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INTRODUCTION The Neonatal Network of Public Hospitals in the city of Buenos Aires closely monitors the progress of newborn infants with a birth weight less than 1500 g (very low birth weight, VLBW) because it largely contributes to neonatal morbidity and mortality. OBJECTIVE To analyze the morbidity and mortality of VLBW infants and determine their riskadjusted mortality using the score of the South American Neonatal Network (Red Neonatal de los paises del Conosur de America, NEOCOSUR). MATERIAL AND METHODS Live infants born in the network hospitals with a birth weight of 500-1499 g between 2008 and 2010 were included in the study. Data was recorded prospectively using a standardized methodology. Mortality, morbidity and risk-adjusted mortality rates according to the NEOCOSUR score were estimated. Results. There were 92,698 infants born during the study period. Of them, 1.26% weighed less than 1500 g at birth. Only 40.4% of these received a full course of antenatal corticosteroids. A total of 62.7% of these developed respiratory distress syndrome, 5.4% enterocolitis, 10.1% intracranial hemorrhage, and 13.4% severe retinopathy. Early sepsis was observed in 5.6%, and late sepsis in 9.6%. Bronchopulmonary dysplasia was present in 10.7% of the cases. Neonatal mortality was 29.2%, and the adjusted mortality with no major malformations was 25.4%. Survival of infants with a birth weight of =750 g and a gestational age of =26 weeks was 50%. The observed/expected mortality ratio was 1.04, with a large variability. CONCLUSIONS The percentage of VLBW infants who received antenatal corticosteroids was low. The incidence of sepsis and the rate of infants with severe retinopathy of prematurity are high. The risk-adjusted mortality is higher than expected.

This study evaluated the success of a national program for the prevention of mother-to-child transmission (MTCT) of HIV-1 in 874 mother-infant pairs from Buenos Aires and surroundings. This population was referred to the National Reference Center for AIDS for diagnosis of neonatal infection during 1993-2000. The data revealed an increase in the use of antiretroviral therapy during pregnancy from 3.2% in 1993-1994 to 73.1% in 1999-2000 and in the use of cesarean delivery (reaching 54.8% in 1999-2000). However, the proportion of HIV-infected women who continued to breast-feed their children remained steady (around 12%). General improvement of the conditions for decreasing MTCT resulted in a significant decrease in the proportion of infected infants from 37.3% before 1995 to 10.7% in 1999-2000 and even 6.5% during 2001. Data on the time of diagnosis indicated that only 42.7% of the women knew about their HIV status before pregnancy, 44.8 knew during pregnancy, and 12.3% knew after the birth of their child. The main risk factor for HIV infection in the mothers was heterosexual contact (73%), and in the fathers, it was injection drug use (67%). These results point out the urgent need to develop additional strategies for prevention of MTCT of HIV-1 to generalize education, counseling, and testing of young women.

The Neonatal Network of Public Hospitals in the city of Buenos Aires closely monitors the progress of newborn infants with a birth weight less than 1500 g (very low birth weight, VLBW) because it largely contributes to neonatal morbidity and mortality.To analyze the morbidity and mortality of VLBW infants and determine their riskadjusted mortality using the score of the South American Neonatal Network (Red Neonatal de los países del Conosur de América, NEOCOSUR).Live infants born in the network hospitals with a birth weight of 500-1499 g between 2008 and 2010 were included in the study. Data was recorded prospectively using a standardized methodology. Mortality, morbidity and risk-adjusted mortality rates according to the NEOCOSUR score were estimated. Results. There were 92,698 infants born during the study period. Of them, 1.26% weighed less than 1500 g at birth. Only 40.4% of these received a full course of antenatal corticosteroids. A total of 62.7% of these developed respiratory distress syndrome, 5.4% enterocolitis, 10.1% intracranial hemorrhage, and 13.4% severe retinopathy. Early sepsis was observed in 5.6%, and late sepsis in 9.6%. Bronchopulmonary dysplasia was present in 10.7% of the cases. Neonatal mortality was 29.2%, and the adjusted mortality with no major malformations was 25.4%. Survival of infants with a birth weight of =750 g and a gestational age of =26 weeks was 50%. The observed/expected mortality ratio was 1.04, with a large variability.The percentage of VLBW infants who received antenatal corticosteroids was low. The incidence of sepsis and the rate of infants with severe retinopathy of prematurity are high. The risk-adjusted mortality is higher than expected.

Neonatal reference values for serum thyrotropin are scarce and comprise only small numbers of patients. During 2006, changes were made in IMMULITE kits for TSH measurement. To validate methodological changes, 80 serum samples from patients were evaluated and to establish reference intervals, 334 neonates and infants were analyzed (divided into 4 groups). Group 1 (G1) (48-72 h of life) (n=153), group 2A (G2A) (7-10 days of life) (n =65), group 2B (G2B) (11- 14 days of life) (n= 35), group 3 (G3) (28-40 days of life) (n =81). Current kits overestimate TSH results by 26 to 37%; TSH (mIU/L) reference intervals (percentile 2.5 ― 97.5) were G1 (1.1-12.7), G2A (1.8-9.8), G2B (1.1-7.1) (p

The aim of this preliminary study was to assess variation in thyrotropin (thyroid-stimulating hormone; TSH) levels using an immunoradiometric assay during the first 6 months of life of normal infants. One hundred and five normal newborns (59 females, 46 males) were evaluated for TSH, triiodothyronine and thyroxine at 48 h of life, and TSH was additionally determined at 15 days (n = 42), 30 days (n = 38), 60 days (n = 24), 90 days (n = 28), and 180 days (n = 30). Complete determinations during the total period of the study were obtained in 17 infants. Samples corresponding to the 48-hour period did not exhibit a normal distribution. In this group, percentile 3 corresponded to 0.9 mU/l, the median to 4.2 mU/l and percentile 97 to 17.7 mU/l. Levels of TSH similar to those of the normal adult population were reached between 30 and 60 days of life. Nevertheless, TSH levels of some of the children remained at higher values for a longer period. In summary, our results suggest that high TSH levels might not always indicate an underlying pathology. A critical evaluation of the normality criteria could avoid unnecessary studies and treatments.