Skin conductance and arousal in the newborn

Article Abstract:

Skin conductance of electrical current can provide an index of emotional arousal by measuring sweat production. The measure has been used to evaluate arousal and psychiatric disorder in adults; its value in measuring arousal in newborn babies was tested here. Eighty-two healthy infants at different gestational and postnatal ages were studied by means of electrodes attached to the sole of a foot. Variations in conductance were noted before, during and after a heel prick test for routine blood sampling, performed on the other foot. In addition, the state of arousal of the infants was recorded on a five-point scale ranging from '0' (non-rapid eye movement sleep, regular breathing) to '4' (crying and vigorous limb movements). Results showed that skin conductance levels prior to the prick test in babies less than 40 weeks' conceptional age (i.e. gestational age when born plus postnatal age) varied little with sleep or waking states, in contrast to levels at later ages (40 to 43 weeks), where they were higher during wakefulness. The heel prick produced arousal in all infants, with a greater proportion (91 percent) of older subjects showing level 4 arousal than younger (47 percent). Skin conductance in response to the prick increased immediately in 7 of 23 babies (30 percent) aged 36 to 39 weeks, and in all but one member of the older group (40-43 weeks). Infants younger than 36 conceptional weeks, however, did not show changes in skin conductance after the prick. This suggests that the anatomical pathways that control arousal (emotional sweating) are still immature at that age. A discussion is presented of pain in infants and the possible relevance of the results to that subject. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Infants (Newborn), Newborn infants, Skin, Electrophysiology, Arousal (Physiology), Arousal (Psychophysiology), Galvanic skin response

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Postnatal circulatory adaptation in healthy term and preterm neonates

Article Abstract:

The adaptation of the circulatory system to life outside the uterus was assessed in 37 healthy infants, including 18 born at full term and 19 born prematurely. The pressure in the pulmonary artery, the major blood vessel supplying the lungs, was assessed in terms of its relationship to the ratio of two measurements. These included the pulmonary artery time to peak velocity, a measure of the blood flow in the pulmonary artery, and right ventricular ejection time, the period during which blood is emptied from the right heart ventricle. Patency of the ductus arteriosus, or persistence of an embryonic channel between the pulmonary artery and the aorta at birth, and interatrial shunting, or abnormal passage of blood between the two heart atria, were monitored. The ratio of pulmonary artery time to peak velocity and right ventricular ejection time increased after birth in all infants, but the rise was more slow in preterm infants. The ratio was lower in preterm infants as compared with full-term infants at six hours of age, and the difference in ratios between the two groups was greatest between 25 and 36 hours of age. However, the difference in ratios between the full-term and preterm infants was negligible between 73 and 96 hours after birth. The ductus arteriosus tended to close at a later stage in preterm infants. Shunting from the left to right atria occurred in all infants. These results show that pulmonary artery pressure declines more slowly in preterm than full-term infants after birth. Also, the persistence of ductal shunting for more than three days is uncommon in healthy preterm infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patent ductus arteriosus, Pulmonary circulation

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Development of intestinal motility

Article Abstract:

Normal intestinal motility consists of the organized movement of food and digestive juices through the intestinal tract. Immature motility in premature infants is a major cause of physiological ileus (intestinal obstruction or dysfunction) seen in these newborns. Intestinal muscular activity is regulated by a hierarchy of controls, from local muscular electrical activity to hormonal factors and nervous system control, the last of which is subject to signals from higher centers of the brain. Although enteral (intestinal) nerves are in place by 22 weeks of gestation, further development is needed, as poor motor (movement) control is common in premature infants. The coordination of sucking and swallowing, needed to ingest food, depends on maturation of lower brain centers and on other centers controlling cranial nerves, the nerves supplying the neck and face. Swallowing initiates a pulse of relaxation and contraction of muscles and sphincter valves in the esophagus and lower parts of the digestive tract, and may be insufficiently established in newborns and in children with cerebral palsy. Stomach emptying and intestinal contractions during fasting and in response to food may be immature in preterm infants, requiring that feeding begin slowly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Food and nutrition, Gastrointestinal system, Gastrointestinal motility

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