Partial hypoparathyroidism: a variant of transient congenital hypoparathyroidism

Article Abstract:

The development of hypocalcemia, or abnormally low blood levels of calcium, in the newborn is usually transient (brief) and rarely indicates a permanent disorder of calcium metabolism. Most infants born with hypocalcemia are premature or have birth asphyxia, the insufficient intake of oxygen birth, or a diabetic mother. Hypocalcemia may also be associated with hypoparathyroidism, or decreased activity of the parathyroid gland, which releases the parathyroid hormone. This hormone functions to regulate calcium and phosphorus metabolism. At birth, the parathyroid glands have limited ability to respond to decreases in blood calcium levels resulting from cessation of calcium supply from the mother and accumulation of phosphate within the body. The brief occurrence of hypocalcemia in newborns is referred to as transient congenital hypoparathyroidism. Hypocalcemia in the newborn usually resolves within weeks to months. The causes of recurrent hypocalcemia in childhood or adolescence are less clear. Cases are described of three children who developed hypocalcemia within the first 48 hours after birth. All of the children were born after a full-term pregnancy and had normal birth weights. Calcium levels recovered to normal within 1 week, 3 months, and 14 months in the three children. However, hypocalcemia recurred at 4, 7, and 12 years of age in these children. The blood levels of parathyroid hormone were low but detectable. These findings suggest that transient congenital hypocalcemia may not always be transient and the development of hypocalcemia at birth may indicate underlying hypoparathyroidism. Hence, calcium levels in children with hypocalcemia at birth should be monitored throughout childhood and adolescence. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Development and progression, Hypoparathyroidism, Hypocalcemia

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Increased transient tachypnea of the newborn in infants of asthmatic mothers

Article Abstract:

To determine whether infants born to asthmatic mothers are at increased risk for transient tachypnea of the newborn (TTN; episodes of very rapid breathing that may be associated with other respiratory complications), the infants of 294 asthmatic mothers were compared with infants of 294 mothers with normal lung function. Of interest were variables related to maternal age, smoking history, and childbirth history; details concerning labor and delivery; and infant health and birth weight. The severity of the mothers' asthma was noted and treatment instituted as indicated during the prenatal period. A newborn infant was diagnosed as having TTN if its respiratory rate was greater than 60 breaths per minute for 12 hours or more, and if certain abnormalities appeared on a chest X-ray. Results showed that TTN was more common among infants born to asthmatic mothers (3.7 percent) than to control mothers (0.3 percent). No differences were found between the two groups of mothers with respect to other risk factors for TTN, such as longer duration of labor, failure to progress in labor, cesarean section, premature births, or low Apgar scores (an index of physical well-being in the newborn). Infants of asthmatic mothers were more likely than those of controls to experience a wheezing episode before the age of 15 months, but TTN infants did not have such episodes. The incidence of respiratory distress syndrome (severe difficulty in breathing) was similar for both groups. A discussion is presented of risk factors for TTN. It appears that asthma in pregnant women should be considered a risk factor for infant TTN. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Asthma, Pregnancy, Complications of, Pregnancy complications, Respiratory tract diseases

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