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Vibration-based mitigation of noxious-evoked responses to skin puncture in neonates and infants: a randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-13 Lance M. Relland, Caitlin P. Kjeldsen, Arnaud Jeanvoine, Lelia Emery, Kathleen Adderley, Rachelle Srinivas, Maeve McLoughlin, Nathalie L. Maitre
Objective To assess the effect of a non-noxious vibratory stimulus on noxious-evoked cortical responses to skin puncture and to determine whether the presence of certain behavioural components may be used to predict such cortical responses. Design Randomised controlled trial. Setting Level IV neonatal intensive care unit at a stand-alone children’s hospital. Patients 134 hospitalised infants between
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Outcomes following the adoption of standard parenteral nutrition in preterm infants: a whole-population non-concurrent control study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-04 Jessica Burgess-Shannon, Mohammad Chehrazi, Julia Lanoue, Neena Modi, Sabita N Uthaya
Objective To evaluate the impact of a quality improvement project of the adoption of standard parenteral nutrition (SPN) in preterm infants. Design Retrospective, multicentre, whole-population, non-concurrent control study using data from the UK National Neonatal Research Database between 1 January 2014 and 31 December 2020. Setting Neonatal units in London UK organised by geographical network. Patients
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Does extremely early expression of colostrum after very preterm birth improve mother’s own milk quantity? A cohort study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-04 Ilana Levene, Maria A Quigley, Mary Fewtrell, Frances O’Brien
Objective Assess the relationship of time to first expression after very preterm birth and mothers’ own milk quantity. Design A cohort study (nested within a randomised trial). Setting Four neonatal units in the UK. Patients 132 mothers of single or twin infants born at 23+0 to 31+6 weeks postmenstrual age. Exposures Time to the first attempt to express after birth. Primary outcomes 24-hour mother’s
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Role of beta-hydroxybutyrate measurement in the evaluation of plasma glucose concentrations in newborn infants Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Charles A Stanley, Philip J Weston, Deborah L Harris, Diva D De León, Jane E Harding
Objective The Glucose in Well Babies (GLOW) Study showed that there are two phases of low glucose concentrations in healthy newborn infants: an initial phase in which plasma concentrations of ketones are low; and a second phase in which low glucose concentrations are accompanied by elevated concentrations of ketones. The implications of these two phases for the brain differ depending on whether ketones
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Vitamin K: missed at peril—the case for extra supplementation to prevent deficiency in breastfed preterm infants Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Paul Clarke, Nicholas D Embleton, Mary Fewtrell, Dominic J Harrington, Anne M Kelly, Naomi Moris, Alexander Patto, Vennila Ponnusamy, Vimal Vasu, Martin J Shearer
Vitamin K deficiency bleeding (VKDB) is a rare but potentially devastating disease which is essentially preventable by prophylactic vitamin K (VK) at birth, and adequate dietary VK intake thereafter. The ultimate consequence of missing prophylaxis, especially for exclusively breastfed preterm babies, was highlighted by the tragic death of a 34-week gestation boy who suffered catastrophic intracranial
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Effect of gestational age on cerebral lesions in neonatal encephalopathy Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-28 Lauren Binet, Thierry Debillon, Jonathan Beck, Antoine Vilotitch, Isabelle Guellec, Anne Ego, Marie Chevallier
Objective To determine the risk on brain lesions according to gestational age (GA) in neonates with neonatal encephalopathy. Design Secondary analysis of the prospective national French population-based cohort, Long-Term Outcome of NeonataL EncePhALopathy. Setting French neonatal intensive care units. Patients Neonates with moderate or severe neonatal encephalopathy (NE) born at ≥34 weeks’ GA (wGA)
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Factors that impact second attempt success for neonatal intubation following first attempt failure: a report from the National Emergency Airway Registry for Neonates Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-28 Mitchell David Johnson, David Gerald Tingay, Elizabeth J Perkins, Arun Sett, Bianca Devsam, Ellen Douglas, Julia K Charlton, Paul Wildenhain, Jennifer Rumpel, Michael Wagner, Vinay Nadkarni, Lindsay Johnston, Heidi M Herrick, Tyler Hartman, Kristen Glass, Philipp Jung, Stephen D DeMeo, Rebecca Shay, Jae H Kim, Jennifer Unrau, Ahmed Moussa, Akira Nishisaki, Elizabeth E Foglia
Objective To determine the factors associated with second attempt success and the risk of adverse events following a failed first attempt at neonatal tracheal intubation. Design Retrospective analysis of prospectively collected data on intubations performed in the neonatal intensive care unit (NICU) and delivery room from the National Emergency Airway Registry for Neonates (NEAR4NEOS). Setting Eighteen
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Associations between physical activity and development in preschool-aged children born <30 weeks’ gestation: a cohort study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-26 Tara L FitzGerald, Kate L Cameron, Reem A Albesher, Benjamin F Mentiplay, Rheanna M Mainzer, Alice C Burnett, Karli Treyvaud, Ross A Clark, Peter J Anderson, Jeanie LY Cheong, Lex W Doyle, Alicia J Spittle
Objective To investigate the effect of physical activity (PA) on development (motor, cognitive, social-emotional) in children 4–5 years old born <30 weeks’ gestation, and to describe subgroups of children at risk of low PA in this cohort. Design Longitudinal cohort study. Patients 123 children born <30 weeks were recruited at birth and assessed between 4 and 5 years’ corrected age. Main outcome measures
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Neurosensory, cognitive and academic outcomes at 8 years in children born 22–23 weeks’ gestation compared with more mature births Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-23 India RM Marks, Lex W Doyle, Rheanna M Mainzer, Alicia J Spittle, Marissa Clark, Rosemarie A Boland, Peter J Anderson, Jeanie LY Cheong
Despite providing intensive care to more infants born <24 weeks’ gestation, data on school-age outcomes, critical for counselling and decision-making, are sparse. Objective To compare major neurosensory, cognitive and academic impairment among school-aged children born extremely preterm at 22–23 weeks’ gestation (EP22–23) with those born 24–25 weeks (EP24–25), 26–27 weeks (EP26–27) and term (≥37 weeks)
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Neonatal brain magnetic resonance imaging: clinical indications, acquisition and reporting Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-23 Topun Austin, Daniel Connolly, Kate Dinwiddy, Anthony Richard Hart, Axel Heep, Sundeep Harigopal, Harriet Joy, Karen Luyt, Christina Malamateniou, Nazakat Merchant, Chrysoula Rizava, Mary A Rutherford, Kelly Spike, Brigitte Vollmer, James P Boardman
This framework for practice was developed by the British Association of Perinatal Medicine and British Society of Neuroradiologists and has been endorsed by the British Paediatric Neurology Association and the Society of Radiographers. MRI has become increasingly available to clinicians to evaluate the newborn. However, with the exception of MRI in term infants with hypoxic-ischaemic encephalopathy
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Fantoms Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Ben J Stenson
The haemodynamic management of preterm infants has evolved over time, supported by epidemiological data, physiologically reasoned and well intentioned, but with little sophistication in the physiological assessment and little evidence to guide drug treatment. Rachel Mullaly and Afif Faisal El Khuffash review the present state of knowledge, highlighting the flaws of using mean blood pressure to guide
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Neurodevelopmental outcomes in early childhood for infants born very preterm in countries outside the UK Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Lex W Doyle
Knowledge of outcomes beyond the primary hospitalisation for infants born very preterm is vital to understanding the impact of interventions in the perinatal and newborn periods, particularly as more infants born <24 weeks’ gestation are being offered active care. van Blankenstein et al 1 report the outcomes at 2 years of age of children born <30 weeks in England and Wales between 2008 and 2018. In
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Haemodynamic assessment and management of hypotension in the preterm Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Rachel Mullaly, Afif Faisal El-Khuffash
The management of low blood flow states in premature neonates is fraught with many challenges. We remain over-reliant on regimented stepwise protocols that use mean blood pressure as a threshold for intervention to guide treatment, without giving due consideration to the underlying pathophysiology. The current available evidence does not reflect the need to concentrate on the unique pathophysiology
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Clinical outcomes of Staphylococcus capitis isolation from neonates, England, 2015–2021: a retrospective case–control study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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Advance care planning in perinatal settings: national survey of implementation using Normalisation Process Theory Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Karen L Shaw, J Spry, Carole Cummins, Andrew K Ewer, Mark D Kilby, Alexandra Mancini
Background Perinatal advance care planning (PnACP) is a process of formal decision-making to help families plan for their baby’s care when recognised that they may have a life-limiting condition. While PnACP is recommended in policy, there is a lack of evidence to support implementation and development in the perinatal setting. Objective To conduct an online survey of UK and Ireland perinatal providers
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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 Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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Neuroimaging in infants with congenital cytomegalovirus infection and its correlation with outcome: emphasis on white matter abnormalities Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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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 Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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
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First-year growth trajectory and early nutritional requirements for optimal growth in infants with congenital diaphragmatic hernia: a retrospective cohort study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Maxime Coignard, Kelly Mellul, Julien Stirnemann, Naziha Khen-Dunlop, Alexandre Lapillonne, Elsa Kermorvant-Duchemin
Objective To describe the growth trajectory of children with congenital diaphragmatic hernia (CDH) during the first year, to assess the risk factors for growth failure (GF) at 1 year and to determine nutritional intakes at discharge required for early optimal growth. Design Single-centre retrospective cohort study based on data from a structured follow-up programme. Setting and patients All neonates
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Preliminary results on validity and reliability from two prospective cohort studies on a new Neonatal Coma Score Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Anthony Richard Hart, Martha Kieran, Elizabeth Matthews, Laura Mandefield, Tamanna Williams, Kathryn Johnson, Sharon English, Denise Evans, Lisa Cutsey, John Goodden
Objective To collect data on content/face validity and interobserver agreement for a Neonatal Coma Score (NCS) in well full-term neonates and on construct validity in unwell and preterm babies, specifically how the NCS changed with gestational age and illness. Design Prospective cohort studies. Setting Two UK tertiary neonatal units (Sheffield and Leeds). Patients 151 well full-term (≥37 weeks gestational
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Congenital duodenal obstruction repair with and without transanastomotic tube feeding: a systematic review and meta-analysis Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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Neurodevelopmental outcomes at age 3 years after moderate preterm, late preterm and early term birth: the Japan Environment and Children’s Study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Katsuya Hirata, Kimiko Ueda, Kazuko Wada, Satoyo Ikehara, Kanami Tanigawa, Tadashi Kimura, Keiichi Ozono, Tomotaka Sobue, Hiroyasu Iso
Objective To assess the association between gestational age classification at birth and the risk of neurodevelopmental impairments at age 3 years. Design Cohort study using the Japan Environment and Children’s Study database. Patients A total of 86 138 singleton children born without physical abnormalities at 32–41 weeks of gestation enrolled between January 2011 and March 2014. Main outcome measures
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Perspectives of extremely prematurely born adults on what to consider in prenatal decision-making: a qualitative focus group study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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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 Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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 Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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Volume-targeted mask ventilation during simulated neonatal resuscitation Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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Prolonged use of closed-loop inspired oxygen support in preterm infants: a randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 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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Impact of adopting a neonatal sepsis risk calculator in a diverse population in Birmingham, UK Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-03-01 Rachel Yew, Laura Macaskill, Sebastian Brown, Michael Dixie, Daniel Dogar, Elizabeth Checketts, Pinki Surana
Kaiser-Permanente Sepsis Risk Calculator (KP-SRC) has safely reduced antibiotic use in the management of early-onset neonatal sepsis (EONS) in the USA and has been endorsed by the American Academy of Pediatrics.1 However, the updated UK National Institute for Health and Care Excellence (NICE) guidance 2021 (NG195) is risk factor based. It does permit the use of KP-SRC, but only with prospective audit
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Extended CPAP or low-flow nasal cannula for intermittent hypoxaemia in preterm infants: a 24-hour randomised clinical trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-16 Siamak Yazdi, Waldemar A Carlo, Arie Nakhmani, Ernestina O Boateng, Immaculada Aban, Namasivayam Ambalavanan, Colm P Travers
Objective Optimal timing of continuous positive airway pressure (CPAP) cessation in preterm infants remains undetermined. We hypothesised that CPAP extension compared with weaning to low-flow nasal cannula (NC) reduces intermittent hypoxaemia (IH) and respiratory instability in preterm infants meeting criteria to discontinue CPAP. Design Single-centre randomised clinical trial. Setting Level 4 neonatal
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State of skin antiseptic choices in UK neonatal intensive care units in 2023 Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-13 Elisabeth Agathos, Carla Kantyka, Paul Clarke
In early 2023, two weaker-concentration chlorhexidine gluconate (CHG) antiseptic products Tisept (0.015% CHG+0.15% cetrimide) and Unisept (0.05% CHG) were discontinued, leaving a dilemma regarding alternatives for very preterm babies to minimise risk of chemical injury in the first postnatal days. We therefore surveyed current antiseptic choices in the wake of their withdrawal. During October–December
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Dextrose gel prophylaxis for neonatal hypoglycaemia and neurocognitive function at early school age: a randomised dosage trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-12 Xingyu Wei, Nike Franke, Jane M Alsweiler, Gavin T L Brown, Gregory D Gamble, Alicia McNeill, Jenny Rogers, Benjamin Thompson, Jason Turuwhenua, Trecia A Wouldes, Jane E Harding, Christopher J D McKinlay
Objective To investigate the effect of different doses of prophylactic dextrose gel on neurocognitive function and health at 6–7 years. Design Early school-age follow-up of the pre-hPOD (hypoglycaemia Prevention with Oral Dextrose) study. Setting Schools and communities. Patients Children born at ≥35 weeks with ≥1 risk factor for neonatal hypoglycaemia: maternal diabetes, small or large for gestational
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Randomised study of a new inline respiratory function monitor (Juno) to improve mask seal and delivered ventilation with neonatal manikins Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-09 Mark Brian Tracy, Murray Hinder, Stephanie Morakeas, Krista Lowe, Archana Priyadarshi, Matthew Crott, Matthew Boustred, Mihaela Culcer
Background Respiratory function monitors (RFMs) have been used extensively in manikin and infant studies yet have not become the standard of training. We report the outcomes of a new portable, lightweight RFM, the Juno, designed to show mask leak and deflation tidal volume to assist in positive pressure ventilation (PPV) competency training using manikins. Methods Two leak-free manikins (preterm and
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Neurodevelopment at age 5.5 years according to Ages & Stages Questionnaire at 2 years’ corrected age in children born preterm: the EPIPAGE-2 cohort study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-09 Marie-Laure Charkaluk, Gildas Delavoix Kana, Valérie Benhammou, Isabelle Guellec, Mathilde Letouzey, Andrei Scott Morgan, Alexandra Nuytten, Héloïse Torchin, Sabrina Twilhaar, Gilles Cambonie, Stéphane Marret, Pierre Yves Ancel, Véronique Pierrat
Objective To report neurodevelopment at age 5.5 years according to developmental delay screening with the Ages & Stages Questionnaire (ASQ) in late infancy in preterm-born children. Design Population-based cohort study, EPIPAGE-2. Setting France, 2011–2017. Participants 2504 children born at 24–26, 27–31 and 32–34 weeks, free of cerebral palsy, deafness or blindness at 2 years’ corrected age. Main
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Using the providers’ perspective on video review of neonatal procedures to create a roadmap: a qualitative study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-07 Veerle Heesters, Henriëtte A van Zanten, Maria C den Boer, Arjan B te Pas, Ruben SGM Witlox
Objective To examine the providers’ perceptions and experiences on implementation of video review (VR) of procedures in the neonatal intensive care unit (NICU). Design Qualitative study using semi-structured interviews with neonatal care providers about their experiences with VR. Interviews were audio-recorded, transcribed and thematically analysed using the data analysis software Atlas.ti V.22.2.
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Place of birth and postnatal transfers in infants with congenital diaphragmatic hernia in England and Wales: a descriptive observational cohort study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-05 Behrouz Nezafat Maldonado, Julia Lanoue, Benjamin Allin, Dougal Hargreaves, Marian Knight, Chris Gale, Cheryl Battersby
Objective To describe clinical pathways for infants with congenital diaphragmatic hernia (CDH) and short-term outcomes. Design Retrospective observational cohort study using the UK National Neonatal Research Database (NNRD). Patients Babies with a diagnosis of CDH admitted to a neonatal unit in England and Wales between 2012 and 2020. Main outcome measures Clinical pathways defined by place of birth
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Comparison of two different oxygen saturation target ranges for automated oxygen control in preterm infants: a randomised cross-over trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-05 Fleur Brouwer, Hylke H Salverda, Sophie J E Cramer, Chantal Schmeits, Jacoline van der Plas, Arjan B te Pas, Janneke Dekker
Objective To compare the effect of peripheral oxygen saturation (SpO2) target range (TR) (either 91%–95% and 92%–96%) on the frequency and duration of hypoxic and hyperoxic episodes while on automated oxygen control using the OxyGenie controller. Design Randomised cross-over study. Setting Tertiary-level neonatal unit in the Netherlands. Patients Infants (n=27) with a median (IQR) gestational age of
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Newborn face mask ventilation training using a standardised intervention and respiratory function monitor: a before and after manikin study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-02-05 Caitriona M Ni Chathasaigh, Linda Smiles, Anna E Curley, Eoin O'Currain
Objective The International Liaison Committee on Resuscitation has recommended improvements in training for neonatal resuscitation, highlighting the potential role of respiratory function monitors (RFMs). Our objective was to determine whether a manikin-based, standardised face mask ventilation training intervention using an RFM with a simple visual display reduced face mask leak. Design Multicentre
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Tracking national neonatal transport activity and metrics using the UK Neonatal Transport Group dataset 2012–2021: a narrative review Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-25 Andrew Leslie, Catherine Harrison, Allan Jackson, Susan Broster, Eileen Clarke, Sarah L Davidson, Colin Devon, Beverley Forshaw, Alex Philpott, Robert Tinnion, Jo Whiston, Alan C Fenton, Don Sharkey
There are no internationally agreed descriptors for categories of neonatal transports which facilitate comparisons between settings. To continually review and enhance neonatal transport care we need robust categories to develop benchmarks. This review aimed to report on the development and application of key measures across a national neonatal transport service. The UK Neonatal Transport Group (UK-NTG)
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Variations in neonatal mortality of preterm infants with intraparenchymal haemorrhage in Europe: the EPICE cohort Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-25 Charline Loth, Ludovic Treluyer, Véronique Pierrat, Anne EGO, Adrien M Aubert, Thierry Debillon, Jennifer Zeitlin, Heloise Torchin, Marie Chevallier
Objective The aim of this study was to investigate variations in mortality before neonatal intensive care unit (NICU) discharge of infants born preterm with intraparenchymal haemorrhage (IPH) in Europe with a special interest for withdrawing life-sustaining therapy (WLST). Design Secondary analysis of the Effective Perinatal Intensive Care in Europe (EPICE) cohort, 2011–2012. Setting Nineteen regions
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New guidelines for congenital diaphragmatic hernia: what is next? Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-22 Dick Tibboel
Developing treatment guidelines for rare diseases is always a challenge, especially when the quality of care varies due to differences in the experience of treatment teams, the low annual number of patients and the presence or absence of high-level evidence. The heterogeneity of the underlying disease makes it even harder to compare results and identify best practices based on core outcome sets. Congenital
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Hydrocortisone in very preterm neonates for BPD prevention: meta-analysis and effect size modifiers Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-17 Daniele De Luca, Sara Ferraioli, Kristi L Watterberg, Olivier Baud, Maria Rosaria Gualano
Objectives To clarify if systemic hydrocortisone, in protocols allowing to start it before the 15th day of life, prevents bronchopulmonary dysplasia (BPD) or other adverse outcomes in very preterm neonates, and to identify any possible effect size modifiers. Study design Systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Additional
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Does ECG monitoring affect resuscitation for neonates with pulseless electrical activity in the delivery room? A simulated, pilot, crossover randomised trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-17 Michael-Andrew Assaad, Laurence Gariepy-Assal, Ahmed Moussa
Objective To evaluate whether ECG monitoring impacts resuscitative steps during simulated neonatal resuscitation in the setting of pulseless electrical activity (PEA) in the delivery room. Design This pilot, crossover randomised controlled trial recruited providers in teams of three who participated in two simulation scenarios (PEA with and without ECG monitoring). Teams were randomised to one scenario
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Influence of clinical experience on newborn manikin mask ventilation performance using a respiratory function monitor Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-16 Allan C Jenkinson, Yohei Minamitani, Theodore Dassios, Anne Greenough
Newborn resuscitation relies on effective face mask ventilation, but performance can vary even after training.1 During the initial 2 min of positive pressure ventilation (PPV), airway obstruction and mask leak are common challenges faced by neonatal healthcare providers.2 A respiratory function monitor (RFM) is a potential tool to enhance the effectiveness of PPV inflations.3 RFMs assess and display
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Non-invasive high-frequency oscillatory ventilation (NHFOV) versus nasal continuous positive airway pressure (NCPAP) for preterm infants: a systematic review and meta-analysis Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-16 Kaixu Wang, Guang Yue, Shuqiang Gao, Fang Li, Rong Ju
Objective To compare the efficacy and safety of non-invasive high-frequency oscillatory ventilation (NHFOV) and nasal continuous positive airway pressure (NCPAP) in preterm infants. Design The study conducted a comprehensive analysis across three databases, namely EMBASE, MEDLINE and Cochrane Central, to identify randomised controlled trials comparing NHFOV and NCPAP. Statistical analysis was performed
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Doxapram for apnoea of prematurity and neurodevelopmental outcomes at age 5–6 years Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-16 Ludovic Tréluyer, Elodie Zana-Taieb, Pierre-Henri Jarreau, Valérie Benhammou, Pierre Kuhn, Mathilde Letouzey, Laetitia Marchand-Martin, Wes Onland, Véronique Pierrat, Lauren Saade, Pierre Yves Ancel, Héloïse Torchin
Objective To assess the long-term neurodevelopmental impact of doxapram for treating apnoea of prematurity. Design Secondary analysis of the French national cohort study EPIPAGE-2. Recruitment took place in 2011. A standardised neurodevelopmental assessment was performed at age 5–6 years. A 2:1 propensity score matching was used to control for the non-randomised assignment of doxapram treatment. Setting
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Polyethylene bags before cord clamping in very preterm infants: a randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-11 Emma A Dunne, Caitriona M Ni Chathasaigh, Lucy E Geraghty, Colm PF O'Donnell, Lisa K McCarthy
Objective Hypothermia on admission to the neonatal intensive care unit (NICU) is associated with an increased risk of death in preterm infants. There are currently no evidence-based recommendations for thermal care before cord clamping (CC). We wished to determine whether placing very preterm infants in a polyethylene bag (PB) before CC, compared with after CC, results in more infants with a temperature
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Early parenteral nutrition is associated with improved growth in very low birth weight infants: a retrospective study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-11 René Liang Shen, Christian Ritz, Yanqi Li, Per Torp Sangild, Ping-Ping Jiang
Objective To assess the association between early initiation of parenteral nutrition (PN) and body growth in preterm infants with very low birth weight (VLBW). Design Causal inference analysis with confounders preselected by causal diagram based on the NeoNutriNet cohort containing data of infants born between 2011 and 2014 from 13 hospitals from 5 continents. Patients Neonates with birth weight ≤1500 g
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Sustained inflation and chest compression versus 3:1 chest compression to ventilation ratio during cardiopulmonary resuscitation of asphyxiated newborns (SURV1VE): A cluster randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-11 Georg M Schmölzer, Gerhard Pichler, Anne Lee Solevåg, Brenda Hiu Yan Law, Souvik Mitra, Michael Wagner, Daniel Pfurtscheller, Maryna Yaskina, Po-Yin Cheung
Objective In newborn infants requiring chest compression (CC) in the delivery room (DR) does continuous CC superimposed by a sustained inflation (CC+SI) compared with a 3:1 compression:ventilation (3:1 C:V) ratio decreases time to return of spontaneous circulation (ROSC). Design International, multicenter, prospective, cluster cross-over randomised trial. Setting DR in four hospitals in Canada and
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Prevalence and early surgical outcome of congenital diaphragmatic hernia in the Netherlands: a population-based cohort study from the European Pediatric Surgical Audit Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-09 Nadine Maria Teunissen, Horst Daniels, J Marco Schnater, Ivo de Blaauw, René M H Wijnen
Background Congenital diaphragmatic hernia (CDH) is a rare birth defect with substantial mortality. This study aims to generate a population-based overview of CDH care and outcomes in the Netherlands. Moreover, it assesses interhospital variations between the two Dutch CDH expert centres. Methods This study uses data from the Dutch branch of the European Pediatric Surgical Audit, a prospective clinical
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Early and exclusive enteral nutrition in infants born very preterm Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-22 Jacqueline Razzaghy, Vivek V Shukla, Emily Gunawan, Audrey Reeves, Kelly Nguyen, Ariel A Salas
Objective To characterise the effects of early and exclusive enteral nutrition with either maternal or donor milk in infants born very preterm (280/7–326/7 weeks of gestation). Design Parallel-group, unmasked randomised controlled trial. Setting Regional, tertiary neonatal intensive care unit. Participants 102 infants born very preterm between 2021 and 2022 (51 in each group). Intervention Infants
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Parent-reported health outcomes at preschool age in preterm survivors: a population-based cohort study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-22 Sydney MacDonald, Alexandra Stratas, Anne R Synnes, Navjot Sandila, Marsha Campbell-Yeo, Prakesh S Shah, Satvinder Ghotra
Objective Literature on health status (HS) and health-related quality of life of preterm survivors at preschool age is sparse. Further, little is known about the relationship between parent-reported HS outcomes and standardised neurodevelopmental outcomes measured in preterm survivors at preschool age. Our objective was to evaluate parent-reported child HS outcomes and their relationship to neurodevelopmental
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Randomised crossover study on pulse oximeter readings from different sensors in very preterm infants Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-21 Christian Achim Maiwald, Christoph E Schwarz, Katrin Böckmann, Laila Springer, Christian F Poets, Axel Franz
Objective In extremely preterm infants, different target ranges for pulse oximeter saturation (SpO2) may affect mortality and morbidity. Thus, the impact of technical changes potentially affecting measurements should be assessed. We studied SpO2 readings from different sensors for systematic deviations. Design Single-centre, randomised, triple crossover study. Setting Tertiary neonatal intensive care
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Probiotics for preterm infants and the recent FDA alert in the USA Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-16 Nicholas D Embleton, Janet Berrington, Paul Clarke, Aniko Deierl, Karen Luyt, Marie Spruce, Sam J Oddie
The US Food and Drug Administration (FDA) recently issued a warning regarding probiotic use in preterm infants1 leading to the withdrawal of at least two products in the USA. Product withdrawal may extend to Europe, if companies become unwilling to risk legal challenges for products that may not generate significant profits. The FDA alert highlighted the risk of ‘invasive, potentially fatal’ sepsis
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Survey of use of probiotics in neonatal units in the UK Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-16 Ashok Karupaiah, Abdulhakim Abdurrazaq, Josephine Quaynor, Ammar Abdelhady
We introduced probiotics in Walsall Manor Hospital, a local neonatal unit (LNU) in West Midlands, in February 2022. During the pre-implementation phase, we struggled to find out the extent of use of probiotics in the region. Some units were already using it, some in the process of implementation, some wanted to wait for more evidence. There was no consensus or uniformity on the probiotic strains for
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Continuous non-invasive measurement of cardiac output in neonatal intensive care using regional impedance cardiography: a prospective observational study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-14 Jayanta Banerjee, Nidal Khatib, Roshni C Mansfield, Sundar Sathiyamurthy, Ujwal Kariholu, Christoph Lees
Objectives To compare agreement between echocardiography and regional impedance cardiography (RIC)-derived cardiac output (CO), and to construct indicative normative ranges of CO for gestational age groups. Design, setting and participants Prospective cohort observational study performed in a tertiary centre in London, UK, including neonates born between 25 and 42 weeks’ gestational age. Exposures
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Assessing the influence of abdominal compression on time to return of circulation during resuscitation of asphyxiated newborn lambs: a randomised preclinical study Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2023-12-14 Graeme R Polglase, Colin Hwang, Douglas A Blank, Shiraz Badurdeen, Kelly J Crossley, Martin Kluckow, Andrew W Gill, Emily Camm, Robert Galinsky, Yoveena Brian, Stuart B Hooper, Calum T Roberts
Objective During neonatal resuscitation, the return of spontaneous circulation (ROSC) can be achieved using epinephrine which optimises coronary perfusion by increasing diastolic pressure. Abdominal compression (AC) applied during resuscitation could potentially increase diastolic pressure and therefore help achieve ROSC. We assessed the use of AC during resuscitation of asystolic newborn lambs, with
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Fantoms Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-01 Ben J Stenson
Aijaz Farooqi et al report survival and morbidity outcomes of infants born at 22-23 weeks of gestation in Sweden in three time windows, from 2004 to 2019. They relate these outcomes to the perinatal activity that was provided. A perinatal activity score was based on indicators of obstetric care (delivery at level III/IV hospital, any antenatal steroids, caesarean delivery) and neonatal care (intubation
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Perils of meta-analysis Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-01 William E Benitz
In a recent issue of the Archives , Batra et al presented a systematic review and meta-analysis comparing two strategies for weaning neonates from positive pressure mechanical ventilation: synchronised intermittent mandatory ventilation (SIMV) and pressure support ventilation (PSV).1 With the former, some breaths are assisted and others are not, but with the latter, all breaths are synchronised with
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Missed or delayed diagnosis of anorectal malformations: a review of the literature, current training and practice in the UK in relation to detection via the NIPE programme Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-01 Govind V S Murthi, Thomas McEwan, Gregor M Walker, Porus Bustani
Anorectal malformations (ARMs) are a spectrum of congenital anomalies where there is abnormal development of the anus and rectum. With an incidence of 1:5000 live births and affecting both males and females, these anomalies vary in their appearance and presentation, lack features enabling antenatal detection and should be detected at birth by the examining midwife or within 72 hours through the newborn
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One-year survival and outcomes of infants born at 22 and 23 weeks of gestation in Sweden 2004–2007, 2014–2016 and 2017–2019 Arch. Dis. Child. Fetal Neonatal Ed. (IF 6.643) Pub Date : 2024-01-01 Aijaz Farooqi, Stellan Hakansson, Fredrik Serenius, Karin Kallen, Lars Björklund, Erik Normann, Magnus Domellöf, Ulrika Ådén, Thomas Abrahamsson, Anders Elfvin, Karin Sävman, Petra Um Bergström, Olof Stephansson, David Ley, Lena Hellstrom-Westas, Mikael Norman
Objective To explore associations between perinatal activity and survival in infants born at 22 and 23 weeks of gestation in Sweden. Design/Setting Data on all births at 22 and 23 weeks’ gestational age (GA) were prospectively collected in 2004–2007 (T1) or obtained from national registers in 2014–2016 (T2) and 2017–2019 (T3). Infants were assigned perinatal activity scores based on 3 key obstetric