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Aspects of Praematurity and Dysmaturity: Groningen 10–12 May 1967 PDF

364 Pages·1968·11.89 MB·English
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ASPECTS OF PRAEMATURITY AND DYSMATURITY Nu tricia Symposium ASPECTS OF PRAEMATURITY AND DYSMATURITY Groningen IO-12 May 1967 EDITORS: J. H. P. JO NXIS, M.D., H. K. A. VISSER, M.D. AND J. A. TROELSTRA, M.D. 1968 H. E. STENFERT KROESE N.V. - LEIDEN COPYRIGHT 1968 SOFTCOVER REPRINT OF THE HARDCOVER 1ST EDITION 1968 BY H. E. STENFERT KROESE N.V. LEIDEN, HOLLAND All rights reserved. No part of this book may be reproduced in any form, by print, photop rint, microfilm, or any other means without written permission from the publisher. ISBN-13: 978-94-010 -3430 -2 e-ISBN-13: 978-94-010-3428-9 DOl: 10.1007/978-94-010-3428-9 CONTENTS SESSION I ROLE OF THE PLACENTA J. W. REYNOLDS, Aspects of steroid metabolism in the foetoplacental unit and the newborn infant . . . . . . . . . . . . . . .. 3 P. GRUENWALD, Problems in the pathologic study of the placenta 21 Discussion . . . . . . . . . . 25 SESSION II ASSESSMENT OF FOETAL DEVELOPMENT P. GRUENWALD, Growth pattern of the normal and the deprived fetus 37 A. MINKOWSKI, S. SAINT-ANNE DARGASSIES, C. DREYFUs-BRISAC, J. CL. LARROCHE, J. VIGNAUD and C. AMIEL, The assessment of foetal age by the examination of the central nervous system . 46 H. C. SCHWARTZ, T. J. GRIBBLE, F. WELLAND, W. NIJHOFF and J. H. P. JONXIS, Developmental changes in fetal hemoglobin. .. 57 F. SERENI and B. LUPPIS, Developmental changes in liver enzyme activities with special reference to the perinatal period of life. .. 68 O. KOLDOVSKY, A. HERINGOVA, V.JIRSOVA,J. KRAML, H. PELICHOVA and J. U HER, Development of enzymes and absorption processes in the small intestine of human fetus 91 Discussion . . . . . . . . . . . . . . . . . . . . . . . .. 99 SESSION III ·EXPERIMENTAL ASPECTS OF DYSMATURITY J. S. WIGGLESWORTH, Dysmaturity in the experimental animal. 119 E. M. WIDDOWSON, Effects of prematurity and dysmaturity in animals 127 Discussion . . . . . . . . . . . . . . . . . . . . . . . .. 139 VI CONTENTS SESSION IV HEREDITARY AND ENVIRONMENTAL ASPECTS OF LOW BIRTHWEIGHT L. O. LUBCHENCO, C. HANSMAN and L. BACKSTROM, Factors influen- cing fetal growth . . . . . . . . . . . 149 M. OUNSTED, The regulation of foetal growth 167 Discussion . . . . . . . . . . . . . . . 189 SESSION V ADAPTATION OF THE LOW BIRTHWEIGHT INFANT TO EXTRA-UTERINE LIFE J. H. P. JONXIS, J. J. VAN DER VLUGT, C. J. DE GROOT, E. R. BOERSMA and E. D. K. MEI]ERS, The metabolic rate in praemature, dysma- ture and sick infants in relation to environmental temperature. . 201 R. SCHWARTZ, P. A.J. ADAM, K. KING and D. KORNHAUSER, Glucose control in the newborn infant. . . . . . . . . . . . . . .. 210 S. J. STRICH, Neuropathological findings in severe neonatal hypogly caemia with remarks concerning lesions due to hypoxia. . . . . 228 J. I. DE BRUI]NE, Hyperbilirubinaemia in dysmature versus premature infants. 235 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . 245 SESSION VI OBSTETRICAL AND PREVENTIVE ASPECTS OF DYSMATURITY G. J. KLOOSTERMAN, The obstetrician and dysmaturity 263 Discussion . . . . . . . . . . . . . . . . . . . 281 SESSION VII DEVELOPMENTAL ASPECTS C. M. DRILLIEN, Causes of handicap in the low weight infant 287 H. F. R. PRECHTL, Neurological findings in newborn infants after pre- and paranatal complications 303 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . 323 CONTENTS VII CLOSING SESSION SUMMING-UP AND GENERAL DISCUSSION Summing-up by H. K. A. VISSER . . 331 Summing-up by G. J. KLOOSTERMAN. 337 General discussion. . . . . . . 339 Summing-up by N. C. R. RA.IHA 341 Summing-up by R. SCHWARTZ 342 General discussion. . . . . . 344 Summing-up by A. MINKOWSKI 345 Index of authors 349 Index of subjects 352 I LIST OF PARTICIPANTS Mme. D. BLUM-BRACHET, Clinique de Medecine Infantile, Hopital Universitaire St. Pierre, Bruxelles. J. H. VAN BOLHUIS, Dept. of Paediatrics, St. Joseph's Hospital, Deventer J. I. DE BRUIJNE, Dept. of Physiology and Pathology of the Newborn, University of Amsterdam C. B. F. DAAMEN, Laboratory of Pathology, Dijkzigt Hospital, Rotterdam N. J. DELBEKE, Dept. of Paediatrics, State University, Gent M. DlWANY, Children's Hospital, Mounira, Cairo J. DODION-FRANSEN, Clinique de Medecine Infantile, Hopital Universitaire St. Pierre, Bruxelles C. DREYFUs-BRISAC, Centre de Recherches Biologiques Neonatales, Hopital de Port-Royal, Paris C. DRILLIEN, Dept. of Child Life and Health, University of Edinburgh A. C. DROGENDIJK, Dept. of Obstetrics, Vrije Universiteit, Amsterdam E. EGGERMONT, Lab. de Chimie Physiologique, Universite de Louvain J. ENGELHARDT, Dept. of Paediatrics, Zuiderziekenhuis, Rotterdam R. FRANQOIS, Clinique de Pediatrie, Hopital Edouard Herriot, Lyon P. GRUENWALD, Dept. of Pathology, Sinai Hospital of Baltimore R. GRUTTNER, Dept. of Paediatrics, State University, Hamburg P. HADDAD, Maternite Alexandre Khoury, Beirut P. G. HART, Dept. of Obstetrics, State University, Utrecht R. HEFFINCK, Paediatrician, Aalst, Belgium J. JANSSENS, Dept. of Obstetrics, Vrije Universiteit, Amsterdam J. H. P.JONXIS, Dept. of Paediatrics, State University, Groningen L. A. JOOSSE, Dept. of Obstetrics, State University, Groningen B. E. KINGMA, Wilhelmina Children's Hospital, Utrecht G. J. KLOOSTERMAN, Dept. of Obstetrics, University of Amsterdam O. KOLDOVSKY, Laboratory of Developmental Nutrition, Prague F. KUIPERS, Emma Children's Hospital, Amsterdam A. LAMBRECHTS, Clinique et Policlinique des Maladies d'Enfance, Hopital de Baviere, Liege R. DE LEEUW, Dept. of Paediatrics, University of Amsterdam H. LOEB, Clinique de Medecine Infantile, Hopital Universitaire St. Pierre, Bruxelles x LIST OF PARTICIPANTS L. O. LUBCHENCO, Dept. of Paediatrics, Medical Center, University of Colorado, Denver B. LUPPIS, Dept. of Paediatrics, University of Milano A. S. MA]A], Augusta Victoria Hospital, Jerusalem J. L. MASTBOOM, Dept. of Obstetrics, Catholic University, Nijmegen N. MATSANIOTIS, Dept. of Paediatrics, University of Athens A. MINKOWSKI, Centre de Recherches Biologiques Neonatales, Hopital de Port-Royal, Paris N. NICOLOPOULOS, Children's Hospital Aghia Sophia, Athens M. OUNSTED, Nuffield Dept. of Obstetrics and Gynaecology, Radcliffe Infirmy, Oxford C. PAPADATOS, Dept. of Paediatrics, University of Athens H. F. R. PRECHTL, Dept. of Developmental Neurology, State University, Groningen N. C. R. RAIHA, Dept. of Paediatrics, University of Helsinki R. RAPPAPORT, Hopital des Enfants Malades, Paris J. W. REYNOLDS, c/o Hormonlaboratoriet, Karolinska Sjukhuset, Stockholm J. H. Ruys, Dept. of Paediatrics, State University, Leiden A. L. C. SCHMIDT, Dept. of Obstetrics, Dijkzigt Ziekenhuis, Rotterdam E. D. A. M. SCHRETLEN, Dept. of Paediatrics, Catholic University, Nijmegen H. SCHWARTZ, Dept. of Pediatrics, Stanford Medical School, Palo Alto R. SCHWARTZ, Dept. of Pediatrics, Cleveland Metropolitan General Hospital, Cleveland F. SERENI, Dept. of Paediatrics, University of Milano A. SIKKEL, Dept. of Obstetrics, State University, Leiden T. D. STAHLIE, Dept. of Paediatrics, Vrije Universiteit, Amsterdam H. STOLLEY, Institute of Research for Children's Nutrition, Dortmund S. J. STRICH, Institute of Psychiatry, Dept. of Neurology, London W. SWOBODA, Children's Hospital, Vienna J. A. TROELSTRA, Dept. of Paediatrics, State University, Groningen T. VALAES, The Anne-Marie Institute of Child Health, Athens G. H. M. VEENEKLAAS, Dept. Paediatrics, State University, Leiden W. VERHOEVEN, Nutricia Co., Zoetermeer H. K. A. VISSER, Dept. of Paediatrics, Medical School, Rotterdam E. M. WIDDOWSON, Medical Research Council, Infant Nutrition Research Division, University of Cambridge J. S. WIGGLESWORTH, Dept. of Child Health, Hammersmith Hospital. London J. C. H. N. WI]FFELS, Dept. of Paediatrics, University of Amsterdam W. VAN ZEBEN, Juliana Children's Hospital, The Hague OPENING PROF. DR. J. H. P. JONXIS I am happy to welcome you at this second Nutricia Symposium and I am glad that you all arrived safely here in Groningen. The first Nutricia Symposium dealt with a related subject. I see some faces belonging to participants of that meeting and many new ones. I hope that we shall have as good a time as we had three years ago here. When I look around I see a group of very quiet people in front of me. Yet we are interested in revolutions, for we are studying the most revolutionary moment in mammalian life: birth. In all forms of mammals, whether small or large litters are concerned, or animals born more or less maturely or praematurely, each time birth is a very dangerous moment in the surviving of the species. In the human being, especially in recent years, birth has become a rather safe event thanks to our neighbours, the obstetricians. Still many of us doubt whether always the nervous central system ends up completely undamaged whereas that very system is the most precious possession of man. So there are also in man still many problems about birth we might discuss. I hope that this meeting will not only be one where we enjoy ourselves and that opens possibilities to exchange scientific views, but also one of some practical results.

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The concept of the foeto-placental unit as an integrated endocrine organ has been defined recently by many in vivo studies at the 17th- 20th week of gestation. A functioning foeto-placental unit is necessary for most of the increased oestrogen production of pregnancy and for the provision of glucoco
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