thesis

Fetal Food - Preemie's Prerequisite? Studies on human fetal and neonatal protein metabolism

Abstract

In 1960, the terms ‘neonatology’ and ‘neonatologist’ were first coined in a textbook on newborns. In hindsight, that decade turned out to be the start of modern care for prematurely born babies. Since then, survival chances for premature infants improved dramatically: for 1-kg-weighing infants from hardly any to approximately 90% nowadays. In addition, due to ongoing research, many infants born too early now have good health outcome, although there is also a large group facing mild handicaps and a smaller group facing more severe handicaps. In the Netherlands, the incidence of all live births delivered preterm – that is before 37 weeks of gestation – was 7.3% in 2004. Infants born alive very preterm (<32 weeks) make up 1.1% of the 194.007 births in the Netherlands that same year. These very preterm infants spent on average 28 days on a neonatal intensive care unit (NICU). In the United States, the current incidence of births delivered preterm amounts 12.8% and is thus higher than in the Netherlands. Moreover, the percentage is on the rise: between 1981 and 2005 it increased with 35% (Figure 1). Although we are aware of several factors responsible for this increase (see below), prematurity is becoming a problem affecting society more and more

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