Journal of Neonatology最新文献

{"title":"Incidence and Predictors of Preterm Mortality in Ethiopia: A Systematic Review and Meta-analysis","authors":"Lencho Kajela Solbana, Diriba Etana, Desalegn Nazi, Firaol Regea, Solomon Berhanu","doi":"10.1177/09732179231221883","DOIUrl":"https://doi.org/10.1177/09732179231221883","url":null,"abstract":"Introduction: Preterm birth complication is the first leading cause of neonatal mortality in Ethiopia. In this study, the pooled prevalence and predictors of preterm mortality in Ethiopia were assessed. Methods: The research protocol was registered to PROSPERO under the CRD42023415334 registration number. PubMed, Google Scholar, Cochrane Library, and Hinari databases were searched for studies up to April 10, 2023. Cohort studies on the incidence of preterm mortality and its predictors in Ethiopia were included in this review. This review was reported using the preferred reporting items for systematic reviews and meta-analyses checklist. We extracted data from the selected papers and exported to R 4.2.3 and STATA version 15.0 for estimating pooled incidence proportion, density rate, and adjusted hazard ratio (AHR). By looking at the funnel plot and using Egger’s test, the publication bias was assessed. This study didn’t receive funds from any organization. Results: From 152 identified studies, 16 studies were selected for final analysis. The pooled incidence proportion and incidence density of preterm mortality were 30% (95% CI: 27%–32%) and 40 (95% CI: 30–40) per 1,000-person days, respectively. Being a male (AHR = 1.43, 95% CI: 1.09, 1.78), gestational age (0.83, 95% CI: 0.80, 0.87), born before 32 weeks (AHR = 2.15, 95% CI: 1.15, 3.84), antepartum hemorrhage (AHR = 2.46, 95% CI: 1.07, 3.84), the fifth minute Apgar rating less than seven (AHR = 1.84, 95% CI: 1.43, 2.25), birth asphyxia (AHR = 1.87, 95% CI; 1.59, 2.14), birth weight 1,000–1,499 g (AHR = 3.63, 95% CI: 1.69, 5.57), respiratory distress syndrome (AHR = 1.80, 95% CI: 1.59, 2.02), jaundice (AHR = 2.39, 95% CI: 1.16, 3.61), neonatal sepsis (AHR = 1.54, 95% CI: 1.25, 1.83), and not using kangaroo mother care (AHR =1.92, 95% CI: 1.11, 2.72) were predictors of time to death of preterm. Conclusions: Almost one third of preterm neonates treated at different health facilities in Ethiopia failed to survive to the first four weeks of life. Because every study that was included was an institution-based cohort study, the results may not generalized to preterm newborns who were not hospitalized at medical facilities.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"43 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385135","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":"Neonatal and Infant Illnesses and Health Seeking Behavior Among Hilly (Porja) Tribal Community: A Qualitative Observational Study","authors":"Srividhya Samakya, Sanghamitra Pati, S. Acharya","doi":"10.1177/09732179231210741","DOIUrl":"https://doi.org/10.1177/09732179231210741","url":null,"abstract":"The study explores the health-seeking behavior for neonatal and infant illnesses of the Porja hilly tribe in Andhra Pradesh, India. This study was a community-based qualitative observational study conducted from July 2022 to February 2023. In-depth interviews ( n = 31) were conducted with parents of neonates and infants. Two focus group discussions (involving 12 each) were conducted to validate the findings with other female family members such as, grandmothers. Data collection was carried out by using a semi-structured questionnaire on traditional practices and basic socio-demographic characteristics along with an in-depth interview guide for undertaking qualitative interviews. Qualitative findings were analyzed using the thematic framework approach, followed by the analysis of data from the field notes. Three themes (along with six sub-themes) were generated: (a) Early essential care, (b) Emergency of hospital care, (c) Effective Ethnomedical/Ritualistic Care (not requiring hospital care) which explained the tribal parents’ ways of care and treatment for their neonates and infants from various morbidity and mortality risks. Culture-specified traditional beliefs play crucial roles in shaping the neonatal and infant health of indigenous hilly tribal communities. Preserving the beneficial traditional methods and preventing harmful practices can help improve the overall child health status in such resource scanty settings with inadequate neonatal services.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387438","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":"Pathogen-wise Clinical Profile, Outcome and Antibiotic Sensitivity Profile of Septic Newborns in Level III Neonatal Intensive Care Unit of a Tertiary Teaching Hospital: A Retrospective Study","authors":"Ramya Srinivasa Rangan, C. Valvi, Rema S Nagpal, A. Kinikar, Karyakarte Rajesh, S. G. N., Chaiti Aranke","doi":"10.1177/09732179231218823","DOIUrl":"https://doi.org/10.1177/09732179231218823","url":null,"abstract":"Introduction: Culture positive sepsis remains to be a leading cause of death in Neonatal Intensive Care Unit (NICU) mainly among preterm and low birth weight newborns. The objective was to analyze the initial signs of sepsis, antibiotic sensitivity, and outcome of septic newborns in NICU. Methods: The demographic data, initial clinical features at suspicion of sepsis, diagnosis, laboratory abnormalities, pathogen isolated and antibiotic sensitivity patterns of the septic neonates, and their outcome were documented from their case records. Results: A total of 161 culture positive septic newborns, 76.4% were preterm and 54 died of sepsis (33.54%). Early and late onset sepsis was seen in 56 and 109 neonates, respectively. The initial clinical findings at suspicion of sepsis which had a statistical significance were tachycardia in Escherichia coli and Pseudomonas sepsis, hyperglycemia in Burkholderia, fever in Candida, sclerema in Klebsiella pneumoniae (KP), and seizures in E. coli sepsis. The cerebrospinal fluid culture positive newborns commonly presented with apnea, poor perfusion, and lethargy. Raised C reactive protein was seen in a higher proportion of newborns with Candida (60%) sepsis and E. coli (50%) sepsis. Severe thrombocytopenia was seen in 53%–62% newborns with gram-negative and fungal sepsis. Metabolic acidosis was seen in all gram-negative sepsis neonates, particularly in >80% cases of Klebsiella and Candida sepsis. Mortality was highest and statistically significant in KP (55.4%) and Citrobacter koseri (55.6%) sepsis ( p = .004). The statistically significant risk factors for mortality included neonates with raised C Reactive Protein (CRP). Most of the gram-negative pathogens were sensitive to colistin and aminoglycosides and resistant to carbapenems. Conclusion: Observing the initial clinical features at suspicion of sepsis may help predicting the likely pathogen awaiting the final blood/CSF culture report and knowing the antibiotic sensitivity profile of commonly isolated organisms in our NICU helps in the selection of a rational empirical antibiotic.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"66 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139385569","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":"Comparison of Ultrasound Assisted Versus Palpation Method for Diagnostic Lumbar Puncture in Neonates: A Randomized Control Trial","authors":"Pradeep Chandu, Ashish Jain, Nidhi Jain, Swati Gupta, Natasha Gupta","doi":"10.1177/09732179231210734","DOIUrl":"https://doi.org/10.1177/09732179231210734","url":null,"abstract":"Background: Our purpose was to determine the beneficial effect of ultrasound (US) assisted lumbar puncture (UALP) to increase lumbar puncture (LP) success compared with the clinical conventional palpation (CCP) method. Methods: This parallel randomized controlled single-center trial was conducted in a Neonatal Intensive Care Unit in a tertiary care Hospital. Neonates >28 weeks requiring LP were enrolled and stratified into two groups ≥34 and <34 weeks gestational age. Prior to study initiation, training under the supervision of a qualified radiologist was undertaken. The primary outcome was successful LP (defined as no dry tap and cerebrospinal fluid RBC <1,000/mm 3 ). Secondary outcomes were time taken for the procedure, US estimation of the point of formation of conus. Results: A total of 55 cases were randomized after exclusion out of which 29 cases were assigned to UALP and 26 cases to CCP. There was no difference in the primary outcome of LP success between the UALP group and the CCP group [89.7% vs. 84.6%; difference: 5.1% (95% confidence interval: −12.7% to 22.7%)], p = .57. There was a statistically significant difference in time taken for procedure 81.46 ± 65.21 seconds (mean ± SD) in CCP versus 327.93 ± 128.07 seconds in UALP ( p < .001). Results were similar in both groups (<34 and ≥34 weeks gestational age) if analyzed separately. Conclusion: UALP did not improve the successful LP when compared with the CCP method. Time taken for procedure is higher in the UALP group.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139450848","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":"Erythropoietin in Neonates with Perinatal Asphyxia Undergoing Therapeutic Hypothermia—A Prospective Cohort Study","authors":"S. Charki, S. V. Patil, S. Vijayakumar, Yalagurswamy Kolkar","doi":"10.1177/09732179231194455","DOIUrl":"https://doi.org/10.1177/09732179231194455","url":null,"abstract":"Aims: To assess the safety and feasibility of erythropoietin (EPO) in asphyxiated neonates undergoing therapeutic hypothermia (TH). Subjects and methods: This study enrolled 60 neonates with HIE undergoing TH. 30 neonates were divided into EPO with TH group, where neonates received EPO (dose), at a dose rate of 1000 IU/kg/48 hours, for four doses and the remaining 30 neonates undergoing TH were into control group. Magnetic resonance imaging brain was undertaken between 10 and 14 days of life in surviving neonates. The Bayley Scales of Infant (BSI) Development IV was performed at regular intervals up to the age of 12 months. Results: Amplitude-integrated electroencephalogram (aEEG) showed burst suppression (19% vs. 11%), low voltage (10% vs. 4%), and flat trace (7% vs. 3%) in control group in comparison with EPO concurrent with TH group which was statistically significant. Brain magnetic-resonance imaging (MRI) done at 12 days (±2 days) showed significant brain injury patterns such as severe brain injury (4% vs. 9% P = .05) and regional specific HIE (7% vs. 13%, P = .03) in control group of only TH neonates. At 12 months, neurodevelopment outcomes in EPO with TH group neonates showed a favorable outcome. Conclusion: rhEPO concurrent with TH in HIE neonates resulted in significantly less severe brain injuries in MRI brain in HIE neonates. aEEG changes were less statistically significant in EPO with TH group with favorable neurodevelopmental outcomes at 12 months of age.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"22 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139388488","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":"Breaking Barriers: Insights into Complex Breastfeeding Scenarios in a Rural Medical College—A Case Series","authors":"Nida Asif, A. Benakappa","doi":"10.1177/09732179231214409","DOIUrl":"https://doi.org/10.1177/09732179231214409","url":null,"abstract":"Breastfeeding is the only most natural and fundamental part of infant nutrition and early development. It plays a vital role in the optimal nourishment and fostering a myriad of health benefits for newborns. While breastfeeding is a natural process, it may also present challenges. Latching difficulties, maternal perception of inadequate milk supply, maternal medical conditions and her medication use, multiple gestation, congenital abnormalities in the baby, cultural and regional practices of prelacteal feeds, psychosocial factors, and so on can be some of the issues (Charantimath et al. PLoS One. 2020;15(5):e0231755). The problems intensify when these issues present at a rural setting with limited resources and many social factors and myths surrounding breastfeeding. With advancement in the study of breastfeeding techniques and protocols and understanding of the whole physiological process up to molecular level has given us insights as to how these problems can be managed better. An interdepartmental coordination and support are needed for solving these issues and improvise the outcomes in the infant nutrition. We present here a set of 9 mother infant dyads who had a peculiar course of breastfeeding and how they were counseled and managed at a rural medical college setting.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"16 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139451396","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":"Devising a Lesson Plan on Essential Newborn Care Based on Gagne’s Principles","authors":"Poonam Singh, Saurodeep Basu, Sriparna Basu","doi":"10.1177/09732179231195516","DOIUrl":"https://doi.org/10.1177/09732179231195516","url":null,"abstract":"The present lesson plan on essential newborn care (ENC) in a simulation model based on the recommendations of the World Health Organization (WHO) has been prepared using Gagne’s instructional design. Each step of Gagne’s nine events of instruction has been elaborated with the scope of the lesson plan for the achievement of the intended learning outcomes of the medical students involved in small-group teaching. The pros and cons of the application of Gagne’s model have been discussed. Finally, a detailed description of the lesson and the clinical scenario has been summarized.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963098","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":"5p15 Duplication: Clinical Features in a Preterm Infant","authors":"Z. Wynter, Asmaa Semrin, Faizal Z. Asumda, Quyen Pham","doi":"10.1177/09732179231206961","DOIUrl":"https://doi.org/10.1177/09732179231206961","url":null,"abstract":"Trisomy 5p is a rare chromosomal abnormality that results from the partial or complete duplication of chromosome 5. Commonly reported clinical features of Trisomy 5p include congenital heart defects, respiratory failure, seizures, and developmental delay. To date, all reported cases of Trisomy 5p have been school-aged children or adults. We present the first case of an infant who was born preterm with multiple congenital anomalies and subsequently diagnosed with 5p15.1p11 duplication via whole exome sequencing. While our patient shares some of the major features of classic Trisomy 5p, the infant has other clinical features not previously described.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139197387","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":"From the pen of the President NNF…","authors":"Praveen Kumar","doi":"10.1177/09732179231216857","DOIUrl":"https://doi.org/10.1177/09732179231216857","url":null,"abstract":"","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"164 9 1","pages":"301 - 301"},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139226135","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":"A Comparative Study of the Clinical Profile of COVID-19 in Neonates During Different Waves: A Retrospective Observational Study","authors":"Sermadurai Vivek, C. N. Kamalarathnam, M. Anitha, Mariappan Vaideeswaran, Ethirajan Narayanan, T. Sangeetha","doi":"10.1177/09732179231204778","DOIUrl":"https://doi.org/10.1177/09732179231204778","url":null,"abstract":"The severity of coronavirus disease 2019 in neonates was variable. Studies describing the morbidities in neonates due to coronavirus disease 2019 among outborn neonates were limited. The impact of maternal immune status due to vaccination against coronavirus disease in 2019 on neonates remains unexplored. Hence, we aimed to compare the clinical profile of coronavirus disease 2019 among outborn neonates during the different waves. We did a medical record-based retrospective study of neonates with coronavirus disease 2019 admitted between January 2020 and July 2022 in a tertiary care out-born neonatal unit in India. They were stratified based on the period of admission into the first, second, and third waves. Outcome variables, including demographic, clinical, laboratory, radiological, and treatment data of the eligible neonates, were obtained and compared between different waves. Among the 32 neonates enrolled, 17 were admitted during the first wave, 15 during the second wave, and none during the third wave. Of all, 24 (75%) neonates were symptomatic. Contact with coronavirus disease 2019-positive mothers and the occurrence of fever and lethargy were high during the second wave. Inflammatory markers were elevated in 12 (46%), and 28% had abnormal X-rays. Eight (25%) neonates required respiratory support, and five (16%) required mechanical ventilation. The clinical outcome was good, with 91% being discharged home. No significant difference in demographics, laboratory markers, mode of treatment, or clinical outcome between the first and second waves was identified. Transmissibility from coronavirus disease 2019-positive mothers to neonates was high during the second wave, with more coronavirus disease 2019-related symptoms. Symptomatic neonates were milder in severity but improved with supportive care.","PeriodicalId":16516,"journal":{"name":"Journal of Neonatology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139223074","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}