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Sota Iwatani, Jordan Burgess, Flora Kalish, Ronald J Wong, David K Stevenson
BACKGROUND: Increased bilirubin production due to hemolysis can lead to severe neonatal hyperbilirubinemia and, if left untreated, to bilirubin neurotoxicity. Post-cardiac surgery newborns have been shown to be at an increased risk for developing hyperbilirubinemia and also hemolysis. Isoflurane (ISO), a volatile anesthetic agent routinely used in newborn surgery, has been reported to upregulate heme oxygenase 1 (HO-1) expression. HO is the rate-limiting enzyme in the bilirubin production pathway...
September 11, 2018: Neonatology
Himanshu Popat, Claire Galea, Nicholas Evans, Barbara Lingwood, Paul B Colditz, Robert Halliday, David Osborn
BACKGROUND AND OBJECTIVE: The mechanism of reported benefits of delayed cord clamping (DCC) are unclear. We aimed to determine whether DCC compared to immediate cord clamping (ICC) in very preterm infants improves cerebral oxygenation in the first 24 h. STUDY DESIGN: This is a prospective study of a subset of infants at < 30 weeks of gestation who were randomised to DCC (≥60 s) or ICC (< 10 s) and required an indwelling arterial catheter. Regional cerebral oxygenation (rScO2), blood pressure, PI, and peripheral saturation were measured and cerebral fractional tissue oxygen extraction (cFTOE) calculated for the following 3 time intervals: 3-6, 6-12, and 12-28 h of age...
September 10, 2018: Neonatology
Allison J Judkins, Brianna C MacQueen, Robert D Christensen, Erick Henry, Gregory L Snow, Sterling T Bennett
BACKGROUND: Schistocytes are circulating erythrocyte fragments. They can be identified microscopically from a blood smear; but automated systems evaluate more cells and avoid inconsistencies in microscopy. Studies using adult subjects indicate that automated quantification of schistocytes can be clinically useful. However, reference intervals for automated schistocyte counts of neonates have not been published, and the relevance of a high automated schistocyte count from neonates has not been reported...
September 5, 2018: Neonatology
Ashok Buchiboyina, Chi Seong Andrew Yip, Sirisha Madhala, Sanjay Patole
BACKGROUND: In recent years, many neonatal intensive care units have adopted the practice of routinely performing brain magnetic resonance imaging (MRI) of extremely preterm (EP) infants at term-equivalent age (TEA). This practice may result in increased identification of incidental findings (IF). OBJECTIVES: To determine the prevalence and clinical significance of incidental findings on routine MRI of EP infants. METHODS: We retrospectively reviewed findings on routine brain MRI on 165 EP infants at TEA (gestation < 28 weeks) admitted between June 2015 and December 2017...
August 28, 2018: Neonatology
Silvia Carloni, Fabrizio Facchinetti, Nicola Pelizzi, Giuseppe Buonocore, Walter Balduini
BACKGROUND: Hypoxic-ischemic encephalopathy is a major cause of neonatal morbidity. Therapeutic hypothermia, while beneficial, still leaves many treated infants with lifelong disabilities. Thus, adjunctive therapies, such as melatonin, are needed to provide additional neuroprotection. OBJECTIVES: The aim of this study was to determine a range of melatonin concentrations that could result in neuroprotective synergy with hypothermia. METHODS: Hypoxia-ischemia was simulated by transient oxygen-glucose deprivation (OGD) in organotypic hippocampal slice cultures derived from neonatal rats...
August 28, 2018: Neonatology
Lisa Umphrey, Mats Blennow, Morten Breindahl, Alexandra Brown, Charles Christoph Roehr, Ola Didrik Saugstad, Marta Thio, Daniele Trevisanuto
No abstract text is available yet for this article.
August 22, 2018: Neonatology
Sebastian Isac, Anca Maria Panaitescu, Mara Iesanu, Ioana Florentina Grigoras, Alexandra Totan, Amalia Udriste, Natalia Cucu, Gheorghe Peltecu, Leon Zagrean, Ana-Maria Zagrean
BACKGROUND: High-fat diet (HFD) is a detrimental habit with harmful systemic consequences, including low-grade, long-lasting inflammation. During pregnancy, HFD can induce developmental changes. Moreover, HFD-related maternal obesity might enhance the risk of peripartum complications including hypoxic-ischemic encephalopathy secondary to perinatal asphyxia (PA). OBJECTIVES: Following our previous results showing that PA increases neuroinflammation and neuronal injury in the immature hippocampus and modifies hippocampal epigenetic programming, we further aimed to establish the impact of maternal HFD on offspring hippocampus response to PA...
August 22, 2018: Neonatology
Masayoshi Zaitsu, Tatsuya Yoshihara, Hiromitsu Nakai, Shiro Kubota
BACKGROUND: Neonatal jaundice is strongly attributable to excess body-weight loss as a result of insufficient calorific intake. OBJECTIVES: To examine the incidence of neonatal jaundice (defined by use of phototherapy) and body-weight loss, as well as their association, among neonates under optimal thermal control with sufficient nutrition, a local protocol for temperature and nutritional regulation. METHODS: We retrospectively identified a cohort of 10,544 neonates (birth weight ≥2,500 g) placed in thermo-controlled incubators for 2 h immediately after birth...
August 22, 2018: Neonatology
Marc R Mendler, Ines Mendler, Mohammad A Hassan, Benjamin Mayer, Harald Bode, Helmut D Hummler
BACKGROUND: The so-called Thompson-score (TS) for newborns with hypoxic-ischemic encephalopathy (HIE) was developed before the introduction of controlled hypothermia as clinical routine. Information on the predictive value of TS in newborns undergoing therapeutic hypothermia to estimate long-term outcome is limited. OBJECTIVES: To determine the predictive value of TS to estimate long-term cognitive and neurological outcome in newborns with perinatal asphyxia treated with controlled hypothermia...
August 21, 2018: Neonatology
Allison J Judkins, Brianna C MacQueen, Robert D Christensen, Jessica Comstock, Rong Mao, Josue Flores-Daboub
A late-preterm infant with a prenatal diagnosis of non-immune hydrops was born with hypotonia, poor respiratory effort, chylothorax, encephalopathy, coagulopathy, progressive hepatic failure, and refractory pulmonary hypertension. Life support was withdrawn at 7 days of life due to multisystem organ failure. Rapid whole exome sequencing revealed novel compound heterozygous mutations in the gene encoding S-adenosylhomocysteine hydrolase (AHCY); each novel variant was carried by an asymptomatic parent. Reports of neonates with other AHCY mutations describe a pathology of varying severity...
August 17, 2018: Neonatology
Brian A Darlow, Máximo Vento, Marc Beltempo, Liisa Lehtonen, Stellan Håkansson, Brian Reichman, Kjell Helenius, Gunnar Sjörs, Emilio Sigali, Shoo Lee, Akihiko Noguchi, Naho Morisaki, Satoshi Kusuda, Dirk Bassler, Laura San Feliciano, Mark Adams, Tetsuya Isayama, Prakesh S Shah, Kei Lui
BACKGROUND: Rates of retinopathy of prematurity (ROP) and ROP treatment vary between neonatal intensive care units (NICUs). Neonatal care practices, including oxygen saturation (SpO2) targets and criteria for the screening and treatment of ROP, are potential contributing factors to the variations. OBJECTIVES: To survey variations in SpO2 targets in 2015 (and whether there had been recent changes) and criteria for ROP screening and treatment across the networks of the International Network for Evaluating Outcomes in Neonates (iNeo)...
August 8, 2018: Neonatology
Benedikt M Huber, Patrick M Meyer Sauteur, Wendy W J Unger, Paul Hasters, Marcel R Eugster, Simone Brandt, Guido V Bloemberg, Giancarlo Natalucci, Christoph Berger
Mycoplasma pneumoniae is a significant cause of pneumonia in school-aged children and young adults. We report a case of neonatal M. pneumoniae pneumonia in a preterm child manifesting in the first hours of life. Vertical transmission was demonstrated by the detection of M. pneumoniae in inflamed placental tissue indicating chorioamnionitis.
August 8, 2018: Neonatology
Willemien S Kalteren, Hendrik J Ter Horst, Anne E den Heijer, Leanne de Vetten, Elisabeth M W Kooi, Arend F Bos
BACKGROUND: Perinatal anemia may cause perinatal asphyxia. Its pathophysiology and neurodevelopmental effects are theoretically different from other causes of perinatal asphyxia. OBJECTIVE: The study aimed to determine whether perinatal anemia results in different short-term and long-term outcomes than other causes of perinatal asphyxia treated with therapeutic hypothermia. METHODS: We retrospectively included infants with moderate to severe hypoxic-ischemic encephalopathy, born between May 2009 and October 2015...
July 19, 2018: Neonatology
Kasper Jacobsen Kyng, Anders Valdemar Edhager, Tine Brink Henriksen, Christer Zøylner Swan, Niels Gregersen, Johan Palmfeldt
BACKGROUND: Biomarkers may qualify diagnosis, treatment allocation, and prognostication in neonatal encephalopathy. Biomarker development is challenged by competing etiologies, inter-individual genetic variability, and a lack of specific neonatal markers. To address these challenges, we used a standardized neonatal hypoxic-ischemic (HI) encephalopathy model with pre- and post-HI sampling of cerebrospinal fluid (CSF) and plasma. OBJECTIVES: The study aimed to identify novel candidate protein biomarkers of HI encephalopathy in a newborn piglet model in CSF and plasma...
July 19, 2018: Neonatology
Mutaz Dana, Eitan Fibach
BACKGROUND: Fetal-maternal hemorrhage (FMH) occurs when fetal red blood cells (RBC) pass into the maternal circulation as a result of obstetric- or trauma-related complications to pregnancy. Their detection in the maternal blood is commonly used as a diagnostic test. There is, however, a serious and general limitation to this test that is sometimes ignored. Fetal RBC carrying the father's antigens (most crucially, the ABO blood antigens) may be incompatible with the mother's plasma. They are expected to be eliminated by the maternal natural antibodies, thus, negative results may be false...
July 16, 2018: Neonatology
Line Hedegaard Toftlund, Susanne Halken, Lone Agertoft, Gitte Zachariassen
BACKGROUND: Breastfeeding promotes healthy growth in very-preterm-born infants (VPI), but extra nutritional supply is needed to ensure catch-up growth and brain development. OBJECTIVES: To investigate how different types of post-discharge nutrition affect growth until 6 years of age in children born VPI. METHODS: This was a 6-year follow-up study of 281 VPI. Median gestational age (GA) was 30 + 0 weeks (range 24-32 weeks). When breastfed at discharge, they were randomized to unfortified human milk (UHM) or fortified human milk (FHM)...
July 16, 2018: Neonatology
Maria Elena Cavicchiolo, Francesco Cavallin, Federica Bertuola, Damiano Pizzol, Giulia Segafredo, Olivier Manzungu Wingi, Liviana Da Dalt, Giovanni Putoto, Daniele Trevisanuto
BACKGROUND: As intrapartum-related events represent a quarter of all neonatal deaths, education on neonatal resuscitation is a critical priority. OBJECTIVE: To assess the impact of a low-dose/high-frequency neonatal resuscitation training on clinical practice of midwives in a low-resource setting. METHODS: Eight months after a modified Neonatal Resuscitation Program (NRP) course, we implemented a low-dose/high-frequency training for midwives at Beira Central Hospital, Mozambique...
July 16, 2018: Neonatology
Daniel J C Berkhout, Patrick Klaassen, Hendrik J Niemarkt, Willem P de Boode, Veerle Cossey, Johannes B van Goudoever, Christiaan V Hulzebos, Peter Andriessen, Anton H van Kaam, Boris W Kramer, Richard A van Lingen, Daniel C Vijlbrief, Mirjam M van Weissenbruch, Marc Benninga, Nanne K H de Boer, Tim G J de Meij
BACKGROUND: The identification of independent clinical risk factors for necrotizing enterocolitis (NEC) may contribute to early selection of infants at risk, allowing for the development of targeted strategies aimed at the prevention of NEC. OBJECTIVE: The objective of this study was to identify independent risk factors contributing to the development of NEC in a large multicenter cohort. METHODS: This prospective cohort study was performed in 9 neonatal intensive care units...
2018: Neonatology
Kobi Best, Fiona Bogossian, Karen New
BACKGROUND: Elevated sound levels and low language exposures of preterm infants (< 37 weeks) cared for in the neonatal unit contribute to poorer growth, cognition, language and motor outcomes. These delays can have lasting effects on childhood development and continue throughout adult life. Whilst recommendations have been established for appropriate sound exposure levels in neonatal units, very little is known about the optimal level of language exposure. OBJECTIVES: To examine the evidence regarding language exposure, both measured (observational) and prescribed (interventional), in preterm infants (< 37 weeks) cared for in neonatal units and to identify optimal exposure levels to promote neurodevelopment...
2018: Neonatology
Ken Imai, Linda S de Vries, Thomas Alderliesten, Nienke Wagenaar, Niek E van der Aa, Maarten H Lequin, Manon J N L Benders, Ingrid C van Haastert, Floris Groenendaal
BACKGROUND: Magnetic resonance imaging (MRI) is the standard neuroimaging technique to assess perinatal asphyxia-associated brain injury in full-term infants. Diffusion-weighted imaging (DWI) is most informative when assessed during the first week after the insult. OBJECTIVES: To study the DWI abnormalities of the thalamus and basal ganglia in full-term infants with perinatal asphyxia. METHODS: Fifty-five (near) term infants (normothermia n = 23; hypothermia n = 32) with thalamus and/or basal ganglia injury were included...
2018: Neonatology
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