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Necrotizing enterocolitis in preterm infant

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https://www.readbyqxmd.com/read/28228499/neonatal-morbidity-and-1-year-survival-of-extremely-preterm-infants
#1
Hans Jorgen Stensvold, Claus Klingenberg, Ragnhild Stoen, Dag Moster, Kristin Braekke, Hans Jorgen Guthe, Henriette Astrup, Siren Rettedal, Morten Gronn, Arild E Ronnestad
OBJECTIVE: To determine 1-year survival and major neonatal morbidities (intracranial hemorrhage grade >2, cystic periventricular leukomalacia, retinopathy of prematurity grade >2, necrotizing enterocolitis, severe bronchopulmonary dysplasia) among extremely preterm infants in Norway in 2013-2014, and to compare the results to the first Norwegian Extreme Prematurity Study 1999-2000 and similar contemporary European population-based studies. METHODS: Population-based study of all infants born at 22 through 26 weeks' gestation in Norway in 2013-2014...
February 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28224332/association-of-single-nucleotide-polymorphisms-of-il23r-and-il17-with-necrotizing-enterocolitis-in-premature-infants
#2
Jiayi Tian, Yanjun Liu, Yanfang Jiang, Haohan Zhou, Tong Zhu, Xiaoqi Zhao, Liping Peng, Chaoying Yan
Necrotizing enterocolitis (NEC) is a severe gastrointestinal inflammatory disease in neonates, particularly in preterm infants. The interleukin (IL) 23/IL17 axis has been shown to play an important role in the gastrointestinal inflammation. However, the association of gene polymorphisms in the IL23/IL17 axis and the development of NEC remains unknown. In this study, we aimed to explore a possible genetic role of IL23R and IL17 in the development of NEC. We identified single nucleotide polymorphisms (SNPs) in IL23R (rs10889677), IL17A (rs2275913), and IL17F (rs763780) by polymerase chain reaction and Sanger sequencing...
February 21, 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28206997/pulmonary-hypertension-in-preterm-infants-results-of-a-prospective-screening-program
#3
C G Weismann, J D Asnes, A Bazzy-Asaad, C Tolomeo, R A Ehrenkranz, M J Bizzarro
OBJECTIVE: Determine prevalence and associations with pulmonary hypertension (PH) in preterm infants. STUDY DESIGN: Prospective institutional echocardiographic PH screening at 36 to 38 weeks' corrected gestational age (GA) for infants born <32 weeks' GA who had bronchopulmonary dysplasia (BPD; group BPD), and infants without BPD who had a birth weight (BW) <750 g, or clinical suspicion for PH (group NoBPD). RESULTS: Two hundred and four infants were screened (GA 25...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28196391/pentoxifylline-treatment-of-very-low-birth-weight-neonates-with-nosocomial-sepsis
#4
Şahin Hamilçıkan, Emrah Can, Övgü Büke, Meltem Erol, Özlem Bostan Gayret
Objective The objective of this study was to assess the result of intravenous pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity in very low birth weight (VLBW) preterm neonates with nosocomial sepsis. Methods For the 18 VLBW preterm neonates, as an adjunct therapy to antibiotics regimens, pentoxifylline (5 mg/kg/h for 6 hours) was administered to premature infants with sepsis on 3 successive days. Clinical and laboratory parameters were recorded before and after treatment. Results Following pentoxifylline therapy, the immature-to-total neutrophil ratio and C-reactive protein (CRP) levels were significantly decreased, while the blood pH and base excess were significantly increased (p < 0...
February 14, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28196365/the-golden-age-of-probiotics-a-systematic-review-and-meta-analysis-of-randomized-and-observational-studies-in-preterm-infants
#5
Elda Dermyshi, Yizhong Wang, Chongbin Yan, Wenchao Hong, Gang Qiu, Xiaohui Gong, Ting Zhang
BACKGROUND: Over the last few years, probiotics have been one of the most studied interventions in neonatal medicine. OBJECTIVES: The aim of this work was to analyse all studies (randomized controlled trials, RCTs, and observational studies) assessing the use of probiotics in very low birth weight (VLBW) preterm infants. SEARCH METHODS: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, and Web of Science...
February 15, 2017: Neonatology
https://www.readbyqxmd.com/read/28182644/multiple-strains-probiotics-appear-to-be-the-most-effective-probiotics-in-the-prevention-of-necrotizing-enterocolitis-and-mortality-an-updated-meta-analysis
#6
Hung-Yang Chang, Jin-Hua Chen, Jui-Hsing Chang, Hung-Chih Lin, Chien-Yu Lin, Chun-Chih Peng
BACKGROUND: Some oral probiotics have been shown to prevent necrotizing enterocolitis (NEC) and decrease mortality effectively in preterm very low birth weight (PVLBW) infants. However, it is unclear whether a single probiotic or a mixture of probiotics is most effective for the prevention of NEC. OBJECTIVE: A meta-analysis was conducted by reviewing the most up to date literature to investigate whether multiple strains probiotics are more effective than a single strain in reducing NEC and death in PVLBW infants...
2017: PloS One
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#7
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28159211/should-women-providing-milk-to-their-preterm-infants-take-docosahexaenoic-acid-supplements
#8
REVIEW
Berthold Koletzko
Based on the available data, a high milk docosahexaenoic acid supply to very low-birth-weight infants and to extremely low-birth-weight infants at levels that support tissue accretion rates similar to the high rates of intrauterine deposition has the potential to enhance the early visual and cognitive development, and to reduce the occurrence of adverse events, such as severe developmental delay, bronchopulmonary dysplasia, necrotizing enterocolitis, and allergic manifestations in infancy and early childhood...
March 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28159206/human-milk-oligosaccharides-and-the-preterm-infant-a-journey-in-sickness-and-in-health
#9
REVIEW
Sara Moukarzel, Lars Bode
Human milk oligosaccharides (HMOs) are a group of approximately 200 different unconjugated sugar structures in human milk proposed to support infant growth and development. Data from several preclinical animal studies and human cohort studies suggest HMOs reduce preterm infant mortality and morbidity by shaping the gut microbiome and protecting against necrotizing enterocolitis, candidiasis, and several other immune-related diseases. Current feeding practices and clinical algorithms do not consider infant HMO intake when assessing dietary adequacy or disease risk...
March 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28152280/surfactant-administration-via-a-thin-endotracheal-catheter-during-spontaneous-breathing-in-preterm-infants
#10
REVIEW
Wanliang Wu, Yan Shi, Fengxia Li, Zhuoyu Wen, Hongli Liu
To systematically review the clinical outcomes of surfactant administration via a thin endotracheal catheter during spontaneous breathing compared with conventional administration involving tracheal intubation, mechanical ventilation (MV), and tracheal extubation, in preterm infants. PubMed, EMBASE, and the Cochrane Library were searched to identify relevant clinical trials. Data were analyzed using the Cochrane Collaboration methods. Primary outcome measures included the incidence of MV and bronchopulmonary dysplasia (BPD)...
February 2, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28145652/amniotic-fluid-infection-cytokine-levels-and-mortality-and-adverse-pulmonary-intestinal-and-neurologic-outcomes-in-infants-at-32-weeks-gestation-or-less
#11
Eun Young Jung, Kyo Hoon Park, Bo Ryoung Han, Soo Hyun Cho, Ha Na Yoo, Juyoung Lee
To what extent the risks of neonatal morbidities are directly related to premature birth or to biological mechanisms of preterm birth remains uncertain. We aimed to examine the effect of exposure to amniotic fluid (AF) infection and elevated cytokine levels on the mortality and pulmonary, intestinal, and neurologic outcomes of preterm infants, and whether these associations persist after adjustment for gestational age at birth. This retrospective cohort study included 152 premature singleton infants who were born at ≤ 32 weeks...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28141547/efficacy-of-and-potential-morbidities-associated-with-the-use-of-antacid-medications-in-preterm-neonates
#12
Uday P Patil, Sean M Bailey, Elena V Wachtel, Evan Orosz, Rebecca Zarchin, Pradeep V Mally
OBJECTIVES: Antacid medications are frequently administered to preterm infants. These medications can change gastric pH levels and can affect regular gastrointestinal function and gut micro-bacterial flora. We hypothesized that preterm infants exposed to antacid medications are at a greater risk of necrotizing enterocolitis (NEC) and sepsis, and set out to determine any association, as well as to assess the clinical efficacy of these medications. MATERIALS AND METHODS: Retrospective chart review of preterm infants ≤30 weeks' gestational age or birth weight ≤1250 g over a 2-year period at New York University Langone Medical Center...
January 31, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28131458/biomarkers-for-the-diagnosis-of-neonatal-sepsis-and-necrotizing-entercolitis-clinical-practice-guidelines
#13
Margaret Gilfillan, Vineet Bhandari
Sepsis and necrotizing enterocolitis are major contributors to morbidity and mortality in neonates, especially in those born preterm. While therapeutic interventions are available for both (for e.g. antibiotics), a major dilemma is early diagnosis so that these interventions can be done in a timely manner. As clinical evaluation alone is unreliable in identifying infants in the early stages of neonatal sepsis or necrotizing enterocolitis, there is a need to find specific biomarkers associated with these conditions to improve diagnostic capabilities...
January 25, 2017: Early Human Development
https://www.readbyqxmd.com/read/28096129/current-knowledge-of-necrotizing-enterocolitis-in-preterm-infants-and-the-impact-of-different-types-of-enteral-nutrition-products
#14
REVIEW
Jocelyn Shulhan, Bryan Dicken, Lisa Hartling, Bodil Mk Larsen
Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birth-weight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required...
January 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28056921/bifidobacterium-adolescentis-protects-against-necrotizing-enterocolitis-and-upregulates-tollip-and-sigirr-in-premature-neonatal-rats
#15
Wenshen Wu, Yanli Wang, Jingjing Zou, Fang Long, Huiheng Yan, Lijuan Zeng, Yunbin Chen
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disorder that is often seen in premature infants. Probiotics decrease the risk of NEC; however, the mechanism by which probiotics work is not clear. The goal of this study was to evaluate the preventive effect of Bifidobacterium adolescentis in an NEC rat model. METHODS: Sprague-Dawley neonatal rats were obtained by caesarean section after 20-21 d gestation and randomly divided into the following 3 groups: dam fed (DF), formula fed (FF), and formula + B...
January 5, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28045982/fecal-bile-salts-and-the-development-of-necrotizing-enterocolitis-in-preterm-infants
#16
Christian V Hulzebos, Anne G J F van Zoonen, Jan B F Hulscher, Trijntje E Schat, Elisabeth M W Kooi, Martijn Koehorst, Renze Boverhof, Paul F M Krabbe, Albert K Groen, Henkjan J Verkade
BACKGROUND: Intestinal bile salts (BSs) may be implicated in NEC development. We hypothesized that fecal BS levels are higher in preterm infants at risk for NEC. METHODS: We compared the composition and concentration of fecal BSs in ten preterm infants who developed NEC (Bell's Stage ≥ II) with twenty matched control infants without NEC. Conjugated and unconjugated fecal BSs were measured after birth (T1) and twice prior to NEC (T2, T3). Data are presented as medians and interquartile ranges...
2017: PloS One
https://www.readbyqxmd.com/read/28034306/influence-of-maternal-breast-milk-ingestion-on-acquisition-of-the-intestinal-microbiome-in-preterm-infants
#17
Katherine E Gregory, Buck S Samuel, Pearl Houghteling, Guru Shan, Frederick M Ausubel, Ruslan I Sadreyev, W Allan Walker
BACKGROUND: The initial acquisition and early development of the intestinal microbiome during infancy are important to human health across the lifespan. Mode of birth, antibiotic administration, environment of care, and nutrition have all been shown to play a role in the assembly of the intestinal microbiome during early life. For preterm infants, who are disproportionately at risk of inflammatory intestinal disease (i.e., necrotizing enterocolitis), a unique set of clinical factors influence the establishment of the microbiome...
December 30, 2016: Microbiome
https://www.readbyqxmd.com/read/28030867/medications-that-increase-osmolality-and-compromise-the-safety-of-enteral-feeding-in-preterm-infants
#18
Suresh Chandran, Mei Chien Chua, Wanyun Lin, Jia Min Wong, Seyed Ehsan Saffari, Victor Samuel Rajadurai
BACKGROUND: Medications added to preterm milk feeds have the potential to raise osmolality, causing feed intolerance and necrotizing enterocolitis. OBJECTIVE: The aim of this study was to evaluate changes in the osmolality of milk feeds and water with 14 medications and the diluent amounts required to keep the osmolality below the safety threshold of ≤450 mOsm/kg. Changes in the osmolality of milk with medications while on continuous infusion over 2 and 4 h were determined...
December 29, 2016: Neonatology
https://www.readbyqxmd.com/read/28013313/increased-intestinal-inflammation-and-digestive-dysfunction-in-preterm-pigs-with-severe-necrotizing-enterocolitis
#19
Ann Cathrine F Støy, Peter M H Heegaard, Kerstin Skovgaard, Stine B Bering, Mette Bjerre, Per T Sangild
BACKGROUND: The risk factors for necrotizing enterocolitis (NEC) are well known, but the factors involved in the different NEC presentations remain unclear. OBJECTIVES: We hypothesized that digestive dysfunction and intestinal inflammation are mainly affected by severe NEC lesions. METHODS: In 48 preterm pigs, the association between the macroscopic NEC score (range 1-6) and the expression of 48 genes related to inflammation, morphological, and digestive parameters in the distal small intestine was investigated...
December 24, 2016: Neonatology
https://www.readbyqxmd.com/read/28002310/committee-opinion-no-684-delayed-umbilical-cord-clamping-after-birth
#20
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
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