturated fatty acids, and lactoferrin, on disease outcomes in premature infants. These studies support a role for nutrients to modulate host defense mechanisms in premature infants, to develop normal digestive function, to protect from bacterial translocation, and to preserve mucosal barrier integrity. These effects are clearly important. However, not enough is yet known to design specific clinical care practices that support a healthy microbiota. Source


De Los Santos-Garate A.M.,Hospital Infantil de Mexico Federico Gomez | Villa-Guillen M.,Hospital Infantil de Mexico Federico Gomez | Villanueva-Garcia D.,Hospital Infantil de Mexico Federico Gomez | Vallejos-Ruiz M.L.,Hospital Infantil de Mexico Federico Gomez | Murguia-Peniche M.T.,National Center for Child and Adolescent Health
Journal of Perinatology | Year: 2011

Objective: The objective of this study is to identify adverse perinatal outcomes associated with pregnancies at or beyond 40 weeks. Study Design: Retrospective cohort study conducted in Mexico, with information obtained from the NEOSANO's Perinatal Network Database from April 2006 to April 2009. Multiple births, babies with inaccurate gestational age or babies with congenital malformations were excluded. Logistic regression models were used to analyze perinatal complications associated with pregnancies ≥40 weeks. Result: A total of 21 275 babies were analyzed; of these, 4545 (21.3%) were of 40 to 406 7 weeks, 3024 (14.2%) 41 to 416 7 weeks and 388 (1.8%) 42 to 44 weeks of gestation. Adverse perinatal outcomes associated with 40 to 406 7 weeks deliveries were (odds ratio; 95% confidence interval): macrosomia (1.9; 1.5 to 2.6), acute fetal distress (1.4; 1.2 to 1.7), emergency cesarean delivery (1.4; 1.2 to 1.5) and chorioamnionitis (1.4; 1.2 to 1.6). Adverse perinatal outcomes associated with 41 to 416 7 weeks were macrosomia (2.5; 1.8 to 3.3), chorioamnionitis (2; 1.7 to 2.3), emergency cesarean delivery (1.8; 1.6 to 2.1) and acute fetal distress (1.4; 1.1 to 1.7). Adverse perinatal outcomes associated with 42 to 44 weeks were macrosomia (7; 4.6 to 10.7), meconium aspiration syndrome (5.6; 2.8 to 11.2), neonatal death (4.8; 1.7 to 13.8), stillbirth (4.3; 1.4 to 13.5), 50 Apgar <4 (4.2; 1.1 to 15.7), chorioamnionitis (2.8; 2.2 to 3.9), admission to neonatal intensive care unit (2.7; 1.5 to 4.8), admission to neonatal intensive care unit or step-down unit (2.4; 1.5 to 3.9), acute fetal distress (1.8; 1.2 to 2.6) and emergency cesarean delivery (1.8; 1.3 to 2.4). Conclusion: An increased risk for perinatal and maternal complications were detected as early as 40 weeks' gestation. The risks of stillbirth and neonatal death were significantly higher in the post-term group than the control group. © 2011 Nature America, Inc. All rights reserved. Source


Patel M.M.,Centers for Disease Control and Prevention | Parashar U.D.,Centers for Disease Control and Prevention | Santosham M.,Johns Hopkins University | Richardson V.,National Center for Child and Adolescent Health
Clinical Infectious Diseases | Year: 2013

The recent introduction of a rotavirus vaccine program in Mexico to control rotavirus disease, a common killer of children worldwide, has dramatically reduced the number of Mexican children dying and being hospitalized because of diarrhea. The successful introduction of a rotavirus vaccine program was preceded by several decades of focused research efforts to document the burden of disease and to generate the knowledge base to develop and deploy a vaccine. The postlicensure experience from Mexico demonstrates that evaluating the impact and safety of the vaccination program is vitally necessary for sustaining it. All in all, the immensely successful Mexico experience with control of rotavirus disease, if copied, could yield tremendously favorable results for children and parents worldwide. © 2012 Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2012. Source

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