Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years

Doyle et al, N Engl J Med. 2017 Jul BACKGROUND: Assist­ed ven­ti­la­tion for extreme­ly preterm infants (<28 weeks of ges­ta­tion) has become less inva­sive, but it is unclear whether such devel­op­ments in care are asso­ci­at­ed with improve­men ts in short-term or long-term lung func­tion. We com­pared changes over time in the use of assist­ed ven­ti­la­tion and oxy­gen ther­a­py…

Con­tin­ue read­ing

Delayed versus Immediate Cord Clamping in Preterm Infants

Tarnow-Mor­di W et al, N Engl J Med. 2017 Dec BACKGROUND The pre­ferred tim­ing of umbil­i­cal-cord clamp­ing in preterm infants is unclear.  METHODS The pri­ma­ry com­pos­ite out­come was death or major mor­bid­i­ty (defined as severe brain injury on post­na­tal ultra­sonog­ra­phy, severe retinopa­thy of pre­ma­tu­ri­ty, necro­tiz­ing ente­ro­col­i­tis, or late-onset sep­sis) by 36 weeks…

Con­tin­ue read­ing

Long-Term Effects of Inhaled Budesonide for Bronchopulmonary Dysplasia

Bassler et at, N Engl J Med. 2018 Jan BACKGROUND : The long-term effects on neu­rode­vel­op­ment of the use of inhaled glu­co­cor­ti­coids in extreme­ly preterm infants for the pre­ven­tion or treat­ment of bron­chopul­monary dys­pla­sia are uncer­tain.  CONCLUSIONS   Among sur­viv­ing extreme­ly preterm infants, the rate of neu­rode­vel­op­men­tal dis­abil­i­ty at 2 years did…

Con­tin­ue read­ing

Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials

Roth et al, BMJ, 2017 Abstract Objec­tives: To esti­mate the effects of vit­a­min D sup­ple­men­ta­tion dur­ing preg­nan­cy on 11 mater­nal and 27 neonatal/infant out­comes; to deter­mine fre­quen­cies at which tri­al out­come data were miss­ing, unre­port­ed, or incon­sis­tent­ly report­ed; and to project the poten­tial con­tri­bu­tions of reg­is­tered ongo­ing or planned tri­als. Design: Sys­tem­at­ic…

Con­tin­ue read­ing

Benign Neonatal Shudders, Shivers, Jitteriness, or Tremors: Early Signs of Vitamin D Deficiency

Collins & Young Pedi­atrics, July 2017 Abstract and tremors in the new­born peri­od typ­i­cal­ly pre­cip­i­tate an exten­sive, inva­sive, and expen­sive search for the eti­ol­o­gy. Vit­a­min D defi­cien­cy has not been his­tor­i­cal­ly includ­ed in the dif­fer­en­tial of tremors. We report a shiv­er­ing, jit­tery new­born who was sub­ject­ed to a bat­tery of test­ing, with…

Con­tin­ue read­ing

Ventilator-Associated Pneumonia in Low Birth Weight Neonates at a Neonatal Intensive Care Unit: A Retrospective Observational Study

Lee et al, Feb­ru­ary 2017 Back­ground Ven­ti­la­tor-asso­ci­at­ed pneu­mo­nia (VAP) is one of the most com­mon health­care-asso­ci­at­ed infec­tions among ven­ti­lat­ed patients. The aim of this study was to deter­mine the clin­i­cal char­ac­ter­is­tics and risk fac­tors for the devel­op­ment of VAP in intu­bat­ed low birth weight (LBW) neonates in a neona­tal inten­sive care…

Con­tin­ue read­ing

Bosentan as Adjunctive Therapy for Persistent Pulmonary Hypertension of the Newborn: Results of the Randomized Multicenter Placebo-Controlled Exploratory Trial.

Stein­horn et al, J Pedi­atr. 2016 Oct Abstract OBJECTIVE: To eval­u­ate the effi­ca­cy, safe­ty, and phar­ma­co­ki­net­ics of the endothe­lin recep­tor antag­o­nist bosen­tan as adjunc­tive ther­a­py for neonates with per­sis­tent pul­monary hyper­ten­sion of the new­born (PPHN). STUDY DESIGN: This was a phase 3, mul­ti­cen­ter, ran­dom­ized, place­bo-con­trolled explorato­ry tri­al (FUTURE-4). Eli­gi­ble patients were >34 weeks ges­ta­tion, <7 days old,…

Con­tin­ue read­ing

Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study

Lu et al, April 2017 Back­ground Necro­tiz­ing ente­ro­col­i­tis (NEC) in neonates is dev­as­tat­ing, and risk-fac­tor iden­ti­fi­ca­tion is cru­cial. This study aimed to eval­u­ate risk fac­tors for NEC in dif­fer­ent ges­ta­tion­al age (GA) groups. Meth­ods Risk fac­tors asso­ci­at­ed with NEC were inves­ti­gat­ed using a ret­ro­spec­tive case-con­trol design.   Con­clu­sion Intra­hep­at­ic cholesta­sis of…

Con­tin­ue read­ing

Probiotics Prevent Candida Colonization and Invasive Fungal Sepsis in Preterm Neonates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hua-Jian Hu, Pedi­atrics & neona­tol­ogy, April 2017 To inves­ti­gate whether pro­bi­ot­ic sup­ple­men­ta­tion could reduce the risk of fun­gal infec­tion in preterm neonates in neona­tal inten­sive care units (NICUs) The out­comes of inter­est were Can­di­da col­o­niza­tion and inva­sive fun­gal sep­sis. Sev­en tri­als involv­ing 1371 preterm neonates were includ­ed. Lim­it­ed data sup­port that pro­bi­ot­ic…

Con­tin­ue read­ing

Continuous Glucose Monitoring in Very Preterm Infants: A Randomized Controlled Trial

Galderisi et al, Pedi­atrics, Octo­ber 2017, VOLUME 140 / ISSUE 4 Abstract BACKGROUND AND OBJECTIVES: Impaired glu­cose con­trol in very preterm infants is asso­ci­at­ed with increased mor­bid­i­ty, mor­tal­i­ty, and poor neu­ro­log­ic out­come. Strate­gies based on insulin titra­tion have been unsuc­cess­ful in achiev­ing eug­lycemia in absence of an increase in hypo­glycemia and mor­tal­i­ty.…

Con­tin­ue read­ing

The recent updates in Congenital Zika management in Infants

Cen­ters for Dis­ease Con­trol and Pre­ven­tion CDC Zika virus test­ing is rec­om­mend­ed for infants with clin­i­cal find­ings con­sis­tent with con­gen­i­tal Zika syn­drome and pos­si­ble mater­nal Zika virus expo­sure dur­ing preg­nan­cy, regard­less of mater­nal test­ing results. Test­ing CSF for Zika virus RNA and Zika virus IgM anti­bod­ies should be con­sid­ered, espe­cial­ly…

Con­tin­ue read­ing

Maternal and Placental Factors Associated with Congenital Hearing Loss in Very Preterm Neonates.

Kim et al, Pedi­atr Neona­tol. 2017   BACKGROUND: Sen­sorineur­al hear­ing loss (SNHL) is a mul­ti­fac­to­r­i­al dis­ease that more fre­quent­ly affects pretermnew­borns. Although a num­ber of mater­nal con­di­tions have been report­ed to  be asso­ci­at­ed with preterm birth, lit­tle infor­ma­tion is avail­able con­cern­ing mater­nal risk fac­tors for the devel­op­ment of SNHL. We aimed to iden­ti­fy mater­na­land pla­cen­tal risk fac­tors asso­ci­at­ed with a “refer” result on the new­born hear­ing screen­ing (NHS) test and sub­se­quent­ly con­firmed SNHL in very preterm neonates.…

Con­tin­ue read­ing

Red Blood Cell Transfusion and Clinical Outcomes in Extremely Low Birth Weight Preterm Infants

Wang et al, Pedi­atr Neona­tol. 2017  Back­ground Red blood cell (RBC) trans­fu­sion is often con­sid­ered a life-sav­ing mea­sure in crit­i­cal­ly ill neonates. The small­est and least mature  infants tend to receive the largest amount of trans­fu­sions. RBC trans­fu­sion itself has also been sug­gest­ed as an inde­pen­dent risk fac­to r of poor…

Con­tin­ue read­ing

SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment

TASK FORCE ON SUDDEN INFANT DEATH SYNDROME Pedi­atrics, Octo­ber 2016, From the Amer­i­can Acad­e­my of Pedi­atrics, Pol­i­cy State­ment Abstract Approx­i­mate­ly 3500 infants die annu­al­ly in the Unit­ed  States from sleep-relat­ed infant deaths, includ­ing sud­den infant death syn­drome (SIDS; Inter­na­tion­al Clas­si­fi­ca­tion of Dis­eases, 10th Revi­sion [ICD-10], R95), ill-defined deaths (ICD-10 R99), and acci­den­tal…

Con­tin­ue read­ing

Gestational Age and Cardiorespiratory Fitness in Individuals Born At Term: A Life Course Study

Fer­reira et al, J Am Heart Assoc. 2017 Sep Abstract BACKGROUND: In con­trast to the effects of preterm birth, the extent to which short­er ges­ta­tion­al age affects the car­diores­pi­ra­to­ry fit­ness (CRF) lev­els of indi­vid­u­als who were born at term (ie, between 37 and 42 weeks) is large­ly unknown. The aim of this study was…

Con­tin­ue read­ing

Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants 2 Months of Age: A Case-Control Evaluation

Skoff et al, Clin­i­cal Infec­tious Dis­eases, Sep­tem­ber 2017   Abstract Back­ground Infants aged <1 year are at high­est risk for per­tus­sis-relat­ed mor­bid­i­ty and mor­tal­i­ty. In 2012, Tdap (tetanus tox­oid, reduced diph­the­ria tox­oid, and acel­lu­lar per­tus­sis) vac­cine was rec­om­mend­ed for women dur­ing each preg­nan­cy to pro­tect infants in the first months of life;…

Con­tin­ue read­ing

Risk of Autism Associated With Hyperbilirubinemia and Phototherapy

Wu et al, Pedi­atrics 2016 Abstract OBJECTIVE: Whether neona­tal hyper­biliru­bine­mia and/or pho­tother­a­py increase the risk of autism spec­trum disorder(ASD) is unclear. We sought to quan­ti­fy the risk of ASD asso­ci­at­ed with ele­vat­ed total serum biliru­bin (TSB) lev­els and with pho­tother­a­py. CONCLUSIONS: After adjust­ment for the effects of sociode­mo­graph­ic fac­tors and birth weight, nei­ther hyper­biliru­bine­mia nor pho­tother­a­py was an…

Con­tin­ue read­ing

Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant data meta-analysis.

Crowther et al, PLoS Med. 2017 Abstract BACKGROUND: Babies born preterm are at an increased risk of dying in the first weeks of life, and those who sur­vive have a high­er rate of cere­bral pal­sy (CP) com­pared with babies born at term. The aim of this indi­vid­ual par tic­i­pant data (IPD) meta-analy­sis (MA)…

Con­tin­ue read­ing

Systematic Review of the Effect of Enteral Feeding on Gut Microbiota in Preterm Infants

Xu et al, J Obstet Gynecol Neona­tal Nurs. 2017 Oct Abstract OBJECTIVE: To exam­ine the effect of feed­ing type on micro­bial pat­terns among preterm infants and to iden­ti­fy feed­ing fac­tors that pro­mote the col­o­niza­tion of ben­e­fi­cial bac­te­ria. Con­clu­sion: Moth­ers’ own milk is con­sid­ered the best form of nutri­tion for preterm infants and the gut micro­bial…

Con­tin­ue read­ing

Late (> 7 days) systemic postnatal corticosteroids for prevention of bronchopulmonary dysplasia in preterm infants.

Cochrane Data­base Syst Rev. 2017 Oct, Doyle et al Abstract BACKGROUND: Many preterm infants who sur­vive go on to devel­op bron­chopul­monary dys­pla­sia, prob­a­bly as the result of per­sis­tent inflam­ma­tion in the lun gs. Cor­ti­cos­teroids have pow­er­ful anti-inflam­ma­to­ry effects and have been used to treat indi­vid­u­als with estab­lished bron­chopul­monary dys­pla­sia. How­ev­er, it is unclear whether any…

Con­tin­ue read­ing

Neurally adjusted ventilatory assist compared to other forms of triggered ventilation for neonatal respiratory support.

Rossor et al, Cochrane Data­base Syst Rev. 2017 Oct  Abstract BACKGROUND: Effec­tive syn­chro­ni­sa­tion of infant res­pi­ra­to­ry effort with mechan­i­cal ven­ti­la­tion may allow ade­quate gas exchange to occur at low­er peak air­way pres­sures, poten­tial­ly reduc­ing baro­trau­ma and volu­trau­ma and devel­op­ment of air leaks and bron­chopul­monary dys­pla­sia. Dur­ing neu­ral­ly adjust­ed ven­ti­la­to­ry assist ven­ti­la­tion (NAVA),…

Con­tin­ue read­ing

AAP Recommends Newborn Hepatitis B Vaccine by 24 Hours of Age

Amer­i­can acad­e­my of pedi­atrics COMMITTEE ON INFECTIOUS DISEASESCOMMITTEE ON FETUS AND NEWBORN. Pedi­atrics. Sep­tem­ber 2017  New rec­om­men­da­tions from the Amer­i­can Acad­e­my of Pedi­atrics (AAP) say med­ical­ly sta­ble new­borns weigh­ing 2000 g or more should receive their first dose of the hepati­tis B vac­cine with­in the first 24 hours of life. The AAP’s…

Con­tin­ue read­ing

Oesophageal eosinophilia in children with coeliac disease

Ari et al, Arch Dis Child. 2017 Apr 12 Abstract OBJECTIVES: An asso­ci­a­tion between coeli­ac dis­ease (CD) and eosinophilicoesophagitis(EoE)/oesophageal eosinophil­ia (EE) has been sug­gest­ed.  Set­ting: Sin­gle large, ter­tiary pae­di­atric cen­tre. CONCLUSION: Patients with CD found to have EE share char­ac­ter­is­tics with both iso­lat­ed CD and EoE. It appears that these are two coex­ist­ing enti­ties pre­sent­ing in the same…

Con­tin­ue read­ing

Two-year development of children conceived by IVM: a prospective controlled single-blinded study

Roes­ner et al, Hum Reprod (2017)  Abstract STUDY QUESTION Is there a dif­fer­ence in men­tal devel­op­ment of chil­dren c onceived by IVM in com­par­i­son to IVF or ICSI, inde­pen­dent­ly, at the age of 2 years? SUMMARY ANSWER No dif­fer­ences could be found in men­tal devel­op­ment  of IVM chil­dren com­pared to IVF

Con­tin­ue read­ing