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journal of perinatology

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https://www.readbyqxmd.com/read/28933776/association-of-nursing-overtime-nurse-staffing-and-unit-occupancy-with-medical-incidents-and-outcomes-of-very-preterm-infants
#1
M Beltempo, G Lacroix, M Cabot, R Blais, B Piedboeuf
OBJECTIVE: To examine the association of nursing overtime, nursing provision and unit occupancy rate with medical incident rates in the neonatal intensive care unit (NICU) and the risk of mortality or major morbidity among very preterm infants. STUDY DESIGN: Single center retrospective cohort study of infants born within 23 to 29 weeks of gestational age or birth weight <1000 g admitted at a 56 bed, level III NICU. Nursing overtime ratios (nursing overtime hours/total nursing hours), nursing provision ratios (nursing hours/recommended nursing hours based on patient dependency categories) and unit occupancy rates were pooled for all shifts during NICU hospitalization of each infant...
September 21, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28933775/choosing-entrustable-professional-activities-for-neonatology-a-delphi-study
#2
T A Parker, G Guiton, M D Jones
OBJECTIVE: To assess candidate neonatology EPAs taken from separate but overlapping sets from two organizations. STUDY DESIGN: Using a Delphi process, we asked that neonatology fellowship directors (1) assess importance and scope of 19 candidate EPAs, and (2) propose additional EPAs if necessary. In round 2, we sought clarification of first round responses and evaluated proposed additional EPAs. RESULTS: Twenty program directors participated...
September 21, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28933774/developmental-care-neonatal-behavior-and-postnatal-maternal-depressive-symptomatology-predict-internalizing-problems-at-18-months-for-very-preterm-children
#3
R Montirosso, L Giusti, P De Carli, E Tronick, R Borgatti
OBJECTIVE: To provide a prospective developmental model for behavioral outcomes in preterm infants in relation to developmental care (DC) practices and postnatal maternal depression. STUDY DESIGN: A longitudinal, multicenter, follow-up study conducted in 25 Italian tertiary neonatal intensive care units (NICUs). Participants were 162 healthy very preterm infants and their mothers. The level of quality of DC was assessed for each hospital. Infant's neurobehavioral profile was evaluated twice: at discharge (T1) and at 18 months for behavioral problems (T3)...
September 21, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28906497/different-formulas-different-thresholds-and-different-performance-the-prediction-of-macrosomia-by-ultrasound
#4
A Aviram, Y Yogev, E Ashwal, L Hiersch, D Danon, E Hadar, R Gabbay-Benziv
OBJECTIVE: The sonographic prediction of fetal macrosomia affects obstetrical decision regarding the timing and mode of delivery. We aimed to compare the accuracy of various formulas for prediction of macrosomia at different thresholds. STUDY DESIGN: This was a retrospective cohort study of singleton gestations at term, with fetal biometrical measurements taken up to 7 days prior to delivery (2007 to 2014). Sonographic estimated fetal weight was calculated using 20 previously published formulas...
September 14, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28906496/urinary-nt-probnp-levels-and-echocardiographic-parameters-for-patent-ductus-arteriosus
#5
S S Khan, T Sithisarn, H S Bada, M Vranicar, P M Westgate, M Hanna
OBJECTIVE: Patent ductus arteriosus (PDA) is common in preterm infants and is associated with significant morbidities. B type natriuretic peptide (BNP) is synthesized in the ventricles secondary to volume overload and excreted as urinary N-terminal pro-brain natriuretic peptide (NT-proBNP). STUDY DESIGN: We report an observational prospective study of 64 preterm infants with birth weight ⩽1000 g. Echocardiographic parameters were obtained from clinical echocardiograms performed in the first week of life...
September 14, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28906495/effects-of-a-transition-home-program-on-preterm-infant-emergency-room-visits-within-90-days-of-discharge
#6
B Vohr, E McGowan, L Keszler, M O'Donnell, K Hawes, R Tucker
OBJECTIVE: To evaluate effects of a transition home program (THP) and risk factors on emergency room (ER) use within 90 days of discharge for preterm (PT) infants <37 weeks gestation. STUDY DESIGN: This is a prospective 3-year cohort study of 804 mothers and 954 PT infants. Mothers received enhanced neonatal intensive care unit transition support services until 90 days postdischarge. Regression models were run to identify the effects of THP implementation year and risk factors on ER visits...
September 14, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28880261/bronchopulmonary-dysplasia-associated-pulmonary-hypertension-clues-from-placental-pathology
#7
A M Kunjunju, K R Gopagondanahalli, Y Chan, A Sehgal
OBJECTIVES: Bronchopulmonary dysplasia (BPD) and the associated complication of pulmonary hypertension (PH) leads to increased mortality and a longer length of stay among survivors. Placental histopathology may give early clues of subsequent events. The objective was to evaluate the relationship of maternal vascular underperfusion (MVU) changes on placental histopathology with subsequent development of BPD-associated PH in a cohort of extremely premature infants. STUDY DESIGN: In a cohort of preterm infants '⩽28 weeks' gestational age (GA) and with 'severe' BPD, this retrospective study evaluated specific placental histopathological changes and assessed the relationship with subsequent development of PH...
September 7, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28880260/barriers-to-enrollment-in-a-randomized-controlled-trial-of-hydrocortisone-for-cardiovascular-insufficiency-in-term-and-late-preterm-newborn-infants
#8
K L Watterberg, E Fernandez, M C Walsh, W E Truog, B J Stoll, G M Sokol, K A Kennedy, M V Fraga, S S Beauman, B Carper, A Das, A F Duncan, W F Buss, C Gauldin, C B Lacy, P J Sanchez, S Chawla, S Lakshminrusimha, C M Cotten, K P Van Meurs, B B Poindexter, E F Bell, W A Carlo, U Devaskar, M H Wyckoff, R D Higgins
OBJECTIVE: To analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns. STUDY DESIGN: The original study was a multicenter RCT. Eligibility: ⩾34 weeks' gestation, <72 h old, mechanically ventilated, receiving inotrope. Primary outcome was NDI at 2 years; infants with diagnoses at high risk for NDI were excluded...
September 7, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28880259/management-of-asymptomatic-neonates-born-in-the-setting-of-chorioamnionitis-a-safety-comparison-of-the-well-baby-and-intensive-care-setting
#9
D Peterson, S B Hoffman, D El-Metwally, M Martino-Gomez, D R Chinta, C Hughes Driscoll
BACKGROUND: Evaluate the safety of a change in care setting for asymptomatic neonates born to mothers with chorioamnionitis from the neonatal intensive care unit to the well baby nursery.Local problem:The neonatal intensive care unit evaluation and management of babies born to mothers with chorioamionitis often involves separation of the mother-baby dyad and more invasive interventions. METHODS: A single-center pre/post-intervention study of neonates born from January 2011 to November 2016, comparing safety outcomes in the neonatal intensive care unit (pre-intervention) and well baby nursery (post-intervention), following initiation of a triage protocol...
September 7, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28880258/do-trials-reduce-uncertainty-assessing-impact-through-cumulative-meta-analysis-of-neonatal-rcts
#10
S C Hay, H Kirpalani, C Viner, R Soll, D Dukhovny, W-Y Mao, J Profit, S B DeMauro, J A F Zupancic
OBJECTIVE: To assess the impact of the latest randomized controlled trial (RCT) to each systematic review (SR) in Cochrane Neonatal Reviews. STUDY DESIGN: We selected meta-analyses reporting the typical point estimate of the risk ratio for the primary outcome of the latest study (n=130), mortality (n=128) and the mean difference for the primary outcome (n=44). We employed cumulative meta-analysis to determine the typical estimate after each trial was added, and then performed multivariable logistic regression to determine factors predictive of study impact...
September 7, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28837138/in-vivo-assessment-of-placental-and-brain-volumes-in-growth-restricted-fetuses-with-and-without-fetal-doppler-changes-using-quantitative-3d-mri
#11
N Andescavage, A duPlessis, M Metzler, D Bulas, G Vezina, M Jacobs, S N Iqbal, A Baschat, C Limperopoulos
OBJECTIVE: The relationship between placental and fetal brain growth is poorly understood and difficult to assess. The objective of this study was to interrogate placental and fetal brain growth in healthy pregnancies and those complicated by fetal growth restriction (FGR). STUDY DESIGN: In a prospective, observational study, pregnant women with normal pregnancies or pregnancies complicated by FGR underwent fetal magnetic resonance imaging (MRI). Placental, global and regional brain volumes were calculated...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28837137/maternal-and-neonatal-demographics-of-macrosomic-infants-admitted-to-the-neonatal-intensive-care-unit
#12
J N Tolosa, D A Calhoun
OBJECTIVE: The objective of this study is to determine the incidence, significance, associated demographics and impact of macrosomic infants (⩾4 kg) admitted to the Neonatal Intensive Care Unit (NICU) on NICU census and resources. STUDY DESIGN: A retrospective cohort review was performed from 2010 to 2015. Descriptive statistical analyses were used. RESULTS: Of 19 308 deliveries, 1823 were infants ⩾4000 g and 213 were admitted to the NICU...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28837136/cord-blood-neutropenia-is-an-independent-predictor-of-early-sepsis
#13
E Beaulieu, E Massé, F Dallaire
OBJECTIVE: The significance of cord blood neutropenia as a screening tool for early-onset sepsis (EOS) is unclear. The objectives were to define reference values for cord blood neutrophil count and to determine the sensitivity and positive likelihood ratio of cord neutropenia for the detection of EOS. STUDY DESIGN: This retrospective observational cohort study included all mother-infant pairs with deliveries between 2009 and 2014 for whom cord neutrophil counts were routinely done...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28837135/identifying-a-quality-improvement-project
#14
Lakshmi Katakam, Gautham K Suresh
An important step on the roadmap to a successful quality improvement (QI) project is careful selection of topics and aims to be addressed by QI projects. Using information from a variety of data monitoring systems as well as individual events and experiences, leaders of neonatal units and QI teams should first identify quality and safety gaps in their unit. They should then use an explicit, formal process for selecting the best projects to which their limited time and resources should be allocated. Priority should be given to projects that address a quality gap of high magnitude and impact, have a high likelihood of success, have a champion, fit with the unit's state of readiness for change, have organizational support and align with organizational priorities...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28837134/clinician-performed-ultrasound-in-fetal-growth-restriction-fetal-neonatal-and-pediatric-aspects
#15
A Sehgal, F Crispi, M R Skilton, W-P de Boode
Fetal growth restriction (FGR) affects 7-10% pregnancies. Conventional and tissue Doppler imaging has noted cardiac compromise during fetal and early neonatal periods in this cohort. In this article, we discuss the use of salient ultrasound parameters across age groups. During fetal life, certain feto-placental sonographic parameters have been linked to adverse perinatal outcomes and are predictive of later life hypertension. During the early postnatal period altered morphometry (hypertrophied and globular hearts) with sub-clinical impairment of cardiac function has been noted in both term and preterm infants with FGR...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28817114/trauma-informed-care-in-the-newborn-intensive-care-unit-promoting-safety-security-and-connectedness
#16
M R Sanders, S L Hall
Both babies and their parents may experience a stay in the newborn intensive care unit (NICU) as a traumatic or a 'toxic stress,' which can lead to dysregulation of the hypothalamic-pituitary-adrenal axis and ultimately to poorly controlled cortisol secretion. Toxic stresses in childhood or adverse childhood experiences (ACEs) are strongly linked to poor health outcomes across the lifespan and trauma-informed care is an approach to caregiving based on the recognition of this relationship. Practitioners of trauma-informed care seek to understand clients' or patients' behaviors in light of previous traumas they have experienced, including ACEs...
August 17, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28796241/the-neonatal-intensive-parenting-unit-an-introduction
#17
S L Hall, M T Hynan, R Phillips, S Lassen, J W Craig, E Goyer, R F Hatfield, H Cohen
This paper describes a paradigm shift occurring in neonatal intensive care. Care teams are moving from a focus limited to healing the baby's medical problems towards a focus that also requires effective partnerships with families. These partnerships encourage extensive participation of mothers and fathers in their baby's care and ongoing bi-directional communication with the care team. The term Newborn Intensive Parenting Unit (NIPU) was derived to capture this concept. One component of the NIPU is family-integrated care, where parents are intimately involved in a baby's care for as many hours a day as possible...
August 10, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28771221/childhood-outcomes-following-preterm-prelabor-rupture-of-the-membranes-pprom-a-population-based-record-linkage-cohort-study
#18
C L Roberts, P Wagland, S Torvaldsen, J R Bowen, J P Bentley, J M Morris
OBJECTIVE: The objective of this study is to determine child health, development and educational outcomes for infants born following preterm prelabor rupture of the membrane (PPROM). STUDY DESIGN: Population-based record linkage cohort study using data from NSW, Australia, 2001 to 2014. RESULTS: Of 121 822 births at 20 to 37 weeks, 18 799 (15%) followed PPROM, 56 406 (46%) followed spontaneous labor and 46 617 (38%) were planned. Compared with infants of a similar gestational age born following spontaneous labor or planned delivery, exposure to PPROM did not increase the risk of childhood mortality, childhood hospitalization, developmentally vulnerable at school entry, low reading or numeracy scores...
August 3, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28749488/trends-in-provider-initiated-versus-spontaneous-preterm-deliveries-2004-2013
#19
M L Ada, M R Hacker, T H Golen, M J Haviland, S A Shainker, H H Burris
OBJECTIVE: The objectives of this study were as follows: (i) to estimate the proportion of preterm deliveries at a tertiary perinatal center that were provider-initiated versus spontaneous before and after a 2009 policy to reduce elective early-term deliveries, and (ii)to evaluate whether shifts in type of preterm delivery varied by race/ethnicity. METHOD: We performed a retrospective cohort study of preterm deliveries over a 10-year period, 2004 to 2013, including detailed review of 929 of 5566 preterm deliveries, to designate each delivery as provider-initiated or spontaneous...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28749487/autoimmune-conditions-and-comorbid-depression-in-pregnancy-examining-the-risk-of-preterm-birth-and-preeclampsia
#20
G Bandoli, C D Chambers
OBJECTIVE: The objective of this study was to determine whether prenatal depression interacts with autoimmune conditions to further increase the risk of preterm birth or preeclampsia. STUDY DESIGN: Our sample included 3034 pregnant women with rheumatoid arthritis (RA), Crohn's disease (CD) or psoriasis, or controls that were prospectively enrolled into MothertoBaby pregnancy studies. We estimated the independent and joint effects of the three autoimmune conditions and depression on the select outcomes...
July 27, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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