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Chest compressions superimposed with sustained inflation during neonatal cardiopulmonary resuscitation: are we ready for a clinical trial? Fetal Neonatal (IF 4.4) Pub Date : 2024-03-07 Jenny Koo, Po-Yin Cheung, Gerhard Pichler, Anne Lee Solevåg, Brenda Hiu Yan Law, Anup C Katheria, Georg M Schmölzer
Neonates requiring cardiopulmonary resuscitation (CPR) are at risk of mortality and neurodevelopmental injury. Poor outcomes following the need for chest compressions (CCs) in the delivery room prompt the critical need for improvements in resuscitation strategies. This article explores a technique of CPR which involves CCs with sustained inflation (CC+SI). Unique features of CC+SI include (1) improved
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Fetal single ventricle journey to first postnatal procedure: a multicentre UK cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-12-19 Peter John Lillitos, Oscar Nolan, Daniel G W Cave, Catherine Lomax, Shuba Barwick, James R Bentham, Anna N Seale
Objectives UK single ventricle (SV) palliation outcomes after first postnatal procedure (FPP) are well documented. However, survival determinants from fetal diagnosis to FPP are lacking. To better inform parental-fetal counselling, we examined factors favouring survival at two large UK centres. Design Retrospective multicentre cohort study. Setting Two UK congenital cardiac centres: Leeds and Birmingham
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Impact of cord clamping on haemodynamic transition in term newborn infants Fetal Neonatal (IF 4.4) Pub Date : 2023-12-06 Roberto Chioma, Daragh Finn, David B Healy, Ita Herlihy, Vicki Livingstone, Jurate Panaviene, Eugene M Dempsey
Objective To assess the haemodynamic consequences of cord clamping (CC) in healthy term infants. Design Cohort study. Setting Tertiary maternity hospital. Patients 46 full-term vigorous infants born by caesarean section. Interventions Echocardiography was performed before CC, immediately after CC and at 5 min after birth. Main outcome measures Pulsed wave Doppler-derived cardiac output and the pulmonary
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Treatment courses and outcomes of oesophageal atresia in patients with trisomy 18: a case series of 271 patients from a nationwide database in Japan Fetal Neonatal (IF 4.4) Pub Date : 2023-12-06 Mai Kutsukake, Takaaki Konishi, Michimasa Fujiogi, Naohiro Takamoto, Kaori Morita, Ikuta Yasuhisa, Yohei Hashimoto, Hiroki Matsui, Kiyohide Fushimi, Jun Fujishiro, Hideo Yasunaga
Objective To describe characteristics, treatments and clinical outcomes of patients with trisomy 18 and oesophageal atresia, using a nationwide database in Japan. Design Descriptive study using a retrospective cohort. Setting A nationwide inpatient database including 90% of hospitals with neonatal intensive care units in Japan. Patients Patients hospitalised within a day after birth for both oesophageal
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Building a better model: abandon kitchen sink regression Fetal Neonatal (IF 4.4) Pub Date : 2023-12-06 Stefan Kuhle, Mary Margaret Brown, Sanja Stanojevic
This paper critically examines ‘kitchen sink regression’, a practice characterised by the manual or automated selection of variables for a multivariable regression model based on p values or model-based information criteria. We highlight the pitfalls of this method, using examples from perinatal/neonatal medicine, and propose more robust alternatives. The concept of directed acyclic graphs (DAGs) is
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Recognising risk of neonatal encephalopathy with advancing gestation in nulliparous women is crucial for case review Fetal Neonatal (IF 4.4) Pub Date : 2023-12-02 Malcolm Battin, Lynn Sadler, Meghan Hill
In neonatal encephalopathy (NE), establishing the history includes scrutiny of the perinatal events contributing to the infant’s condition. For births initially considered ‘low risk’ but resulting in peripartum hypoxia, it is crucial to perform interdisciplinary case review. The neonatal perspective (although retrospective) is valuable, but the denominator of healthy babies is not reviewed, only the
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Maternal treatment with selective serotonin reuptake inhibitors during pregnancy and delayed neonatal adaptation: a population-based cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-29 Marie-Coralie Cornet, Yvonne W Wu, Heather Forquer, Lyndsay A Avalos, Achyuth Sriram, Aaron W Scheffler, Thomas B Newman, Michael W Kuzniewicz
Objective Selective serotonin reuptake inhibitor (SSRI) use is common in pregnancy. It is associated with delayed neonatal adaptation. Most previous studies have not adjusted for the severity of maternal mental health disorders or examined the impact of SSRI type and dosage. We examined whether treatment with SSRIs in late pregnancy (after 20 weeks) is associated with delayed neonatal adaptation independent
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Response to: ‘Herpes simplex virus infection among neonates suspected of invasive bacterial infection: a population-based cohort study’ by Dungu et al Fetal Neonatal (IF 4.4) Pub Date : 2023-11-27 Georgina Yan, Annalie Shears, Julia R Dudley, Paddy McMaster, Katy J Fidler
Our recent prospective UK-wide British Paediatric Surveillance Unit (BPSU) cohort study findings echo the increase in incidence of neonatal herpes simplex virus (HSV) described by Dungu et al. 1 We found that the incidence of neonatal HSV infection has tripled over the last three decades in the UK from 1.65/100 000 in 1986–19912 to a minimum of 6/100 000 infants between August 2019 and February 2022
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Bronchopulmonary dysplasia: temporal trend from 2010 to 2019 in the Brazilian Network on Neonatal Research Fetal Neonatal (IF 4.4) Pub Date : 2023-11-27 Camila Stolz, Daniela Testoni Costa-Nobre, Adriana Sanudo, Daniela Marques de Lima Mota Ferreira, José Mariano Sales Alves, Julia Paula dos Santos, Milton Harumi Miyoshi, Nathalia Moura de Mello Silva, Fernanda Pegoraro de Godoi Melo, Regina Vieira Cavalcanti da Silva, Dafne Barcala, Marynea Silva Vale, Ligia Maria Suppo de Souza Rugolo, Edna Maria Albuquerque Diniz, Manoel Ribeiro, Sérgio T M Marba
Objective To evaluate the temporal trend of bronchopulmonary dysplasia (BPD) in preterm infants who survived to at least 36 weeks’ post-menstrual age (PMA) and BPD or death at 36 weeks’ PMA, and to analyse variables associated with both outcomes. Design Retrospective cohort with data retrieved from an ongoing national registry. Setting 19 Brazilian university public hospitals. Patients Infants born
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Evolution of the Sarnat exam and association with 2-year outcomes in infants with moderate or severe hypoxic-ischaemic encephalopathy: a secondary analysis of the HEAL Trial Fetal Neonatal (IF 4.4) Pub Date : 2023-11-27 Ulrike Mietzsch, Sarah E Kolnik, Thomas Ragnar Wood, Niranjana Natarajan, Fernando F Gonzalez, Hannah Glass, Dennis E Mayock, Sonia L Bonifacio, Krisa Van Meurs, Bryan A Comstock, Patrick J Heagerty, Tai-Wei Wu, Yvonne W Wu, Sandra E Juul
Objective To study the association between the Sarnat exam (SE) performed before and after therapeutic hypothermia (TH) and outcomes at 2 years in infants with moderate or severe hypoxic-ischaemic encephalopathy (HIE). Design Secondary analysis of the H igh-dose E rythropoietin for A sphyxia and Encepha L opathy Trial. Adjusted ORs (aORs) for death or neurodevelopmental impairment (NDI) based on SE
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Neurodevelopmental outcome at 5.5 years in Dutch preterm infants born at 24–26 weeks’ gestational age: the EPI-DAF study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-27 Pauline E van Beek, Monique Rijken, Lisa Broeders, Hendrik J ter Horst, Corine Koopman-Esseboom, Ellen de Kort, A R C Laarman, S M Mulder - de Tollenaer, Katerina Steiner, Renate M C Swarte, Elke van Westering-Kroon, Guid Oei, Aleid G Leemhuis, Peter Andriessen
Objective After lowering the Dutch threshold for active treatment from 25 to 24 completed weeks’ gestation, survival to discharge increased by 10% in extremely preterm live born infants. Now that this guideline has been implemented, an accurate description of neurodevelopmental outcome at school age is needed. Design Population-based cohort study. Setting All neonatal intensive care units in the Netherlands
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Effect of body position on ventilation distribution in healthy newborn infants: an observational study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-24 Marika Rahtu, Inéz Frerichs, Tytti Pokka, Tobias Becher, Outi Peltoniemi, Merja Kallio
Objectives Newborn infants have unique respiratory physiology compared with older children and adults due to their lungs’ structural and functional immaturity and highly compliant chest wall. To date, ventilation distribution has seldom been studied in this age group. This study aims to assess the effect of body position on ventilation distribution in spontaneously breathing healthy neonates. Design
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Late surfactant administration after 48 hours of age in preterm neonates with respiratory insufficiency: a systematic review and meta-analysis Fetal Neonatal (IF 4.4) Pub Date : 2023-11-23 Gonzalo Solís-García, Sara Elias, Michael Dunn, Bonny Jasani
Objective To systematically review and meta-analyse the effect of late surfactant administration versus placebo in reducing the incidence of death or bronchopulmonary dysplasia (BPD) in preterm infants. Design PubMed, EMBASE, CINAHL and Cochrane CENTRAL were searched until 30 May 2023, for randomised controlled trials (RCTs) comparing administration of surfactant after 48 hours of age versus placebo
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Parental perspectives about information and deferred versus two-stage consent in studies of neonatal asphyxia Fetal Neonatal (IF 4.4) Pub Date : 2023-11-16 Christian A Maiwald, Charlotte Rovers, Annie Janvier, Heidrun Sturm, Martina Michaelis, Georg Marckmann, Hans-Joerg Ehni, Christian F Poets, Mario Rüdiger, Axel R Franz
Objective The ALBINO Trial ([NCT03162653][1]) investigates effects of very early postnatal allopurinol on neurocognitive outcome following perinatal asphyxia where prenatal informed consent (IC) is impossible. Ethically and legally, waiver of consent and/or deferred consent (DC) is acceptable in such an emergency. Short oral/two-step consent (SOC, brief information and oral consent followed by IC)
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Characteristics and outcomes of neonates hospitalised with SARS-CoV-2 infection in the UK by variant: a prospective national cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-15 Chris Gale, Don Sharkey, Kathryn E Fitzpatrick, Helen Mactier, Alessandra Morelli, Mariko Nakahara, Madeleine Hurd, Anna Placzek, Marian Knight, Shamez N Ladhani, Elizabeth S Draper, Cora Doherty, Maria A Quigley, Jennifer J Kurinczuk
Objective Neonatal infection with wildtype SARS-CoV-2 is rare and good outcomes predominate. We investigated neonatal outcomes using national population-level data to describe the impact of different SARS-CoV-2 variants. Design Prospective population-based cohort study. Setting Neonatal, paediatric and paediatric intensive care inpatient care settings in the UK. Patients Neonates (first 28 days after
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Prevalence of bradycardia in 4876 newborns in the first minute after birth and association with positive pressure ventilation: a population-based cross-sectional study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-08 Siren Rettedal, Amalie Kibsgaard, Jan Terje Kvaløy, Joar Eilevstjønn, Hege Langli Ersdal
Objective To determine the prevalence of bradycardia in the first minute after birth and association with positive pressure ventilation (PPV). Method A population-based cross-sectional study was conducted from June 2019 to December 2021 at Stavanger University Hospital, Norway. Parents consented to participation during pregnancy, and newborns ≥28 weeks’ gestation were included at birth. Heart rate
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Congenital duodenal obstruction repair with and without transanastomotic tube feeding: a systematic review and meta-analysis Fetal Neonatal (IF 4.4) Pub Date : 2023-11-03 George Stephen Bethell, Jonathan J Neville, Mark John Johnson, Joanne Turnbull, Nigel J Hall
Objective To determine the impact of transanastomotic tube (TAT) feeding in congenital duodenal obstruction (CDO). Design Systematic review with meta-analysis. Patients Infants with CDO requiring surgical repair. Interventions TAT feeding following CDO repair versus no TAT feeding. Main outcome measures The main outcome was time to full enteral feeds. Additional outcomes included use of parenteral
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Paediatric intensive care admissions of preterm children born <32 weeks gestation: a national retrospective cohort study using data linkage Fetal Neonatal (IF 4.4) Pub Date : 2023-11-03 Tim J van Hasselt, Chris Gale, Cheryl Battersby, Peter J Davis, Elizabeth Draper, Sarah E Seaton
Objective Survival of babies born very preterm (<32 weeks gestational age) has increased, although preterm-born children may have ongoing morbidity. We aimed to investigate the risk of admission to paediatric intensive care units (PICUs) of children born very preterm following discharge home from neonatal care. Design Retrospective cohort study, using data linkage of National Neonatal Research Database
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2% chlorhexidine gluconate aqueous versus 2% chlorhexidine gluconate in 70% isopropyl alcohol for skin disinfection prior to percutaneous central venous catheterisation: the ARCTIC randomised controlled feasibility trial Fetal Neonatal (IF 4.4) Pub Date : 2023-10-31 Paul Clarke, Aung Soe, Amy Nichols, Helen Harizaj, Mark A Webber, Louise Linsell, Jennifer L Bell, Catherine Tremlett, Priyadarsini Muthukumar, Santosh Pattnayak, Christopher Partlett, Andrew King, Ed Juszczak, Paul T Heath
Objective Catheter-related sepsis (CRS) is a major complication with significant morbidity and mortality. Evidence is lacking regarding the most appropriate antiseptic for skin disinfection before percutaneous central venous catheter (PCVC) insertion in preterm neonates. To inform the feasibility and design of a definitive randomised controlled trial (RCT) of two antiseptic formulations, we conducted
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Neurodevelopmental outcomes of preterm neonates receiving rescue inhaled nitric oxide in the first week of age: a cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-10-27 Sujith Kumar Reddy Gurram Venkata, Abhay Lodha, Matthew Hicks, Amish Jain, Anie Lapointe, Hala Makary, Jaideep Kanungo, Kyong-Soon Lee, Xiang Ye, Prakesh S Shah, Amuchou S Soraisham
Objective To assess the neurodevelopmental outcomes of preterm neonates who received inhaled nitric oxide (iNO) in the first week of age for hypoxaemic respiratory failure (HRF). Methods In this retrospective cohort study, we included neonates born at <29 weeks gestational age (GA) between January 2010 and December 2018 who had a neurodevelopmental assessment at 18–24 months corrected age (CA) at one
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Current management of neonatal abstinence syndrome: a survey of practice in the UK and Ireland Fetal Neonatal (IF 4.4) Pub Date : 2023-10-25 Sharon Dempsey, Michael J O’ Grady
Objective To study the current management practices of neonatal abstinence syndrome (NAS) throughout the UK and Ireland and identify changes in practice from the most recent survey in 2008. Design Postal questionnaire to a consultant paediatrician or neonatologist in all 215 neonatal units in the UK and Ireland in January 2020. Results Response rate was 62%. An objective scoring tool was used in 97%
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Diagnosis and management of congenital diaphragmatic hernia: a 2023 update from the Canadian Congenital Diaphragmatic Hernia Collaborative Fetal Neonatal (IF 4.4) Pub Date : 2023-10-25 Pramod Puligandla, Erik Skarsgard, Robert Baird, Elena Guadagno, Alexandra Dimmer, Olivia Ganescu, Nimrah Abbasi, Gabriel Altit, Mary Brindle, Sairvan Fernandes, Shyamala Dakshinamurti, Helene Flageole, Audrey Hebert, Richard Keijzer, Martin Offringa, Dylan Patel, Greg Ryan, Michael Traynor, Augusto Zani, Priscilla Chiu
Objective The Canadian Congenital Diaphragmatic Hernia (CDH) Collaborative sought to make its existing clinical practice guideline, published in 2018, into a ‘living document’. Design and main outcome measures Critical appraisal of CDH literature adhering to Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Evidence accumulated between 1 January 2017 and 30 August
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Parenting stress and health-related quality of life among parents of extremely preterm born early adolescents in England: a cross-sectional study Fetal Neonatal (IF 4.4) Pub Date : 2023-10-25 Emmi Suonpera, Anne Lanceley, Yanyan Ni, Neil Marlow
Objective To determine whether extremely preterm (EP) birth exerts persisting effects on parents in early adolescence. Design Cross-sectional survey conducted between March 2017 and October 2018. Setting Evaluation of a longitudinal population-based birth cohort in England at 11 years of age (EPICure2@11 Study). Participants Parents of EP (<27 weeks of gestation) adolescents and control parents of
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Fantoms Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Ben J Stenson
Sarah Seaton et al have provided valuable new outcome information about extremely preterm babies born in the UK between 2016 and 2020. These data will be highly valuable in discussions with families. We have been relying on evidence from earlier years and from other health systems. They report neonatal survival figures. This means the proportion of babies who are still alive 28 days after birth. Outcomes
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Neonatal seizures. Treat! But when, with what and for how long? Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Rod W Hunt
Neonatal seizures remain a complex challenge for those of us involved in these babies’ care. While relatively common, our approaches to these patients vary between clinicians, subspecialties and centres. Nearly every facet of detection, investigation, treatment and follow-up of these patients is subject to some variation in practice. Sewell et al , on behalf of the Eunice Kennedy Shriver National Institute
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Can we balance early exogenous surfactant therapy and non-invasive respiratory support to optimise outcomes in extremely preterm infants? A nuanced review of the current literature Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Kirsten Glaser, Nicolas A Bamat, Clyde J Wright
Therapeutic advances have significantly improved the survival of premature infants. However, a high burden of bronchopulmonary dysplasia (BPD) persists. Aiming at prevention of neonatal lung injury, continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) strategies have replaced mechanical ventilation for early respiratory support and treatment of respiratory distress syndrome
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Estimated neonatal survival of very preterm births across the care pathway: a UK cohort 2016–2020 Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Sarah E Seaton, Ridhi Agarwal, Elizabeth S Draper, Alan C Fenton, Jennifer J Kurinczuk, Bradley N Manktelow, Lucy K Smith
Objective Currently used estimates of survival are nearly 10 years old and relate to only those babies admitted for neonatal care. Due to ongoing improvements in neonatal care, here we update estimates of survival for singleton and multiple births at 22+0 to 31+6 weeks gestational age across the perinatal care pathway by gestational age and birth weight. Design Retrospective analysis of routinely collected
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National priority setting partnership using a Delphi consensus process to develop neonatal research questions suitable for practice-changing randomised trials in the UK Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Katie Evans, Cheryl Battersby, James P Boardman, Elaine Boyle, Will Carroll, Kate Dinwiddy, Jon Dorling, Katie Gallagher, Pollyanna Hardy, Emma Johnston, Helen Mactier, Claire Marcroft, James William Harrison Webbe, Chris Gale
Background The provision of neonatal care is variable and commonly lacks adequate evidence base; strategic development of methodologically robust clinical trials is needed to improve outcomes and maximise research resources. Historically, neonatal research topics have been selected by researchers; prioritisation processes involving wider stakeholder groups have generally identified research themes
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Fragility and resilience: parental and family perspectives on the impacts of extreme prematurity Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Annie Janvier, Claude Julie Bourque, Rebecca Pearce, Emilie Thivierge, Laurie-Anne Duquette, Magdalena Jaworski, Keith J Barrington, Anne R Synnes, Paige Church, Thuy Mai Luu
Objectives Extremely preterm babies have a significant risk of neurodevelopmental impairment (NDI). There has been little investigation regarding the impact of prematurity on families. The objective of this study was to explore parental perspectives regarding the impact of prematurity on themselves/their family. Methods Over 1 year, parents of children born <29 weeks’ gestational age (GA) who were
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Health-related quality of life in adults born extremely preterm or with extremely low birth weight in the postsurfactant era: a longitudinal cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Christopher Selman, Rheanna Mainzer, Katherine Lee, Peter Anderson, Alice Burnett, Suzanne M Garland, George C Patton, Lauren Pigdon, Gehan Roberts, John Wark, Lex W Doyle, Jeanie Ling Yoong Cheong
Objectives To compare health-related quality of life (HRQoL) at 25 and 18 years in individuals born extremely preterm (EP, <28 weeks’ gestation) or with extremely low birth weight (ELBW, birth weight <1000 g) with term-born (≥37 weeks) controls. Within the EP/ELBW cohort, to determine whether HRQoL differed between those with lower and higher IQs. Methods HRQoL was self-reported using the Health Utilities
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Video laryngoscopy-assisted less-invasive surfactant administration quality improvement initiative Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Dalibor Kurepa, Vitaliya Boyar, Olena Predtechenska, Venkata Gupta, Barry Weinberger, Margaret Pulju, Alla Zaytseva, Stephanie G Galanti, Gangajal Kasniya, Shahana Perveen
Objective To describe the use of quality improvement methodology in transitioning from delivery of surfactant by INSURE (INtubation–SURfactant administration–Extubation) to video laryngoscope-assisted LISA (less-invasive surfactant administration) for infants with respiratory distress syndrome (RDS) receiving non-invasive ventilatory support. Setting Two large neonatal intensive care units (NICUs)
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Effect of initial and subsequent mask applications on breathing and heart rate in preterm infants at birth Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Kristel L A M Kuypers, Anouk Hopman, Sophie J E Cramer, Janneke Dekker, Remco Visser, Stuart B Hooper, Arjan B te Pas
Objective Application of a face mask may provoke the trigeminocardiac reflex, leading to apnoea and bradycardia. This study investigates whether re-application of a face mask in preterm infants at birth alters the risk of apnoea compared with the initial application, and identify factors that influence this risk. Methods Resuscitation videos and respiratory function monitor data collected from preterm
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Neonatal outcomes following early fetal growth restriction: a subgroup analysis of the EVERREST study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Ingran Lingam, Jade Okell, Katarzyna Maksym, Rebecca Spencer, Donald Peebles, Gina Buquis, Gareth Ambler, Eva Morsing, David Ley, Dominique Singer, Violeta Tenorio, Jade Dyer, Yuval Ginsberg, Tal Weissbach, Angela Huertas-Ceballos, Neil Marlow, Anna David
Objective To quantify the risks of mortality, morbidity and postnatal characteristics associated with extreme preterm fetal growth restriction (EP-FGR). Design The EVERREST (Do e s v ascular endothelial growth factor gene therapy saf e ly imp r ove outcome in seve r e e arly-onset fetal growth re st riction?) prospective multicentre study of women diagnosed with EP-FGR (singleton, estimated fetal weight
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Ultra-high frequency lung ultrasound in preterm neonates: a test validation study on interpretation agreement and reliability Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Victor Sartorius, Barbara Loi, Laura Vivalda, Giulia Regiroli, Sofia de la Rubia Ortega, Roberta Centorrino, Daniele De Luca
Objective To verify if increasing frequency, through the use of ultra-high frequency transducers, has an impact on lung ultrasound pattern recognition. Design Test validation study. Setting Tertiary academic referral neonatal intensive care unit. Patients Neonates admitted with respiratory distress signs. Interventions Lung ultrasound performed with four micro-linear probes (10, 15, 20 and 22 MHz)
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Hyper high haemoglobin content in red blood cells and erythropoietic transitions postnatally in infants of 22 to 26 weeks’ gestation: a prospective cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Sara Marie Larsson, Tommy Ulinder, Alexander Rakow, Mireille Vanpee, Dirk Wackernagel, Karin Sävman, Ingrid Hansen-Pupp, Ann Hellström, David Ley, Ola Andersson
Objective Blood cell populations, including red blood cells (RBC) unique to the extremely preterm (EPT) infant, are potentially lost due to frequent clinical blood sampling during neonatal intensive care. Currently, neonatal RBC population heterogeneity is not described by measurement of total haemoglobin or haematocrit. We therefore aimed to describe a subpopulation of large RBCs with hyper high haemoglobin
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Experiences of healthcare personnel with death in the neonatal intensive care unit: a systematic review of qualitative studies Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Jessica Qing Hui Wong, Judith Sharon Charles, Hao Ting Mok, Teresa Shu Zhen Tan, Zubair Amin, Yvonne Peng Mei Ng
Objective To synthesise evidence from qualitative studies on the experiences of healthcare personnel (HCP) in the neonatal intensive care unit (NICU) caring for dying neonates. Methods We conducted a systematic search, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO: CRD42021250015), of four databases (PubMed, Embase, PsycINFO and CINAHL) from
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Early initiation of antibiotic therapy and short-term outcomes in preterm infants: a single-centre retrospective cohort analysis Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Natascha Köstlin-Gille, Lina Maria Serna-Higuita, Caren Bubser, Joerg Arand, Laura Haag, Christoph E Schwarz, Martin Heideking, Christian F Poets, Christian Gille
Background Sepsis is one of the most important complications in preterm infants. For this reason, many such infants receive antibiotics during their hospital stay. However, early antibiotic therapy has also been associated with adverse outcome. It is yet largely unclear if the time of onset of antibiotic therapy influences the outcome. We here investigated whether the timing of initiation of antibiotic
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Prognostic value of echocardiographic parameters in congenital diaphragmatic hernia: a systematic review and meta-analysis Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Mohan Pammi, Yashaswini Kelagere, Sara Koh, Amy Sisson, Joseph Hagan, Joshua Kailin, Caraciolo J Fernandes
Background Prognostication of mortality and decision to offer extracorporeal membrane oxygenation (ECMO) treatment in infants with congenital diaphragmatic hernia (CDH) can inform clinical management. Objective To summarise the prognostic value of echocardiography in infants with CDH. Methods Electronic databases Ovid MEDLINE, Embase, Scopus, CINAHL, the Cochrane Library and conference proceedings
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Measuring Oxygenation in Newborn Infants with Targeted Oxygen Ranges (MONITOR): a randomised crossover pilot study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Fraser G Christie, Rod Kelly, James P Boardman, Ben J Stenson
Objective The Neonatal Oxygenation Prospective Meta-analysis (NeOProM) Collaboration showed that high (91–95%) versus low (85–89%) SpO2 targets reduced mortality. Trials of higher targets are needed to determine whether any more survival advantage may be gained. This pilot study explored the achieved oxygenation patterns observed when targeting SpO2 92–97% to facilitate the design of future trials
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Clinical usefulness of reintubation criteria in extremely preterm infants: a cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Tugba Alarcon-Martinez, Samantha Latremouille, Lajos Kovacs, Robert E Kearney, Guilherme M Sant’Anna, Wissam Shalish
Objective To describe the thresholds of instability used by clinicians at reintubation and evaluate the accuracy of different combinations of criteria in predicting reintubation decisions. Design Secondary analysis using data obtained from the prospective observational Automated Prediction of Extubation Readiness study ([NCT01909947][1]) between 2013 and 2018. Setting Multicentre (three neonatal intensive
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Diagnostic accuracy of small-for-gestational-age status for infant mortality and school-age outcomes of live births <28 weeks’ gestation: a cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Lex W Doyle, Julie Chen, Rosemarie Anne Boland, Stefan Charles Kane, Rheanna Mainzer, Gehan Roberts, Elisha K Josev, Marissa Clark, Peter J Anderson, Jeanie Ling Yoong Cheong
Objectives To determine the diagnostic accuracy of small-for-gestational-age (SGA; <10th centile) status for infant mortality and adverse school-age outcomes in infants born extremely preterm (EP; <28 weeks’ gestation). Design Geographical cohort studies. Setting The state of Victoria, Australia. Patients For mortality, live births 22–27 weeks’ gestation from 2009 to 2017 offered active care after
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Herpes simplex virus infection among neonates suspected of invasive bacterial infection: a population-based cohort study Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Kia Hee Schultz Dungu, Stine Lund, Emma Louise Malchau Carlsen, Ulla Birgitte Hartling, Astrid Thaarup Matthesen, Kristina Træholt Franck, Marianne Kragh Thomsen, Ulrik Stenz Justesen, Hans Linde Nielsen, Alex Christian Yde Nielsen, Tine Brink Henriksen, Ulrikka Nygaard
Objective To estimate the incidence of neonatal herpes simplex virus (HSV) infection and the number of neonates with suspected invasive bacterial infection (IBI) needed to treat (NNT) with acyclovir to ensure prompt treatment of invasive HSV infections. Design A nationwide population-based cohort study. Setting All neonatal and paediatric emergency departments in Denmark from 1 January 2010 to 31 December
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Thermal care for preterm infants in the delivery room has not been compromised since the routine adoption of delayed cord clamping in our unit Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Rebecca Clarke, Jessica Burgess-Shannon, Claire Howarth, Victoria Rowell, Narendra Aladangady
It was with great interest that we read the work of Dunne et al describing higher rates of admission hypothermia in preterm infants following the introduction of delayed cord clamping (DCC) (6% to 54%).1 We share their concerns given the association between admission hypothermia and increased mortality.2 The 2021 National Neonatal Audit Programme (NNAP) data highlighted our tertiary, medical neonatal
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Vertical transmission of SARS-CoV-2 – are there differences in rates of neonatal SARS-CoV-2 infection in two classification systems? Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Nadine Mand, Matthias Hutten, Rolf Felix Maier, Lars Mense, Ulrich Pecks, Mario Rüdiger
Neonatal SARS-CoV-2 infection due to vertical transmission has been summarised in recent reviews.1 2 However, the comparability of the underlying case reports and case series might be limited because of the often inconsistent use of different classification systems.1 COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS) was a prospective German registry enrolling pregnant women with confirmed
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Subcortical bruising in the preterm infant Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Sriya Roychaudhuri, Carol Benson, Mohamed El-Dib
A cranial ultrasound (CUS) was performed on day 2 of a 27-week, 3-day gestational age newborn, with no external clinical signs or history of trauma during delivery nor concerns of significant thrombocytopenia or coagulopathy, prompted by acute drop in haematocrit (from 17.5 to 11.4 g/dL). Perinatal history was significant for in vitro fertilisation pregnancy, cervical cerclage, pregestational diabetes
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Cutaneous mucormycosis in an extremely premature infant Fetal Neonatal (IF 4.4) Pub Date : 2023-11-01 Kristina Chmelova, Robert Tinnion, Stefan Zalewski
This case concerns a female infant born at 23+4/40 weighing 460 g. She was referred to us on day 6 with focal intestinal perforation, requiring small bowel resection and ileostomy. On day 7, skin necrosis was seen extending bilaterally from under the endotracheal tube (ETT) fixation (figure 1). Removing the device revealed extensive soft tissue damage. Honey dressings were applied and a non-adhesive
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Prolonged use of closed-loop inspired oxygen support in preterm infants: a randomised controlled trial Fetal Neonatal (IF 4.4) Pub Date : 2023-10-12 Tim M R Schouten, Ameen Abu-Hanna, Anton H van Kaam, Maria E N van den Heuvel, Thomas E Bachman, Ruud W van Leuteren, G Jeroen Hutten, Wes Onland
Objective This randomised study in preterm infants on non-invasive respiratory support investigated the effectiveness of automated oxygen control (A-FiO2) in keeping the oxygen saturation (SpO2) within a target range (TR) during a 28-day period compared with manual titration (M-FiO2). Design A single-centre randomised control trial. Setting A level III neonatal intensive care unit. Patients Preterm
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Effects of prophylactic hydrocortisone in a tertiary Canadian NICU Fetal Neonatal (IF 4.4) Pub Date : 2023-10-12 Marisa de Souza, Raymond Melika, Bernard Thebaud, Nicholas James Barrowman, Anne Tsampalieros, Brigitte Lemyre
Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Recent evidence suggests that the use of physiological doses of hydrocortisone for the prevention of death or BPD may outweigh the potential risks.1–3 Starting in 2019, all infants born <28 weeks gestational age (GA) in our tertiary care NICU received physiologic doses of hydrocortisone, starting within 24 hours post-birth
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Neuroimaging in infants with congenital cytomegalovirus infection and its correlation with outcome: emphasis on white matter abnormalities Fetal Neonatal (IF 4.4) Pub Date : 2023-10-05 Ana Alarcón, Linda S de Vries, Alessandro Parodi, Juan Arnáez, Fernando Cabañas, Sylke J Steggerda, Mónica Rebollo, Luca Ramenghi, Izaskun Dorronsoro, Manuela López-Azorín, Juliane Schneider, Antoni Noguera-Julian, María Ríos-Barnés, Manuel Recio, Myriam Bickle-Graz, Miriam Martínez-Biarge, Clàudia Fortuny, Alfredo García-Alix, Anita C Truttmann
Objective To evaluate the association between neuroimaging and outcome in infants with congenital cytomegalovirus (cCMV), focusing on qualitative MRI and quantitative diffusion-weighted imaging of white matter abnormalities (WMAs). Methods Multicentre retrospective cohort study of 160 infants with cCMV (103 symptomatic). A four-grade neuroimaging scoring system was applied to cranial ultrasonography
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Two-year neurodevelopmental data for preterm infants born over an 11-year period in England and Wales, 2008–2018: a retrospective study using the National Neonatal Research Database Fetal Neonatal (IF 4.4) Pub Date : 2023-10-03 Emily van Blankenstein, Tia Sodiwala, Julia Lanoue, Neena Modi, Sabita N Uthaya, Cheryl Battersby
Objective United Kingdom guidelines recommend all infants born <30 weeks’ gestation receive neurodevelopmental follow-up at 2 years corrected age. In this study, we describe completeness and results of 2-year neurodevelopmental records in the National Neonatal Research Database (NNRD). Design This retrospective cohort study uses data from the NNRD, which holds data on all neonatal admissions in England
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Factors associated with the increased incidence of necrotising enterocolitis in extremely preterm infants in Sweden between two population-based national cohorts (2004–2007 vs 2014–2016) Fetal Neonatal (IF 4.4) Pub Date : 2023-10-03 Pontus Challis, Karin Källén, Lars Björklund, Anders Elfvin, Aijaz Farooqi, Stellan Håkansson, David Ley, Mikael Norman, Erik Normann, Fredrik Serenius, Karin Sävman, Lena Hellström-Westas, Petra Um-Bergström, Ulrika Ådén, Thomas Abrahamsson, Magnus Domellöf
Objective To investigate potential risk factors behind the increased incidence of necrotising enterocolitis (NEC) in Swedish extremely preterm infants. Design Registry data from two population-based national cohorts were studied. NEC diagnoses (Bell stage ≥II) were validated against hospital records. Patients All liveborn infants <27 weeks of gestation 2004–2007 (n=704) and 2014–2016 (n=895) in Sweden
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Volume-targeted mask ventilation during simulated neonatal resuscitation Fetal Neonatal (IF 4.4) Pub Date : 2023-09-29 Brenda Hiu Yan Law, Georg M Schmölzer
Objective Mask positive pressure ventilation (PPV) in the delivery room is routinely delivered with set peak inflation pressures. To aid mask PPV, stand-alone respiratory function monitors (RFMs) have been used in the delivery room, while ventilator-based, volume-targeted ventilation (VTV) is routinely used in the neonatal intensive care unit (NICU). Design This is a prospective, randomised, crossover
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Clinical outcomes of Staphylococcus capitis isolation from neonates, England, 2015–2021: a retrospective case–control study Fetal Neonatal (IF 4.4) Pub Date : 2023-09-26 Jin-Min Yuan, Christopher Nugent, Allegra Wilson, Neville Q Verlander, Eliza Alexander, Paul Fleming, Neena Modi, Kayleigh Oughham, Natasha Ratnaraja, Yu Wan, Louise Thorn, Heather Felgate, Mark A Webber, Enitan Ogundipe, Colin S Brown, Karthik Paranthaman, Alicia Demirjian
Objective Staphylococcus capitis , a coagulase-negative staphylococci (CoNS) species, has been increasingly detected from UK sterile site samples and has caused neonatal unit outbreaks worldwide. We compared survival to discharge and 30-day mortality for the detection of S. capitis versus other CoNS species. Methods In this retrospective case–control study, we included hospitalised infants with any
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Clinical value of placental examination for paediatricians Fetal Neonatal (IF 4.4) Pub Date : 2023-09-26 Daniel Cromb, Megan Hall, Lisa Story, Panicos Shangaris, Mudher Al-Adnani, Mary A Rutherford, Grenville F Fox, Neelam Gupta
The placenta contains valuable clinical information that is linked to fetal development, neonatal morbidity and mortality, and future health outcomes. Both gross inspection and histopathological examination of the placenta may identify intrinsic or secondary placental lesions, which can contribute directly to adverse neonatal outcomes or indicate the presence of an unfavourable intrauterine environment
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Statistical power in ‘Prophylactic surfactant nebulisation for the early aeration of the preterm lung: a randomised clinical trial’ Fetal Neonatal (IF 4.4) Pub Date : 2023-09-22 Joseph Hagan
Gaertner et al 1 published a randomised clinical trial of preterm infants comparing, as the primary outcome, the difference in end-expiratory lung impedance from birth to 30 min after birth (ΔEELI30min) for infants randomised to receive positive distending pressure, either alone (standard care) or with surfactant nebulisation (SN). The study sample size of 16 patients per treatment arm was calculated
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Reply to: ‘Statistical power in “Prophylactic surfactant nebulisation for the early aeration of the preterm lung: a randomised clinical trial”’ Fetal Neonatal (IF 4.4) Pub Date : 2023-09-22 Vincent D Gaertner, Dirk Bassler, Christoph Martin Rüegger
We thank Dr Hagan for his letter highlighting the importance of a critical interpretation of statistical analyses. 1 2 Designing trials to investigate novel therapeutic approaches in the neonatal population is difficult, mainly due to lack of high-quality data for adequate sample size calculation. For this reason, we performed electrical impedance tomography pilot measurements in five healthy very
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Trends in infant mortality due to haemolytic disease and other perinatal jaundice in the USA, 1999–2020 Fetal Neonatal (IF 4.4) Pub Date : 2023-09-21 Ramesh Vidavalur, Vinod K Bhutani
Monitoring infant mortality rates (IMRs) related to severe neonatal hyperbilirubinaemia is crucial. Periodic updates of evidence-based clinical practice guidelines since 1994 have improved care and monitoring for hyperbilirubinaemia in newborns.1 2 However, knowledge gaps exist regarding IMRs associated with jaundice over the past two decades. This study aims to fill these gaps by utilising a national
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Neonatal high-frequency oscillatory ventilation: where are we now? Fetal Neonatal (IF 4.4) Pub Date : 2023-09-19 Jakob Hibberd, Justin Leontini, Thomas Scott, J Jane Pillow, Martijn Miedema, Peter C Rimensberger, David Gerald Tingay
High-frequency oscillatory ventilation (HFOV) is an established mode of respiratory support in the neonatal intensive care unit. Large clinical trial data is based on first intention use in preterm infants with acute respiratory distress syndrome. Clinical practice has evolved from this narrow population. HFOV is most often reserved for term and preterm infants with severe, and often complex, respiratory
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Perspectives of extremely prematurely born adults on what to consider in prenatal decision-making: a qualitative focus group study Fetal Neonatal (IF 4.4) Pub Date : 2023-09-19 Angret de Boer, Lien De Proost, Marieke de Vries, Marije Hogeveen, E J T (Joanne) Verweij, Rosa Geurtzen
Objective A shared decision-making (SDM) approach is recommended for prenatal decisions at the limit of viability, with a guiding role for parental values. People born extremely premature experience the consequences of the decision made, but information about their perspectives on prenatal decisions is lacking. Therefore, this study aims to describe their perspectives on what is important in decision-making
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Identifying effect modifiers of systemic hydrocortisone treatment initiated 7–14 days after birth in ventilated very preterm infants on long-term outcome: secondary analysis of a randomised controlled trial Fetal Neonatal (IF 4.4) Pub Date : 2023-09-18 Nienke Marjolein Halbmeijer, Michel Sonnaert, Renate M Swarte, Corine Koopman-Esseboom, Margriet van Stuijvenberg, Susanne Mulder-de Tollenaer, Ratna N G B Tan, Thilo Mohns, Els Bruneel, Katerina Steiner, Boris W Kramer, Anne Debeer, Mirjam M van Weissenbruch, Yoann Marechal, Henry Blom, Katleen Plaskie, Martin Offringa, Maruschka P Merkus, Wes Onland, Aleid G Leemhuis, Anton H van Kaam
Objective To explore clinical effect modifiers of systemic hydrocortisone in ventilated very preterm infants for survival and neurodevelopmental outcome at 2 years’ corrected age (CA). Design Secondary analysis of a randomised placebo-controlled trial. Setting Dutch and Belgian neonatal intensive care units. Patients Infants born <30 weeks’ gestational age (GA), ventilator-dependent in the second week