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https://www.readbyqxmd.com/read/28723921/postnatal-dexamethasone-respiratory-and-neurodevelopmental-outcomes-at-two-years-in-babies-born-extremely-preterm
#1
Gordon Qin, Jessica W Lo, Neil Marlow, Sandy A Calvert, Anne Greenough, Janet L Peacock
IMPORTANCE: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes. OBJECTIVE: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors. MATERIALS AND METHODS: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone...
2017: PloS One
https://www.readbyqxmd.com/read/28723887/in-vitro-and-in-vivo-characterization-of-poractant-alfa-supplemented-with-budesonide-for-safe-and-effective-intratracheal-administration
#2
Francesca Ricci, Chiara Catozzi, Francesca Ravanetti, Xabier Murgia, Francesco D'Aló, Natalia Macchidani, Elisa Sgarbi, Valentina Di Lallo, Federica Saccani, Marisa Pertile, Antonio Cacchioli, Silvia Catinella, Gino Villetti, Maurizio Civelli, Francesco Amadei, Franco Stellari Fabio, Barbara Pioselli, Fabrizio Salomone
BACKGROUND: The intratracheal (IT) administration of budesonide using surfactant as a vehicle has been shown to reduce the incidence of bronchopulmonary dysplasia (BPD) in preterm infants. OBJECTIVE: To characterize the in vitro characteristics and in vivo safety and efficacy of the extemporaneous combination of budesonide and poractant alfa. METHODS: The stability, minimum surface tension, and viscosity of the preparation were evaluated by means of HPLC, Wilhelmy balance, and Rheometer, respectively...
July 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28723885/term-versus-preterm-cord-blood-cells-for-the-prevention-of-preterm-brain-injury
#3
Jingang Li, Tamara Yawno, Amy Sutherland, Jan Loose, Ilias Nitsos, Beth J Allison, Robert Bischof, Courtney A McDonald, Graham Jenkin, Suzanne L Miller
BACKGROUND: White matter brain injury in preterm infants can induce neurodevelopmental deficits. Umbilical cord blood (UCB) cells demonstrate neuroprotective properties, but it is unknown whether cells obtained from preterm versus term cord blood have similar efficacy. This study compared the ability of term cord blood (TCB) versus preterm cord blood (PCB) cells to reduce white matter injury in preterm fetal sheep. METHODS: Hypoxia-ischemia (HI) was induced in fetal sheep (0...
July 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28721812/update-on-phototherapy-in-jaundiced-neonates
#4
Finn Ebbesen, Thor Willy Ruud Hansen, M Jeffrey Maisels
BACKGROUND: Even relatively low serum bilirubin concentrations can cause neurodevelopmental impairment in extremely low birth weight (EBWL) infants, while sequelae from hyperbilirubinemia in late preterm and term infants are rare and occur only at very high serum bilirubin lev-els. Phototherapy is the current treatment of choice. OBJECTIVE: To present an update on the most important issues involved in phototherapy for jaundiced infants. RESULTS: Light absorption by bilirubin in the skin transforms the native Z,Z-bilirubin to conformational photoisomers Z,E-bilirubin and E,Z-bilirubin and structural photoisomers E,Z-lumirubin and E,E-lumirubin...
July 18, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28721223/atrial-fibrillation-in-a-preterm-newborn-with-structurally-normal-heart
#5
Pier Paolo Bassareo, Andrea Raffaele Marras, Mariangela Marras, Silvia Marras, Giuseppe Mercuro
Atrial fibrillation (AF) is a really uncommon arrhythmia in newborns. Here, we report the case of a 1-day-old infant who was recovered in Neonatal Intensive Care Unit for a twin-to-twin transfusion. The appearance of an unexpected AF was registered at his continuous electrocardiographic monitoring. Both chest X-ray and echocardiographic examination revealed the anomalous insertion of the tip of a central venous catheter (CVC) into the heart ('umbilical artery → inferior vena cava → right atrium → patent foramen ovale → left atrium')...
March 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28720616/concomitant-preterm-birth-and-severe-small-for-gestational-age-birth-weight-among-infants-of-immigrant-mothers-in-ontario-originating-from-the-philippines-and-east-asia-a-population-based-study
#6
Emily Bartsch, Alison L Park, Jennifer Jairam, Joel G Ray
OBJECTIVES: Women from the Philippines form one of the largest immigrant groups to North America. Their newborns experience higher rates of preterm birth (PTB), and separately, small-for-gestational age (SGA) birth weight, compared with other East Asians. It is not known if Filipino women are at elevated risk of concomitant PTB and severe SGA (PTB-SGA), a pathological state likely reflective of placental dysfunction and neonatal morbidity. METHODS: We conducted a population-based study of all singleton or twin live births in Ontario, from 2002 to 2011, among immigrant mothers from the Philippines (n=27 946), Vietnam (n=15 297), Hong Kong (n=5618), South Korea (n=5148) and China (n=42 517)...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28720571/the-integrated-stress-response-in-hypoxia-induced-diffuse-white-matter-injury
#7
Benjamin Ll Clayton, Aaron Huang, Rejani B Kunjamma, Ani Solanki, Brian Popko
Currently no treatments exist for preterm infants with diffuse white matter injury (DWMI) caused by hypoxia. Due to improved care of preterm neonates and increased recognition by advanced imaging techniques, the prevalence of DWMI is increasing. A better understanding of the pathophysiology of DWMI is therefore of critical importance. The integrated stress response (ISR), a conserved eukaryotic response to myriad stressors including hypoxia, may play a role in hypoxia-induced DWMI and may represent a novel target for much needed therapies...
July 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28720399/prenatal-and-postnatal-administration-of-prebiotics-and-probiotics
#8
REVIEW
Kristin Sohn, Mark A Underwood
Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates...
July 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28720035/home-visiting-and-the-health-of-preterm-infants
#9
Patrick H Casey, Carmen Irby, Sandra Withers, Susan Dorsey, Jingyun Li, Malik Rettiganti
The results of home visiting programs which target medically fragile low-birth-weight preterm infants (LBWPT) have been inconsistent. We provided nurse/social worker home visits to families of LBWPT infants on a regular schedule. Teams were trained in approaches to improve the health and development of the infants. The completion of immunization series was sigmificantly higher and the infant mortality rates of the home visits childen were significanly lower compared to national and state rates. We used state Medicaid data and examined frequency of hospitalization, emergency department visits, routine and nonscheduled visits to primary care physician, and pharmacy use of the home-visited subjects compared with a propensity-matched group...
August 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28719503/central-peripheral-temperature-monitoring-as-a-marker-for-diagnosing-late-onset-neonatal-sepsis
#10
José Luis Leante-Castellanos, Antonio Martínez-Gimeno, Manuel Cidrás-Pidré, Gerardo Martínez-Munar, Ana García-González, Carmen Fuentes-Gutiérrez
BACKGROUND: The prognosis for late-onset sepsis depends largely on a timely diagnosis. We assess central-peripheral temperature difference monitoring as a marker for late-onset neonatal sepsis diagnosis. METHODS: We performed a prospective, observational study focusing on a cohort of 129 very low birth weight infants. Thermal gradient alteration was defined as a difference of > 2°C maintained during 4 hours. We then determined its association with the late-onset sepsis variable through logistic regression...
July 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28719076/multimodal-image-analysis-of-clinical-influences-on-preterm-brain-development
#11
Gareth Ball, Paul Aljabar, Phumza Nongena, Nigel Kennea, Nuria Gonzalez-Cinca, Shona Falconer, Andrew T M Chew, Nicholas Harper, Julia Wurie, Mary A Rutherford, Serena J Counsell, A David Edwards
Objective Premature birth is associated with numerous complex abnormalities of white and grey matter and a high incidence of long-term neurocognitive impairment. An integrated understanding of these abnormalities and their association with clinical events is lacking. The aim of this study was to identify specific patterns of abnormal cerebral development and their antenatal and postnatal antecedents. Methods In a prospective cohort of 449 infants (226 male), we performed a multi-variate and data-driven analysis combining multiple imaging modalities...
July 18, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28718356/comparison-of-three-non-invasive-ventilation-strategies-nsippv-bipap-ncpap-for-rds-in-vlbw-infants
#12
Vincenzo Salvo, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J I Zimmermann, Antonio W D Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferraù, Diego Gazzolo
BACKGROUND: Noninvasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness and failure. OBJECTIVE: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV) and nasal bilevel CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW)...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28718213/safety-and-dose-finding-trial-of-tadalafil-administered-for-fetal-growth-restriction-a-phase-1-clinical-study
#13
Michiko Kubo, Hiroaki Tanaka, Shintaro Maki, Masafumi Nii, Nao Murabayashi, Kazuhiro Osato, Yuki Kamimoto, Takashi Umekawa, Eiji Kondo, Tomoaki Ikeda
AIM: We designed a safety and dose-finding trial of tadalafil administered for fetal growth restriction (FGR). METHODS: Three cases were initially commenced on 10 mg/day and monitored for major adverse events. Should a major adverse event be observed in one or more of the three cases, an examination into its relation with tadalafil would be conducted by a safety evaluation committee. If one or more of these new cases exhibited the same adverse event, the trial would be stopped completely...
July 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28716870/necrotising-enterocolitis-after-supraventricular-tachycardia-an-unusual-precursor-to-a-common-problem
#14
Jennie Saini, Aideen Moore, Kate Hodgson
Supraventricular tachycardia (SVT) is the most common neonatal arrhythmia. Necrotising enterocolitis (NEC) is a disease with multifactorial aetiology, most common in preterm infants. There are three previous case reports in the literature of NEC following neonatal SVT. We present two cases of late preterm infants with NEC, characterised by pneumatosis on abdominal X-ray and ultrasound, following recurrent SVT without haemodynamic instability. The infants were successfully treated with antibiotic therapy and bowel rest...
July 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716018/prediction-of-extubation-readiness-in-extremely-preterm-infants-by-the-automated-analysis-of-cardiorespiratory-behavior-study-protocol
#15
Wissam Shalish, Lara J Kanbar, Smita Rao, Carlos A Robles-Rubio, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
BACKGROUND: Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significant number of infants fail extubation and require reintubation, an intervention that may be associated with increased morbidities...
July 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28715797/neurodevelopment-at-3-years-in-neonates-born-by-vaginal-delivery-versus-cesarean-section-at-26-weeks-of-gestation-retrospective-analysis-of-a-nationwide-registry-in-japan
#16
Takeshi Kimura, Masato Takeuchi, Takumi Imai, Shiro Tanaka, Koji Kawakami
BACKGROUND: A high proportion of extremely preterm (EPT) infants are born by cesarean section (CS). However, whether the mode of delivery is related to long-term neurodevelopment in these infants is unclear. OBJECTIVES: This study aimed to determine whether the mode of delivery is associated with mortality and long-term outcomes in EPT infants. METHODS: We analyzed data of the Neonatal Research Network in Japan (NRNJ), a population-based, nationwide registry...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28715355/repeated-exposure-to-sucrose-for-procedural-pain-in-mouse-pups-leads-to-long-term-widespread-brain-alterations
#17
Sophie Tremblay, Manon Ranger, Cecil M Y Chau, Jacob Ellegood, Jason P Lerch, Liisa Holsti, Daniel Goldowitz, Ruth E Grunau
Oral sucrose is administered routinely to reduce pain of minor procedures in premature infants and is recommended as standard care in international guidelines. No human or animal studies on effects of early repeated sucrose exposure on long-term brain development have been done in the context of pain. We evaluated the effects of repeated neonatal sucrose treatment before an intervention on long-term brain structure in mouse pups. Neonatal C57Bl/6J mice (n = 109) were randomly assigned to one of 2 treatments (vehicle vs sucrose) and one of 3 interventions (handling, touch, or needle-prick)...
August 2017: Pain
https://www.readbyqxmd.com/read/28714605/epigenetic-alterations-and-prenatal-maternal-depression
#18
REVIEW
Zsofia Nemoda, Moshe Szyf
Major depressive disorder of the mother affects 6 to 17% of pregnancies worldwide and can lead to negative outcomes, such as preterm delivery and later mental health problems of the child. It has been proposed that developmental programming has long-lasting effects in the offspring that might be mediated by epigenetic mechanisms, such as DNA methylation. Altered stress regulation or impaired immunological function of the mother can potentially affect DNA methylation processes of the fetus, changing gene expression levels in utero...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28714339/inhaled-and-systemic-steroid-exposure-and-neurodevelopmental-outcome-of-preterm-neonates
#19
Edmond N Kelly, Vibhuti S Shah, Jody Levenbach, Michael Vincer, Orlando DaSilva, Prakesh S Shah
OBJECTIVES: To compare death and/or neurodevelopmental outcomes of preterm infants exposed to inhaled and/or systemic steroids with those without exposure, and examine the impact of timing of exposure. METHODS: Retrospective study of infants born <29 weeks gestation and assessed at 18-21 months corrected age (CA). Neurodevelopmental impairment (NDI) was defined as any Bayley Scales of Infant and Toddler Development-III (BSID-III) score <85, cerebral palsy ≥ grade one, and visual or hearing impairment...
July 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28714327/elevated-levels-of-circulating-cell-free-dna-and-neutrophil-proteins-are-associated-with-neonatal-sepsis-and-necrotizing-enterocolitis-in-immature-mice-pigs-and-infants
#20
Duc Ninh Nguyen, Allan Stensballe, Jacqueline Cy Lai, Pingping Jiang, Anders Brunse, Yanqi Li, Jing Sun, Carina Mallard, Tom Skeath, Nicholas D Embleton, Janet E Berrington, Per T Sangild
Preterm infants are highly susceptible to late-onset sepsis (LOS) and necrotizing enterocolitis (NEC), but disease pathogenesis and specific diagnostic markers are lacking. Circulating cell-free DNA (cfDNA) and immune cell-derived proteins are involved in multiple immune diseases in adults but have not been investigated in preterm neonates. We explored the relation of circulating neutrophil-associated proteins and cfDNA to LOS and/or NEC. Using a clinically relevant preterm pig model of spontaneous LOS and NEC development, we investigated neutrophil-associated proteins and cfDNA in plasma, together with cytokines in gut tissues...
January 1, 2017: Innate Immunity
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