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Preterm AND NICU

John Ibrahim, Imran Mir, Lina Chalak
The aim is to review the evidence about the utility of term-equivalent age (TEA) magnetic resonance imaging (MRI) in predicting neurodevelopmental outcomes for preterm neonates. Preterm birth accounts for ~12% of all deliveries in the United States and is the leading cause of neurologic disabilities in children. From the neonatologist perspective, it is critically important to identify preterm infants at risk of subsequent neurodevelopmental disability who may benefit from early intervention services. However "the choose wisely campaign" also emphasizes the need to have ongoing cost/benefit discussions regarding care of preterm newborns to avoid waste that comes from subjecting infants to procedures that do not help...
October 12, 2018: Pediatric Research
Se Jin Kim, Ga Eun Kim, Jae Hyun Park, Sang Lak Lee, Chun Soo Kim
Purpose: This study was undertaken to investigate the clinical features and prognostic factors of early-onset sepsis (EOS) in neonatal intensive care unit (NICU) patients. Methods: A retrospective analysis of the medical records was conducted in a NICU of a university hospital over a 7.5-year period (Jan 2010-Jun 2017). Results: During the study period, there were 45 (1.2%) episodes of EOS in 3,862 infants. The most common pathogen responsible for EOS was Streptococcus group B (GBS) in 10 cases (22...
September 27, 2018: Korean Journal of Pediatrics
Malcolm R Battin, Christopher Jd McKinlay
AIM: The aim was to survey the Australian and New Zealand Neonatal Network (ANZNN) member units regarding current services and management guidelines for the ex-premature infant with severe chronic lung disease (CLD) still requiring significant respiratory support at term. METHODS: A 16-question survey was sent to clinical directors of all Level 3 units in Australia and New Zealand via the network. Reminder emails were sent, as required, to prompt a satisfactory response rate...
October 10, 2018: Journal of Paediatrics and Child Health
Jacqueline Elizabeth Van Wijlen
AIM: This discursive paper aims to bring to the foreground the ongoing influence of Cartesian dualism and other important contextual complexities on breastfeeding in the neonatal intensive care unit (NICU). BACKGROUND: Breastfeeding is widely supported as the optimal form of nutrition for the first six months of life and beyond. Amidst a myriad of contextual factors, current breastfeeding rates are below globally targeted goals. For premature and/or critically ill infants, the importance of receiving breast milk is often encouraged based on its immunological and nutritive benefits as opposed to the entirety of the breastfeeding interaction, underscoring the influence of dualism in the NICU...
October 9, 2018: Journal of Clinical Nursing
Beatrice Beebe, Michael M Myers, Sang Han Lee, Adrianne Lange, Julie Ewing, Nataliya Rubinchik, Howard Andrews, Judy Austin, Amie Hane, Amy E Margolis, Myron Hofer, Robert J Ludwig, Martha G Welch
Although preterm infants are at risk for social deficits, interventions to improve mother-infant interaction in the neonatal intensive care unit (NICU) are not part of standard care (SC). Study participants were a subset from a randomized controlled trial of a new intervention for premature infants, the Family Nurture Intervention (FNI), designed to help mothers and infants establish an emotional connection. At infants' 4 months corrected age, mother-infant face-to-face interaction was filmed and coded on a 1-s time base for mother touch, infant vocal affect, mother gaze, and infant gaze...
October 4, 2018: Developmental Psychology
Qi Guan, Beth A Sproule, Simone N Vigod, Suzanne M Cadarette, Simon Greaves, Diana Martins, Tara Gomes
BACKGROUND AND AIMS: Methadone maintenance therapy (MMT) is associated with improved outcomes for children exposed to maternal opioid dependence in utero. We examined Ontario's population of pregnant women on MMT and determined the impact of timing of MMT initiation on perinatal outcomes. DESIGN: Cohort study. SETTING: Ontario, Canada PARTICIPANTS: Women eligible for public drug benefits and on MMT during pregnancy between 2005-2015. MEASUREMENTS: We stratified women based on their timing of MMT initiation: 1) stabilized prior to conception, 2) newly initiated prior to conception, 3) initiation in trimester one, 4) initiation in trimester two, or 5) initiation in trimester three...
October 1, 2018: Addiction
Nam Hyo Kim, Young Ah Youn, Su Jin Cho, Jong-Hee Hwang, Ee-Kyung Kim, Ellen Ai-Rhan Kim, Soon Min Lee
The critical need to emphasize preterm infant follow-up after neonatal intensive care unit (NICU) discharge assures early identification of and intervention for neurodevelopmental disability. The aims of this study were to observe the follow-up rates in high-risk follow-up clinics, and analyze factors associated with non-compliance to follow-up among very low birth weight (VLBW) infants. The data was prospectively collected for 3063 VLBW infants between January 2013 and December 2014 from 57 Korean neonatal network (KNN) centers at a corrected age of 18-24 months...
2018: PloS One
Caroline Diguisto, Laurence Foix L'Helias, Andrei S Morgan, Pierre-Yves Ancel, Gilles Kayem, Monique Kaminski, Franck Perrotin, Babak Khoshnood, Francois Goffinet
OBJECTIVE: To evaluate the association between active antenatal management and neonatal outcomes in extremely preterm newborns admitted to a neonatal intensive care unit (NICU). STUDY DESIGN: This population-based cohort study was conducted in 25 regions of France. Infants born in 2011 between 220/7 and 266/7 weeks of gestation and admitted to a NICU were included. Infants with lethal congenital malformations or death in the delivery room were excluded. A multilevel multivariable analysis was performed, accounting for clustering by mother (multiple pregnancies) and hospital plus individual characteristics, to estimate the association between the main exposure of no active antenatal management (not receiving antenatal corticosteroids, magnesium sulfate, or cesarean delivery for fetal indications) and a composite outcome of death or severe neonatal morbidity (including severe forms of brain or lung injury, retinopathy of prematurity, and necrotizing enterocolitis)...
September 27, 2018: Journal of Pediatrics
Stephanie L Bourque, Claire Levek, Diane L Melara, Theresa R Grover, Sunah S Hwang
Objectives To describe the demographics, clinical characteristics and referral patterns of premature infants to a regional level IV neonatal intensive care unit (NICU); to determine the prevalence and predictors of back-transport of infants ≤ 32 weeks gestational age in a level IV NICU; for infants not back-transported closer to maternal residence, determine the length of stay beyond attainment of clinical stability. Methods Data (2010-2014) from the Children's Hospital Neonatal Database and individual chart review for infants ≤ 32 weeks admitted to a level IV NICU whose maternal residence was outside the metro area were included...
September 25, 2018: Maternal and Child Health Journal
Ian Zuzarte, Premananda Indic, Dagmar Sternad, David Paydarfar
Long-term recordings of movement in preterm infants might reveal important clinical information. However, measurement of movement is limited because of time-consuming and subjective analysis of video or reluctance to attach additional sensors to the infant. We evaluated whether photoplethysmogram (PPG), routinely used for oximetry in preterm infants in the neonatal intensive care unit (NICU), can provide reliable long-term measurements of movement. In 18 infants [mean post-conceptional age (PCA) 31.10 weeks, range 29-34...
September 25, 2018: Annals of Biomedical Engineering
Katherine L Wisner, Dorothy Sit, Kelly O'Shea, Debra L Bogen, Crystal T Clark, Emily Pinheiro, Amy Yang, Jody D Ciolino
OBJECTIVE: The hypotheses were: (1) pregnant women with bipolar disorder (BD) have less favorable pregnancy outcomes than unaffected women, and (2) psychotropic treated women with BD have better outcomes than un-medicated women. METHOD: This prospective study included 174 mother-infant dyads. Women had BD without psychotropic exposure (BD-NP, n = 38), BD with psychotropic treatment (BD-P, n = 49), or neither psychotropic exposure nor major mood disorder (Comp, n = 87)...
January 15, 2019: Journal of Affective Disorders
Ivana Chandra, Lizhou Sun
OBJECTIVE: To analyze the similarities and differences in the clinical parameters, laboratory biomarkers, and pregnancy outcomes between preterm and term preeclampsia (PE). METHODS: Data on 185 women diagnosed with PE were collected from a Jiangsu Province Hospital from January 2017 to December 2017 and analyzed. 74 (40%) patients were diagnosed with preterm PE, of which 70 (94.6%) patients with PE with severe features (PEs) and the rest with PE. 111 (60%) patients were diagnosed with term PE, of which 54 (48...
September 22, 2018: Postgraduate Medicine
Leila Jouybari, Ezzat Abbariki, Maryam Jebeli, Fatemeh Mehravar, Leila Asadi, Negarin Akbari, Akram Sanagoo, Zahra Moradi
OBJECTIVE: This study was conducted to examine the effect of narrative writing and art therapy on maternal stress in the neonatal intensive care units (NICUs) during infants' hospitalization. MATERIAL AND METHODS: randomized controlled clinical trial with three parallel arms study was conducted among three groups of mothers with preterm infants in the NICUs of two teaching hospitals of Shahroud University of Medical Sciences. Pre- and post-tests were administered to a sample size of 105 during 9 months...
September 23, 2018: Journal of Maternal-fetal & Neonatal Medicine
James I Hagadorn, Mihoko V Bennett, Elizabeth A Brownell, Kurlen S E Payton, William E Benitz, Henry C Lee
OBJECTIVE: To test the hypothesis that neonatal intensive care unit (NICU)-specific changes in patent ductus arteriosus (PDA) management are associated with changes in local outcomes in preterm infants. STUDY DESIGN: This retrospective repeated-measures study of aggregated data included infants born 400-1499 g admitted within 2 days of delivery to NICUs participating in the California Perinatal Quality Care Collaborative. The period 2008-2015 was divided into four 2-year epochs...
September 20, 2018: Journal of Pediatrics
S Lalani, A J Choudhry, B Firth, V Bacal, Mark Walker, S W Wen, S Singh, A Amath, M Hodge, I Chen
STUDY QUESTION: How is endometriosis associated with adverse maternal, fetal and neonatal outcomes of pregnancy? SUMMARY ANSWER: Women with endometriosis are at elevated risk for serious and important adverse maternal (pre-eclampsia, gestational diabetes, placenta praevia and Cesarean section) and fetal or neonatal outcomes (preterm birth, PPROM, small for gestational age, stillbirth and neonatal death). WHAT IS KNOWN ALREADY: A number of studies have shown an association between endometriosis and certain adverse maternal and fetal outcomes, but the results have been conflicting with potential for confounding by the use of assisted reproductive technology...
September 17, 2018: Human Reproduction
Jenn Gonya, Tondi Harrison, Keith Feldman, Melanie Stein, Nitesh Chawla
AIMS: This pilot study explored how maternal stress experienced in the neonatal intensive care unit (NICU) is affected by the individual nursing structure and the network that provides care to extremely preterm infants. BACKGROUND: Mothers experience high stress when their extremely preterm infants are hospitalized in the NICU. This often translates into maladaptive parenting behaviours that negatively affect the long-term cognitive, social, and emotional development of the infant...
September 20, 2018: Journal of Nursing Management
Kazune Kozen, Theodore Dassios, Nick Kametas, Ritika R Kapoor, Anne Greenough
Admission to neonatal care causes separation of infants from their parents, can adversely affect breast-feeding and is associated with painful procedures. Our aim was to identify perinatal factors and cost of care associated with transient neonatal hyperinsulinaemic hypoglycaemia (HH). Infants born after 35 weeks of gestation admitted because of hypoglycaemia were studied. The neonates were divided into two groups (HH and non-HH), and their length and cost of care were compared and perinatal factors predicting those outcomes explored...
September 19, 2018: European Journal of Pediatrics
Çağrι Gülümser, Mahir Kinap, Filiz Bilgin Yanik, Nihal Sahin Uysal, Gokhan Moray, Mehmet Haberal
OBJECTIVE: To investigate pregnancy outcomes and to define preventative measures against to risk factors and complications in pregnancy after liver transplantation. Secondary aim is to report postpartum allograft functions in these patients. METHOD: This is a case series study. All pregnant women with liver transplantations performed in our hospital were enrolled. Patients' hospital medical records, electronic records Neonatal Intensive Care Unit (NICU) records were used to collect data...
September 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
J Gonya, K Feldman, K Brown, M Stein, S Keim, K Boone, W Rumpf, W Ray, N Chawla, E Butter
BACKGROUND: Extremely preterm infants represent one of the highest risk categories for impairments in social competence. Few studies have explored the impact of the neonatal intensive care unit (NICU) environment on social development. However, none have specifically analyzed the effects of the care structure the infant receives during hospitalization on later social competence indicators. OBJECTIVE: To identify associations between the care structures received by extremely preterm infants in the NICU and scores on the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) post-discharge...
September 12, 2018: Early Human Development
Brandi R Harbin, Ellise D Adams, Pamela V OʼNeal
PURPOSE: The purpose of this study was to explore airway clearance practices for the preterm newborn in the neonatal intensive care unit (NICU). STUDY DESIGN AND METHODS: This descriptive, retrospective medical record review analyzed airway clearance practices in a level III regional NICU from 2016 to 2017 in preterm newborns ranging from 32 weeks to 36 weeks and 6 days. There were 87 preterm newborns and 384 suctioning events reviewed during the entire length of stay...
September 13, 2018: MCN. the American Journal of Maternal Child Nursing
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