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Tan TJ, Chen WJ, Lin WC, Yang MC, Tsai CC, Yang YN, Yang SN, Liu HK. Early-Term Neonates Demonstrate a Higher Likelihood of Requiring Phototherapy Compared to Those Born Full-Term. Children (Basel) 2023; 10:1819. [PMID: 38002910 PMCID: PMC10670379 DOI: 10.3390/children10111819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Early-term neonates (with a gestational age (GA) of 37 and 0/7 weeks to 38 and 6/7 weeks) face higher morbidities, including respiratory and neurodevelopmental issues, than full-term (39 and 0/7 weeks to 40 and 6/7 weeks) infants. This study explores whether hyperbilirubinemia necessitating phototherapy also differs between these groups. A retrospective study was conducted on neonates born from January 2021-June 2022, excluding those with specific conditions. Evaluated factors included GA, birth weight, bilirubin levels, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and feeding type, with phototherapy given as per AAP guidelines. Of 1085 neonates, 356 met the criteria. When stratifying the neonates based on the need for phototherapy, a higher proportion of early-term neonates required phototherapy compared to full-term (p < 0.05). After factoring in various risks (GA; birth weight; gender; feeding type; G6PD deficiency; transcutaneous bilirubin levels at 24 h and 24-48 h postpartum; maternal diabetes; and the presence of caput succedaneum or cephalohematoma), early-term neonates were more likely to need phototherapy than full-term babies (OR: 2.15, 95% CI: 1.21 to 3.80). The optimal cut-off for transcutaneous bilirubin levels 24-48 h postpartum that were used to predict phototherapy need was 9.85 mg/dl. In conclusion, early-term neonates are at a greater risk for developing jaundice and requiring phototherapy than full-term neonates. Monitoring bilirubin 24-48 h postpartum enhances early prediction and intervention.
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Affiliation(s)
- Teck-Jin Tan
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (T.-J.T.); (M.-C.Y.); (C.-C.T.); (Y.-N.Y.); (S.-N.Y.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Wan-Ju Chen
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
- Department of Pediatrics, E-Da Dachang Hospital, I-Shou University, Kaohsiung 80794, Taiwan
| | - Wan-Chun Lin
- Department of Nurse Practitioners, Yuan’s General Hospital, Kaohsiung 80249, Taiwan;
| | - Ming-Chun Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (T.-J.T.); (M.-C.Y.); (C.-C.T.); (Y.-N.Y.); (S.-N.Y.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Ching-Chung Tsai
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (T.-J.T.); (M.-C.Y.); (C.-C.T.); (Y.-N.Y.); (S.-N.Y.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Yung-Ning Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (T.-J.T.); (M.-C.Y.); (C.-C.T.); (Y.-N.Y.); (S.-N.Y.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
| | - San-Nan Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (T.-J.T.); (M.-C.Y.); (C.-C.T.); (Y.-N.Y.); (S.-N.Y.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Hsien-Kuan Liu
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; (T.-J.T.); (M.-C.Y.); (C.-C.T.); (Y.-N.Y.); (S.-N.Y.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
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Acun C, Nusairat L, Kadri A, Nusairat A, Yeaney N, Abu Shaweesh J, Aly H. Pneumothorax prevalence and mortality per gestational age in the newborn. Pediatr Pulmonol 2021; 56:2583-2588. [PMID: 34002954 DOI: 10.1002/ppul.25454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Pneumothorax (PTX) in newborns is a life-threatening condition associated with high morbidity and mortality especially in premature infants. The frequency of PTX in neonates at different gestational ages (GA) and its impact on neonatal mortality have not been quantified. We aimed to determine: (1) the prevalence of PTX in neonates at different GA from ≤24 to ≥37 weeks, (2) the impact of PTX on mortality per GA, and (3) the impact of PTX on the length of stay (LOS) per GA. METHODS The national Kids' Inpatient Database for the years of 2006-2012 were used. We included all infants admitted to the hospital with a documented GA and International Classification of Disease 9 code of PTX. Bivariate and multivariate analyses were conducted and odds ratios (OR) were calculated. RESULTS A total of 10,625,036 infants were included; of them 3665 infants (0.034%) had a diagnosis of PTX, with highest prevalence at ≤24 weeks GA (0.67%), and lowest at term (0.02%). The overall mortality rate of patients with PTX was 8.8%, and greater in preterm (16.3%) versus term infants (2.7%). The association of mortality with PTX was greatest at GA of 29-32 weeks (OR = 8.55; 95% confidence interval: 6.56-11.13). Infants who survived until discharge had a median of 2-12 days longer LOS depending on GA category. CONCLUSIONS The prevalence of PTX peaks in infants less than 24 weeks, however, its impact on mortality is greatest at 29-32 weeks. PTX is associated with longer LOS in survivors.
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Affiliation(s)
- Ceyda Acun
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Leen Nusairat
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Amer Kadri
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Aseel Nusairat
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Natalie Yeaney
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Jalal Abu Shaweesh
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Hany Aly
- Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio, USA
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Yokoyama S, Nakaoka T, Nukada T, Ikeda Y, Hara S. Meconium-related ileus mimicking ileal atresia in a full-term neonate. Pediatr Int 2021; 63:229-231. [PMID: 33529482 DOI: 10.1111/ped.14531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/27/2020] [Accepted: 07/07/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Satoshi Yokoyama
- Department of Pediatric Surgery, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
| | - Tatsuo Nakaoka
- Department of Pediatric Surgery, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
| | - Takayuki Nukada
- Department of Pediatrics, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
| | - Yuka Ikeda
- Department of Pediatrics, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
| | - Shigeto Hara
- Department of Pediatrics, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
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Hua Y, Kaciroti N, Jiang Y, Li X, Xu G, Richards B, Li M, Lozoff B. Inadequate iron stores in early term neonates. J Perinatol 2018; 38:1017-21. [PMID: 29880794 DOI: 10.1038/s41372-018-0140-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/08/2018] [Accepted: 05/16/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To characterize neonatal iron stores depending on gestational age (GA) at term. STUDY DESIGN Participants were 751 mother-newborn pairs from the placebo arm of a randomized clinical trial of prenatal iron-folate supplementation in China. We compared mean cord serum ferritin (SF) by weeks GA and, following the general linear model, assessed whether maternal iron deficiency (ID) influenced relations between GA and cord SF. RESULTS Controlling for covariates, cord SF increased between 37 and 41 weeks (ps < 0.05-0.01). Cord SF was lower in infants of ID vs. non-ID mothers (geometric mean 96.3 [95% CI: 91.3-101.6] µg/L vs. 115.9 [95% CI: 105.0-127.8] µg/L, effect size = 0.33 SD, p = 0.0012). There was no significant increase with GA among infants of ID mothers. For non-ID mothers, cord-blood SF increased sharply with GA until 38 5/7 weeks, after which it plateaued. CONCLUSIONS The findings emphasize that neonates at 37-38 weeks, although considered term, are not fully mature.
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Lu Q, Cheng S, Zhou M, Yu J. Risk Factors for Necrotizing Enterocolitis in Neonates: A Retrospective Case-Control Study. Pediatr Neonatol 2017; 58:165-170. [PMID: 27543379 DOI: 10.1016/j.pedneo.2016.04.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/28/2016] [Accepted: 04/22/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Necrotizing enterocolitis (NEC) in neonates is devastating, and risk-factor identification is crucial. This study aimed to evaluate risk factors for NEC in different gestational age (GA) groups. METHODS Risk factors associated with NEC were investigated using a retrospective case-control design. Patients with Bell's Stage NEC≥II were divided into three groups based on GA: I, <34 weeks; II, ≥34 weeks but <37 weeks; III, ≥37 weeks. Each case was paired with two GA- and weight-matched controls. Data were collected from medical records, and univariate and conditional logistic regression analyses employed. RESULTS A total of 238 cases and 476 controls were enrolled. Variation in the months when NEC was diagnosed was noted, with a peak in January and a trough in August. Intrahepatic cholestasis of pregnancy and transfusion with packed red blood cells were significantly associated with NEC in preterm infants. Meconium aspiration syndrome was an independent risk factor for a greater chance of NEC development in full-term infants. Postnatal asphyxia and sepsis were associated with an increased risk of NEC in all groups. Probiotic use was associated with a reduced risk of NEC. Patients aged >34 weeks with congenital heart disease were more likely than controls to have NEC. CONCLUSION Intrahepatic cholestasis of pregnancy and meconium aspiration syndrome may be new risk factors for NEC.
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Affiliation(s)
- Qi Lu
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
| | - Shupeng Cheng
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China; Department of Pediatrics, Anhui Provincial Hospital of Anhui Medical University, Hefei, China
| | - Min Zhou
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China; Department of Pediatrics, Chengdu First People's Hospital, Chengdu, China
| | - Jialin Yu
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
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Briere CE, Jensen T, McGrath JM, Young EE, Finck C. Stem-Like Cell Characteristics from Breast Milk of Mothers with Preterm Infants as Compared to Mothers with Term Infants. Breastfeed Med 2017; 12:174-179. [PMID: 28277748 DOI: 10.1089/bfm.2017.0002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Breast milk stem cells are hypothesized to be involved in infant health and development. Our research team is the first known team to enroll mothers of hospitalized preterm infants during the first few weeks of lactation and compare stem cell phenotypes and gene expression to mothers of healthy full-term infants. SETTINGS Participants were recruited from a Level IV Neonatal Intensive Care Unit (preterm dyads) and the community (full-term dyads) in the northeastern United States. PARTICIPANTS Mothers of hospitalized preterm infants (<37 weeks gestational age at birth) and mothers of healthy full-term infants (>39 weeks gestational age at birth). RESULTS Breast milk stem-like cell populations were identified in both preterm and full-term breast milk samples. The data suggest variability in the proportion of stem cell phenotypes present, as well as statistically significant differential expression (both over- and underexpression) of stem cell-specific genetic markers when comparing mothers' milk for preterm and full-term births. CONCLUSIONS Our findings indicate that (1) stem cells are present in preterm breast milk; (2) differential expression of stem cell-specific markers can be detected in preterm and full-term breast milk samples; and (3) the percentage of cells expressing the various stem cell-specific markers differs when preterm and full-term breast milk samples are compared.
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Affiliation(s)
- Carrie-Ellen Briere
- 1 Department of Nursing Research, Connecticut Children's Medical Center , Hartford, Connecticut.,2 School of Nursing, University of Connecticut , Storrs, Connecticut
| | - Todd Jensen
- 3 Department of Pediatrics, UConn Health , Farmington, Connecticut
| | - Jacqueline M McGrath
- 1 Department of Nursing Research, Connecticut Children's Medical Center , Hartford, Connecticut.,2 School of Nursing, University of Connecticut , Storrs, Connecticut
| | - Erin E Young
- 2 School of Nursing, University of Connecticut , Storrs, Connecticut.,4 Department of Genetics and Genome Sciences, UConn Health, Farmington, Connecticut.,5 Institute for Systems Genomics, University of Connecticut, Storrs, Connecticut
| | - Christine Finck
- 3 Department of Pediatrics, UConn Health , Farmington, Connecticut.,6 Department of Surgery, Connecticut Children's Medical Center , Hartford, Connecticut
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Dritsakou K, Liosis G, Gioni M, Glynou E, Avdeliodi K, Papagaroufalis K. CRP levels in extremely low birth weight (ELBW) septic infants. J Matern Fetal Neonatal Med 2014; 28:237-9. [PMID: 24670235 DOI: 10.3109/14767058.2014.908842] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Testing the validity of C-reactive protein (CRP) in extremely low birth weight (ELBW) infants. METHODS During a five-year period, 483 infants with probable (36%) and definite sepsis (64%) were enrolled in the study. RESULTS ELBW infants with definitive sepsis had CRP levels comparable with full-terms (p=0.992). However, the highest (hs) values were observed in infants >2500 g, 24 h after the septic work up whereas in those with birth weight (BW) <1000 g after 48 h. Highest CRP levels of infants with early sepsis were similar to those of the late onset ones (p=0.825). The causative microorganism had a strong influence on CRP values, as Gram negative germs produced significantly higher CRP levels in comparison to infants with Gram positive sepsis. CONCLUSIONS Highest CRP values in <1000 g infants increase in levels comparable to full terms, but with a 24-h delay.
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Davis EP, Buss C, Muftuler LT, Head K, Hasso A, Wing DA, Hobel C, Sandman CA. Children's Brain Development Benefits from Longer Gestation. Front Psychol 2011; 2:1. [PMID: 21713130 PMCID: PMC3111445 DOI: 10.3389/fpsyg.2011.00001] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 01/01/2011] [Indexed: 11/13/2022] Open
Abstract
Disruptions to brain development associated with shortened gestation place individuals at risk for the development of behavioral and psychological dysfunction throughout the lifespan. The purpose of the present study was to determine if the benefit for brain development conferred by increased gestational length exists on a continuum across the gestational age spectrum among healthy children with a stable neonatal course. Neurodevelopment was evaluated with structural magnetic resonance imaging in 100 healthy right-handed 6- to 10-year-old children born between 28 and 41 gestational weeks with a stable neonatal course. Data indicate that a longer gestational period confers an advantage for neurodevelopment. Longer duration of gestation was associated with region-specific increases in gray matter density. Further, the benefit of longer gestation for brain development was present even when only children born full term were considered. These findings demonstrate that even modest decreases in the duration of gestation can exert profound and lasting effects on neurodevelopment for both term and preterm infants and may contribute to long-term risk for health and disease.
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Affiliation(s)
- Elysia Poggi Davis
- Women and Children's Health and Well-Being Project, Department of Psychiatry and Human Behavior, University of California Irvine Orange, CA, USA
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