1
|
Haneda K, Hosoya M, Fujimori K, Yasumura S, Nishigori H, Kuse M, Kyozuka H, Maeda H, Sato A, Ogata Y, Hashimoto K. Gestational Age and Neurodevelopmental Delay in Term Births at 6 and 12 Months: The Japan Environment and Children's Study (JECS). Matern Child Health J 2024; 28:1031-1041. [PMID: 38466370 PMCID: PMC11058617 DOI: 10.1007/s10995-024-03908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND In the recent years, a high risk of developmental delay not only in very low birth weight infants and late preterm infants but also in early term infants (37-38 weeks) have increasingly been reported. However, in Japan, there are virtually no studies regarding the development delays in early term infants. METHODS This study used the data from the Japan Environment and Children's Study (JECS), a birth cohort study conducted in Japan. Data were selected for analysis from the records of 104,065 fetal records. The risk of neurodevelopmental delays at 6 months and 12 months after birth was evaluated using multivariate analysis for infants of various gestational ages, using the 40th week of pregnancy as a reference value. Neurodevelopment was evaluated at 6 months and 12 months after birth using the Ages and Stages Questionnaires, Japanese translation (J-ASQ-3). RESULTS The proportion of infants born at a gestational age of 37 to 38 weeks who did not reach the J-ASQ-3 score cutoff value was significantly higher in all areas at both 6 months and 12 months after birth, when compared to that of infants born at 40 weeks. The odds ratio decreased at 12 months after birth compared to that at 6 months after birth. CONCLUSION Early term infants in Japan are at an increased risk of neurodevelopmental delay at 12 months after birth.
Collapse
Affiliation(s)
- Kentaro Haneda
- Department of Pediatrics, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.
| | - Mitsuaki Hosoya
- Department of Pediatrics, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hidekazu Nishigori
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | - Masahito Kuse
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hajime Maeda
- Department of Pediatrics, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Koich Hashimoto
- Department of Pediatrics, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| |
Collapse
|
2
|
Abreu RAD, Almeida LLD, Brito MMD, Rosa Filho RRD, Veronesi MC, Vannucchi CI. Maternal and neonatal cortisol and catecholamines throughout vaginal eutocia and C-section in dogs. Domest Anim Endocrinol 2024; 87:106838. [PMID: 38401307 DOI: 10.1016/j.domaniend.2024.106838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
Increased fetal cortisol is associated with catecholamine release, a primary factor for neonatal adaptive responses. However, relationship between canine peripartum cortisol and catecholamine is unknown. We aimed to compare serum adrenaline, noradrenaline and cortisol during peripartum in bitches and neonates of distinct obstetric conditions and to assess amniotic fluid cortisol concentration. Twenty females and maximum of three puppies per litter were allocated into Vaginal Eutocia (10 females; 17 neonates) and Elective C-section (10 females; 20 neonates) groups. Amniotic fluid was collected at delivery for cortisol concentration. Maternal and neonatal blood were collected prepartum, intrapartum, postpartum and 1h postpartum, and at birth, 30 and 60min, 12hs and 24hs, respectively, for cortisol, adrenaline and noradrenaline assessment. C-section determined higher noradrenaline throughout delivery and cortisol concentration from intrapartum through 1h postpartum, compared to vaginal birth. C-section maternal cortisol showed progressive increase from intrapartum onwards, while neonatal cortisol remained unchanged. No difference of maternal cortisol concentration occurred along whelping, whereas a significant decrease was verified for vaginal delivery puppies from birth until the 12hs. Puppies delivered vaginally had higher cortisol concentration at birth and 30min, compared to c-section puppies. There was a higher concentration of amniotic fluid cortisol in vaginal eutocia. In conclusion, c-section induces higher maternal stress during and after surgery, whilst vaginal delivery is a more neonatal physiologically stressful condition, contributing to better adaptation during transition.
Collapse
Affiliation(s)
- Renata Azevedo de Abreu
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Letícia Lima de Almeida
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Maíra Morales de Brito
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Roberto Rodrigues da Rosa Filho
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Maria Cristina Veronesi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Italy
| | - Camila Infantosi Vannucchi
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
3
|
Yaremenko AV, Pechnikova NA, Porpodis K, Damdoumis S, Aggeli A, Theodora P, Domvri K. Association of Fetal Lung Development Disorders with Adult Diseases: A Comprehensive Review. J Pers Med 2024; 14:368. [PMID: 38672994 PMCID: PMC11051200 DOI: 10.3390/jpm14040368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Fetal lung development is a crucial and complex process that lays the groundwork for postnatal respiratory health. However, disruptions in this delicate developmental journey can lead to fetal lung development disorders, impacting neonatal outcomes and potentially influencing health outcomes well into adulthood. Recent research has shed light on the intriguing association between fetal lung development disorders and the development of adult diseases. Understanding these links can provide valuable insights into the developmental origins of health and disease, paving the way for targeted preventive measures and clinical interventions. This review article aims to comprehensively explore the association of fetal lung development disorders with adult diseases. We delve into the stages of fetal lung development, examining key factors influencing fetal lung maturation. Subsequently, we investigate specific fetal lung development disorders, such as respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), congenital diaphragmatic hernia (CDH), and other abnormalities. Furthermore, we explore the potential mechanisms underlying these associations, considering the role of epigenetic modifications, transgenerational effects, and intrauterine environmental factors. Additionally, we examine the epidemiological evidence and clinical findings linking fetal lung development disorders to adult respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), and other respiratory ailments. This review provides valuable insights for healthcare professionals and researchers, guiding future investigations and shaping strategies for preventive interventions and long-term care.
Collapse
Affiliation(s)
- Alexey V. Yaremenko
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
| | - Nadezhda A. Pechnikova
- Laboratory of Chemical Engineering A’, School of Chemical Engineering, Faculty of Engineering, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (N.A.P.); (A.A.)
- Saint Petersburg Pasteur Institute, Saint Petersburg 197101, Russia
| | - Konstantinos Porpodis
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
| | - Savvas Damdoumis
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
| | - Amalia Aggeli
- Laboratory of Chemical Engineering A’, School of Chemical Engineering, Faculty of Engineering, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (N.A.P.); (A.A.)
| | - Papamitsou Theodora
- Laboratory of Histology-Embryology, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Kalliopi Domvri
- Oncology Unit, Pulmonary Department, George Papanikolaou Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (K.P.); (S.D.)
- Laboratory of Histology-Embryology, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
- Pathology Department, George Papanikolaou Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| |
Collapse
|
4
|
Momany AM, Jasper E, Markon KE, Nikolas MA, Ryckman KK. Latent class analysis to characterize neonatal risk for neurodevelopmental differences. J Child Psychol Psychiatry 2023; 64:100-109. [PMID: 35837724 PMCID: PMC9771897 DOI: 10.1111/jcpp.13671] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neonatal risk factors, such as preterm birth and low birth weight, have been robustly linked to neurodevelopmental deficits, yet it is still unclear why some infants born preterm and/or low birth weight experience neurodevelopmental difficulties while others do not. The current study investigated this heterogeneity in neurodevelopmental abilities by examining additional neonatal morbidities as risk factors, utilizing latent class analysis to classify neonates into groups based on similar neonatal risk factors, and including neonates from the full spectrum of gestational age. METHODS Neonates who received neonatal care at an academic public hospital during an almost 10-year period (n = 19,951) were included in the latent class analysis, and 21 neonatal indicators of health were used. Neonatal class, sex, and the interaction between neonatal class and sex were used to examine differences in neurodevelopment at 18 months of age in a typically developing population. RESULTS The best fitting model included five infant classes: healthy, hypoxic, critically ill, minorly ill, and complicated delivery. Scores on the parent-rated neurodevelopmental measure differed by class such that infants in the critically ill, minorly ill, and complicated delivery classes had lower scores. There was no main effect of sex on the neurodevelopmental measure scores, but the interaction between sex and neonatal class was significant for three out of five neurodevelopmental domains. CONCLUSIONS The current study extends the understanding of risk factors in neurodevelopment by including several neonatal medical conditions that are often overlooked and by using a person-centered, as opposed to variable-centered, approach. Future work should continue to examine risk factors, such as maternal health during pregnancy and medical interventions for newborns, in relation to neonatal risks and neurodevelopment by using a person-centered approach.
Collapse
Affiliation(s)
- Allison M. Momany
- Stead Family Department of Pediatrics, Carver College of MedicineUniversity of IowaIowa CityIAUSA
| | - Elizabeth Jasper
- Department of Obstetrics and GynecologyVanderbilt University Medical CenterNashvilleTNUSA
- Department of Biomedical Informatics and Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTNUSA
| | - Kristian E. Markon
- Department of Psychological and Brain SciencesUniversity of IowaIowa CityIAUSA
| | - Molly A. Nikolas
- Department of Psychological and Brain SciencesUniversity of IowaIowa CityIAUSA
| | | |
Collapse
|
5
|
Mally P, Katz J, Verma S, Purrier S, Wachtel EV, Trillo R, Bhutada K, Bailey SM. Impact on neonatal morbidities after a change in policy to administer antenatal corticosteroids to mothers at risk for late preterm delivery. J Perinat Med 2022; 51:573-579. [PMID: 36318716 DOI: 10.1515/jpm-2022-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Antenatal corticosteroids (ACS) administered to mothers at risk for preterm delivery before 34 weeks has been standard care to improve neonatal outcomes. After introducing a new obstetric policy based on updated recommendations advising the administration of ACS to pregnant women at risk for late preterm (LPT) delivery (34-36 6/7 weeks), we set out to determine the short-term clinical impact on those LPT neonates. METHODS Retrospective chart review of LPT neonates delivered at NYU Langone Medical Center both one year before and after the policy went into place. We excluded subjects born to mothers with pre-gestational diabetes, multiple gestations, and those with congenital/genetic abnormalities. We also excluded subjects whose mothers already received ACS previously in pregnancy. Subjects were divided into pre-policy and post-policy groups. Neonatal and maternal data were compared for both groups. RESULTS 388 subjects; 180 in the pre-policy and 208 in the post-policy group. This policy change resulted in a significant increase in ACS administration to mothers who delivered LPT neonates (67.3 vs. 20.6%, p<0.001). In turn, there was a significant reduction in LPT neonatal intensive care unit (NICU) admissions (44.2 vs. 54.4%, p=0.04) and need for respiratory support (27.9 vs. 42.8%, p<0.01). However, we also found an increased incidence of hypoglycemia (49.5 vs. 28.3%, p<0.001). CONCLUSIONS This LPT ACS policy appears effective in reducing the need for LPT NICU level care overall. However, clinicians must be attentive to monitor for adverse effects like hypoglycemia, and there remains a need for better understanding of potential long-term impacts.
Collapse
Affiliation(s)
- Pradeep Mally
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Julia Katz
- Zucker School of Medicine at Hofstra/Northwell, Uniondale, NY, USA
| | - Sourabh Verma
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Sheryl Purrier
- Division of Neonatal Perinatal Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Elena V Wachtel
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | - Sean M Bailey
- Division of Neonatology, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
6
|
Perri A, Fattore S, D’Andrea V, Sbordone A, Patti ML, Nobile S, Tirone C, Giordano L, Tana M, Priolo F, Serrao F, Riccardi R, Prontera G, Vento G. Lowering of the Neonatal Lung Ultrasonography Score after nCPAP Positioning in Neonates over 32 Weeks of Gestational Age with Neonatal Respiratory Distress. Diagnostics (Basel) 2022; 12:diagnostics12081909. [PMID: 36010259 PMCID: PMC9406690 DOI: 10.3390/diagnostics12081909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
Respiratory distress (RD) is one of the most common causes of admission to the neonatal intensive care unit. Correct diagnosis and timely intervention are crucial. Lung ultrasonography (LU) is a useful diagnostic tool for the neonatologist in the diagnosis of RD; the neonatal lung ultrasonography score (nLUS) can be used in the diagnostic process, but some authors hypothesise that it is also useful for the management of some neonatal RD. The aim of this study is to analyse the changes in nLUS score before (T0) and after (T1) the start of respiratory support with nasal CPAP in neonates over 32 weeks of age with RD. Thirty-three newborns were enrolled in this retrospective study. LU was performed before and after the start of CPAP. The median nLUS scores at T0 and T1 were 9 (IQR 7−12) and 7 (IQR 4−10), respectively, and showed a significant difference (p < 0.001). The magnitude of reduction in nLUS score, expressed as a percentage, was inversely related to the need for subsequent administration of exogenous surfactant. The study suggests the usefulness of the nLUS score in assessing the response to CPAP in neonates over 32 weeks gestational age.
Collapse
Affiliation(s)
- Alessandro Perri
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Simona Fattore
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Vito D’Andrea
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-0630154357; Fax: +39-063383211
| | - Annamaria Sbordone
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Maria Letizia Patti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Stefano Nobile
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Chiara Tirone
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Lucia Giordano
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Milena Tana
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Francesca Priolo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Francesca Serrao
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Riccardo Riccardi
- Neonatal Intensive Care Unit, “San Giovanni Calibita Fatebenefratelli” Hospital, Isola Tiberina, 00186 Rome, Italy
| | - Giorgia Prontera
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| |
Collapse
|
7
|
Shim GH. Factors Associated with Nasal Intermittent Positive Pressure Ventilation Failure in Late Preterm and Term Infants with Respiratory Distress after Birth. NEONATAL MEDICINE 2022. [DOI: 10.5385/nm.2022.29.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Purpose: We examined the factors associated with nasal intermittent positive pressure ventilation (NIPPV) failure in late preterm and term infants with respiratory distress after birth.Methods: A retrospective cohort study was conducted on late preterm and term infants with respiratory distress after birth from January 2015 to December 2020. The medical records of 132 infants, who received NIPPV as primary respiratory therapy before 6 hours of age, were retrospectively examined. We excluded five neonates who were either transferred to another hospital (n=2) or presented with congenital anomalies (n=3).Results:The remaining 127 neonates were divided into the NIPPV success group (n=82) and NIPPV failure group (n=45). NIPPV failure was associated with birth in a community hospital, the need for a surfactant, and a high maximum respiratory severity score (RSS ≥2.5) on the first day of life. In the subgroup analysis, NIPPV failure in late preterm infants was associated with a lower gestational age, birth in a community hospital, and an RSS ≥2.5 on the first day of life. In addition, NIPPV failure in term infants was associated with birth in a community hospital, the need for a surfactant, and an RSS ≥2.5 on the first day of life.Conclusion: Birth in a community hospital, the need for a surfactant, and an RSS ≥2.5 on the first day of life were significant factors associated with NIPPV failure in late preterm and term infants.
Collapse
|
8
|
Srinivasan SMD, Neeti AMD, Sushma MMD, Anupam JMD. Role of Lung Ultrasound in Diagnosing and Differentiating Transient Tachypnea of Newborn and Respiratory Distress Syndrome in Preterm Neonates. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2022. [DOI: 10.37015/audt.2022.210034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
9
|
Harmony T, Gutiérrez-Hernández CC, Carlier M, Hinojosa-Rodríguez M, Carrillo C. Early detection and treatment of attention deficits in preterm and at term infants with risk factors for brain damage. Int J Psychophysiol 2021; 172:17-23. [PMID: 34921894 DOI: 10.1016/j.ijpsycho.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/25/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
Cognitive deficits in infants born preterm and infants at term with risk factors for brain damage are a common outcome. Attention deficits in preterm infants are related to the development of attention-deficit/hyperactivity disorder (ADHD), and therefore, there is a need for earlier evaluations and treatment procedures that are implemented before the presence of signs of ADHD. METHODS We studied preterm (74%) and term infants with the Infant Scale of Selective Attention (ISSA, Escala de Evaluación de la Atención Selectiva (EEAS), in Spanish). This scale evaluates both visual- and auditory-orienting attention. Two groups participated, one with attention deficits (n = 26) and another with regular performance (n = 36). An early attention-stimulation program (EASP) was implemented in the infant group with attention deficits from three to eight months of age. All infants underwent magnetic resonance imaging (MRI), and visual and auditory evoked responses were assessed. RESULTS All infants had prenatal and perinatal risk factors for brain damage and abnormal MRI findings, and the majority had abnormalities compatible with white matter injury. However, there were four infants with porencephalic cysts; 3 of them were in the treated group. At the beginning of the treatment, ISSA values showed differences between groups. These differences persisted for five months in the visual test and up to the sixth month in the auditory evaluation. Afterward, there were no significant differences, indicating that infants with attention deficits had satisfactorily responded to the treatment. CONCLUSIONS The ISSA is helpful for the early evaluation of visual and auditory attention. Infants with attention deficits react well enough after six months of EASP.
Collapse
Affiliation(s)
- Thalía Harmony
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva del Instituto de Neurobiología de la Universidad Nacional Autónoma de México Campus Juriquilla, Mexico.
| | - Claudia Calipso Gutiérrez-Hernández
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva del Instituto de Neurobiología de la Universidad Nacional Autónoma de México Campus Juriquilla, Mexico
| | - Mónica Carlier
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva del Instituto de Neurobiología de la Universidad Nacional Autónoma de México Campus Juriquilla, Mexico
| | - Manuel Hinojosa-Rodríguez
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva del Instituto de Neurobiología de la Universidad Nacional Autónoma de México Campus Juriquilla, Mexico
| | - Cristina Carrillo
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva del Instituto de Neurobiología de la Universidad Nacional Autónoma de México Campus Juriquilla, Mexico
| |
Collapse
|
10
|
Smyrni N, Koutsaki M, Petra M, Nikaina E, Gontika M, Strataki H, Davora F, Bouza H, Damianos G, Skouteli H, Mastroyianni S, Dalivigka Z, Dinopoulos A, Tzaki M, Papavasiliou A. Moderately and Late Preterm Infants: Short- and Long-Term Outcomes From a Registry-Based Cohort. Front Neurol 2021; 12:628066. [PMID: 33643206 PMCID: PMC7907517 DOI: 10.3389/fneur.2021.628066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background: While most studies on the association of preterm birth and cerebral palsy (CP) have focused on very preterm infants, lately, attention has been paid to moderately preterm [32 to <34 weeks gestational age (GA)] and late preterm infants (34 to <37 weeks GA). Methods: In order to report on the outcomes of a cohort of moderately and late preterm infants, derived from a population-based CP Registry, a comparative analysis of data on 95 moderately preterm infants and 96 late preterm infants out of 1,016 with CP, was performed. Results: Moderately preterm neonates with CP were more likely to have a history of N-ICU admission (p = 0.001) and require respiratory support (p < 0.001) than late preterm neonates. Birth weight was significantly related to early neonatal outcome with children with lower birth weight being more likely to have a history of N-ICU admission [moderately preterm infants (p = 0.006)/late preterm infants (p < 0.001)], to require ventilator support [moderately preterm infants (p = 0.025)/late preterm infants (p = 0.014)] and not to have neonatal seizures [moderately preterm infants (p = 0.044)/late preterm infants (p = 0.263)]. In both subgroups, the majority of children had bilateral spastic CP with moderately preterm infants being more likely to have bilateral spastic CP and less likely to have ataxic CP as compared to late preterm infants (p = 0.006). The prevailing imaging findings were white matter lesions in both subgroups, with statistically significant difference between moderately preterm infants who required ventilator support and mainly presented with this type of lesion vs. those who did not and presented with gray matter lesions, maldevelopments or miscellaneous findings. Gross motor function was also assessed in both subgroups without significant difference. Among late preterm infants, those who needed N-ICU admission and ventilator support as neonates achieved worse fine motor outcomes than those who did not. Conclusions: Low birth weight is associated with early neonatal problems in both moderately and late preterm infants with CP. The majority of children had bilateral spastic CP and white matter lesions in neuroimaging. GMFCS levels were comparable in both subgroups while BFMF was worse in late preterm infants with a history of N-ICU admission and ventilator support.
Collapse
Affiliation(s)
- Nikoletta Smyrni
- Second Department of Neurology, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Maria Koutsaki
- Third Pediatric Department, University General Hospital Attikon, Athens, Greece
| | - Marianna Petra
- Department of Orthopedics, Penteli Children's Hospital, Athens, Greece
| | - Eirini Nikaina
- Department of Pediatrics, Agia Sophia Children's Hospital, Athens, Greece
| | - Maria Gontika
- Department of Neurology, Evaggelismos General Hospital, Athens, Greece
| | - Helen Strataki
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Fotini Davora
- Department of Neurology, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Helen Bouza
- Department of Neonatal Intensive Care Unit, Agia Sophia Children's Hospital, Athens, Greece
| | - George Damianos
- Department of Neurology, Penteli Children's Hospital, Athens, Greece
| | - Helen Skouteli
- Department of Pediatric Neurology, IASO General Hospital, Athens, Greece
| | | | - Zoi Dalivigka
- Rehabilitation Center, Children's Hospital Aglaia Kyriakou, Athens, Greece
| | - Argyris Dinopoulos
- Third Pediatric Department, University General Hospital Attikon, Athens, Greece
| | - Margarita Tzaki
- Neonatal Intensive Care Unit, Elena Venizelou General Hospital, Athens, Greece
| | | |
Collapse
|
11
|
Moresco L, Romantsik O, Calevo MG, Bruschettini M. Non-invasive respiratory support for the management of transient tachypnea of the newborn. Cochrane Database Syst Rev 2020; 4:CD013231. [PMID: 32302428 PMCID: PMC7164572 DOI: 10.1002/14651858.cd013231.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Transient tachypnea of the newborn (TTN) is characterized by tachypnea and signs of respiratory distress. Transient tachypnea typically appears within the first two hours of life in term and late preterm newborns. Supportive management might be sufficient. Non-invasive (i.e. without endotracheal intubation) respiratory support may, however, be administered to reduce respiratory distress during TTN. In addition, non-invasive respiratory support might improve clearance of lung liquid thus reducing the effort required to breathe, improving respiratory distress and potentially reducing the duration of tachypnea. OBJECTIVES To assess benefits and harms of non-invasive respiratory support for the management of transient tachypnea of the newborn. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), MEDLINE (1996 to 19 February 2019), Embase (1980 to 19 February 2019) and CINAHL (1982 to 19 February 2019). We applied no language restrictions. We searched clinical trial registries for ongoing studies. SELECTION CRITERIA Randomized controlled trials, quasi-randomized controlled trials and cluster trials on non-invasive respiratory support provided to infants born at 34 weeks' gestational age or more and less than three days of age with transient tachypnea of the newborn. DATA COLLECTION AND ANALYSIS For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure [CPAP] and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were need for mechanical ventilation and pneumothorax. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS We included three trials (150 infants) comparing either CPAP to free-flow oxygen, nasal intermittent mandatory ventilation to nasal CPAP, or nasal high-frequency percussive ventilation versus nasal CPAP. Due to these different comparisons and to high clinical heterogeneity in the baseline clinical characteristics, we did not pool the three studies. The use of CPAP versus free oxygen did not improve the primary outcomes of this review: need for mechanical ventilation (risk ratio [RR] 0.30, 95% confidence interval [CI] 0.01 to 6.99; 1 study, 64 participants); and pneumothorax (not estimable, no cases occurred). Among secondary outcomes, CPAP reduced the duration of tachypnea as compared to free oxygen (mean difference [MD] -21.10 hours, 95% CI -22.92 to -19.28; 1 study, 64 participants). Nasal intermittent ventilation did not reduce the need for mechanical ventilation as compared with CPAP (RR 4.00, 95% CI 0.49 to 32.72; 1 study, 40 participants) or the incidence of pneumothorax (RR 1.00, 95% CI 0.07 to 14.90; 1 study, 40 participants); duration of tachypnea did not differ (MD 4.30, 95% CI -19.14 to 27.74; 1 study, 40 participants). In the study comparing nasal high-frequency ventilation to CPAP, no cases of mechanical ventilation of pneumothorax occurred (not estimable; 1 study, 46 participants); duration of tachypnea was reduced in the nasal high-frequency ventilation group (MD -4.53, 95% CI -5.64 to -3.42; 1 study, 46 participants). The quality of the evidence was very low due to the imprecision of the estimates and unclear risk of bias for detection bias and high risk of bias for reporting bias. Tests for heterogeneity were not applicable for any of the analyses as no studies were pooled. Two trials are ongoing. AUTHORS' CONCLUSIONS There is insufficient evidence to establish the benefit and harms of non-invasive respiratory support in the management of transient tachypnea of the newborn. Though two of the included trials showed a shorter duration of tachypnea, clinically relevant outcomes did not differ amongst the groups. Given the limited and low quality of the evidence available, it was impossible to determine whether non-invasive respiratory support was safe or effective for the treatment of transient tachypnea of the newborn.
Collapse
Affiliation(s)
- Luca Moresco
- Ospedale San PaoloPediatric and Neonatology UnitSavonaItaly
| | - Olga Romantsik
- Lund University, Skåne University HospitalDepartment of Clinical Sciences Lund, PaediatricsLundSweden
| | - Maria Grazia Calevo
- Istituto Giannina GasliniEpidemiology, Biostatistics Unit, IRCCSGenoaItaly16147
| | - Matteo Bruschettini
- Lund University, Skåne University HospitalDepartment of Clinical Sciences Lund, PaediatricsLundSweden
- Skåne University HospitalCochrane SwedenWigerthuset, Remissgatan 4, First FloorRoom 11‐221LundSweden22185
| | | |
Collapse
|
12
|
Bruschettini M, Moresco L, Calevo MG, Romantsik O. Postnatal corticosteroids for transient tachypnoea of the newborn. Cochrane Database Syst Rev 2020; 3:CD013222. [PMID: 32180216 PMCID: PMC7076329 DOI: 10.1002/14651858.cd013222.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Transient tachypnoea of the newborn (TTN) is characterized by tachypnoea and signs of respiratory distress. Transient tachypnoea typically appears within the first two hours of life in term and late preterm newborns. The administration of corticosteroids might compensate for the impaired hormonal changes which occur when infants are delivered late preterm, or at term but before the onset of spontaneous labour (elective caesarean section). Corticosteroids might improve the clearance of liquid from the lungs, thus reducing the effort required to breathe and improving respiratory distress. OBJECTIVES The objective of this review is to assess whether postnatal corticosteroids - compared to placebo, no treatment or any other drugs administered to treat TTN - are effective and safe in the treatment of TTN in infants born at 34 weeks' gestational age or more. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), MEDLINE (1996 to 19 February 2019), Embase (1980 to 19 February 2019) and CINAHL (1982 to 19 February 2019). We applied no language restrictions. We searched clinical trial registries for ongoing studies. SELECTION CRITERIA We included randomized controlled trials, quasi-randomized controlled trials and cluster-randomized trials comparing postnatal corticosteroids versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with TTN. DATA COLLECTION AND ANALYSIS For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure, need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization and blinding, completeness of follow-up). The primary outcomes considered in this review were need for nasal continuous positive airway pressure and need for mechanical ventilation. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS One trial, which included 49 infants, met the inclusion criteria. The trial compared the use of inhaled corticosteroids (budesonide) with placebo. We found no differences between groups in terms of need for nasal continuous positive airway pressure (risk ratio (RR) 1.27, 95% confidence interval (CI) 0.65 to 2.51; 1 study, 49 participants) and need for mechanical ventilation (RR 0.52, 95% CI 0.05 to 5.38; 1 study, 49 participants). The type of mechanical ventilation used in the included study was high-frequency oscillation. Tests for heterogeneity were not applicable for any of the analyses as only one study was included. Out of the secondary outcomes we deemed to be of greatest importance to patients, the study only reported on duration of hospital stay, which was no different between groups. The quality of the evidence is very low, due to the imprecision of the estimates and indirectness. We identified no ongoing trials. AUTHORS' CONCLUSIONS Given the paucity and very low quality of the available evidence, we are unable to determine the benefits and harms of postnatal administration of either inhaled or systemic corticosteroids for the management of TTN.
Collapse
Affiliation(s)
- Matteo Bruschettini
- Lund University, Skåne University HospitalDepartment of Clinical Sciences Lund, PaediatricsLundSweden
- Skåne University HospitalCochrane SwedenWigerthuset, Remissgatan 4, first floorroom 11‐221LundSweden22185
| | - Luca Moresco
- Ospedale San PaoloPediatric and Neonatology UnitSavonaItaly
| | - Maria Grazia Calevo
- Istituto Giannina GasliniEpidemiology, Biostatistics Unit, IRCCSGenoaItaly16147
| | - Olga Romantsik
- Lund University, Skåne University HospitalDepartment of Clinical Sciences Lund, PaediatricsLundSweden
| | | |
Collapse
|
13
|
Williams TC, Drake AJ. Preterm birth in evolutionary context: a predictive adaptive response? Philos Trans R Soc Lond B Biol Sci 2020; 374:20180121. [PMID: 30966892 PMCID: PMC6460087 DOI: 10.1098/rstb.2018.0121] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Preterm birth is a significant public health problem worldwide, leading to substantial mortality in the newborn period, and a considerable burden of complications longer term, for affected infants and their carers. The fact that it is so common, and rates vary between different populations, raising the question of whether in some circumstances it might be an adaptive trait. In this review, we outline some of the evolutionary explanations put forward for preterm birth. We specifically address the hypothesis of the predictive adaptive response, setting it in the context of the Developmental Origins of Health and Disease, and explore the predictions that this hypothesis makes for the potential causes and consequences of preterm birth. We describe how preterm birth can be triggered by a range of adverse environmental factors, including nutrition, stress and relative socioeconomic status. Examining the literature for any associated longer-term phenotypic changes, we find no strong evidence for a marked temporal shift in the reproductive life-history trajectory, but more persuasive evidence for a re-programming of the cardiovascular and endocrine system, and a range of effects on neurodevelopment. Distinguishing between preterm birth as a predictive, rather than immediate adaptive response will depend on the demonstration of a positive effect of these alterations in developmental trajectories on reproductive fitness. This article is part of the theme issue ‘Developing differences: early-life effects and evolutionary medicine'.
Collapse
Affiliation(s)
- Thomas C Williams
- 1 MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh , Edinburgh EH4 2XU , UK
| | - Amanda J Drake
- 2 British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute , Edinburgh EH16 4TJ , UK
| |
Collapse
|
14
|
Zhou L, Marzbanrad F, Ramanathan A, Fattahi D, Pharande P, Malhotra A. Acoustic analysis of neonatal breath sounds using digital stethoscope technology. Pediatr Pulmonol 2020; 55:624-630. [PMID: 31917903 DOI: 10.1002/ppul.24633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is no published literature regarding the use of the digital stethoscope (DS) and computerized breath sound analysis in neonates, despite neonates experiencing a high burden of respiratory disease. We aimed to determine if the DS could be used to study breath sounds of term and preterm neonates without respiratory disease, and detect a difference in acoustic characteristics between them. METHODS A commercially available DS was used to record breath sounds of term and preterm neonates not receiving respiratory support between 24 and 48 hours after birth. Recordings were extracted, filtered, and computer analysis performed to obtain power spectra and mel frequency cepstral coefficient (MFCC) profiles. RESULTS Recordings from 26 term and 26 preterm infants were obtained. The preterm cohort had an average gestational age (median and interquartile range) of 32 (31-33) weeks and term 39 (38-39) weeks. Birth weight (mean and SD) was 1767 (411) g for the preterm and 3456 (442) g for the term cohort. Power spectra demonstrated the greatest power in the low-frequency range of 100 to 250 Hz for both groups. There were significant differences (P < .05) in the average power at low (100-250 Hz), medium (250-500 Hz), high (500-1000 Hz), and very high (1000-2000 Hz) frequency bands. MFCC profiles also demonstrated significant differences between groups (P < .05). CONCLUSION It is feasible to use DS technology to analyze breath sounds in neonates. DS was able to determine significant differences between the acoustic characteristics of term and preterm infants breathing in room air. Further investigation of DS technology for neonatal breath sounds is warranted.
Collapse
Affiliation(s)
- Lindsay Zhou
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| | - Faezeh Marzbanrad
- Department of Computer Systems and Electrical Engineering, Monash University, Melbourne, Australia
| | | | - Davood Fattahi
- Department of Computer Systems and Electrical Engineering, Monash University, Melbourne, Australia
| | | | - Atul Malhotra
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Monash University, Melbourne, Australia
| |
Collapse
|
15
|
Shen YQ, Bao ZD, Pan JJ, Mao XN, Cheng R, Zhou XG, Zhou XY, Yang Y. MicroRNA‑431 inhibits the expression of surfactant proteins through the BMP4/activin/TGF‑β signaling pathway by targeting SMAD4. Int J Mol Med 2020; 45:1571-1582. [PMID: 32323744 DOI: 10.3892/ijmm.2020.4511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 01/13/2020] [Indexed: 11/06/2022] Open
Abstract
The synthesis and secretion of surfactant proteins (SPs) is an important sign of lung maturation. Furthermore, the morbidity of lung developmental diseases, including respiratory distress syndrome and bronchopulmonary dysplasia which are mainly caused by immature lung development and lack of SPs, is increasing. As is well known, multiple microRNAs (miRs/miRNAs) are able to influence lung development via numerous different signaling pathways. However, few studies examine the association between the miRNAs and lung developmental diseases. A previous study has demonstrated that miR‑431 was significantly (F=33.49; P<0.001) downregulated in the lung tissues of Sprague‑Dawley rats at 3 time points, embryonic day 19, embryonic day 21 and postnatal day 3. The present study reported that the regulation of miR‑431 may influence the expression of SPs. Thus, the further potential mechanisms of miR‑431 in negatively regulating lung development were examined in the present study. Stable A549 cell lines overexpressing or knocking down SMAD family member 4 (SMAD4) transfected with miR‑431 overexpressed or knocked down, and their control groups were established. Subsequently, the expression of bone morphogenetic protein 4 (BMP4), SMAD4 and SPs (SP‑A, SP‑B and SP‑C) at the RNA and protein levels were validated respectively by reverse transcription quantitative PCR and western blotting. miR‑431 exhibited a decreased expression, while BMP4 and SPs exhibited increased expression at the mRNA and protein levels in the SMAD4 knockdown group. Meanwhile, the expression of SPs were reduced in the SMAD4‑knockdown group via overexpressing miR‑431 and increased in the SMAD4‑overexpression group via inhibiting miR‑431. The present results indicate that SMAD4 negatively regulates the expression of SPs, and that miR‑431 negatively regulates the expression of SPs through inhibiting the BMP4/activin/transforming growth factor‑β signaling pathway by targeting SMAD4.
Collapse
Affiliation(s)
- Yan-Qing Shen
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Zhi-Dan Bao
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Jing-Jing Pan
- Department of Pediatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Xiao-Nan Mao
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Rui Cheng
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Xiao-Guang Zhou
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Xiao-Yu Zhou
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Yang Yang
- Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| |
Collapse
|
16
|
Sharma D, Padmavathi IV, Tabatabaii SA, Farahbakhsh N. Late preterm: a new high risk group in neonatology. J Matern Fetal Neonatal Med 2019; 34:2717-2730. [PMID: 31575303 DOI: 10.1080/14767058.2019.1670796] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Late preterm infants are those infants born between 34 0/7 weeks through 36 6/7 week of gestation. These are physiologically less mature and have limited compensatory responses to the extrauterine environment compared with term infants. Despite their increased risk for morbidity and mortality, late preterm newborns are often cared in the well-baby nurseries of hospital after birth and are discharged from the hospital by 2-3 days of postnatal age. They are usually treated like developmentally mature term infants because many of them are of same birth weight and same size as term infants. There is a steady increase in the late preterm birth rate in last decade because of either maternal, fetal, or placental/uterine causes. There has been shift in the distribution of births from term and post-term toward earlier gestations. Although late preterm infants are the largest subgroup of preterm infants, there has been little research on this group until recently. This is mainly because of labeling them as "near-term". Such infants were being looked upon as "almost mature", and were thought as neonate requiring either no or minimal concern. In the obstetric and pediatric practice, late preterm infants are often considered functionally and developmentally mature and often managed by protocols developed for full-term infants. Thus, limited efforts are taken to prolong pregnancy in cases of preterm labor beyond 34 weeks, moreover after 34 weeks most centers do not administer antenatal prophylactic steroids. These practices are based on previous studies reporting neonatal mortality and morbidity in the late preterm period to be only slightly higher in comparison with term infants and whereas in the current scenario the difference is significant. Late preterm infants have 2-3-fold increased risk of morbidities such as hypothermia, hypoglycemia, delayed lung fluid clearance, respiratory distress, poor feeding, jaundice, sepsis, and readmission rates after initial hospital discharge. This leads to huge impact on the overall health care resources. In this review, we cover various aspects of these late preterm infants like etiology, immediate and long-term outcome.
Collapse
Affiliation(s)
- Deepak Sharma
- Department of Neonatology, National Institute of Medical Sciences, Jaipur, India
| | | | | | - Nazanin Farahbakhsh
- Department of Pulmonology, Pediatric Department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
17
|
Oktem A, Yigit S, Oğuz B, Celik T, Haliloğlu M, Yurdakok M. Accuracy of lung ultrasonography in the diagnosis of respiratory distress syndrome in newborns. J Matern Fetal Neonatal Med 2019; 34:281-286. [DOI: 10.1080/14767058.2019.1605350] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Ahmet Oktem
- Department of Neonatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sule Yigit
- Department of Neonatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Berna Oğuz
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tolga Celik
- Department of Neonatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mithat Haliloğlu
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Murat Yurdakok
- Department of Neonatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
18
|
Muganthan T, Boyle EM. Early childhood health and morbidity, including respiratory function in late preterm and early term births. Semin Fetal Neonatal Med 2019; 24:48-53. [PMID: 30348617 DOI: 10.1016/j.siny.2018.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Late preterm (LP) and early term (ET) infants have generally been considered in the same way as their healthy full term (FT) counterparts. It is only in the last decade that an increased risk of later poor health in children born LP has been recognised; evidence for health outcomes following ET birth is still emerging. However, reports are largely consistent in highlighting an increased risk, which lessens approaching FT but is measurable and persists into adolescence and beyond. The most thoroughly explored area to date is respiratory morbidity. This article reviews the body of available evidence for effects of LP birth on pulmonary function and ongoing morbidity, and other areas where an increased risk of health problems has been identified in this population. Implications for delivery of health care are considered and areas for further research are highlighted.
Collapse
Affiliation(s)
- Trishula Muganthan
- Neonatal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elaine M Boyle
- Department of Health Sciences, University of Leicester, Leicester, UK.
| |
Collapse
|
19
|
Al-Lawama M, Alkhatib H, Wakileh Z, Elqaisi R, AlMassad G, Badran E, Hartman T. Bubble CPAP therapy for neonatal respiratory distress in level III neonatal unit in Amman, Jordan: a prospective observational study. Int J Gen Med 2018; 12:25-30. [PMID: 30636889 PMCID: PMC6307683 DOI: 10.2147/ijgm.s185264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Bubble continuous positive airway pressure (bCPAP), a noninvasive respiratory support modality used to manage newborns with respiratory distress, provides continuous pressure that helps prevent derecruitment of alveoli, increasing the lungs' functional residual capacity, and thus decreasing the work of breathing. bCPAP can be used to manage various respiratory conditions in the newborn. In this prospective study, we describe our experience using bCPAP therapy as the primary respiratory support in a level III neonatal unit in Amman, Jordan. In addition to reporting therapeutic indications, durations, and side effects, we aimed to identify areas requiring improvement in bCPAP therapy in our population. PATIENTS AND METHODS This prospective observational study investigated the usage of bCPAP in the management of respiratory distress in newborns admitted to a Jordan University Hospital in Amman. The newborns were followed until discharge. The patients' demographic and clinical data were recorded. RESULTS A total of 143 babies (mean gestational age, 36±2.7 weeks; mean birth weight, 2,770±1,800 g) were included. All received bCPAP as the primary respiratory support. The most common underlying cause of respiratory distress was transient tachypnea of the newborn (42%), followed by prolonged respiratory transition (34%). The therapy success rate was 93.7%; only nine infants failed bCPAP. The most common side effect was physical facial injury. CONCLUSION The use of neonatal bCPAP therapy is well established in Jordan University Hospital. The area of potential improvement was the low rate of bCPAP use as a primary respiratory support in extremely premature infants.
Collapse
Affiliation(s)
- Manar Al-Lawama
- Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan,
| | - Haitham Alkhatib
- Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan,
| | - Zaid Wakileh
- Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan,
| | - Randa Elqaisi
- Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan,
| | - Ghada AlMassad
- Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan,
| | - Eman Badran
- Pediatric Department, School of Medicine, Jordan University Hospital, The University of Jordan, Queen Rania Street, Amman 11942, Jordan,
| | - Tyler Hartman
- Pediatric department, Geisel School of Medicine, Dartmouth University, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
| |
Collapse
|
20
|
Moresco L, Romantsik O, Calevo MG, Bruschettini M. Non-invasive respiratory support for the management of transient tachypnea of the newborn. Hippokratia 2018. [DOI: 10.1002/14651858.cd013231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Luca Moresco
- Ospedale San Paolo; Pediatric and Neonatology Unit; Savona Italy
| | - Olga Romantsik
- Lund University, Skåne University Hospital; Department of Paediatrics; Lund Sweden
| | - Maria Grazia Calevo
- Istituto Giannina Gaslini; Epidemiology, Biostatistics and Committees Unit; Genoa Italy 16147
| | - Matteo Bruschettini
- Lund University, Skåne University Hospital; Department of Paediatrics; Lund Sweden
- Skåne University Hospital; Cochrane Sweden; Wigerthuset, Remissgatan 4, first floor room 11-221 Lund Sweden 22185
| |
Collapse
|
21
|
Bruschettini M, Moresco L, Calevo MG, Romantsik O. Postnatal corticosteroids for transient tachypnea of the newborn. Hippokratia 2018. [DOI: 10.1002/14651858.cd013222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Matteo Bruschettini
- Lund University, Skåne University Hospital; Department of Paediatrics; Lund Sweden
- Skåne University Hospital; Cochrane Sweden; Wigerthuset, Remissgatan 4, first floor room 11-221 Lund Sweden 22185
| | - Luca Moresco
- Ospedale San Paolo; Pediatric and Neonatology Unit; Savona Italy
| | - Maria Grazia Calevo
- Istituto Giannina Gaslini; Epidemiology, Biostatistics and Committees Unit; Genoa Italy 16147
| | - Olga Romantsik
- Lund University, Skåne University Hospital; Department of Paediatrics; Lund Sweden
| |
Collapse
|
22
|
Vannucchi CI, Silva LCG, Unruh SM, Lúcio CF, Veiga GAL. Calving duration and obstetric assistance influence pulmonary function of Holstein calves during immediate fetal-to-neonatal transition. PLoS One 2018; 13:e0204129. [PMID: 30226864 PMCID: PMC6143257 DOI: 10.1371/journal.pone.0204129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 09/04/2018] [Indexed: 11/19/2022] Open
Abstract
Neonatal immediate adaptation to extrauterine life depends mainly on adequate lung function, which is under the influence of previous fetal maturation and obstetrical condition, both acting to stimulate the efficient liquid removal from the pulmonary parenchyma during the immediate transition period. The objective of the present study is to identify chest radiographic changes of neonatal calves born under the influence of different duration of calving and obstetric assistance and correlate with clinical analysis and blood acid-base balance. Experimental groups were determined according to the duration of calving: 2 h (n = 16), 2–4 h (n = 16) and >4 h (n = 12), and additionally by two sub-groups: no-intervention calving (n = 22) and intervention calving (n = 22). Neonatal calves were evaluated for heart and respiratory rate at birth, 5 min, every 10 min until 90 min. Arterial acid-base balance was determined immediately after calving and thoracic radiographs were made at 10 min of life. Lung radiopacity was higher in the 2–4 hr Group compared to the 2 hr Group. When calving duration was greater than 4 hours, a significant respiratory depression was observed. Calving greater than 2 hours slower neonatal pulmonary clearance, 100% and 91.6% of the calves born in the 2–4 hr and >4 hr Groups, respectively, had mild to moderate lung parenchyma opacity. There was a positive correlation between lung radiographic changes and blood TCO2 and negative correlation between pulmonary opacity score and blood PaO2 and SO2. Hence, it is possible to infer that neonatal hypoxia during prolonged calving has an imperative influence on pulmonary fluid absorption in calves. In conclusion, calving greater than 2 hours impacts pulmonary function at birth, leading to altered lung gas exchange, pulmonary clearance, cardiac and respiratory pattern. Conversely, obstetric intervention when calving has duration greater than 4 hours is beneficial for neonatal oxygenation.
Collapse
Affiliation(s)
- Camila Infantosi Vannucchi
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
- * E-mail:
| | - Liege Cristina Garcia Silva
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Silvana Maria Unruh
- Radiology and Diagnostic Imaging, Veterinary Hospital, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Cristina Fátima Lúcio
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Gisele Almeida Lima Veiga
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, São Paulo, Brazil
| |
Collapse
|
23
|
Abstract
Predelivery diagnosis of placenta accreta, increta, and percreta (from here referred to as placenta accreta, unless otherwise noted) has increasingly created opportunities to optimize antenatal management. Despite the increased frequency of placenta accreta today, occurring in as many as 1 in 533 to 1 in 272 deliveries, high-quality data are lacking for many aspects of antenatal management. This chapter will discuss antenatal management of, and risks faced by, women with suspected placenta accreta, a condition that most frequently requires a potentially morbid cesarean hysterectomy.
Collapse
|
24
|
Sweet LR, Keech C, Klein NP, Marshall HS, Tagbo BN, Quine D, Kaur P, Tikhonov I, Nisar MI, Kochhar S, Muñoz FM. Respiratory distress in the neonate: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 2017; 35:6506-6517. [PMID: 29150056 PMCID: PMC5710987 DOI: 10.1016/j.vaccine.2017.01.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 01/13/2017] [Indexed: 02/07/2023]
Affiliation(s)
| | - Cheryl Keech
- Pharmaceutical Product Development, United States
| | | | - Helen S Marshall
- Women's and Children's Health Network and Robinson Research Institute and School of Medicine, University of Adelaide, South Australia, Australia
| | - Beckie N Tagbo
- Institute of Child Health & Department of Paediatrics, University of Nigeria Teaching Hospital, Nigeria
| | - David Quine
- Simpson's Centre for Reproductive Health, Royal Infirmary Edinburgh, Scotland, United Kingdom
| | | | | | | | - Sonali Kochhar
- Global Healthcare Consulting, India; Erasmus University Medical Center, Rotterdam, The Netherlands
| | | |
Collapse
|
25
|
Echaide M, Autilio C, Arroyo R, Perez-Gil J. Restoring pulmonary surfactant membranes and films at the respiratory surface. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2017; 1859:1725-1739. [PMID: 28341439 DOI: 10.1016/j.bbamem.2017.03.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/14/2017] [Accepted: 03/19/2017] [Indexed: 02/08/2023]
Abstract
Pulmonary surfactant is a complex of lipids and proteins assembled and secreted by the alveolar epithelium into the thin layer of fluid coating the respiratory surface of lungs. There, surfactant forms interfacial films at the air-water interface, reducing dramatically surface tension and thus stabilizing the air-exposed interface to prevent alveolar collapse along respiratory mechanics. The absence or deficiency of surfactant produces severe lung pathologies. This review describes some of the most important surfactant-related pathologies, which are a cause of high morbidity and mortality in neonates and adults. The review also updates current therapeutic approaches pursuing restoration of surfactant operative films in diseased lungs, mainly through supplementation with exogenous clinical surfactant preparations. This article is part of a Special Issue entitled: Membrane Lipid Therapy: Drugs Targeting Biomembranes edited by Pablo V. Escribá.
Collapse
Affiliation(s)
- Mercedes Echaide
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain
| | - Chiara Autilio
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain
| | - Raquel Arroyo
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain
| | - Jesus Perez-Gil
- Dept. Biochemistry, Faculty of Biology, and Research Institute "Hospital 12 de Octubre", Complutense University, Madrid, Spain.
| |
Collapse
|
26
|
Wallace ME, Mendola P, Kim SS, Epps N, Chen Z, Smarr M, Hinkle SN, Zhu Y, Grantz KL. Racial/ethnic differences in preterm perinatal outcomes. Am J Obstet Gynecol 2017; 216:306.e1-306.e12. [PMID: 27865977 DOI: 10.1016/j.ajog.2016.11.1026] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/26/2016] [Accepted: 11/09/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Racial disparities in preterm birth and infant death have been well documented. Less is known about racial disparities in neonatal morbidities among infants who are born at <37 weeks of gestation. OBJECTIVE The purpose of this study was to determine whether the risk for morbidity and death among infants who are born preterm differs by maternal race. STUDY DESIGN A retrospective cohort design included medical records from preterm deliveries of 19,325 black, Hispanic, and white women in the Consortium on Safe Labor. Sequentially adjusted Poisson models with generalized estimating equations estimated racial differences in the risk for neonatal morbidities and death, controlling for maternal demographics, health behaviors, and medical history. Sex differences between and within race were examined. RESULTS Black preterm infants had an elevated risk for perinatal death, but there was no difference in risk for neonatal death across racial groups. Relative to white infants, black infants were significantly more likely to experience sepsis (9.1% vs 13.6%), peri- or intraventricular hemorrhage (2.6% vs 3.3%), intracranial hemorrhage (0.6% vs 1.8%), and retinopathy of prematurity (1.0% vs 2.6%). Hispanic and white preterm neonates had similar risk profiles. In general, female infants had lower risk relative to male infants, with white female infants having the lowest prevalence of a composite indicator of perinatal death or any morbidity across all races (30.9%). Differences in maternal demographics, health behaviors, and medical history did little to influence these associations, which were robust to sensitivity analyses of pregnancy complications as potential underlying mechanisms. CONCLUSION Preterm infants were at similar risk for neonatal death, regardless of race; however, there were notable racial disparities and sex differences in rare, but serious, adverse neonatal morbidities.
Collapse
Affiliation(s)
- Maeve E Wallace
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Pauline Mendola
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Sung Soo Kim
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Nikira Epps
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Zhen Chen
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Melissa Smarr
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Stefanie N Hinkle
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Yeyi Zhu
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD
| | - Katherine L Grantz
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
| |
Collapse
|
27
|
Kotecha SJ, Watkins WJ, Lowe J, Henderson AJ, Kotecha S. Effect of early-term birth on respiratory symptoms and lung function in childhood and adolescence. Pediatr Pulmonol 2016; 51:1212-1221. [PMID: 27124554 DOI: 10.1002/ppul.23448] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/07/2016] [Accepted: 04/08/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Early-term-born subjects, (37-38 weeks' gestation), form a large part of the population and have an increased risk of neonatal respiratory morbidity and childhood respiratory symptoms; there is a paucity of data on their later lung function. We sought to (1) compare lung function at 8-9 and 14-17 years in early-term-born children with full-term-born children (39-43 weeks' gestation); (2) assess the role of caesarean section delivery; and (3) compare respiratory symptoms and diagnosis of asthma. METHODS Caucasian, singleton, term births from the Avon Longitudinal Study of Parents and Children (n = 14,062) who had lung spirometry at 8-9 (n = 5,465) and/or 14-17 (n = 3,666) years were classified as early or full term. RESULTS At 8-9 years, standardized spirometry measures, although within the normal range, were lower in the early-term-born group, (n = 911), compared to full-term controls (n = 4,554). Delivery by caesarean section did not influence later spirometry, and the effect of early-term birth was not modified by delivery by caesarean section. At 14-17 years, the spirometry measures in the early-term group, (n = 602), were similar to the full-term group (3,064), and the rates of asthma and respiratory symptoms were also similar between the two gestation groups. CONCLUSIONS Early-term-born children had lower lung function values at 8-9 years compared to the full-term group, but were similar by 14-17 years of age. Delivery at early term should be avoided due to early and late morbidity. Pediatr Pulmonol. 2016;51:1212-1221. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - William John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom.
| |
Collapse
|
28
|
Karsli T, Sutter J, Shekhawat PS. X-linked Adrenal Hypoplasia Congenita Due to NR0B1 (DAX1) Deficiency Presenting as Severe Respiratory Distress in Near Term Infants. Pediatr Neonatol 2016; 57:444-445. [PMID: 27026067 DOI: 10.1016/j.pedneo.2015.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/25/2015] [Accepted: 10/21/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Tijen Karsli
- Department of Pediatrics, Section of Neonatology, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Jennifer Sutter
- Pediatric Endocrinology, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Prem S Shekhawat
- Department of Pediatrics, Division Neonatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
| |
Collapse
|
29
|
Condò V, Cipriani S, Colnaghi M, Bellù R, Zanini R, Bulfoni C, Parazzini F, Mosca F. Neonatal respiratory distress syndrome: are risk factors the same in preterm and term infants? J Matern Fetal Neonatal Med 2016; 30:1267-1272. [DOI: 10.1080/14767058.2016.1210597] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
30
|
Leal MDC, Esteves-Pereira AP, Nakamura-Pereira M, Torres JA, Domingues RMSM, Dias MAB, Moreira ME, Theme-Filha M, da Gama SGN. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services. PLoS One 2016; 11:e0155511. [PMID: 27196102 PMCID: PMC4873204 DOI: 10.1371/journal.pone.0155511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/01/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. METHODS This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. RESULTS Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. CONCLUSION The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.
Collapse
Affiliation(s)
- Maria do Carmo Leal
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ana Paula Esteves-Pereira
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Marcos Nakamura-Pereira
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Marcos Augusto Bastos Dias
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Maria Elizabeth Moreira
- National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Mariza Theme-Filha
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Silvana Granado Nogueira da Gama
- Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| |
Collapse
|
31
|
Makanya AN. Membrane mediated development of the vertebrate blood-gas-barrier. ACTA ACUST UNITED AC 2016; 108:85-97. [PMID: 26991887 DOI: 10.1002/bdrc.21120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/22/2016] [Indexed: 01/24/2023]
Abstract
During embryonic lung development, establishment of the gas-exchanging units is guided by epithelial tubes lined by columnar cells. Ultimately, a thin blood-gas barrier (BGB) is established and forms the interface for efficient gas exchange. This thin BGB is achieved through processes, which entail lowering of tight junctions, stretching, and thinning in mammals. In birds the processes are termed peremerecytosis, if they involve cell squeezing and constriction, or secarecytosis, if they entail cutting cells to size. In peremerecytosis, cells constrict at a point below the protruding apical part, resulting in fusion of the opposing membranes and discharge of the aposome, or the cell may be squeezed by the more endowed cognate neighbors. Secarecytosis may entail formation of double membranes below the aposome, subsequent unzipping and discharge of the aposome, or vesicles form below the aposome, fuse in a bilateral manner, and release the aposome. These processes occur within limited developmental windows, and are mediated through cell membranes that appear to be of intracellular in origin. In addition, basement membranes (BM) play pivotal roles in differentiation of the epithelial and endothelial layers of the BGB. Laminins found in the BM are particularly important in the signaling pathways that result in formation of squamous pneumocytes and pulmonary capillaries, the two major components of the BGB. Some information exists on the contribution by BM to BGB formation, but little is known regarding the molecules that drive peremerecytosis, or even the origins and composition of the double and vesicular membranes involved in secarecytosis.
Collapse
Affiliation(s)
- Andrew N Makanya
- Department of Vet Anatomy and Physiology, Riverside Drive, Chiromo Campus, University of , Box 30197-00100, Nairobi
| |
Collapse
|
32
|
Mally PV, Agathis NT, Bailey SM. Early term infants are at increased risk of requiring neonatal intensive care. World J Pediatr 2016; 12:76-81. [PMID: 26547208 DOI: 10.1007/s12519-015-0049-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 12/18/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Increasing evidence is demonstrating that infants born early on during the term period are at increased risk of morbidity compared with infants born closer to a complete 40 week gestational pregnancy. The purpose of this study was to compare early term [gestation age (GA): 37-37 6/7 weeks] neonatal outcomes with those of other full term neonatal intensive care unit (NICU) admissions. METHODS Retrospective chart review of all term infants admitted to the NICU at New York University Langone Medical Center over a 17 month period. Subjects were grouped and analyzed according to their GA at birth: 1) early term infants (GA between 37 0/7 to 37 6/7 weeks) and 2) other term infants (38 0/7 weeks and older). RESULTS Early term infants were more likely to require NICU care than other term infants [relative risk: 1.42, 95% confidence interval (CI)=1.07-1.88), P=0.01]. In the NICU, they are more likely to manifest respiratory distress syndrome [odds ratio (OR)=5.7, 95% CI=1.6-19.8, P<0.01] and hypoglycemia (OR=4.6, 95% CI=2.0-10.4, P<0.001). In addition, early term neonates were more likely to be born via elective cesarean section than other term neonates (OR=4.1, 95% CI=2.0-8.5, P<0.001). CONCLUSIONS Being born at early term is associated with increased risk of respiratory disease and hypoglycemia requiring neonatal intensive care. Further efforts directed at decreasing early term deliveries may be warranted.
Collapse
Affiliation(s)
- Pradeep Vittal Mally
- New York University School of Medicine, New York University Langone Medical Center, New York, NY, USA.
| | | | - Sean Michael Bailey
- New York University School of Medicine, New York University Langone Medical Center, New York, NY, USA
| |
Collapse
|
33
|
Abstract
Gene-environment interactions likely account for some degree of the variance in response rates that are clinically observed with antenatal corticosteroids, breast milk prophylaxis, surfactant administration, early recognition and treatment of sepsis, utility of non-invasive ventilation, and judicious exposure to supplemental oxygen. While these therapies and practice guidelines have significantly decreased overall neonatal mortality in the NICU, they have not made a marked impact on the frequency and severity of conditions such as bronchopulmonary dysplasia (BPD), necrotizing enterocolitis, and periventricular leukomalacia. One possible explanation is that genetic factors in the neonate modulate response to external intervention or preventative agents, culminating in variable levels of injury and different degrees of resolution and repair. Gene-environment explanations are supported by the observed heritability of BPD in twin studies, but they do not differentiate the interactions between neonate and offending toxin or pathogen, from interactions between neonate and intervention or therapeutic agent. Likely, both kinds of interactions are important in determining outcome.
Collapse
Affiliation(s)
- Vineet Bhandari
- Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Yale Child Health Research Center, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
| | - Jeffrey R Gruen
- Division of Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Yale Child Health Research Center, Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Department of Genetics, Yale University School of Medicine, New Haven, CT; Department of Investigative Medicine, Yale University School of Medicine, New Haven, CT
| |
Collapse
|
34
|
Liu PL, Chong IW, Lee YC, Tsai JR, Wang HM, Hsieh CC, Kuo HF, Liu WL, Chen YH, Chen HL. Anti-inflammatory Effects of Resveratrol on Hypoxia/Reoxygenation-Induced Alveolar Epithelial Cell Dysfunction. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2015; 63:9480-9487. [PMID: 26466890 DOI: 10.1021/acs.jafc.5b01168] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Reducing oxidative stress is crucial to prevent hypoxia-reoxygenation (H/R)-induced lung injury. Resveratrol has excellent antioxidant and anti-inflammatory effects, and this study investigated its role in H/R-induced type II pneumocyte dysfunction. H/R conditions increased expression of inflammatory cytokines including interleukin (IL)-1β (142.3 ± 21.2%, P < 0.05) and IL-6 (301.9 ± 35.1%, P < 0.01) in a type II alveolar epithelial cell line (A549), while the anti-inflammatory cytokine IL-10 (64.6 ± 9.8%, P < 0.05) and surfactant proteins (SPs) decreased. However, resveratrol treatment effectively inhibited these effects. H/R significantly activated an inflammatory transcription factor, nuclear factor (NF)-κB, while resveratrol significantly inhibited H/R-induced NF-κB transcription activities. To the best of our knowledge, this is the first study showing resveratrol-mediated reversal of H/R-induced inflammatory responses and dysfunction of type II pneumocyte cells in vitro. The effects of resveratrol were partially mediated by promoting SP expression and inhibiting inflammation with NF-κB pathway involvement. Therefore, our study provides new insights into mechanisms underlying the action of resveratrol in type II pneumocyte dysfunction.
Collapse
Affiliation(s)
- Po-Len Liu
- Department of Respiratory Therapy, Department of Fragrance and Cosmetic Science, College of Medicine, Kaohsiung Medical University , Kaohsiung 807, Taiwan
| | - Inn-Wen Chong
- Department of Respiratory Therapy, Department of Fragrance and Cosmetic Science, College of Medicine, Kaohsiung Medical University , Kaohsiung 807, Taiwan
- Department of Pediatrics, Department of Internal Medicine, Department of Chest Surgery, Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung 807, Taiwan
| | - Yi-Chen Lee
- Department of Respiratory Therapy, Department of Fragrance and Cosmetic Science, College of Medicine, Kaohsiung Medical University , Kaohsiung 807, Taiwan
| | - Jong-Rung Tsai
- Department of Respiratory Therapy, Department of Fragrance and Cosmetic Science, College of Medicine, Kaohsiung Medical University , Kaohsiung 807, Taiwan
- Department of Pediatrics, Department of Internal Medicine, Department of Chest Surgery, Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung 807, Taiwan
| | - Hui-Min Wang
- Department of Respiratory Therapy, Department of Fragrance and Cosmetic Science, College of Medicine, Kaohsiung Medical University , Kaohsiung 807, Taiwan
| | - Chong-Chao Hsieh
- Department of Pediatrics, Department of Internal Medicine, Department of Chest Surgery, Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung 807, Taiwan
| | - Hsuan-Fu Kuo
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung 801, Taiwan
| | - Wei-Lun Liu
- Department of Intensive Care Medicine, Chi Mei Medical Center , Tainan 736, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University , Taichung 404, Taiwan
- Department of Medical Research, China Medical University Hospital , Taichung 404, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University , Taichung 413, Taiwan
| | - Hsiu-Lin Chen
- Department of Respiratory Therapy, Department of Fragrance and Cosmetic Science, College of Medicine, Kaohsiung Medical University , Kaohsiung 807, Taiwan
- Department of Pediatrics, Department of Internal Medicine, Department of Chest Surgery, Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital , Kaohsiung 807, Taiwan
| |
Collapse
|
35
|
Hernandez-Andrade E, Garcia M, Ahn H, Korzeniewski SJ, Saker H, Yeo L, Chaiworapongsa T, Hassan SS, Romero R. Strain at the internal cervical os assessed with quasi-static elastography is associated with the risk of spontaneous preterm delivery at ≤34 weeks of gestation. J Perinat Med 2015; 43:657-66. [PMID: 25781664 PMCID: PMC5625351 DOI: 10.1515/jpm-2014-0382] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/06/2015] [Indexed: 01/31/2023]
Abstract
AIM To evaluate the association between cervical strain assessed with quasi-static elastography and spontaneous preterm delivery. METHODS Quasi-static elastography was used to estimate cervical strain in 545 pregnant women with singleton pregnancies from 11 weeks to 28 weeks of gestation. Cervical strain was evaluated in one sagittal plane and in the cross-sectional planes of the internal cervical os and external cervical os. The distribution of strain values was categorized into quartiles for each studied region and their association with spontaneous preterm delivery at ≤34 weeks and at <37 weeks of gestation was evaluated using logistic regression. RESULTS The prevalence of spontaneous preterm delivery at <37 weeks of gestation was 8.2% (n=45), and that at ≤34 weeks of gestation was 3.8% (n=21). Strain in the internal cervical os was the only elastography value associated with spontaneous preterm delivery. Women with strain values in the 3rd and 4th quartiles had a significantly higher risk of spontaneous preterm delivery at ≤34 weeks and at <37 weeks of gestation when compared to women with strain values in the lowest quartile. When adjusting for a short cervix (<25 mm) and gestational age at examination, women with strain values in the 3rd quartile maintained a significant association with spontaneous preterm delivery at ≤34 weeks (OR 9.0; 95% CI, 1.1-74.0; P=0.02), whereas women with strain values in the highest quartile were marginally more likely than women with lowest quartile strain values to deliver spontaneously at ≤37 weeks of gestation (OR 95% CI: 2.8; [0.9-9.0]; P=0.08). CONCLUSION Increased strain in the internal cervical os is associated with higher risk of spontaneous preterm delivery both at ≤34 and <37 weeks of gestation.
Collapse
Affiliation(s)
- Edgar Hernandez-Andrade
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Maynor Garcia
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hyunyoung Ahn
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Steven J. Korzeniewski
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Homam Saker
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lami Yeo
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Sonia S. Hassan
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, and Bethesda, MD, USA,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
36
|
Chen L, Wang L, Li J, Wang N, Shi Y. Noninvasive Ventilation for Preterm Twin Neonates with Respiratory Distress Syndrome: A Randomized Controlled Trial. Sci Rep 2015; 5:14483. [PMID: 26399752 PMCID: PMC4585863 DOI: 10.1038/srep14483] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/17/2015] [Indexed: 11/08/2022] Open
Abstract
Noninvasive ventilation has been proven to be effective strategies for reducing the need for endotracheal ventilation in preterm infant with respiratory distress syndrome (RDS), however the best option needs to be further determined. A single center, paired design, randomized, controlled trial was conducted between Jan 2011 and July 2014. Preterm twins with RDS were included. One of a pair was randomized to NIPPV, while another to NCPAP. Surfactant was administrated as rescue treatment. The primary outcome was the need for endotracheal ventilation. The secondary outcomes were the complications. 143 pairs were randomized and 129 pairs finished the trial. The rates of endotracheal ventilation did not differ significantly between NIPPV and NCPAP groups (11.9% vs 19.6%, P = 0.080). This difference was not observed in the subgroup of infants who received surfactant therapy (11.1% vs 19.7%, P = 0.087). No secondary outcomes also differed significantly between the two groups. NIPPV did not result in a significantly lower incidence of intubation as compared with NCPAP in preterm twins with RDS.
Collapse
Affiliation(s)
- Long Chen
- Department of Pediatrics, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, 400042, China
| | - Li Wang
- Department of Pediatrics, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, 400042, China
| | - Jie Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Nan Wang
- Department of Pediatrics, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, 400042, China
| | - Yuan Shi
- Department of Pediatrics, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, 400042, China
| |
Collapse
|
37
|
Pérez-Cuevas R, Jasso Gutiérrez L, Doubova S, Flores Hernández S, Mantilla Trollé C, González Guerra E, Muñoz Hernández O. [Evaluation of the quality of care of transient tachypnea in newborns affiliated with the Medical Insurance Siglo XXI program]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2015; 71:346-351. [PMID: 29421630 DOI: 10.1016/j.bmhimx.2015.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 01/16/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Evaluation of the quality of care of the newborn with complications is an indispensable element for the improvement of strategies directed to reduce newborn mortality rates. The aim of this work was to evaluate the quality of technical and interpersonal care in the management of transient tachypnea of the newborn (TTN) of patients affiliated with the program "Medical Insurance Siglo XXI". METHODS A cross-sectional study was conducted in 61 hospitals affiliated with the Health Ministry with at least two cases of TTN during the first semester of 2011. Variables such as mother's health, pregnancy, birth and birth complication characteristics were analyzed. Also, newborn interventions and health conditions upon discharge were included. To measure the quality of care according to prevention, diagnosis and treatment, quality indicators were defined and validated. RESULTS We analyzed 256 case files with a diagnosis of TTN; 8.9% of the mothers presented risk factors (asthma, diabetes) and 53.5% had complications during pregnancy. There were 60% of cases with TTN born by cesarean delivery; one third of these children had low birth weight and 14% were transferred to another hospital. As for the quality indicators in the area of prevention, more than 90% of risk factors (smoking, asthma, cesarean delivery) were identified. Diagnostic indicators showed that 86-98% of respiratory distress symptoms were sought. Indicators of treatment achieved satisfactory figures for monitoring and support measures. CONCLUSIONS Prevention, diagnosis and treatment indicators made it possible to consider that most TTN cases received appropriate treatment. It is advisable to develop effective strategies to prevent TTN, such as increasing efforts to reduce the increasing rates of cesarean deliveries.
Collapse
Affiliation(s)
- Ricardo Pérez-Cuevas
- División de Protección Social y Salud, Banco Interamericano de Desarrollo, México, D.F., México; Dirección de Investigación, Hospital Infantil de México Federico Gómez, México, D.F., México.
| | - Luis Jasso Gutiérrez
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Svetlana Doubova
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México
| | | | | | | | - Onofre Muñoz Hernández
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, México, D.F., México
| |
Collapse
|
38
|
Kitsommart R, Phatihattakorn C, Pornladnun P, Paes B. A prospective study of the severity of early respiratory distress in late preterms compared to term infants. J Matern Fetal Neonatal Med 2014; 29:207-12. [DOI: 10.3109/14767058.2014.992335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ratchada Kitsommart
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,
| | - Chayawat Phatihattakorn
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, and
| | - Pornpat Pornladnun
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,
| | - Bosco Paes
- Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
39
|
Abstract
Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks’ gestation. Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34). On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks’ gestation (7) to prevent MAS.
Collapse
Affiliation(s)
- Suzanne Reuter
- Department of Neonatal-Perinatal Medicine, Sanford School of Medicine-University of South Dakota, Sanford Children's Specialty Clinic, Sioux Falls, SD
| | - Chuanpit Moser
- Department of Pediatric Pulmonology, Sanford School of Medicine-University of South Dakota, Sanford Children's Specialty Clinic, Sioux Falls, SD
| | - Michelle Baack
- Department of Neonatal-Perinatal Medicine, Sanford School of Medicine-University of South Dakota, Sanford Children's Specialty Clinic, Sioux Falls, SD. Sanford Children's Health Research Center, Sioux Falls, SD
| |
Collapse
|