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Canadian Neonatal Network

Tiffany Hunter, Jyotsna Shah, Anne Synnes, Sandesh Shivananda, Greg Ryan, Prakesh S Shah, Kellie E Murphy
PURPOSE: To compare neonatal outcomes of twins delivered <33 weeks' gestation in tertiary centers in Canada according to the mode of birth and presentation. MATERIALS AND METHODS: This retrospective cohort from the Canadian Neonatal Network database studied preterm twins born from 24 + 0 to 32 + 6 weeks' gestation between 2005 and 2012. Twins were grouped by the mode of birth: both vaginal, combined vaginal/cesarean section (CS), and both CS. Additionally, twins were grouped by the mode of presentation: both vertex, vertex/breech, breech/vertex, and both breech...
March 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
Elad Mei-Dan, Jyotsna Shah, Shoo Lee, Prakesh S Shah, Kellie E Murphy
Objective  This retrospective cohort study examined the effect of birth order on neonatal morbidity and mortality in very preterm twins. Study Design Using 2005 to 2012 data from the Canadian Neonatal Network, very preterm twins born between 24 (0/7) and 32 (6/7) weeks of gestation were included. Odds of morbidity and mortality of second-born cotwins compared with first-born cotwins were examined by matched-pair analysis. Outcomes were neonatal death, severe brain injury (intraventricular hemorrhage grade 3 or 4 or persistent periventricular echogenicity), bronchopulmonary dysplasia, severe retinopathy of prematurity (ROP) (> stage 2), necrotizing enterocolitis (≥ stage 2), and respiratory distress syndrome (RDS)...
February 23, 2017: American Journal of Perinatology
Tetsuya Isayama, Shoo K Lee, Junmin Yang, David Lee, Sibasis Daspal, Michael Dunn, Prakesh S Shah
Importance: Several definitions of bronchopulmonary dysplasia are clinically used; however, their validity remains uncertain considering ongoing changes in the panoply of respiratory support treatment strategies used within neonatal units. Objective: To identify the optimal definition of bronchopulmonary dysplasia that best predicts respiratory and neurodevelopmental outcomes in preterm infants. Design, Setting, and Participants: Retrospective cohort study at tertiary neonatal intensive care units...
March 1, 2017: JAMA Pediatrics
Julie E Robertson, Sarka Lisonkova, Tang Lee, Dane A De Silva, Peter von Dadelszen, Anne R Synnes, K S Joseph, Robert M Liston, Laura A Magee
BACKGROUND: Few studies have examined fetal, infant and maternal mortality and morbidity among pregnant women at very early gestation with an open cervix and prolapsed membranes. We carried out a study describing the outcomes of women hospitalized with prolapsed membranes at 22-28 weeks' gestation. METHODS: We prospectively recruited women with singleton pregnancies admitted at 22-28 weeks' gestation to tertiary hospitals of the Canadian Perinatal Network between 2005 and 2009...
2016: PloS One
Amit Mukerji, Prakesh S Shah, Sandesh Shivananda, Wendy Yee, Brooke Read, John Minski, Ruben Alvaro, Christoph Fusch
AIM: To evaluate practice variation with respect to noninvasive respiratory support (NRS) use across Canadian neonatal intensive care units (NICUs). METHODS: A web-based survey was sent to all site investigators of the 30 level 3 NICUs participating in the Canadian Neonatal Network. The survey inquired about the use of five commonly described NRS modes. In addition, the presence and adherence to local guidelines were ascertained. Descriptive analyses were performed to identify variations in practice...
March 2017: Acta Paediatrica
Joseph Y Ting, Anne Synnes, Ashley Roberts, Akhil Deshpandey, Kimberly Dow, Eugene W Yoon, Kyong-Soon Lee, Simon Dobson, Shoo K Lee, Prakesh S Shah
Importance: Excessive antibiotic use has been associated with altered bacterial colonization and may result in antibiotic resistance, fungemia, necrotizing enterocolitis (NEC), and mortality. Exploring the association between antibiotic exposure and neonatal outcomes other than infection-related morbidities may provide insight on the importance of rational antibiotic use, especially in the setting of culture-negative neonatal sepsis. Objective: To evaluate the trend of antibiotic use among all hospitalized very low-birth-weight (VLBW) infants across Canada and the association between antibiotic use rates (AURs) and mortality and morbidity among neonates without culture-proven sepsis or NEC...
December 1, 2016: JAMA Pediatrics
Anne Synnes, Thuy Mai Luu, Diane Moddemann, Paige Church, David Lee, Michael Vincer, Marilyn Ballantyne, Annette Majnemer, Dianne Creighton, Junmin Yang, Reginald Sauve, Saroj Saigal, Prakesh Shah, Shoo K Lee
OBJECTIVES: Identify determinants of neurodevelopmental outcome in preterm children. METHODS: Prospective national cohort study of children born between 2009 and 2011 at <29 weeks gestational age, admitted to one of 28 Canadian neonatal intensive care units and assessed at a Canadian Neonatal Follow-up Network site at 21 months corrected age for cerebral palsy (CP), visual, hearing and developmental status using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III)...
May 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Nir Melamed, Alex Pittini, Jon Barrett, Jyotsna Shah, Eugene W Yoon, Brigitte Lemyre, Shoo K Lee, Kellie E Murphy, Prakesh S Shah
OBJECTIVE: To assess the association of antenatal corticosteroids and neonatal outcomes of preterm small-for-gestational-age (SGA) neonates and estimate whether the association is similar to that observed in appropriate-for-gestational-age (AGA) neonates. METHODS: We conducted a retrospective cohort study using data collected on singleton neonates born between 24 0/7 and 33 6/7 weeks of gestation and admitted to tertiary neonatal units in Canada between 2010 and 2014...
November 2016: Obstetrics and Gynecology
Armend Lokku, Lucia Mirea, Shoo K Lee, Prakeshkumar S Shah
Objective To assess trends in patent ductus arteriosus (PDA) management and examine concurrent changes in neonatal mortality and morbidities. Methods This retrospective observational study examined infants born at 23 to 32 weeks' gestational age with PDA and admitted to a neonatal unit during 2006 to 2012. Multivariable logistic regression assessed trends in yearly PDA treatment rates and compared a composite outcome of mortality or any severe morbidity (bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, or necrotizing enterocolitis) between and within time periods and PDA treatments...
April 2017: American Journal of Perinatology
Liron Borenstein-Levin, Anne Synnes, Ruth E Grunau, Steven P Miller, Eugene W Yoon, Prakesh S Shah
OBJECTIVES: To evaluate patterns of narcotic and sedative use in neonatal intensive care units (NICUs) across Canada using data collected by the Canadian Neonatal Network. STUDY DESIGN: We conducted a retrospective observational cohort study of preterm neonates at <33 weeks' gestation and admitted to a participating Canadian Neonatal Network NICU. The proportion of all neonates who received sedative(s), narcotic(s), or either sedative(s), narcotic(s), or both during their NICU stay was calculated for each year...
January 2017: Journal of Pediatrics
Elizabeth V Asztalos, Paige T Church, Patricia Riley, Carlos Fajardo, Prakesh S Shah
Objective This study aims to examine the association between the absence of neonatal comorbidities, as well as the presence of indicators of clinical progress with good neurodevelopmental (ND) outcomes, at 18 months corrected age in a national cohort of preterm infants of < 29 weeks' gestation. Design Study subjects included preterm infants (< 29 weeks' gestation) born in 2010 and 2011. Univariate analyses were conducted and regression estimates were calculated for variables where odds of a good ND outcome, composite scores ≥ 100 in three domains (cognitive, language, and motor) in the Bayley Scales of Infant and Toddler Development, 3rd ed...
March 2017: American Journal of Perinatology
Elizabeth V Asztalos, Paige T Church, Patricia Riley, Carlos Fajardo, Prakesh S Shah
Objective This study aims to explore the association between primary caregiver education and cognitive and language composite scores of the Bayley Scales of Infant and Toddler Development, 3rd ed. (Bayley-III) in preterm infants at 18 to 21 months corrected age. Design An observational study was performed on preterm infants born before 29 weeks' gestation between 2010 and 2011. Primary caregivers were categorized by their highest education level and cognitive and language composite scores of the Bayley-III were compared among infants between these groups with adjustment for perinatal and neonatal factors...
March 2017: American Journal of Perinatology
Nir Melamed, Jyotsna Shah, Eugene W Yoon, Ermelinda Pelausa, Shoo K Lee, Prakesh S Shah, Kellie E Murphy
BACKGROUND: Data regarding the effects of antenatal corticosteroids in twin pregnancies are limited because of the insufficient number of women with twins enrolled in randomized controlled trials on antenatal corticosteroids. Furthermore, the interpretation of available data is limited by the fact that the interval from the administration of antenatal corticosteroids to delivery is greater than 7 days in a large proportion of twins, a factor that has been shown to affect the efficacy of antenatal corticosteroids and has not been controlled for in previous studies...
October 2016: American Journal of Obstetrics and Gynecology
Julie Morin, Thuy Mai Luu, Rosanne Superstein, Luis H Ospina, Francine Lefebvre, Marie-Noëlle Simard, Vibhuti Shah, Prakesh S Shah, Edmond N Kelly
BACKGROUND AND OBJECTIVE: Bevacizumab intravitreal injection, a vascular endothelial growth factor inhibitor, is used to treat retinopathy of prematurity (ROP). However, concerns have been raised regarding its systemic absorption and effect on developing tissues including brain. This study compared neurodevelopment at 18 months' corrected age in preterm infants of <29 weeks' gestation treated with bevacizumab versus laser ablation. METHODS: Data from the Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network databases were retrospectively reviewed...
April 2016: Pediatrics
Fouad Youssef, Li Hsia Alicia Cheong, Sherif Emil
BACKGROUND: Care of infants with gastroschisis is centralized in Canada and noncentralized in the United States. We conducted an outcomes comparison between the two countries and analyzed the determinants of such outcomes. METHODS: Inpatient mortality and hospital stay of gastroschisis patients from the Canadian Pediatric Surgery Network prospective clinical database for the period 2005-2013 were compared with those from the US Kids Inpatient Database for the period 2003-2012...
June 2016: Journal of Pediatric Surgery
Amuchou S Soraisham, Andrei Harabor, Sandesh Shivananda, Ruben Alvaro, Xiang Y Ye, Shoo K Lee, Prakesh S Shah
Objective To determine the proportion of infants who receive inhaled nitric oxide (iNO), and to characterize the variations in its use by gestational age (GA) and center in infants <34 weeks' gestation. Design Retrospective analysis was performed in infants born at <34 weeks' gestation and admitted to neonatal intensive care units participating in the Canadian Neonatal Network between January 2010 and December 2013. Results Of 19,525 infants, 831 (4.2%) received iNO. A total of 369 infants (44%) received iNO during the first 2 days after birth...
June 2016: American Journal of Perinatology
Pankaj Sakhuja, Michael Finelli, Judy Hawes, Hilary Whyte
Objectives. To examine current opinions and practices regarding endotracheal tube placement across several Canadian Neonatal Intensive Care Units. Design. Clinical directors from Canadian Neonatal Network affiliated NICUs and Neonatal-Perinatal Programs across Canada were invited via email to participate in and disseminate the online survey to staff neonatologists, neonatal fellows, respiratory therapists, and nurse practitioners. Result. There is wide variability in the beliefs and practices related to ETT placement...
2016: International Journal of Pediatrics
Sadia Hossain, Prakesh S Shah, Xiang Y Ye, Brian A Darlow, Shoo K Lee, Kei Lui
BACKGROUND: Very preterm infants born outside tertiary centers are at higher risks of adverse outcomes than inborn infants. Regionalization of perinatal care has been introduced worldwide to improve outcomes. OBJECTIVE: To compare the risk-adjusted outcomes of both inborn and outborn infants cared for in tertiary neonatal intensive care units in Australia and New Zealand and in Canada. METHODS: Deidentified data of infants <32 weeks' gestational age from the 29 Australian and New Zealand Neonatal Network units (ANZNN; n = 9,893) and 26 Canadian Neonatal Network units (CNN; n = 7,133) between 2005 and 2007 were analyzed for predischarge adverse outcomes...
2016: Neonatology
Mohamed Shalabi, Mohamed Adel, Eugene Yoon, Khalid Aziz, Shoo Lee, Prakesh S Shah
OBJECTIVE: To compare the rates of catheter-associated bloodstream infection (CABSI) in preterm infants born at <30 weeks' gestation who received a peripherally inserted central catheter (PICC) versus an umbilical venous catheter (UVC) immediately after birth as their primary venous access. METHODS: This retrospective matched cohort study examined data from infants born at <30 weeks' gestation and admitted between January 2010 and December 2013 to neonatal units in the Canadian Neonatal Network...
December 2015: Pediatrics
Yacov Rabi, Abhay Lodha, Amuchou Soraisham, Nalini Singhal, Keith Barrington, Prakesh S Shah
BACKGROUND: After 2006 most neonatal intensive care units (NICUs) in Canada stopped initiating newborn resuscitation with 100% oxygen. METHODS: In this retrospective cohort study, we compared neonatal outcomes in infants born at ≤ 27 weeks gestation that received <100% oxygen (OXtitrate group, typically 21-40% oxygen) during delivery room resuscitation to infants that received 100% oxygen (OX100 group). RESULTS: Data from 17 NICUs included 2326 infants, 1244 in the OXtitrate group and 1082 in the OX100 group...
November 2015: Resuscitation
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