Journal of Neonatology最新文献

{"title":"Post-operative Ultrashort Bowel Syndrome in a Term Neonate: One-year Follow-up","authors":"Kaushaki Shankar, Bhavya Kukreja, Harsh Wardhan, Vipul Saneja, Vishnu Dutta Agrawal","doi":"10.1177/09732179241256749","DOIUrl":"https://doi.org/10.1177/09732179241256749","url":null,"abstract":"Ultrashort bowel syndrome occurs when the length of the small bowel is below 10–25 cm, or 10% of that expected for age. It is a rare occurrence in neonates; however, when it occurs, it results in high morbidity and mortality. Surviving newborns face a significant detriment in growth and development due to malabsorption of nutrients. A multidisciplinary approach with aggressive parenteral nutrition is the mainstay of management. Our case presented at 20 days of life, with malrotation and midgut volvulus resulting in post-surgical ultrashort bowel syndrome. In spite of being left with only 20 cm of short bowel, the infant survived on conservative management and is thriving well; the infant has been off parenteral nutrition completely since 11 months of age.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141350638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent Struggles Beyond Breath: Decoding Hemostatic Dynamics and Bleeding in Neonates Affected by Perinatal Asphyxia","authors":"Vivek K. V, Minakshi Johari","doi":"10.1177/09732179241256757","DOIUrl":"https://doi.org/10.1177/09732179241256757","url":null,"abstract":"Perinatal asphyxia, a prevalent neonatal challenge, induces significant hemodynamic perturbations leading to life-threatening bleeding. This study aimed to estimate the incidence of hemostatic dysfunction and characterize bleeding events in neonates with perinatal asphyxia. Secondary objectives included evaluating the relationship between specific components of hemostatic parameters and the severity of bleeding events, along with identifying parameters predicting abnormal bleeding. This observational study, spanning 20 months in the NICUs of S. M. S. Medical College and an attached group of hospitals in Jaipur, enrolled 110 neonates with perinatal asphyxia on whom hemostatic testing was done within 24 hours of birth. The presence of one or more of the following—platelet count < 1 lakh/mm³, PT > 20 seconds, INR > 1.5, aPTT > 45 seconds, and fibrinogen < 150 mg/dl—was defined as hemostatic dysfunction. Bleeding events were assessed for up to 96 hours using the Neonatal Bleeding Assessment Tool and graded by the WHO Bleeding Scale. Among 110 neonates, the incidence of initial hemostatic dysfunction was 70%. Fifty-one neonates (46.3%) experienced bleeding, among whom 5 (9.8%) had minor, 21 (41.18%) had moderate, 15 (29.42%) had major, and 10 (19.6%) had severe bleeding events. Forty-seven neonates (42.72%) received at least one blood product transfusion, with fresh frozen plasma (FFP) being the most common (100%). Neonates with perinatal asphyxia exhibit a high incidence of hemostatic dysfunction, signifying an elevated risk of bleeding and transfusion requirements. While routine hemostatic testing identifies dysfunction, predicting bleeding warrants a search for better investigations. This helps in establishing guidelines for early interventions, which is crucial to reduce mortality risks in these neonates.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141369792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kangaroo Mother Care Foundation, India: Champion Organization Focusing on the Essentials","authors":"Shashi N. Vani","doi":"10.1177/09732179241257728","DOIUrl":"https://doi.org/10.1177/09732179241257728","url":null,"abstract":"","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"385 2","pages":"165 - 166"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141401560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Milk Output and Factors Influencing Sustained Feeding with Mother’s Own Milk in Very Preterm Births: A Prospective Observational Study","authors":"Sruthi Nair, Aditi Shroff, Yadalakshmi Raggala, Sai Kiran Deshabotla, Venkatakeshwarlu Varadhelli, T. Oleti","doi":"10.1177/09732179241254248","DOIUrl":"https://doi.org/10.1177/09732179241254248","url":null,"abstract":"In very low birth weight infants, mother’s own milk (MOM) feeding is an essential part of the bundle of best practices to reduce potentially preventable neonatal morbidities and associated costs. Mothers of preterm infants can have an altered sequence of lactogenesis because of their preterm delivery and mother–infant separation. Healthy mothers with term infants typically experience coming to volume (CTV), that is, MOM volume of ≥ 500 ml/day, by the end of the second week of postpartum. There is paucity of data regarding MOM output in preterm mothers. To assess MOM output and factors influencing MOM volume among mothers delivering <32 weeks during the first two weeks after birth. To determine the proportion of mothers attaining CTV and whether the first two weeks’ MOM volume predicts MOM feeding at discharge and 40 weeks corrected gestational age (CGA). In this prospective observational study conducted at a tertiary care NICU over a period of 18 months, the milk output of the preterm mothers was quantified, and the proportion of infants fed with MOM at discharge and 40 weeks of corrected age was assessed. The median milk output per day at the end of the first and second weeks was 180 IQR (100, 290) ml and 300 IQR (178, 420) ml, respectively. Earlier initiation of kangaroo mother care, higher birth weight of the infant, increase in the frequency of daytime milk expression and non-nutritive suckling (NNS) contributed to increased MOM output per day. The proportion of mothers who came to volume (milk output of ≥500 ml/day) by day 14 was 26 (19%). The proportion of babies on predominant MOM feeding at discharge and at 40 weeks’ follow-up was 96 (72%) and 75 (61.5%) infants, respectively. Mothers who came to volume were more likely to feed MOM at 40 weeks [odds ratio (OR) 5.2 (1.2–23.0)]. Higher birth weight, more frequency of daytime milk expression, earlier initiation of KMC and NNS and longer duration of KMC are factors improving the MOM output. Mothers who came to volume by the first two weeks after birth sustained feeding with MOM till 40 weeks CGA.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"28 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141276191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Central Catheter Tip Position in Neonates by Ultrasonography Versus X-ray","authors":"Prachi Patwal, Chinmay Chetan, Brajendra Singh, Vinayak Madhukar Jedhe, Girish Gupta, S. Patra","doi":"10.1177/09732179241254245","DOIUrl":"https://doi.org/10.1177/09732179241254245","url":null,"abstract":"Central catheters are frequently inserted in neonatal intensive care units. The tip of these catheters should be in the correct position; otherwise, it may lead to life-threatening complications. X-ray has been universally used as a standard imaging modality to localize the position of central lines. Ultrasonography is an upcoming promising modality. We compared the catheter tip localization using ultrasonography versus X-ray.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"32 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141276334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Kangaroo Mother Care on Retinopathy of Prematurity in Neonates Less Than 1,800 g or Below 34 Weeks of Gestation","authors":"Chetan Singh, Sugandha Arya, H. Chellani, P. Anand, Richa Singhal","doi":"10.1177/09732179241244567","DOIUrl":"https://doi.org/10.1177/09732179241244567","url":null,"abstract":"KMC (Kangaroo Mother Care) is an established intervention to reduce mortality and morbidity in low birth weight (LBW) neonates. A multitude of risk factors and preventive strategies for ROP (retinopathy of prematurity) have been studied, however, the effect of KMC on ROP has not been reported. This study aims to study the effect of KMC on ROP in neonates with birth weights between 1,000 and 1,800 g. The babies who received effective KMC (>6 hours per 24 hours for three consecutive days) were analysed in the intervention group and those with ineffective KMC were analysed in the control group. Variables significant in univariate analysis were entered into backward regression models in multivariate analysis. Odds ratios and 95% confidence intervals were calculated. P values < .05 are taken as significant. Of 783 neonates enrolled, 66 (8.4%) developed ROP (any stage). The incidence of ROP requiring intervention was 1.02%. Effective KMC reduced the risk of ROP by 95%, RR 0.05 (0.02–0.12) and number needed to treat = 5. The proportion of neonates with ROP in zone 1 and stage 3 was more in the ineffective KMC (42.4% vs. 1.5%) group than in the effective KMC group (51.5% vs. 0%) ( P < .001). Ineffective KMC, gestation <30 weeks, small for gestation, obstetric complications, asphyxia, sepsis, higher initial PEEP and lack of breastfeeding were significant risk factors for developing ROP. KMC, an effective intervention to improve the mortality and morbidity in LBW neonates, was significantly associated with the reduction of any stage ROP and ROP needing intervention, potentially preventing a significant cause of childhood blindness.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"24 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of One-on-one Structured Counselling of Mothers and Family Members Using GALPAC Technique Compared to Standard Counselling on Post-discharge Kangaroo Mother Care and Related Outcomes in Low-birth-weight Infants: A Quasi-randomised Controlled Trial","authors":"Bhaswati Ghoshal, Sahay Mondal, Meghna Siddhanta, Shyamal Banerjee","doi":"10.1177/09732179241247931","DOIUrl":"https://doi.org/10.1177/09732179241247931","url":null,"abstract":"Kangaroo mother care (KMC) improves low-birth-weight neonatal survival. It is recommended for low-birth-weight babies in all settings and should be continued at home as well. Counselling of mothers and family members is necessary for successful initiation and continuation of KMC. This study aims to use the greet, ask, listen, praise, advise, check understanding (GALPAC) method of counselling to improve the outcome of home-based KMC. This quasi-randomised controlled trial was done in 266 stable low-birth-weight neonates born in the hospital. In the intervention group, GALPAC counselling was done by trained nurses and paediatricians during the hospital stay, through telephone after discharge and by local ASHA during home visits. The control group received routine counselling during discharge and on follow-up visits by the treating paediatrician. Both groups were examined on the 15th, 30th and 60th day post-discharge for weight changes and were monitored for morbidity, mortality, breastfeeding and continuation of KMC. The neonates were divided randomly in two groups: 132 in the intervention group and 134 in the control group. The basic demographic parameters were comparable in both the groups. On the 15th day of follow-up, breastfeeding rate was 86% in the intervention group and 80% in the control group, morbidity was 13.4% and 15.7%, KMC continuation was 84% and 71.3% and re-admission rate was 6.1% and 7.04%, respectively. By the 60th day, the breastfeeding rate was 67.6% and 55.05%, morbidity 3.8% and 19.1%, KMC continuation 65% and 47% and re-admission rate 1.8% and 20.2% in the intervention and control groups, respectively. Mortality was 11.2% in the control group and 1.8% in the intervention group by the 60th day. Weight gain was more in the intervention group than in the control group (1,055.30 ± 122.46 g and 745.77 ± 99.34 g) by day 60. The outcome of KMC in the intervention group was better in comparison to the control group for all parameters studied. Therefore, one-on-one structured counselling with regular communication and follow-up is an effective intervention to improve maintenance of KMC at home.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"14 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidermolysis Bullosa in an Infant Heterozygous for Mutation in LAMC2 Gene: A Case Report","authors":"G. Milas, Vasiliki Tsolaki, Vasileios Issaris, Stefanos Fragkos, Aakash Pandita","doi":"10.1177/09732179241249323","DOIUrl":"https://doi.org/10.1177/09732179241249323","url":null,"abstract":"Epidermolysis bullosa is a heterogenous skin disease caused by genes associated with skin integrity and dermal–epidermal adhesion. The four main categories include: epidermolysis bullosa simplex, junctional epidermolysis bullosa, dystrophic epidermolysis bullosa, and kindler syndrome. We report the case of a one-month-old infant who was brought to the emergency department due to complaint of fever and a bullous exanthem. Skin cultures were positive for methicillin-sensitive Staphylococcus aureus and Escherichia coli. Whole exome sequencing revealed mutations in LAMC2 gene. Junctional epidermolysis bullosa is associated with poor prognosis. Healthcare professionals and parents should be educated in a specific way as patients with this condition are in need of special care.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"112 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140978126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, and Practices Toward Kangaroo Mother Care Among Mothers in a Tertiary Neonatal Care Unit","authors":"Monalisa Pradhan, Shrutiprajna Kar, Tanushree Sahoo, T. Som, P. Mohanty, U. Devi","doi":"10.1177/09732179241242227","DOIUrl":"https://doi.org/10.1177/09732179241242227","url":null,"abstract":"Aim: To study the knowledge, attitude, and practices of Kangaroo Mother Care (KMC) among eligible postnatal mothers in the postnatal ward (PNW) and neonatal intensive care unit (NICU) of a tertiary neonatal unit in Eastern India. Methods: A cross-sectional survey was conducted among 100 mothers of low-birth-weight babies in our PNW and NICU. As part of the unit protocol, all mothers of eligible babies were counseled about KMC at first contact verbally as well as by using an informative video on KMC. Data was collected using a structured questionnaire after the routine counseling of the mothers on their first visit after delivery. The analysis of the data was done using appropriate statistics. Results: More than three-fourths (83.2%) of mothers had good knowledge of KMC. A good attitude toward using KMC was found in 91.6% of the mothers. Almost all the mothers (98%) knew the correct KMC position, and 12% of mothers had a previous preterm baby and had given KMC. Many mothers felt the small size of the baby, pain after cesarean section, and central or peripheral intravenous lines in the baby were barriers to KMC. Conclusion: The knowledge regarding KMC among mothers whose babies were admitted into the PNW/NICU was good. Though the attitude toward KMC was good, mothers felt there were multiple barriers to initiating KMC.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"81 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140675358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mother Support Groups for Raising Awareness in the Community About Kangaroo Mother Care \u2028and Breastfeeding in the Era of COVID-19: Experiential Learning","authors":"K. Sameer, S. Nimbalkar, Reshma Pujara, Dipen Patel","doi":"10.1177/09732179241234517","DOIUrl":"https://doi.org/10.1177/09732179241234517","url":null,"abstract":"Introduction: This article explores the establishment and subsequent challenges faced by a Mother Support Group (MSG) initiated in Gujarat, India, focusing on promoting Kangaroo Mother Care (KMC) and exclusive breastfeeding, particularly amid the COVID-19 era. Methods: The methodology involved adapting to COVID-19 restrictions, utilizing online platforms for training and webinars, and collaborating with ASHA workers for community outreach. The MSG members received training on breastfeeding and KMC, followed by practical demonstrations and community visits. Although initial efforts were promising, the group’s sustainability faltered when key stakeholders withdrew, revealing challenges in maintaining community-driven interventions. Results and discussion: The article underscores the importance of sustained efforts in establishing and retaining parent support groups. The lack of comprehensive data collection limits the ability to evaluate specific outcomes, but we highlight the potential benefits of MSG, including improved breastfeeding practices and KMC adherence. We acknowledge the need for robust frameworks and standard operating procedures to enhance the sustainability of such initiatives, emphasizing the importance of community involvement and leadership in supporting disadvantaged newborns. Conclusion: We draw attention to the complexities of sustaining grassroots initiatives and call for further research to develop effective models that address the unique needs of marginalized communities, particularly regarding the care of preterm newborns.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"45 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}