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Neonate and hypoglycemia

Valentina R Garbarino, Taylor A Santos, Anastassia R Nelson, Wynne Q Zhang, Corey M Smolik, Martin A Javors, Lynette C Daws, Georgianna G Gould
Poorly managed gestational diabetes can lead to severe complications for mother and child including fetal overgrowth, neonatal hypoglycemia and increased autism risk. Use of metformin to control it is relatively new and promising. Yet safety concerns regarding gestational metformin use remain, as its long-term effects in offspring are unclear. In light of beneficial findings with metformin for adult mouse social behavior, we hypothesized gestational metformin treatment might also promote offspring sociability...
November 10, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Kenji Yamada, Takeshi Taketani
Mitochondrial fatty acid oxidation disorders (FAODs) are caused by defects in β-oxidation enzymes, including very long-chain acyl-CoA dehydrogenase (VLCAD), trifunctional protein (TFP), carnitine palmitoyltransferase-2 (CPT2), carnitine-acylcarnitine translocase (CACT) and others. During prolonged fasting, infection, or exercise, patients with FAODs present with hypoglycemia, rhabdomyolysis, cardiomyopathy, liver dysfunction, and occasionally sudden death. This article describes the diagnosis, newborn screening, and treatment of long-chain FAODs with a focus on VLCAD deficiency...
November 6, 2018: Journal of Human Genetics
Erin B Kennedy, Michele R Hacker, David Miedema, DeWayne M Pursley, Anna M Modest, Toni H Golen, Heather H Burris
BACKGROUND AND OBJECTIVES: Early term infants (37-<39 weeks' gestation) are at higher risk of adverse outcomes than term infants (39-<41 weeks' gestation). We hypothesized that a policy to eliminate elective, early term deliveries would result in fewer NICU admissions and shorter lengths of stay among infants born ≥37 weeks. METHODS: This was a retrospective cohort study of singleton infants born ≥37 weeks at a tertiary medical center from 2004 to 2015 (preperiod: 2004-2008; postperiod: 2010-2015; washout period: 2009)...
November 2018: Hospital Pediatrics
Joshua I Rosenbloom, Adam K Lewkowitz, Kristina E Sondgeroth, Jessica L Hudson, George A Macones, Alison G Cahill, Methodius G Tuuli, Su-Hsin Chang
OBJECTIVE: To evaluate whether administration of antenatal late-preterm betamethasone is cost-effective in the immediate neonatal period. STUDY DESIGN: Cost-effectiveness analysis of late-preterm betamethasone administration with a time horizon of 7.5 days was conducted using a health-system perspective. Data for neonatal outcomes, including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and hypoglycemia, were from the Antenatal Betamethasone for Women at Risk for Late-Preterm Delivery trial...
November 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
N Scott Adzick, Diva D De Leon, Lisa J States, Katherine Lord, Tricia R Bhatti, Susan A Becker, Charles A Stanley
BACKGROUND: Congenital Hyperinsulinism (HI) causes severe hypoglycemia in neonates and children. We reviewed our experience with pancreatectomy for the various types of HI. METHODS: From 1998 to 2018, 500 patients with HI underwent pancreatectomy: 246 for focal HI, 202 for diffuse HI, 37 for atypical HI (16 for Localized Islet Nuclear Enlargement [LINE], 21 for Beckwith-Wiedemann Syndrome), and 15 for insulinoma. Focal HI neonates were treated with partial pancreatectomy...
October 5, 2018: Journal of Pediatric Surgery
Denice S Feig, Rosa Corcoy, Lois E Donovan, Kellie E Murphy, Jon F R Barrett, J Johanna Sanchez, Tim Wysocki, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
OBJECTIVE: To compare glycemic control, quality of life, and pregnancy outcomes of women using insulin pumps and multiple daily injection therapy (MDI) during the Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Trial (CONCEPTT). RESEARCH DESIGN AND METHODS: This was a prespecified analysis of CONCEPTT involving 248 pregnant women from 31 centers. Randomization was stratified for pump versus MDI and HbA1c . The primary outcome was change in HbA1c from randomization to 34 weeks' gestation...
October 16, 2018: Diabetes Care
B Ryder, M Tolomeo, Z Nochi, M Colella, M Barile, R K Olsen, M Inbar-Feigenberg
Multiple acyl-CoA dehydrogenase deficiency (MADD) or glutaric aciduria type II (GAII) is a clinically heterogeneous disorder affecting fatty acid and amino acid metabolism. Presentations range from a severe neonatal form with hypoglycemia, metabolic acidosis, and hepatomegaly with or without congenital anomalies to later-onset lipid storage myopathy. Genetic testing for MADD traditionally comprises analysis of ETFA, ETFB, and ETFDH. Patients may respond to pharmacological doses of riboflavin, particularly those with late-onset MADD due to variants in ETFDH...
October 12, 2018: JIMD Reports
Joshua Clive Anchan, Nicholas Ryan Carr, Kaashif Aqeeb Ahmad
No abstract text is available yet for this article.
October 10, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Suraiya Begum, Sanjoy K Dey, Kanij Fatema
Background: Diabetes is a common medical complication during pregnancy that results in significant neonatal morbidities. In infants of diabetic mothers (IDMs), hypoglycemia is a common complication. Objective: To study the neonatal hypoglycemia in IDMs in a tertiary care hospital. Settings and Design: A cross-sectional study was done in postnatal ward in Bangladesh Institute of Research and Rehabilitation in Diabetic, Endocrine and Metabolic Disorders from January to December 2009...
September 2018: Indian Journal of Endocrinology and Metabolism
Y Liu, D C Han, Y L Hu, L M Chen, J C Li, Y W Su, C X Hu
Objective: To summarize the clinical presentations and imaging features of cerebral venous sinus thrombosis (CVST) in 5 newborns. Methods: The clinical data of 5 newborns with CVST admitted to Department of Neonatology of Maternal and Children Hospital of Hubei Province from February 2017 to April 2018 were analyzed retrospectively. The risk factors, clinical presentations, imaging manifestations and treatment of CVST were investigated. Results: Of the 5 full term neonates, 4 were males and 1 female, with 4 aged less than 7 days and 1 more than 7 days; one with the history of maternal gestational diabetes mellitus, one with maternal gestational hypertension...
October 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Noah M Seymore, Bachir Zoghbi, Cirilo Sotelo-Avila, Shannon G Farmakis
Pancreatic heterotopia is a rare congenital anomaly more commonly incidentally found in adults. While intra-abdominal cysts found on prenatal imaging are not uncommon, we examine a case of pancreatic heterotopia presenting in an abdominopelvic cyst on prenatal imaging. At birth, the neonate was found to have hypoglycemia unresponsive to treatment that resolved after cyst resection. We will review the etiology, imaging findings and clinical course of this anomaly, which should be considered in the differential diagnosis of newborns presenting with unexplained hypoglycemia...
October 6, 2018: Pediatric Radiology
Mohsen Mollamohammadi, Zeinab Sadat Amirhoseini, Alireza Saadati, Zahra Pirzadeh, Masoud Hassan Amouzadeh
Objective: Seizure is the most common signs of nervous system disease in neonates. The first line of treatments in neonatal seizures (after ruling out and emergency treatment of electrolyte imbalance and hypoglycemia) are phenobarbital and phenytoin. We aimed to evaluate drugs that are more effective on neonatal seizure. Materials & Methods: Patients admitted to neonatal wards & NICUs (level   IIa&  IIb) in Qom hospitals (2015-2017), central Iran with presentation of seizure, were enrolled in this clinical trial study...
2018: Iranian Journal of Child Neurology
Amanda Skoll, Amélie Boutin, Emmanuel Bujold, Jason Burrows, Joan Crane, Michael Geary, Venu Jain, Thierry Lacaze-Masmonteil, Jessica Liauw, William Mundle, Kellie Murphy, Suzanne Wong, K S Joseph
OBJECTIVE: To assess the benefits and risks of antenatal corticosteroid therapy for women at risk of preterm birth or undergoing pre-labour Caesarean section at term and to make recommendations for improving neonatal and long-term outcomes. OPTIONS: To administer or withhold antenatal corticosteroid therapy for women at high risk of preterm birth or women undergoing pre-labour Caesarean section at term. OUTCOMES: Perinatal morbidity, including respiratory distress syndrome, intraventricular hemorrhage, bronchopulmonary dysplasia, infection, hypoglycemia, somatic and brain growth, and neurodevelopment; perinatal mortality; and maternal morbidity, including infection and adrenal suppression...
September 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Matthew M Finneran, Mark B Landon
PURPOSE OF REVIEW: To review the current evidence of the safety and efficacy of the use of oral agents for treatment of gestational diabetes (GDM). RECENT FINDINGS: The use of metformin and glyburide in pregnancy for treatment of GDM has dramatically increased since the early 2000s. Meta-analyses suggest that glyburide may increase the risk for large for gestational (LGA) infants and neonatal hypoglycemia. Conversely, metformin may potentially decrease rates of pregnancy-induced hypertension, LGA, neonatal hypoglycemia, and maternal weight gain...
September 28, 2018: Current Diabetes Reports
Joseph A Sujka, Katrina L Weaver, Joel D Lim, Katherine W Gonzalez, Deborah J Biondo, David Juang, Pablo Aguayo, Richard J Hendrickson
INTRODUCTION: Hepatic dysfunction in patients reliant on total parenteral nutrition (TPN) may benefit from cycled TPN. A concern for neonatal hypoglycemia has limited the use of cycled TPN in neonates less than 1 week of age. We sought to determine both the safety and efficacy of cycled TPN in surgical neonates less than 1 week of age. METHODS: A retrospective chart review was conducted on surgical neonates placed on prophylactic and therapeutic cycled TPN from January 2013 to March 2016...
November 2018: Pediatric Surgery International
Karim Gariani, Michael Egloff, Sarah Prati, Jacques Philippe, Michel Boulvain, François R Jornayvaz
AIMS: To evaluate if the adoption of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria for Gestational Diabetes Mellitus (GDM) led to changes in the management and in the occurrence of pregnancy complications. METHODS: This was a retrospective study of women with GDM followed at a single university center, diagnosed in 2009-2010 using the Carpenter and Coustan criteria (period 1) and in 2012-2013 using the IADPSG criteria (period 2)...
September 26, 2018: Experimental and Clinical Endocrinology & Diabetes
Jincy Immanuel, David Simmons
Blood glucose monitoring is fundamental for hyperglycemia management during pregnancy, but are the devices up to the job? Studies assessing the accuracy of 10 commercially available glucose meters during pregnancy showed that although >98-99% of the meter values were in the acceptable zones of the error grid for the majority of the meters, the meter performance varied, with the majority showing positive bias and a few showing minimal negative bias. The mean difference between meter and laboratory plasma values varied between -0...
October 2018: Diabetes Care
Basilio Pintaudi, Raffaella Fresa, Mariagrazia Dalfrà, Alessandro Roberto Dodesini, Ester Vitacolonna, Andrea Tumminia, Laura Sciacca, Cristina Lencioni, Teresa Marcone, Giuseppe Lucisano, Antonio Nicolucci, Matteo Bonomo, Angela Napoli
AIMS: To assess the risk of adverse neonatal outcomes in women with gestational diabetes (GDM) by identifying subgroups of women at higher risk to recognize the characteristics most associated with an excess of risk. METHODS: Observational, retrospective, multicenter study involving consecutive women with GDM. To identify distinct and homogeneous subgroups of women at a higher risk, the RECursive Partitioning and AMalgamation (RECPAM) method was used. Overall, 2736 pregnancies complicated by GDM were analyzed...
September 17, 2018: Acta Diabetologica
Tiffany L Harriman, Brigit Carter, Robin B Dail, Katherine E Stowell
BACKGROUND: Preterm infants are a vulnerable patient population, especially during the first hours of life. Hypothermia, hypoglycemia, and early-onset sepsis are common problems related to prematurity. Implementation of a Golden Hour protocol has been shown to improve outcomes for preterm infants. PURPOSE: To evaluate the effectiveness of a Golden Hour protocol for infants born at less than 32 weeks' gestation on improving the admission process in a military care facility...
September 12, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Nayereh Ghomian, Seyede Houra Mousavi Vahed, Samaneh Firouz, Mohammad Ali Yaghoubi, Masoud Mohebbi, Amirhossein Sahebkar
BACKGROUND: Insulin has been a conventional medication in the treatment of female patients suffering from gestational diabetes mellitus (GDM). However, the need for a large number of insulin injections in these patients causes them a lot of discomforts. Recently, an alternative medication, metformin, has received considerable attention in the treatment of GDM. The aim of this study was to compare the efficacy of metformin and insulin in regulating blood glucose levels and fetal outcomes in GDM...
September 7, 2018: Journal of Cellular Physiology
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