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Necrotizing enterocolitis in preterm infant

Benjamin D Reed, Kurt R Schibler, Hitesh Deshmukh, Namasivayam Ambalavanan, Ardythe L Morrow
OBJECTIVES: We examined the impact of prenatal exposure to maternal antibiotics on risk of necrotizing enterocolitis (NEC), late onset sepsis (LOS), and death in infants born preterm. STUDY DESIGN: Secondary data analysis was conducted via an extant cohort of 580 infants born <32 weeks of gestation and enrolled in 3 level III neonatal intensive care units. Prenatal antibiotic exposure was defined as antibiotics received by the mother within 72 hours before delivery...
March 16, 2018: Journal of Pediatrics
Zbynĕk Straňák, Simona Feyereislová, Peter Korček, Eugene Dempsey
Postnatal adaptation in preterm newborn comprises complex physiological processes that involve significant changes in the circulatory and respiratory system. Increasing hemoglobin level and blood volume following placental transfusion may be of importance in enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. The European consensus on resuscitation of preterm infants recommends delayed cord clamping (DCC) for at least 60 s to promote placenta-fetal transfusion in uncompromised neonates...
2018: Frontiers in Pediatrics
Deonne Dersch-Mills, Belal Alshaikh, Amuchou S Soraisham, Albert Akierman, Kamran Yusuf
Background: There is no injectable ibuprofen product marketed to treat patent ductus arteriosus (PDA) in newborns in Canada. The authors' institution has used ibuprofen arginine in the past. In the absence of published evidence supporting use of this salt form of ibuprofen for neonatal PDA, a retrospective analysis was undertaken. Objective: To compare the effectiveness and adverse effects of ibuprofen arginine, ibuprofen tromethamine, and indomethacin in the treatment of PDA...
January 2018: Canadian Journal of Hospital Pharmacy
Ling-Rong Yang, Hua Li, Tong Zhang, Ru-Cui Zhao
OBJECTIVE: To evaluate the relationship of vitamin D level with the development of necrotizing enterocolitis (NEC) in preterm infants. METHODS: A total of 429 preterm infants with a gestational age of <36 weeks, who were admitted to the department of neonatology within 2 hours after birth between January and December, 2016, were enrolled in the study. According to whether these infants developed NEC, the 429 subjects were divided into NEC group (n=22) and non-NEC group (n=407)...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Ariel A Salas, Peng Li, Kelli Parks, Charitharth V Lal, Camilia R Martin, Waldemar A Carlo
Background: Due to insufficient evidence, extremely preterm infants (≤28 wk of gestation) rarely receive early progressive feeding (small increments of feeding volumes between 1 and 4 d after birth). We hypothesized that early progressive feeding increases the number of full enteral feeding days in the first month after birth. Objective: The aim of this study was to determine the feasibility and efficacy of early progressive feeding in extremely preterm infants...
February 24, 2018: American Journal of Clinical Nutrition
Marc Beltempo, Prakesh S Shah, Xiang Y Ye, Jehier Afifi, Shoo Lee, Douglas D McMillan
OBJECTIVE: To determine the specific Score of Neonatal Acute Physiology (SNAP-II) cut-off scores associated with outcomes in extremely preterm infants, and to examine its contribution to predictive models that include nonmodifiable birth predictors. STUDY DESIGN: Retrospective observational study of 9240 infants born at 22-28 weeks' gestation and admitted to the Canadian Neonatal Network from 2010 to 2015. Outcomes included early and hospital mortality, composite of mortality/morbidity and individual morbidities...
March 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
Warapan Nakayuenyongsuk, Megan Christofferson, David K Stevenson, Karl Sylvester, Henry C Lee, K T Park
OBJECTIVE: To establish baseline trends in fecal calprotectin, a protein excreted into the stool when there is neutrophilic inflammation in the bowel, in infants at risk for necrotizing enterocolitis (NEC). STUDY DESIGN: We performed a prospective observational cohort study in infants with a birth weight of <1500 g without existing bowel disease at a level IV neonatal intensive care unit from October 2015 to September 2016. Stools were collected once daily for 30 days or until 32 weeks postmenstrual age and processed using the Fecal Calprotectin High Range Quantitative Quantum Blue assay...
March 6, 2018: Journal of Pediatrics
Arpitha Chiruvolu, Elise Elliott, Diana Rich, Genna Leal Stone, Huanying Qin, Robert W Inzer
BACKGROUND: In the range of timing suggested by American College of Obstetricians and Gynecologists 30 to 60 s, preterm infants may potentially derive more short and long-term benefits with delayed cord clamping (DCC) for at least 60 s. However, there are concerns with longer resuscitation delay in this vulnerable population. OBJECTIVE: To compare the clinical consequences of 45 versus 60 s delay in umbilical cord clamping in singleton infants born between 230/7 to 316/7 weeks gestation...
March 5, 2018: Early Human Development
Willemien S Kalteren, Sara J Kuik, Koenraad N J A Van Braeckel, Jan B F Hulscher, Arend F Bos, Elisabeth M W Kooi, Michelle E van der Laan
OBJECTIVE:  To assess intestinal and cerebral oxygenation during and after red blood cell (RBC) transfusions in preterms with or without subsequent transfusion-associated necrotizing enterocolitis (TANEC). STUDY DESIGN:  In preterms of < 32 weeks' gestational age, we measured intestinal and cerebral regional tissue oxygen saturation (rint SO2 , rc SO2 ) and their variabilities using near-infrared spectroscopy during and after transfusions. We compared eight infants who developed TANEC 6 to 48 hours after RBC transfusions with 16 controls...
March 6, 2018: American Journal of Perinatology
Víctor Lago Leal, Loida Pamplona Bueno, Lucía Cabanillas Vilaplana, Estefanía Nicolás Montero, Mónica Martín Blanco, Cristina Fernández Romero, Sara El Bakkali, Tamara Pradillo Aramendi, Lara Sobrino Lorenzano, Paula Castellano Esparza, Esther Ballesteros Benito, Nieves Rayo Navarro, Pablo Del Barrio Fernández, Vanesa Ocaña Martínez, Luis Martínez Cortés
OBJECTIVE: To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. MATERIAL AND METHODS: 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. RESULTS: Initial hemoglobin was significantly higher in the MM group by 1.675 g/dL (p < 0...
March 5, 2018: Fetal Diagnosis and Therapy
Liang Jie, Ce Qi, Jin Sun, Renqiang Yu, Xiangyu Wang, Sameh A Korma, Jingying Xiang, Qingzhe Jin, Casimir C Akoh, Hang Xiao, Xingguo Wang
Breast milk consumption reduces the incidence of necrotizing enterocolitis (NEC) in preterm infants compared to formula. Branched-chain fatty acids (BCFAs) are present in breast milk but not in most formulas intended for preterm infants. We aimed to determine the composition of BCFAs in the breast milk of mothers with preterm infants, and to understand the impact of gestational age at birth and stage of lactation on BCFA content. The main BCFAs in preterm breast milk were iso-14:0, iso-15:0, anteiso-15:0, iso-16:0, iso-17:0, and anteiso-17:0...
March 2, 2018: Food & Function
Susan Trang, John A F Zupancic, Sharon Unger, Alex Kiss, Nicole Bando, Sabrina Wong, Sharyn Gibbins, Deborah L O'Connor
OBJECTIVES: To determine the cost-effectiveness of supplemental donor human milk (DHM) versus preterm formula (PTF) for very low birth weight (VLBW, <1500 g) infants from a societal perspective to 18 months' corrected age. METHODS: This prospective cost-effectiveness analysis of 363 VLBW infants was conducted for a randomized control trial. Infants recruited from October 2010 to December 2012 were fed DHM or PTF whenever mother's milk was unavailable. Formal health care costs for initial hospitalization and readmissions were obtained from standardized cost-accounting systems and physician fees...
February 28, 2018: Pediatrics
Daniel Johannes Cornelis Berkhout, Hendrik Johannes Niemarkt, Nanne Klaas de Boer, Marc Alexander Benninga, Timotheüs Gualtherus Jacob de Meij
Although the exact pathophysiological mechanisms of both necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants are yet to be elucidated, evidence is emerging that the gut microbiota plays a key role in their pathophysiology. Areas covered: In this review, initial microbial colonization and factors influencing microbiota composition are discussed. For both NEC and LOS, an overview of studies investigating preclinical alterations in gut microbiota composition and fecal volatile organic compounds (VOCs) is provided...
February 28, 2018: Expert Review of Gastroenterology & Hepatology
Yimin Chen, Aloka Patel, Paula P Meier, Giamila Fantuzzi
OBJECTIVES: The aim of this study was to determine the effect of digested whole human milk (HM; first sample available after birth from mothers of premature infants) on inflammation, oxidative stress, and cytotoxicity in Caco-2 human intestinal epithelial cells stimulated with lipopolysaccharides or tumor necrosis factor (TNF) to mimic the potential in vivo insults facing the premature infant's gastrointestinal tract. METHODS: Fully differentiated Caco-2 cells were exposed to digested HM (n = 10; samples from 10 different individuals) before stimulation with lipopolysaccharides, TNF, or no stimulation overnight...
February 21, 2018: Journal of Pediatric Gastroenterology and Nutrition
Jing Sun, Yanqi Li, Duc Ninh Nguyen, Martin S Mortensen, Chris H P van den Akker, Tom Skeath, Susanne E Pors, Stanislava Pankratova, Silvia Rudloff, Søren J Sørensen, Douglas G Burrin, Thomas Thymann, Per T Sangild
Background: Nutrient fortification of human milk is often required to secure adequate growth and organ development for very preterm infants. There is concern that formula-based fortifiers (FFs) induce intestinal dysfunction, feeding intolerance, and necrotizing enterocolitis (NEC). Bovine colostrum (BC) may be an alternative nutrient fortifier, considering its high content of protein and milk bioactive factors. Objective: We investigated whether BC was superior to an FF product based on processed bovine milk and vegetable oil to fortify donor human milk (DHM) for preterm pigs, used as a model for infants...
February 16, 2018: Journal of Nutrition
Sara J Kuik, Michelle E van der Laan, Margot T Brouwer-Bergsma, Jan B F Hulscher, Anthony R Absalom, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Preterm infants requiring surgery are at risk of impaired neurocognitive development caused, possibly, by cerebral ischemia associated with impaired cerebrovascular autoregulation (CAR). We evaluated CAR before, during, and after laparotomy. STUDY DESIGN: This was a hypothesis generating prospective observational cohort study. SUBJECTS: We included preterm infants requiring surgery for necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP)...
February 14, 2018: Early Human Development
Pasinee Kanaprach, Nutkridta Pongsakul, Nopporn Apiwattanakul, Chatchai Muanprasat, Sarayut Supapannachart, Pracha Nuntnarumit, Somchai Chutipongtanate
BACKGROUND: Donor human milk is considered the next best nutrition following mother's own milk to prevent neonatal infection and necrotizing enterocolitis in preterm infants who are admitted at neonatal intensive care unit. However, donor milk biofunctionalities after preparative processes have rarely been documented. OBJECTIVE: To evaluate biofunctionalities preserved in donor milk after preparative processes by cell-based assays. MATERIALS AND METHODS: Ten pools of donor milk were produced from 40 independent specimens...
February 16, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Niveditha Dannapaneni, Tejopratap Oleti, Tarakeswari Surapaneni, Deepak Sharma, Srinivas Murki
Background & objectives: With the use of early and appropriate use of antibiotics, outcomes have improved in the mother-infant dyads exposed to preterm pre-labour rupture of membranes (PPROM). This study was undertaken to evaluate immediate neonatal outcomes in infants born before 33 completed weeks of gestation to mothers with PPROM versus without PPROM. Methods: During the study period from January 2013 to December 2013, a total of 182 mother-infant dyads were prospectively included in the study...
October 2017: Indian Journal of Medical Research
Xin Gan, Juan Li
Necrotizing enterocolitis (NEC) is a catastrophic disease caused by a variety of factors in neonates, especially preterm infants. Severe NEC has a high fatality rate, and most survivors may face short- and long-term adverse prognosis. Risk factors for NEC include preterm birth, non-breastfeeding, microbial abnormalities in the digestive tract, and ischemia-reperfusion injury. High-resolution abdominal ultrasound helps with the early diagnosis of NEC. The preventive measures for NEC include protecting the intestinal mucosa through nutritional intervention, interfering with intestinal injury signals, changing intestinal microflora, and performing early minimal enteral nutrition...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Hong-Juan Bi, Jing Xu, Qiu-Fen Wei
OBJECTIVE: To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
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