Journal of neonatal-perinatal medicine最新文献_第5页

Predictive value of serum interleukin-6 for neonatal encephalopathy outcomes. 血清白细胞介素-6对新生儿脑病预后的预测价值。

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 DOI: 10.3233/NPM-230224

Junichi Saito, Jun Shibasaki, Kouji Yamamoto, Maya Fujita, Katsuaki Toyoshima

{"title":"Predictive value of serum interleukin-6 for neonatal encephalopathy outcomes.","authors":"Junichi Saito, Jun Shibasaki, Kouji Yamamoto, Maya Fujita, Katsuaki Toyoshima","doi":"10.3233/NPM-230224","DOIUrl":"10.3233/NPM-230224","url":null,"abstract":"Background: Serum interleukin-6 (IL-6) may predict adverse outcomes of neonatal encephalopathy (NE); however, limited data regarding the predictive utility of IL-6 during neurodevelopmental follow-up are available. We aimed to determine the utility of IL-6 for predicting adverse outcomes at 18 to 22 months of age.Methods: Eighty-seven patients with NE who received therapeutic hypothermia were enrolled in this study. Serial serum IL-6 levels during the first 3 postnatal days were collected. Patients were classified into three groups: (1) death, (2) survival with moderate to severe neurodevelopmental disability (NDD) at 18-22 months of age, and (3) survival without NDD (favorable outcome). The predictive ability of IL-6 was determined by the area under the receiver-operating characteristic curve (AUC).Results: Serial IL-6 data of 80 patients with NE were available and showed peak levels on postnatal day 1; these levels gradually decreased toward day 3. By 18-22 months of age, 13 and 17 patients died and experienced moderate to severe NDD without death, respectively. Fifty patients experienced favorable outcomes. Higher IL-6 levels on day 1 predicted the composite adverse outcome (including death and survival with NDD; n = 30; AUC, 0.648). Higher IL-6 levels on day 1 predicted death (n = 13; AUC, 0.799), whereas higher IL-6 levels on day 1 predicted survival with NDD (n = 17; AUC, 0.536).Conclusions: The AUC of IL-6 that predicted survival with NDD was lower than the AUC of IL-6 that predicted death; therefore, IL-6 may have insufficient utility for predicting NDD without death.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"770-778"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372118","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}

引用次数: 0

Utility of doppler ultrasound in early-onset neonatal sepsis: A case-control study. 多普勒超声在早期新生儿败血症中的应用：病例对照研究

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 DOI: 10.3233/NPM-240028

A H Kasim, S A Mohammad, L A Habib, G A Saleh, S H Salah

{"title":"Utility of doppler ultrasound in early-onset neonatal sepsis: A case-control study.","authors":"A H Kasim, S A Mohammad, L A Habib, G A Saleh, S H Salah","doi":"10.3233/NPM-240028","DOIUrl":"10.3233/NPM-240028","url":null,"abstract":"Background: Early-onset sepsis is one of the leading causes of neonatal morbidity and mortality worldwide and timely diagnosis is, therefore, of paramount importance. As there is a lack of literature regarding early alteration of the cerebral blood flow (CBF) in neonatal sepsis, our study aimed to appraise changes in the CBF velocities and Doppler indices in neonates with early-onset neonatal sepsis (EONS) and to assess its diagnostic accuracy.Methods: A total of 99 neonates were recruited in the study; 56 neonates with EONS, and the age-matched 43 neonates without any manifestations of sepsis. A Transcranial Doppler examination and cerebral hemodynamics were assessed in neonates during the first seventy-two hours of life. Doppler indices and CBFV were measured in the anterior cerebral artery (ACA), and middle cerebral artery (MCA), of either side. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated.Results: A significantly lower resistance in Resistivity (RI) and Pulsatility (PI) indices, a significant high end-diastolic velocity (EDV), and relatively higher peak systolic velocity (PSV) in both ACA and MCA have been documented within 72 hours of birth in neonates with EONS compared to the control group of neonates without sepsis.Conclusion: Our Study revealed that assessment of CBF at early hours of birth by Transcranial Doppler examination showed alteration in cerebral hemodynamics in neonates with EONS with an increase in the CBF and a decrease in the resistance. It can be adopted as a bedside, noninvasive tool with immediate diagnostic value.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"779-786"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372119","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}

引用次数: 0

Liveborn children with trisomy 18: A scoping review.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2024-11-20 DOI: 10.1177/19345798241302276

Mary-Pat Schlosser, Melissa J MacPherson, Maria Castro-Codesal, Cheryl Mack, Kyle Sue-Milne, Tara Wren, Larissa Shapka, Janice Y Kung, Michael van Manen

{"title":"Liveborn children with trisomy 18: A scoping review.","authors":"Mary-Pat Schlosser, Melissa J MacPherson, Maria Castro-Codesal, Cheryl Mack, Kyle Sue-Milne, Tara Wren, Larissa Shapka, Janice Y Kung, Michael van Manen","doi":"10.1177/19345798241302276","DOIUrl":"https://doi.org/10.1177/19345798241302276","url":null,"abstract":"Background: There have been an increasing number of publications related to trisomy 18 associated with a shift in the philosophy of care. The objective of this review is to understand the scope of contemporary literature informing the care of children born alive with trisomy 18.Methods: Included was peer-reviewed, primary literature in MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Cochrane Library from 2012 to 2023 reporting outcomes of children born alive with trisomy 18. Data extraction involved descriptive statistics of the types of studies, and an inductive thematic analysis of the questions addressed by the studies.Results: Of 4628 records identified, 229 met inclusion criteria. Key themes were organized around the domains: What is trisomy 18? What are the chances of survival with trisomy 18? What can be done to improve the chances of survival with trisomy 18? How do children with trisomy 18 die? Do surgical interventions provide a benefit? Are there non-surgical options? What knowledge is informing medical management? How is life described for children with trisomy 18? What are children with trisomy 18 like as babies and as they get older? What is life like for families caring for children with trisomy 18?Conclusions: A sizeable number of publications grouped trisomy 18 with other syndromes. Relatively few showed the longitudinal evolution of medical issues associated with trisomy 18, nor did they unfold the clinical heterogeneity of this population. This review shows the limited knowledge base guiding decision-making and care for children born alive with trisomy 18.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"733-749"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523596","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}

引用次数: 0

Association of cytochrome P450 CYP2C9 (rs1057910) gene polymorphism and ibuprofen response in preterm neonates diagnosed with patent ductus arteriosus.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2024-11-03 DOI: 10.1177/19345798241291324

Reem Nabil Said, Dalia Mossalam, Antoine Fekhry Abdel Massih, Radwa Marawan Abdel Halim, Maisa ElSayed Mohamed Morsi Sweilam

{"title":"Association of cytochrome P450 CYP2C9 (rs1057910) gene polymorphism and ibuprofen response in preterm neonates diagnosed with patent ductus arteriosus.","authors":"Reem Nabil Said, Dalia Mossalam, Antoine Fekhry Abdel Massih, Radwa Marawan Abdel Halim, Maisa ElSayed Mohamed Morsi Sweilam","doi":"10.1177/19345798241291324","DOIUrl":"https://doi.org/10.1177/19345798241291324","url":null,"abstract":"Background: Patent ductus arteriosus (PDA) closure is one of the most significant changes necessary to transition to extrauterine life. The failure of closure in preterm infants has been associated with a variety of complications.Aim and objectives: This study aim to investigate the correlation between cytochrome P450 CYP2C9 gene polymorphism and the response to ibuprofen treatment in preterm neonates with PDA.Subjects and methods: This prospective study was conducted on 64 preterm neonates with patent ductus arteriosus (hsPDA). The neonates were treated with ibuprofen and diagnosed using clinical and echocardiographic examinations. The study was carried out at the Neonatal Intensive Care Unit (NICU), Pediatric Department, Kasr Alainy and ElMounira Pediatric Hospitals, Cairo University, in June 2018.Results: A statistically significant difference in respiratory rate was observed between both groups (p = 0.047). Additionally, there was a significant difference in the duration of treatment with ibuprofen (p = 0.021). Treatment with ibuprofen had no impact on renal function parameters. The platelet count decreased after treatment with no statistical difference.Conclusion: Use of Oral ibuprofen is a highly effective treatment for HsPDA in preterm neonates, demonstrating a remarkable success rate of 92.2% and fewer adverse effects. Whilst no correlation between the CYP2C9 (rs1057910) gene polymorphism and the efficacy of oral ibuprofen response, Other factors affecting the response of oral ibuprofen and subsequent PDA closure include gestational age, birth weight, Apgar score at 5 min, ductal diameter, RDS, and sepsis.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"821-828"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522821","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}

引用次数: 0

Evaluation of risk factors associated with acute kidney injury in a level IV regional NICU.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2025-01-04 DOI: 10.1177/19345798241310117

K L Hartman, E Geraci, J Spencer, M Kukla, N M Acquisto, D J Hutchinson

{"title":"Evaluation of risk factors associated with acute kidney injury in a level IV regional NICU.","authors":"K L Hartman, E Geraci, J Spencer, M Kukla, N M Acquisto, D J Hutchinson","doi":"10.1177/19345798241310117","DOIUrl":"https://doi.org/10.1177/19345798241310117","url":null,"abstract":"Background: Intervening on neonates at risk for developing acute kidney injury (AKI) improves safety and clinical outcomes. This study sought to evaluate risk factors associated with AKI in a level IV neonatal intensive care unit (NICU).Methods: Single-center, case-control study of patients with corrected gestational age (GA) ≤44 weeks from 2018 to 2022. Cases were those that developed AKI after day 4 of life. Controls were the next neonate admitted to the same NICU team that met inclusion criteria but did not develop AKI. Neonatal and maternal factors, nephrotoxic medication administration, and procedures were analyzed to identify risk factors associated with AKI using univariate and multivariate analyses.Results: A total of 94 patients were included: 47 cases and 47 controls. GA <27 weeks, birth weight <1500 grams, low APGAR score, intubation at birth, bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), and sepsis were associated with AKI on univariate analysis. Most cases (89.4%) had >4 risk factors, and this was associated with a 13.1-fold increase in the odds of developing AKI. Multivariate analysis identified GA <27 weeks (OR 7.7, 95% CI 1.7-34.4), vasopressor and/or inotrope administration (OR 4.4, 95% CI 1.2-23.8), and diagnosis of PDA (OR 6.9, 95% CI 1.5-31.3) as independent predictors of AKI.Conclusions: Risk factors associated with AKI were identified, and a 13.1-fold increase in AKI was found when >4 risk factors were present. This information may be used to expand renal acuity surveillance programs focusing on high-risk medication evaluation, demographic, and clinical factors.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"787-794"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523590","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}

引用次数: 0

Early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2025-01-04 DOI: 10.1177/19345798241310110

Sushil Kumar Choudhary, Vikram Datta, Urmila Sunda, Viswas Chhapola

{"title":"Early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler.","authors":"Sushil Kumar Choudhary, Vikram Datta, Urmila Sunda, Viswas Chhapola","doi":"10.1177/19345798241310110","DOIUrl":"https://doi.org/10.1177/19345798241310110","url":null,"abstract":"Objective: To evaluate the early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler.Method: A prospective cohort study was conducted at a tertiary care neonatal unit in India. 30 preterm SGA neonates born to mothers with increased pulsatility index (> 95th centile) were enrolled and compared with 30 SGA neonates with normal pulsatility index (<95th centile). These neonates were followed up to 40 weeks of post-menstrual age. They were evaluated by NAPI score of MDV (Motor development-vigor) and AO (Alertness orientation) at 40 weeks.Result: The mean NAPI score of MDV (Motor development- vigor) in neonates born to mothers with pulsatility index ≥95th percentile in umbilical artery Doppler was 58.59 ± 11.28 as compared to 61.73 ± 10.24 in another group (p-value 0.263) and mean difference (95%CI) was 3.14(2.42-8.71). The mean NAPI score of AO (Alertness-orientation) in the exposed group was 54.47 ± 10.19 as compared to 56.36 ± 9.07 in the unexposed group (p-value 0.44) and mean difference (95%CI) was 1.89 (3.1-6.88).Conclusion: Preterm, SGA neonates born to mothers with high pulsatility index in umbilical artery Doppler had low neurodevelopmental scores as compared to neonates with normal PI.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"763-769"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523527","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}

引用次数: 0

Beyond the bleed: Navigating fetal intraventricular hemorrhage.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2024-12-16 DOI: 10.1177/19345798241308494

Hillary C Lee, Amee A Amin, Danielle N Gonzales

{"title":"Beyond the bleed: Navigating fetal intraventricular hemorrhage.","authors":"Hillary C Lee, Amee A Amin, Danielle N Gonzales","doi":"10.1177/19345798241308494","DOIUrl":"https://doi.org/10.1177/19345798241308494","url":null,"abstract":"Background: Antenatal intraventricular hemorrhage (IVH) is intracranial hemorrhage that occurs in utero at an incidence of 1-5 per 10,000. Though there is very limited data on neurodevelopmental prognosis, antenatally diagnosed fetal intracranial hemorrhages carry a very poor prognosis with an estimated 40% mortality in utero or within the first month after birth. Less than 50% of survivors have normal neurodevelopmental outcomes during their postnatal follow-up. We present a healthy, term infant, who was prenatally diagnosed with a grade IV fetal IVH.Case: A term, male infant was delivered via elective cesarean section following a prenatal diagnosis of unilateral grade IV intraventricular hemorrhage with bilateral cerebral ventriculomegaly. Pregnancy had been unremarkable with no history of trauma, hematologic, or infectious etiology. Extensive post-natal evaluation confirmed the prenatal MRI findings and an unremarkable infectious and hematologic evaluation but revealed a genetic syndrome for 15q11.2 deletion. On day of life 18, the infant was discharged home with parents, tolerating full oral feeds and with appropriate weight gain. Continued outpatient follow-up has revealed no further progression of the bleed on serial neuroimaging with the infant meeting appropriate developmental milestones at 6 months of age.Conclusion: Despite early detection, fetal intracranial hemorrhage (ICH) has poor outcomes compared to post-natal prematurity related IVH. Parents of affected fetuses should be counseled about poor survival rates and adverse neurodevelopmental outcomes, especially following the diagnosis of grade III or IV IVH.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"858-862"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523266","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}

引用次数: 0

An evidence-based treatment algorithm for congenital diaphragmatic hernia. 以证据为基础的先天性膈疝治疗算法。

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2024-12-19 DOI: 10.1177/19345798241308462

Latoya A Stewart, Yeu Sanz Wu, Alexandra Channing, Usha S Krishnan, Tina A Leone, Nimrod Goldshtrom, Diana P Vargas Chaves, Anna Penn, Jennifer DeFazio, Erica M Fallon, William Middlesworth, Steven Stylianos, Vincent P Duron

{"title":"An evidence-based treatment algorithm for congenital diaphragmatic hernia.","authors":"Latoya A Stewart, Yeu Sanz Wu, Alexandra Channing, Usha S Krishnan, Tina A Leone, Nimrod Goldshtrom, Diana P Vargas Chaves, Anna Penn, Jennifer DeFazio, Erica M Fallon, William Middlesworth, Steven Stylianos, Vincent P Duron","doi":"10.1177/19345798241308462","DOIUrl":"https://doi.org/10.1177/19345798241308462","url":null,"abstract":"Background: Congenital diaphragmatic hernia (CDH) affects more than 1100 newborns in the United States each year. Severity of clinical presentation is highly variable. Standardized care improves outcomes by promoting consistency in decision-making and clarifying goals of treatment, but CDH management has not yet been standardized.Methods: We performed a comprehensive literature review with special consideration for-cardiac dysfunction, indications for extracorporeal membrane oxygenation (ECMO), and timing of repair. In collaboration with experts across specialties, we sought to develop and implement a treatment algorithm based on current CDH literature and our own institutional experience.Results: Left ventricular (LV) hypoplasia and dysfunction is increasingly recognized as an important contributor to the severity of clinical presentation and cardiac dysfunction seen with CDH. Cardiac dysfunction is associated with poor outcomes and increased mortality. CDH-associated severe hypoxic respiratory failure refractory to medical therapy is one of the most common indications for ECMO in the neonatal period. The decision to initiate ECMO and selection of configuration should be shared by members of a multidisciplinary care team. The optimal timing of repair with respect to ECMO has been evolving in the last 3 decades.Conclusion: Following our review, we recommend (1) timely and detailed cardiac evaluation with echocardiogram after birth, and (2) early repair on ECMO for high-risk patients and delayed repair post-ECMO for low-risk patients with anticipated short ECMO run. This treatment algorithm is a step toward standardization of CDH management practices, which we expect will improve CDH outcomes at our institution and others.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"750-762"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523702","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}

引用次数: 0

Oral ibuprofen versus placebo in closure of patent ductus arteriosus in preterm neonates, a randomized control trial.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2024-11-29 DOI: 10.1177/19345798241302264

Dalia Fathi El Sherif, Nehal Mohamed El Raggal, Marwa Waheed Nasef, Ghada Ahmad Saleh, Nada Hussein Youssef, Mohamed Hussein Metwally

{"title":"Oral ibuprofen versus placebo in closure of patent ductus arteriosus in preterm neonates, a randomized control trial.","authors":"Dalia Fathi El Sherif, Nehal Mohamed El Raggal, Marwa Waheed Nasef, Ghada Ahmad Saleh, Nada Hussein Youssef, Mohamed Hussein Metwally","doi":"10.1177/19345798241302264","DOIUrl":"https://doi.org/10.1177/19345798241302264","url":null,"abstract":"Background: A consensus on treatment of patent ductus arteriosus (PDA) in preterm neonates remains elusive. Conservative management has recently gained popularity due to medical treatment lacking the evidence of benefit in terms of mortality and morbidity.Objective: This study compares the efficacy of the standard dose of oral Ibuprofen versus placebo in the closure of PDA in preterm neonates ≤34 weeks gestation.Methods: Eighty enrolled preterm neonates with a hemodynamically significant PDA (hsPDA) were randomized to either receive an early 3-day course oral ibuprofen or placebo (1:1). The open-label option and an extended oral ibuprofen therapy were offered if there were concerns over patient's clinical condition being attributed to PDA and only if showing evidence of systemic and/or pulmonary hyperperfusion.Results: No significant difference in PDA closure between both groups (62.5% vs 65% in Ibuprofen & placebo group respectively, p = .816). No significant difference was observed between groups in mortality (p = 1), Bronchopulmonary dysplasia (BPD) (p = 1), or necrotizing enterocolitis (NEC) (0.5). Placebo group required a longer duration of inotropic support (median of 10 vs 7.5 days in Ibuprofen group, p = .013) and were prescribed more diuretic therapy (27 vs 18 in Ibuprofen group, p = .043).Conclusion: The standard dose of oral ibuprofen was comparable to placebo in early treatment of hsPDA in preterm neonates less than 34 weeks in terms of effect on ductal closure after one course of treatment, incidence of mortality, and morbidities like NEC, and BPD. Failure of ductal closure itself was associated in both groups with increased mortality, failure to reach full feeds, and more use of vasopressors and inotropes.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"810-820"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523609","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}

引用次数: 0

Neighborhood deprivation and association with 18-month neurodevelopmental impairment of preterm infants born in a dense urban setting.

Journal of neonatal-perinatal medicine Pub Date : 2024-11-01 Epub Date: 2024-12-14 DOI: 10.1177/19345798241308474

Prateek V Sahni, Faith Kim, Joseph R Isler, Rakesh Sahni

{"title":"Neighborhood deprivation and association with 18-month neurodevelopmental impairment of preterm infants born in a dense urban setting.","authors":"Prateek V Sahni, Faith Kim, Joseph R Isler, Rakesh Sahni","doi":"10.1177/19345798241308474","DOIUrl":"https://doi.org/10.1177/19345798241308474","url":null,"abstract":"Background: Neighborhood adversity's impact on 18-month neurodevelopmental impairment (NDI) is not well-described. The aim of our study was to determine whether area deprivation index (ADI), a measure of neighborhood socioeconomic disadvantage, at birth is associated with 18-month NDI of preterm infants born in dense urban setting.Methods: A retrospective case-cohort study was performed in infants born at 23-32 weeks gestational age (GA) with birth weight (BW) ≤1250 g between 2013 and 2017 and evaluated for NDI at 18-month corrected age (CA). Socioeconomic deprivation was computed geospatially using subject addresses that were mapped to national ADI rankings. Subjects were categorized as low (<26th percentile) or high (26-100th percentile) ADI neighborhoods and with/without NDI if any of Bayley-III cognition, language, or motor composite scores were <70. The relationship between ADI and NDI was analyzed using logistic regression adjusted for GA and BW and group comparisons were made.Results: Data were available in 119 patients (GA = 27.2 ± 2.2 weeks, BW = 870 ± 246 g). Children with NDI at 18-month CA were born at an earlier GA (p < .001) with lower BW (p < .03) and to mothers living in high ADI neighborhoods (p < .02). Patients from lower ADI neighborhoods at birth had higher Bayley-III cognition (p < .0001), language (p < .005), and motor (p = .03) composite scores at 18-month CA. Cognition (p < .01), language (p < .003) and motor (p < .03) composite scores decreased with increasing ADI percentiles.Conclusions: Among infants born 23-32 weeks GA in a dense urban setting, ADI at birth is associated with NDI at 18 months with lower cognitive, language, and motor scores in preterm infants from higher ADI neighborhoods.","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"17 6","pages":"829-837"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523604","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}

引用次数: 0