The neonatal period (birth to 1 month) is a time of extensive and ongoing system transition from uterine environment to external world.
There is a separate page for Neonatal Screening
Page Links: Introduction | Some Recent Findings | NCBI Bookshelf | Very Low Birth Weight | Childhood Disease | Australian Information | NSW Information | American Information | Normal Health Statistics | Postnatal Neural Development | Reading | References | Glossary
Are A, Aronsson L, Wang S, Greicius G, Lee YK, Gustafsson JA, Pettersson S, Arulampalam V. Enterococcus faecalis from newborn babies regulate endogenous PPAR{gamma} activity and IL-10 levels in colonic epithelial cells. Proc Natl Acad Sci U S A. 2008 Jan 30)
Cortex Matures Faster in Youth with Highest IQ (More? Postnatal Neural Development)
Card JP, Levitt P, Gluhovsky M, Rinaman L. Early experience modifies the postnatal assembly of autonomic emotional motor circuits in rats. J Neurosci. 2005 Oct 5;25(40):9102-11. "...These findings support the view that environmental events during early postnatal life can influence the formation of neural circuits that provide limbic and cortical control over autonomic emotional motor output."
VLBW neonates are between 401 to 1500 grams. The table below shows USA (NICHD) data for VLBW infants who survived beyond 3 days and had one or more episodes of blood culture-proven sepsis, the common cause of infection by gram-positive organisms, and the percentage of these resulting from coagulase-negative staphylococci.
Years |
Blood culture-proven sepsis |
Gram-positive organisms |
Staphylococci |
1991-1993 |
25% |
73% |
55% |
1998-2000 |
21% |
70% |
48% |
Reference:Stoll BJ, Gordon T, Korones SB, Shankaran S, Tyson JE, Bauer CR, Fanaroff AA, Lemons JA, Donovan EF, Oh W, Stevenson DK, Ehrenkranz RA, Papile LA, Verter J, Wright LL. Late-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network. J Pediatr. 1996 Jul;129(1):63-71.
Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, Lemons JA, Donovan EF, Stark AR, Tyson JE, Oh W, Bauer CR, Korones SB, Shankaran S, Laptook AR, Stevenson DK, Papile LA, Poole WK. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002 Aug;110(2 Pt 1):285-91.
The NCBI Bookshelf contains a number of complete online publications that relate to neonatal development. Of particular interest, is the new resource "Disease Control Priorities in Developing Countries", which talks to important neonatal health issues in these countries.
ealth Services/Technology Assessment Text | Disease Control Priorities in Developing Countries | Basic Neurochemistry |
Health Services/Technology Assessment Text (HSTAT) Bethesda (MD): National Library of Medicine (US), 2003 Oct.
Criteria for Determining Disability in Infants and Children: Low Birth Weight
Effects of Omega-3 Fatty Acids on Child and Maternal Health
Management of Neonatal Hyperbilirubinemia
Criteria for Determining Disability in Infants and Children: Failure to Thrive
Newborn Screening for Sickle Cell Disease and Other Hemoglobinopathies
Early Identification of Hearing Impairment in Infants and Young Children
The Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes
Improving Treatment for Drug-Exposed Infants
Disease Control Priorities in Developing Countries (2nd ed.) Dean T. Jamison, Joel G. Breman, Anthony R. Measham, George Alleyne, Mariam Claeson, David B. Evans, Prabhat Jha, Anne Mills, Philip Musgrove, editors Washington (DC): IBRD/The World Bank and Oxford University Press; 2006
Maternal and Perinatal Conditions
"Vaccines that prevent measles, tuberculosis, diphtheria, pertussis, Hib, and Neisseria meningitis prevent respiratory diseases.
Vaccines against measles and pertussis, prevent diseases that cause or contribute to malnutrition.
New vaccines, Streptococcus pneumoniae, influenza, typhoid fever, and rotavirus.
Vaccines to prevent mumps and varicella that are routinely used in some developed countries are not included in most vaccination programs in developing countries.
Clean umbilical cord care to reduce the incidence of neonatal tetanus, vitamin A therapy to reduce the case-fatality rate (CFR) from measles."
Basic Neurochemistry, Molecular, Cellular, and Medical Aspects (6th ed.) Siegal, George J.; Agranoff, Bernard W.; Albers, R. Wayne; Fisher, Stephen K.; Uhler, Michael D., editors. Philadelphia: Lippincott, Williams & Wilkins; c1999.
etiology of schizophrenia may involve pathological processes during brain development
steroid hormone receptors become evident in target neurons of the brain
Biochemistry of Thyroid Hormone Actions on Brain
"Hypothyroidism increases synaptic density, at least transiently. Interesting parallels with synapse formation are reported for learning behavior in rats; neonatal hypothyroidism impairs learning ability, whereas hyperthyroidism accelerates learning initially, followed by a decline later in life"
"The outlook is almost uniformly fatal, and the few babies who survive have severely compromised development and a cardiomyopathy that usually proves fatal. In rare cases, a patient stays asymptomatic until after the neonatal period, when hepatomegaly, vomiting, metabolic acidosis, hypoglycemia and a proximal myopathy become evident."
brain utilizes ketones in states of ketosis
"Significant utilization of ketone bodies by the brain is, however, normal in the neonatal period. The newborn infant tends to be hypoglycemic but becomes ketotic when it begins to nurse because of the high fat content of the mother's milk. When weaned onto the normal, relatively high-carbohydrate diet, the ketosis and cerebral ketone utilization disappear."
There are many different diseases that can impact on postnatal development, the most serious of which result in death. Some postnatal diseases may also have different outcomes dependent upon availability of medical support, though even in developed countries other factors can also impact on outcomes.
For example, a recent British Medical Journal (BMJ 25 June 2005) article "Outcome of meningococcal disease in children" identified in this UK study (of 498 children) three independent factors associated with an increased risk of death: not being cared for by a paediatrician, junior staff working with not enough supervision, and failure of staff to administer adequate inotropes.
Meningococcal disease, also called "meningitis", is a viral or bacterial infection of cerebrospinal fluid of the spinal cord and brain. Treatment and outcomes differ for either viral (less severe, resolves without specific treatment) or bacterial (severe, may result in brain damage, hearing loss, or learning disability) infections. For bacterial meningitis, determining the type of bacteria is important because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis. (text modifed from CDC information - More? CDC - meningococcal disease | technical information)
NHMRC- Publications Relating to Child Health Publications List
NHMRC Infectious Diseases School Exclusion recommendations
Institute for Child Health Research (WA), internet required
http://www.ichr.uwa.edu.au/about/intro.html
The following are links to PDF documents prepared by NSW Health designed for clinical care (not patient information). Clinical Practice Guidelines for Paediatric Care
Acute Management of Infants and Children with: Bacterial Meningitis | Otitis Media | Fever | Asthma | Croup |
American Academy of Family Physicians The Newborn Examination: Part I. Emergencies and Common Abnormalities Involving the Skin, Head, Neck, Chest, and Respiratory and Cardiovascular Systems | Part II. Emergencies and Common Abnormalities Involving the Abdomen, Pelvis, Extremities, Genitalia, and Spine | Common Issues in the Care of Sick Neonates
American Medical Association "Kids Health" (these are easy to read general public pages American not Australian Information )
International and Australian Population Statistics
WHO Normal Population Statistics
Global Perinatal and Maternal Causes of Death
Population Comparisons between Countries
USA National Center for Health Statistics - Child
Normal population statistics derived from a number of different sources (as shown on individual pages).
Neurological development contiues postnatally with both growth and reorganization of the central nervous system.
Recent NIH research has looked at the postnatal development of the cortex in children (Cortex Matures Faster in Youth with Highest IQ) "The researchers found that the relationship between cortex thickness and IQ varied with age, particularly in the prefrontal cortex, seat of abstract reasoning, planning, and other "executive" functions. .... While the cortex was thinning in all groups by the teen years, the superior group showed the highest rates of change."
The developmental trajectory in cortex thickness differs as the brain matures in different IQ groups. Thickness of the area at the top/front/center, highlighted in MRI brain maps at left, peaks relatively late, at age 12 (blue arrow), in youth with superior intelligence, perhaps reflecting an extended critical period for development of high-level cognitive circuits. (Image and text source: NIMH Child Psychiatry Branch)
There are several developmental neurological abnormalities that are diagnosed postnatally as learning disorders. (More? Autism | Fragile X | Neural Notes - Autism | Neural Notes - Fragile X)
The following link to PediNeuroLogic Exam by PD Larsen and SS Stensaas (Utah School of Medicine) has a webpage series of movies demonstrating normal postnatal neurological development assessment.
Most embryology textbooks (by definition) do not cover postnatal developmenty in any detail. The links below are to useful external online resources.
Links: Reviews | Articles | Online Textbooks | Search Textbooks | Search PubMed | Glossary
Articles
Search PubMed
Search Feb 2006 "postnatal human development" ?? reference articles of which ?? were reviews.
Search PubMed: term = postnatal human development
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
Normal Dev Page: Normal Dev Page 1 | 2 | Normal Dev Page 3 | Normal Dev Page 4 | Normal Dev Page 5 | Normal Dev Page WWW
Home Page
Embryo stages
Fetal Dev
Dev Notes 1
Dev Notes 2
System Notes
Acknowledgements
Birth
Neonatal
Respiratory
Neural
Milk
Growth Charts
Child Infection Exclusion Times
Immunization
NHMRC Publications
Dysentry
WWW Links
Puberty
ABC Health Reports
Movies
Class Notes
Serial Images
K12 Students
Abnormal
Embryology in the News
Histology
Site Map
School of Med Sci
UNSW Medicine
University of NSW
UNSW Cell Biology
NCBI Books
Dev Biol (Gilbert)
This section of notes covers issues related to the neonatal period.
It would seem obvious to say that development does not stop at birth. In fact many systems (cardiovascular, respiratory, gastrointestinal, homeostasis) undergo significant changes at birth, and many others (neural) have not yet completed their development.
Note this current project focuses on prenatal development, so postnatal content is not as detailed.
This page contains extensive links to external resources including NCBI Bookshelf references.
It is sometimes easy to forget the many health issues that affect childhood development around the world. There are many links to external resources that relate to the many issues of this period of development.
Following childhood we have the early teenager, where hormonal changes trigger changes that lead to growth and reproductive maturation.
Please email Dr Mark Hill if you wish to make a comment about this current project.