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Claiborne A, Wisseman B, Kern K, Steen D, Jevtovic F, Mcdonald S, Strom C, Newton E, Isler C, Devente J, Mouro S, Collier D, Kuehn D, Kelley GA, May LE. Exercise during pregnancy Dose: Influence on preterm birth outcomes. Eur J Obstet Gynecol Reprod Biol 2024; 300:190-195. [PMID: 39025039 DOI: 10.1016/j.ejogrb.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/03/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Preterm delivery typically increases health risk for neonates and is associated with longer infant hospital stay and financial burden. Prenatal exercise dose (frequency, intensity, type, time, volume) have been shown to influence birth outcomes. Increased prenatal exercise dose could therefore provide a critical reduction in health risk and financial burden in preterm neonates. OBJECTIVE It was our aim to explore the effects of prenatal exercise dose from a supervised exercise intervention in pregnant women on the occurrence of preterm (<37 weeks gestation) births, and the impact on health outcomes in preterm neonates. STUDY DESIGN This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Prenatal exercise dose were assessed in supervised aerobic, resistance, and combination sessions throughout pregnancy. In addition to gestational age, birth weight, resting heart rate, neonatal morphometrics (body circumferences, ponderal index), and health status (Apgar-1 and -5) metrics were obtained for 21 women at birth. One-way analysis of variance tests were used to assess the differences between dose grouped as tertiles, while Pearson correlations determined the association between dose and birth outcomes. RESULTS Women exercised for an average of 19.6 wks (range: 6 - 21 wks) during pregnancy. Exercise during pregnancy tended to result in later preterm deliveries (p = 0.08). Greater prenatal exercise volume and duration were associated with reduced infant hospital stay post-delivery (p = 0.02). Weekly exercise volume was associated with increased Apgar scores (p = 0.01). CONCLUSION Increased prenatal exercise volume and duration is associated with improved birth outcomes in preterm neonates.
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Affiliation(s)
- Alex Claiborne
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Breanna Wisseman
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Kara Kern
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Dylan Steen
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Filip Jevtovic
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Samantha Mcdonald
- School of Kinesiology and Recreation, Illinois State University, Normal, IL, USA
| | - Cody Strom
- Department of Kinesiology and Sport, University of Southern Indiana, Evansville, IN, USA
| | - Edward Newton
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - Christy Isler
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - James Devente
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - Steven Mouro
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - David Collier
- Department of Pediatrics, East Carolina University, USA
| | - Devon Kuehn
- Department of Pediatrics, East Carolina University, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, USA; School of Public and Population Health, Boise State University, Boise, ID, USA
| | - Linda E May
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA; Department of Obstetrics & Gynecology, East Carolina University, USA.
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Claiborne A, Wisseman B, Kern K, Steen D, Jevtovic F, McDonald S, Strom C, Newton E, Isler C, Devente J, Mouro S, Collier D, Kuehn D, Kelley GA, May LE. Exercise FITT-V during pregnancy: Association with birth outcomes. Birth Defects Res 2024; 116:e2340. [PMID: 38659157 DOI: 10.1002/bdr2.2340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/07/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Prenatal exercise improves birth outcomes, but research into exercise dose-response effects is limited. METHODS This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Prenatal exercise frequency, intensity, type, time, and volume (FITT-V) were assessed in supervised sessions throughout pregnancy. Gestational age (GA), neonatal resting heart rate (rHR), morphometrics (body circumferences, weight-to-length and ponderal index) Apgar and reflex scores, and placental measures were obtained at birth. Stepwise regressions and Pearson correlations determined associations between FITT-V and birth outcomes. RESULTS Prenatal exercise frequency reduces ponderal index (R2 = 0.15, F = 2.76, p = .05) and increased total number of reflexes present at birth (R2 = 0.24, F = 7.89, p < .001), while exercise intensity was related to greater gestational age and birth length (R2 = 0.08, F = 3.14; R2 = 0.12, F = 3.86, respectively; both p = .04); exercise weekly volume was associated with shorter hospital stay (R2 = 0.24, F = 4.73, p = .01). Furthermore, exercise type was associated with placenta size (R2 = 0.47, F = 3.51, p = .01). CONCLUSIONS Prenatal exercise is positively related to birth and placental outcomes in a dose-dependent manner.
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Affiliation(s)
- Alex Claiborne
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Breanna Wisseman
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Kara Kern
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Dylan Steen
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Filip Jevtovic
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Samantha McDonald
- School of Kinesiology and Recreation, Illinois State University, Normal, Illinois, USA
| | - Cody Strom
- Department of Kinesiology and Sport, University of Southern Indiana, Evansville, Indiana, USA
| | - Edward Newton
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - Christy Isler
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - James Devente
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - Steven Mouro
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - David Collier
- Department of Pediatrics, East Carolina University, Greenville, North Carolina, USA
| | - Devon Kuehn
- Department of Pediatrics, East Carolina University, Greenville, North Carolina, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
- School of Public and Population Health, Boise State University, Boise, Idaho, USA
| | - Linda E May
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
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Mehretie Y, Amare AT, Getnet GB, Mekonnen BA. Length of hospital stay and factors associated with very-low-birth-weight preterm neonates surviving to discharge a cross-sectional study, 2022. BMC Pediatr 2024; 24:80. [PMID: 38279136 PMCID: PMC10811810 DOI: 10.1186/s12887-024-04532-5] [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: 11/16/2023] [Accepted: 01/02/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The length of hospital stay of very-low-birth-weight neonates (birth weight < 1500 g) depends on multiple factors. Numerous factors have been reported to influence the length of hospital stay (LOS). The objective of this study was to identify the length of hospital stay and associated factors among very-low-birth-weight preterm neonates. METHOD A hospital-based, cross-sectional study was conducted. Data was collected using a pretested, structured questionnaire from April 1 to November 30, 2022. The data was entered using Epidata and Stata version 15.1. The frequencies, mean, median, and interquartile range were used to describe the study population about relevant variables. A linear regression model was used to see the effect of independent variables on dependent variables. RESULT About 110 very low-birth-weight preterm neonates who survived to discharge were included in the study. The median birth weight was 1370 g, with an IQR of 1250-1430. The mean gestational age was 32.30 ± 1.79 weeks. The median length of hospital stay was 24 days, with an IQR of 13.5-40. The gestational age, type of initial management given, and presence of complications had a significant association with the length of hospital stay for VLBW preterm neonates. CONCLUSION The median hospital stay was 24 days. The gestational age, presence of complications, and type of initial management given were associated with LOS for VLBW preterm neonates. The length of the hospital stay of the VLBW preterm neonates can be reduced by applying the standards of care of very-low-birth-weight preterm neonates.
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Affiliation(s)
- Yimenu Mehretie
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Science, University of Gondar, Po. Box 196, Gondar, Ethiopia
| | - Ashenafi Tazebew Amare
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Science, University of Gondar, Po. Box 196, Gondar, Ethiopia
| | - Geta Bayu Getnet
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Science, University of Gondar, Po. Box 196, Gondar, Ethiopia
| | - Birhanu Abie Mekonnen
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Science, University of Gondar, Po. Box 196, Gondar, Ethiopia.
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Stylianou-Riga P, Boutsikou T, Kouis P, Michailidou K, Kinni P, Sokou R, Iliodromiti Z, Pitsios C, Yiallouros PK, Iacovidou N. Epidemiology, risk factors, clinical presentation and complications of late-onset neonatal sepsis among preterm neonates in Cyprus: a prospective case-control study. BMC Pediatr 2024; 24:50. [PMID: 38229029 DOI: 10.1186/s12887-023-04359-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 10/12/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Late-onset neonatal sepsis (LOS) is common in preterm neonates, with increasing incidence in recent years. In the present study, we examined the epidemiology, clinical presentation, and complications of LOS in Cyprus and quantified possible risk factors for the development of this condition. METHODS The study subjects were preterm neonates admitted in the Neonatal Intensive Care Unit (NICU) of Archbishop Makarios III Hospital, the only neonatal tertiary centre in Cyprus. A prospective, case-control study was designed, and carried out between April 2017-October 2018. Depending on blood culture results, preterm neonates were classified as "Confirmed LOS": positive blood culture - microorganism isolated and LOS symptoms, "Unconfirmed LOS": negative blood culture and LOS symptoms, and "Controls" group: negative blood culture and absence of LOS symptoms. Comparisons between the 3 groups were performed and the associations between demographic, clinical and treatment characteristics with the likelihood of LOS were assessed using univariate and multivariate logistic regression. RESULTS A total of 350 preterm neonates were included in the study and the incidence of LOS was 41.1%. 79 (22.6%) and 65 (18.6%) neonates were classified as "Confirmed LOS", and "unconfirmed LOS" cases respectively while 206 (58.9%) served as controls. The rate of confirmed LOS ranged from 12.2% in moderate to late preterm neonates to 78.6% in extremely preterm neonates. In the multivariate model, we demonstrated an independent association between LOS and duration of hospitalization (OR: 1.06, 95%CI: 1.01-1.10), duration of ventilation (OR: 1.23, 95%CI: 1.07-1.43) and necrotising enterocolitis (OR: 3.41, 95%CI: 1.13-10.25). CONCLUSIONS The present study highlights the epidemiology of LOS in preterm neonates in Cyprus and its association with the duration of ventilation and hospitalization as well as with necrotizing enterocolitis. Establishment of protocols for the prevention of nosocomial infections during hospitalization in the NICUs and mechanical ventilation of preterm neonates is recommended.
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Affiliation(s)
- Paraskevi Stylianou-Riga
- Neonatal Intensive Care Unit, "Archbishop Makarios III" Hospital, Nicosia, Cyprus.
- Respiratory Physiology Laboratory, Medical School, University of Cyprus Shakolas Educational Center of Clinical, Medicine Palaios Dromos Lefkosias Lemesou 215/6, Aglantzia, Nicosia, 2029, Cyprus.
- Neonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Theodora Boutsikou
- Neonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Kouis
- Respiratory Physiology Laboratory, Medical School, University of Cyprus Shakolas Educational Center of Clinical, Medicine Palaios Dromos Lefkosias Lemesou 215/6, Aglantzia, Nicosia, 2029, Cyprus
| | | | - Paraskevi Kinni
- Respiratory Physiology Laboratory, Medical School, University of Cyprus Shakolas Educational Center of Clinical, Medicine Palaios Dromos Lefkosias Lemesou 215/6, Aglantzia, Nicosia, 2029, Cyprus
| | - Rozeta Sokou
- Neonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Zoi Iliodromiti
- Neonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Pitsios
- Respiratory Physiology Laboratory, Medical School, University of Cyprus Shakolas Educational Center of Clinical, Medicine Palaios Dromos Lefkosias Lemesou 215/6, Aglantzia, Nicosia, 2029, Cyprus
| | - Panayiotis K Yiallouros
- Respiratory Physiology Laboratory, Medical School, University of Cyprus Shakolas Educational Center of Clinical, Medicine Palaios Dromos Lefkosias Lemesou 215/6, Aglantzia, Nicosia, 2029, Cyprus
| | - Nicoletta Iacovidou
- Neonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Bonger ZT, Mamo BT, Birra SB, Yalew AW. Predictors of length of hospital stay for preterm infants in Ethiopia: a competing risk analysis. Front Pediatr 2023; 11:1268087. [PMID: 38027273 PMCID: PMC10663218 DOI: 10.3389/fped.2023.1268087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Length of hospital stay (LOS) is one of the essential indicators for evaluating the efficiency and the quality-of-care service delivered. predicting LOS is critical for resource allocation, decision-making, lowering neonatal morbidity and death, enhancing clinical outcomes and parent counseling. In addition, extended hospital stays (long LOS_NICU) place a burden on the healthcare systems decreasing bed turnover rates as well as their financial stand and the mental stress on families. In Ethiopia, there is limited evidence on the determinant factors that influence on LOS. Objectives To determine factors affecting neonatal intensive care unit length of stay for all preterm newborns who were discharged alive. Method The study used a secondary data source, was collected for the Study of Illness in Preterm (SIP) infants project. The research study was a multicenter, cross-sectional, observational clinical study that took place in five Ethiopia hospitals from July 1, 2016, to May 31, 2018. The predictors of LOS were determined using Fine-Gray's competing risk analysis. Results For this study 3,511 preterm infants admitted to the NICU were analyzed. About 28.8% of the preterm infants died during their time in neonatal care while 66.6% were discharged alive. At the end of the study 4.6% babies were still in the NICU. The overall median LOS (death or discharge) was 7 days, with an interquartile range of 8 days. The cumulative incidence of discharge rose with increasing in gestational age and birth weight, on the contrary, the rate of discharge was decreased by 45.7% with the development of RDS (SDH ratio: 0.543), by 75.9% with the development of apnea (SDH ratio: 0.241), by 36.2% with sepsis, and by 43.6% with pneumonia (SDH ratio: 0.564). Conclusions Preterm newborns with a low gestational age and birth weight have a greater probability of having a prolonged LOS. Complications of the medical conditions RDS, apnea, sepsis, pneumonia, anemia, asphyxia, and NEC substantially raise LOS considerably.
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Affiliation(s)
| | | | - Sosna Bayu Birra
- Department of Statistics, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku Yalew
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Shields LB, Davydov Y, Glyder A, Weymouth C, Udwin M, Eakins M. Impact of Technology on Neonatal Intensive Care Unit Admissions and Length of Stay: A Retrospective Study. Cureus 2023; 15:e40813. [PMID: 37485146 PMCID: PMC10362942 DOI: 10.7759/cureus.40813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Background Neonatal intensive care units (NICU) provide essential medical care to neonates; however, they are associated with hospital-acquired infections, less maternal-newborn bonding, and high costs. Implementing strategies to lower NICU admission rates and shorten NICU length of stay (LOS) is essential. This study uses causal-inference methods to evaluate the impact of care managers using new technology to identify and risk stratify pregnancies on NICU admissions and NICU LOS. The NICU LOS will decrease as a result of the use of new technology by care managers. Study design This retrospective study utilized delivery claims data of pregnant women from the CareFirst BlueCross BlueShield Community Health Plan District of Columbia from 2013 to 2022, which includes the pre-intervention period before the use of new technology by care managers and the post-intervention period with the use of new technology by care managers. Our sample had 4,917 deliveries whose maternal comorbidities were matched with their neonate's outcomes. Methods To evaluate the impact of the technological intervention, both Generalized Linear Models (GLMs) and Bayesian Structural Time-Series (BSTS) models were used. Results Our findings from the GLM models suggest an overall average reduction in the odds of NICU admissions of 29.2% and an average decrease in NICU LOS from 7.5%-58.5%. Using BSTS models, we estimate counterfactuals for NICU admissions and NICU LOS, which suggest an average reduction in 48 NICU admissions and 528 NICU days per year. Conclusion Equipping care managers with better technological tools can lead to significant improvements in neonatal health outcomes as indicated by a reduction in NICU admissions and NICU LOS.
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Affiliation(s)
- Lisa B Shields
- Norton Neuroscience Institute, Norton Healthcare, Louisville, USA
| | | | | | | | - Michael Udwin
- Obstetrics and Gynecology, CareFirst BlueCross BlueShield, Baltimore, USA
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Sisay EA, Mengistu BL, Taye WA, Fentie AM, Yabeyu AB. Length of Hospital Stay and Its Predictors Among Neonatal Sepsis Patients: A Retrospective Follow-Up Study. Int J Gen Med 2022; 15:8133-8142. [PMID: 36389014 PMCID: PMC9657261 DOI: 10.2147/ijgm.s385829] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/25/2022] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Sepsis is common among neonates, and is often fatal. Hospitalization results in severe nosocomial infections which could be resistant to antibiotics. It also incurs higher fees for medical care. METHODS A retrospective follow-up study, which includes 206 neonates, was conducted to assess the length of hospital stay among neonatal sepsis patients from September 2018 to September 2020 at TASH Hospital, Addis Ababa, Ethiopia. Data were collected from medical charts. Mean length of hospital stay was compared using independent sample t-tests. Risk factors for length of stay were identified using binary logistic regression analysis. RESULTS All neonates stayed a total of 325 days, which gives 75,512 neonate-days. Neonates who stayed more than 7 days had low mean birth weight and higher mean age at admission. Mean length of stay was higher among neonates with comorbid illness, neonates with drug therapy problems and male neonates. Even though the mean length of stay is shorter among neonates with maternal PROM and CS delivery, these maternal factors were found to be insignificant in the multivariate logistic regression. DISCUSSION Similar to other studies, neonates with low birth weight and comorbidity had a longer hospital stay. Neonates with maternal PROM and CS delivery had a shorter stay. But these maternal factors, identified by prior studies as risk factors for neonatal sepsis and its mortality, are not found to be predictors of prolonged hospitalization. Having neurologic features and drug therapy problems among neonates with sepsis prolonged hospital stay. CONCLUSION The mean length of stay varies with respect to maternal and neonatal factors. Lower birth weight, presence of neurologic features, presence of comorbidity, presence of drug therapy problems and being male are found to be predictors of a longer hospital stay among neonates with sepsis.
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Affiliation(s)
- Eskinder Ayalew Sisay
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Workeabeba Abebe Taye
- Department of Pediatrics and Child Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atalay Mulu Fentie
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
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Radulova P, Vakrilova L, Hitrova-Nikolova S, Dimitrova V. Lung ultrasound in premature infants as an early predictor of bronchopulmonary dysplasia. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1322-1327. [PMID: 35353383 DOI: 10.1002/jcu.23207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/08/2022] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Lung ultrasound (LUS) is a widely used technique in neonates to diagnose a lot of acute diseases. However, its role in the diagnosis of chronic lung conditions is still to be evaluated. We aimed to describe the changes in ultrasound images as well as the appearance of lung consolidations (LC) in very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD). METHODS For a period of 2 years we prospectively examined 124 VLBW infants, divided into two main groups: below 28 gestational weeks with two subgroups-BPD (moderate and severe) and non-BPD, and 28-32 gestational weeks with two subgroups-BPD (moderate and severe) and non-BPD group. We performed weekly LUS until 36 weeks' postmenstrual age (PMA). On the seventh postnatal day, we calculated the LUS score as a semiquantitative score that represents the aeration (0-3) in three different areas (upper anterior, lower anterior, lateral) of each lung. RESULTS We performed around 750 LUS exams. The BPD groups had LUS scores above 8 on the seventh day, p < 0.001. The number of LC was higher in the BPD groups 14 (3-45) than in the mild or non-BPD groups 2.5 (0-6), p < 0.001, and the difference was significant for the period between 1 week and 1 month after birth, p = 0.001. In the BPD group <28 weeks' PMA, LC appeared equally in the anterior, lateral, and posterior fields, while in the BPD group 28-32 weeks' PMA, LC are more typical for the anterior-lateral fields. CONCLUSION Serial LUS exams and identification of LC could be early predictors of moderate and severe forms of BPD. LUS score >8 on the seventh postnatal day is an early predictor of severe BPD. LC in more lung fields are typical for the severe forms of the disease.
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Affiliation(s)
- Petya Radulova
- Department of Obstetrics and Gynecology, Medical University of Sofia, Sofia, Bulgaria
- Neonatology Clinic, University Hospital of Obstetrics and Gynecology "Maichin Dom", Sofia, Bulgaria
| | - Liliya Vakrilova
- Department of Obstetrics and Gynecology, Medical University of Sofia, Sofia, Bulgaria
- Neonatology Clinic, University Hospital of Obstetrics and Gynecology "Maichin Dom", Sofia, Bulgaria
| | - Stanislava Hitrova-Nikolova
- Department of Obstetrics and Gynecology, Medical University of Sofia, Sofia, Bulgaria
- Neonatology Clinic, University Hospital of Obstetrics and Gynecology "Maichin Dom", Sofia, Bulgaria
| | - Violeta Dimitrova
- Department of Obstetrics and Gynecology, Medical University of Sofia, Sofia, Bulgaria
- Neonatology Clinic, University Hospital of Obstetrics and Gynecology "Maichin Dom", Sofia, Bulgaria
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Sereia AFR, Christoff AP, Cruz GNF, da Cunha PA, da Cruz GCK, Tartari DC, Zamparette CP, Klein TCR, Masukawa II, Silva CI, E Vieira MLV, Scheffer MC, de Oliveira LFV, Sincero TCM, Grisard EC. Healthcare-Associated Infections-Related Bacteriome and Antimicrobial Resistance Profiling: Assessing Contamination Hotspots in a Developing Country Public Hospital. Front Microbiol 2021; 12:711471. [PMID: 34484149 PMCID: PMC8415557 DOI: 10.3389/fmicb.2021.711471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/02/2021] [Indexed: 11/13/2022] Open
Abstract
Hospital-built environment colonization by healthcare-associated infections-related bacteria (HAIrB) and the interaction with their occupants have been studied to support more effective tools for HAI control. To investigate HAIrB dynamics and antimicrobial resistance (AMR) profile we carried out a 6-month surveillance program in a developing country public hospital, targeting patients, hospital environment, and healthcare workers, using culture-dependent and culture-independent 16S rRNA gene sequencing methods. The bacterial abundance in both approaches shows that the HAIrB group has important representativeness, with the taxa Enterobacteriaceae, Pseudomonas, Staphylococcus, E. coli, and A. baumannii widely dispersed and abundant over the time at the five different hospital units included in the survey. We observed a high abundance of HAIrB in the patient rectum, hands, and nasal sites. In the healthcare workers, the HAIrB distribution was similar for the hands, protective clothing, and mobile phones. In the hospital environment, the healthcare workers resting areas, bathrooms, and bed equipment presented a wide distribution of HAIrB and AMR, being classified as contamination hotspots. AMR is highest in patients, followed by the environment and healthcare workers. The most frequently detected beta-lactamases genes were, blaSHV–like, blaOXA–23–like, blaOXA–51–like, blaKPC–like, blaCTX–M–1, blaCTX–M–8, and blaCTX–M–9 groups. Our results demonstrate that there is a wide spread of antimicrobial resistance due to HAIrB in the hospital environment, circulating among patients and healthcare workers. The contamination hotspots identified proved to be constant over time. In the fight for patient safety, these findings can reorient practices and help to set up new guidelines for HAI control.
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Affiliation(s)
- Aline Fernanda Rodrigues Sereia
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianópolis, Brazil.,BiomeHub, Florianópolis, Brazil
| | | | | | - Patrícia Amorim da Cunha
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | - Caetana Paes Zamparette
- Department of Clinical Analysis, Federal University of Santa Catarina, Florianopólis, Brazil
| | - Taise Costa Ribeiro Klein
- Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ivete Ioshiko Masukawa
- Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Clarice Iomara Silva
- Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Maria Luiza Vieira E Vieira
- Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Mara Cristina Scheffer
- Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | - Edmundo Carlos Grisard
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianópolis, Brazil
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