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neonatal developmental care

Krystal Hay, MaryAnn Nelin, Helen Carey, Olena Chorna, Melissa Moore-Clingenpeel Ma Mas, Nathalie Maitre
BACKGROUND: The Hammersmith Infant Neurological Examination is one of several useful tools for early identification of cerebral palsy; however, cut-off scores for cerebral palsy do not consistently distinguish infants with hemiplegia from those typically developing. We hypothesized that use of an asymmetry score, in addition to the assessment's standard total cutoff score, could remedy this problem in a clinical setting. METHODS: This retrospective study of a neonatal intensive care follow-up program with consistent clinical use of the Hammersmith Infant Neurological Examination matched infants with a diagnosis of cerebral palsy to infants without motor delays or evidence of neurodevelopmental impairments...
July 25, 2018: Pediatric Neurology
Nhu N Tran, S Ram Kumar, Felicia S Hodge, Paul M Macey
BACKGROUND: Congenital heart disease (CHD) is a leading birth defect in the United States, affecting about 40 000 neonates each year. Despite efforts to prevent developmental delays, many children with CHD have neurological deficits that last into adulthood, influencing employability, self-care, and quality of life. OBJECTIVE: To determine if neonates with CHD have impaired cerebral autoregulation and poorer neurodevelopmental outcomes compared with healthy controls...
September 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Anna M Lavezzi, Stefano Ferrero, Beatrice Paradiso, Liliya Chamitava, Francesco Piscioli, Teresa Pusiol
OBJECTIVE:  To find a possible pathogenetic mechanism of the early sudden infant death occurring in newborns during the skin-to-skin care (SSC), through the examination of neuronal centers regulating the vital activities. STUDY DESIGN:  This is an in-depth examination of the brain stem in 22 healthy term newborns, suddenly died in the first hour of life without the identification of a cause at autopsy (early sudden infant death syndrome [eSIDS]), 12 of them concomitantly with SSC, and 10 with age-matched controls died of known pathology...
August 31, 2018: American Journal of Perinatology
S Humphry, D Thompson, N Price, P R Williams
Aims: The significance of the 'clicky hip' in neonatal and infant examination remains controversial with recent conflicting papers reigniting the debate. We aimed to quantify rates of developmental dysplasia of the hip (DDH) in babies referred with 'clicky hips' to our dedicated DDH clinic. Patients and Methods: A three-year prospective cohort study was undertaken between 2014 and 2016 assessing the diagnosis and treatment outcomes of all children referred specifically with 'clicky hips' as the primary reason for referral to our dedicated DDH clinic...
September 2018: Bone & Joint Journal
Frances A Carter, Michael E Msall
To understand the trajectories of risk and resilience in the vulnerable preterm and neonatal brain, clinicians must go beyond survival and critically examine on a population basis the functional outcomes of children, adolescents, and adults across their life course. Evaluations must go well beyond Bayley assessments and counts of neonatal morbidities, such as bronchopulmonary dysplasia, retinopathy of prematurity, sonographic brain injury, sepsis, and necrotizing enterocolitis. Proactively providing support to families and developmental and educational supports to children can optimize academic functioning and participation in adult learning, physical and behavioral health activities, community living, relationships, and employment...
September 2018: Clinics in Perinatology
Shaylynn W Smith, Amanda J Ortmann, William W Clark
Introduction: Environmental noise is associated with negative developmental outcomes for infants treated in the neonatal intensive care unit (NICU). The existing noise level recommendations are outdated, with current studies showing that these standards are universally unattainable in the modern NICU environment. Study Aim: This study sought to identify the types, rate, and levels of acoustic events that occur in the NICU and their potential effects on infant physiologic state...
July 2018: Noise & Health
Mostafa A Abolfotouh, Saif Al Saif, Waleed A Altwaijri, Mohammed A Al Rowaily
BACKGROUND: Survival of preterm neonates has steadily improved over the past five decades, due to changes in the neonatal intensive care. However, in Saudi Arabia, there are no written guidelines on the definition of the lower limit of viability, and there has been a call for such a limit. The aims of this study were: (1) to determine lower limits of viability and survival in extremely low birthweight (ELBW) infants, and (2) to determine incidence of neurodevelopmental and cognitive abnormalities within 3-6 years after birth...
August 22, 2018: BMC Pediatrics
Francesco Pisani, Carlotta Facini, Elisa Bianchi, Giorgia Giussani, Benedetta Piccolo, Ettore Beghi
OBJECTIVE: Information about the incidence of neonatal seizures (NS) is scarce. Previous studies relied primarily on a clinical diagnosis of seizures. This population-based, retrospective study evaluated the incidence of electroencephalography (EEG)-confirmed seizures in neonates born in the province of Parma and the perinatal risk factors for mortality and epilepsy. METHODS: All neonates with suspected seizures or with medical conditions at high risk for seizures from the study area were recorded in the neonatal intensive care unit (NICU) of the Parma University Hospital...
September 2018: Epilepsia
Naureen Memon, Ian J Griffin, Chris W Lee, Aimee Herdt, Barry I Weinberger, Thomas Hegyi, Mary O Carayannopoulos, Lauren M Aleksunes, Grace L Guo
INTRODUCTION: Fibroblast growth factor 19 (FGF19) is a gut-derived hormone that regulates the expression of CYP7A1, the rate-limiting enzyme in bile acid (BA) synthesis pathway. Dysregulation of the FGF19-CYP7A1 (gut-liver) axis is associated with cholestatic liver disease. Infants, especially preterm infants and those with intestinal failure are at high risk for developing cholestatic liver disease. The activity of the gut-liver axis has not been characterized in this population. Our objective was to assess relationships between circulating FGF19 concentrations and CYP7A1 activity in neonates...
August 19, 2018: Journal of Maternal-fetal & Neonatal Medicine
Hassib Chehade, Umberto Simeoni, Jean-Pierre Guignard, Farid Boubred
Cardiovascular and chronic kidney diseases are part of non-communicable chronic diseases, the leading causes of premature death worldwide. They are recognized as having early origins through altered developmental programming, due to adverse environmental conditions during development. Preterm birth is increasingly recognized as such an adverse factor. Rates of preterm birth have increased the last decades, however, with the improvement in perinatal and neonatal care, a growing cohort have survived to the neonatal period and are now entering adulthood...
August 13, 2018: Current Pediatric Reviews
Jin-Hua Liao, Rong-Fang Hu, Li-Jing Su, Shuo Wang, Qin Xu, Xiao-Fang Qian, Hong-Gu He
BACKGROUND: Nonpharmacological interventions are often used to promote sleep among preterm infants in the neonatal intensive care unit (NICU). However, there is a lack of synthesis in the evidence of their effectiveness. AIM: To synthesize the evidence on the effectiveness of nonpharmacological interventions on NICU preterm infants' sleep during hospital stay. METHODS: Seven databases were searched, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Wan-fang database, China National Knowledge Infrastructure, China Biological Medicine Database, and VIP Journal Integration Platform from their inceptions to August 2017...
August 11, 2018: Worldviews on Evidence-based Nursing
Ling-Ju Chuang, Shih-Hao Wang, Mi-Chia Ma, Chia-Ni Lin, Chih-Ling Chen, Mei-Chih Huang
AIMS AND OBJECTIVES: To determine the comparative efficacy of developmental care versus standard care for reducing pain and stress in preterm infants during examinations for retinopathy of prematurity (ROP). BACKGROUND: ROP examinations are routinely performed in neonatal intensive care units to detect these lesions. Pain scores recorded during and after eye examinations have revealed physiological and behavioural manifestations of pain and stress. DESIGN: A randomised crossover trial was conducted...
August 9, 2018: Journal of Clinical Nursing
Kristin Leifsdottir, Huseyin Mehmet, Staffan Eksborg, Eric Herlenius
BACKGROUND: Cerebral ischemia generates neuroinflammation that can induce neural cell death. This cohort study assessed whether Fas-ligand (FasL) and interleukin (IL)-6 levels in the cerebrospinal fluid (CSF) after hypoxic-ischemic encephalopathy (HIE) can serve as biomarkers of hypoxic brain injury in neonates. METHODS: Term infants (> 37-week gestational age) who were admitted to the neonatal intensive care unit of Karolinska University Hospital in years 2002 to 2004 with perinatal asphyxia were enrolled prospectively...
August 8, 2018: Journal of Neuroinflammation
Alan Hall Jobe
Antenatal corticosteroids (ACS) are standard of care for women at risk of preterm delivery between 24 -34 weeks gestation. Their use decreases preterm morbidities and mortality. However, ACS treatments mimic a stress response by increasing fetal steroid levels at early gestational ages when the fetus is normally protected from high glucocorticoid levels. Within the context of concept of the developmental origins of adult health and disease, ACS are effective stressors in fetal animal models that alter developmental programs and outcome in adult animals...
August 8, 2018: Canadian Journal of Physiology and Pharmacology
Amir Kugelman, Liron Borenstein-Levin, Huda Jubran, Gil Dinur, Shlomit Ben-David, Elena Segal, Julie Haddad, Fanny Timstut, Iris Stein, Imad R Makhoul, Ori Hochwald
Iatrogenesis is more common in neonatal intensive care units (NICUs) because the infants are vulnerable and exposed to prolonged intensive care. Sixty percent of extremely low-birth-weight infants are exposed to iatrogenesis. The risk factors for iatrogenesis in NICUs include prematurity, mechanical or non-invasive ventilation, central lines, and prolonged length of stay. This led to the notion that "less is more." In the delivery room delayed cord clamping is recommended for term and preterm infants, and suction for the airways in newborns with meconium-stained fluid is not performed anymore...
July 30, 2018: Rambam Maimonides Medical Journal
Lovya George, Jasminkumar B Patel, Nesha Park, Winston M Manimtim
Hearing loss is the most common congenital birth defect. In 2007, American Academy of Pediatrics updated the hearing screen guidelines to recommend hearing screen by 1 month of age, diagnostic evaluation by 3 months, and early interventions by 6 months. Early interventions have been shown to improve developmental outcome in children with hearing loss. Infants admitted to the neonatal intensive care unit (NICU) are at higher risk for hearing loss. For infants born before 34 weeks' gestation, there are no guidelines for initial hearing screen...
August 6, 2018: American Journal of Perinatology
Gabrielle Simcock, Sue Kildea, Sue Kruske, David P Laplante, Guillaume Elgbeili, Suzanne King
BACKGROUND: Research shows that continuity of midwifery carer in pregnancy improves maternal and neonatal outcomes. This study examines whether midwifery group practice (MGP) care during pregnancy affects infant neurodevelopment at 6-months of age compared to women receiving standard hospital maternity care (SC) in the context of a natural disaster. METHODS: This prospective cohort study included 115 women who were affected by a sudden-onset flood during pregnancy...
July 27, 2018: BMC Pregnancy and Childbirth
Jayalaxmi Shripati Aihole, Aruna Gowdra, Deepak Javaregowda, Vinay Jadhav, M Narendra Babu, Ravidra Sahadev
Background: Congenital diaphragmatic hernia (CDH) is a complex developmental defect having a multifactorial etiology; i majority of cases (~80%), the cause is not known. Survival rates for patients with CDH have increased over the past decade with early prenatal detection and better postnatal management including surgery. Clinical profile and the outcome of 83 CDH neonates were studied and analyzed over a period of 12 years in our institute. Aims and Objectives: The clinical study was to analyze the clinical profile and outcome of CDH among the neonates in a tertiary care referral neonatal and pediatric center in Karnataka, India...
July 2018: Journal of Indian Association of Pediatric Surgeons
M Avellanet, A Mena, E Aisa-Pardo
INTRODUCTION: Cerebral palsy describes a group of developmental and posture disorders, which cause a limitation of activity due to non-progressive damage occurring in the developing brain. A population register facilitates the identification of cerebral palsy cases within a specific geographic population. Its usefulness is recognized in the world literature but in Spain, published databases focus on the treatment or complications of cerebral palsy. AIMS: To propose a population register that can be useful in different areas of our environment and to evaluate its validity through its application in two differentiated and geographically delimited health areas...
September 1, 2018: Revista de Neurologia
Ronny Wickström, Beatrice Skiöld, Gunnar Petersson, Olof Stephansson, Maria Altman
To determine whether moderate neonatal hypoglycemia in otherwise healthy infants is associated with adverse neurodevelopmental outcome in pre-school children. Population-based cohort study with prospectively collected register data from Sweden. All singletons born July 1st 2008 through December 31st 2012 (n = 101,060) in the region were included. Infants with congenital malformations, infants treated in neonatal intensive care unit, infants with inborn errors of metabolism and infants to mothers with diabetes were excluded...
October 2018: European Journal of Epidemiology
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