Journal of neonatal-perinatal medicine最新文献

{"title":"National variation in delayed cord clamping implementation - A survey of the challenges in universal adoption of DCC in the United Kingdom.","authors":"Ahmed Marya, Claudia Chetcuti Ganado","doi":"10.1177/19345798251318596","DOIUrl":"10.1177/19345798251318596","url":null,"abstract":"<p><p>BackgroundEvidence shows that allowing the umbilical cord to pulsate for 1-3 minutes before clamping greatly improves newborn outcomes. In preterm infants, DCC reduces mortality by a third, reduces sepsis, bowel inflammation, and severe brain bleeds yet uptake has been variable in the latter cohort. Our survey aimed to understand the challenges faced when implementing DCC.MethodsSurvey questions were designed and user tested prior to dissemination. An electronic and word format of the questionnaire were sent through emails to units in England and Wales. The survey was also disseminated via social media.ResultsA total of 116 responses were obtained with 44% being from level three units and 50% from level two and the remainder from Level one. Although all but 1 respondent said they implemented DCC in their hospital, 30% respondents said they only apply DCC for stable term babies. The remaining 70% implement DCC for both preterm and term stable babies. While 21% of respondents said they implemented cord intact stabilisation for planned deliveries, only 3% implemented it in emergency scenarios. 71% of respondents undertaking cord intact stabilisation use the Lifestart TM trolley. Respondents highlighted several challenges when using Lifestart particularly the lack of familiarity with its use, need for advance planning and ineffective heating surface.ConclusionThe survey highlights that challenges in adopting DCC in extreme preterm and sick infants remain unaddressed. More research is required to enable delivery of placental transfusion safely allowing the needs of all newborns to be met.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"150-156"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458438","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":"Surgical NEC-associated cerebellar underdevelopment and PDA: Call for close monitoring and action.","authors":"Parvesh Mohan Garg","doi":"10.1177/19345798251317986","DOIUrl":"10.1177/19345798251317986","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is a systemic inflammatory disease of very low birth weight infants and is associated with brain injury and poor neurodevelopmental outcomes. The cerebellar injury is seen in one third of cases with surgical cases. The association between patent ductus arteriosus (PDA) and necrotizing enterocolitis, cerebral and gut hemodynamics in preterm infants is well documented. The cerebellum is at the high risk of underdevelopment and injury in preterm infants with surgical NEC and PDA. The combined exposure of NEC and PDA most likely affect the normal cerebellar development further due to inflammatory and hypoperfusion insults. There is a need to develop the targeted monitoring and therapeutic approach for cerebellum in preterm infants with surgical NEC and PDA.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"165-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ratio of non-protein calories to grams of amino acids and amino acid blood levels in preterm infants receiving parenteral nutrition.","authors":"Robert K Huston, Reese H Clark, Donald H Chace","doi":"10.1177/19345798251318605","DOIUrl":"10.1177/19345798251318605","url":null,"abstract":"<p><p>BackgroundStudies evaluating the optimal intake of amino acids for preterm infants have often not considered the effect of the non-protein calorie to grams of amino acids ratio (NPKcal:g AA) in parenteral nutrition solutions. The objectives of this study were to document the ratio in a group of preterm infants and explore any associations of the ratio to AA and acylcarnitine levels.MethodsThis was descriptive cohort study of data collected from a previously published prospective study evaluating the influence that gestational age had on amino acid and acylcarnitine profiles in preterm infants ≤31 weeks postmenstrual age. Acylcarnitine and AA levels on day of life 7 of three study groups, based upon terciles of the NPKcal:g AA, who were receiving minimal enteral feedings and an enterally fed comparison group were measured. Growth velocities and changes in z-scores were also evaluated.ResultsNPKcal:g AA terciles were: 6.3-17.6:1 (low, <i>N</i> = 153), 17.7-21.2:1 (mid, <i>N</i> = 150), and 21.3-36.2:1 (high, <i>N</i> = 159). Higher levels of ornithine, citrulline, blood urea nitrogen, isovalerylcarnitine + methylbutyrylcarnitine, and octenoylcarnitine were found in the low versus the high group. From day 1-42 of life, the low group had a lower head circumference (HC) growth velocity and the low and mid groups had more negative HC changes in z-scores versus the enteral group.ConclusionsThis study suggests that preterm infants may receive parenteral nutrition solutions containing inadequate energy to prevent oxidation of administered AA. The impact of inadequate non-protein caloric intake needs to be considered when evaluating growth and outcomes in nutritional studies of VLBW infants.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"126-136"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458448","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":"Infantile myofibromatosis: Small bumps pose big problems.","authors":"Hillary C Lee, Amee A Amin, Kudakwashe R Chikwava, Valeria R Smith, Caraciolo J Fernandes","doi":"10.1177/19345798251318587","DOIUrl":"10.1177/19345798251318587","url":null,"abstract":"<p><p>BackgroundInfantile myofibromatosis (IM) is a disorder characterized by proliferation of benign myofibroblastic tumors that typically manifest as solitary or multiple nodules in the skin, muscle, bone, subcutaneous tissues, and visceral organs and can pose significant morbidity and mortality risks, particularly in cases involving visceral organs or causing functional impairment. These soft tissue lesions are the most prevalent benign fibrous tumors that present before age two and can undergo spontaneous regression or are amenable to surgical resection.CaseA preterm, male infant was born via Caesarean section to a mother with a trichorionic, triamniotic pregnancy following preterm labor. Within the first week of life, several well-circumscribed, smooth, non-tender, and soft nodules with some mobility were noticed along the border of the ribs, across the trunk, back, and lower extremities. Ultrasound imaging confirmed well-circumscribed hypoechoic, intramuscular nodules, and biopsy evaluation showed atypical spindle cell proliferation. The biopsied lesion was <i>PDGFRB</i>-mutated on molecular genetic studies, confirming a diagnosis of myofibromatosis. The infant developed mixed lytic and sclerotic deformities of a variety of bones, necessitating treatment given disease progression.ConclusionSuccessful clinical management with low-dose metronomic chemotherapy (methotrexate and vinblastine) is possible and can treat extensive disease, as seen in our patient.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"179-183"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive values of prognostic nutritional index and systemic immüne- inflammatory index in the follow-up newborns of preeclamptic mothers.","authors":"Seda Aydoğan, Caner Köse, Eda Tüfekçioğlu, Meltem Aksu, Hasan Akduman, Ferit Kulalı","doi":"10.1177/19345798251318599","DOIUrl":"10.1177/19345798251318599","url":null,"abstract":"<p><p><b>Background</b>: Preeclampsia (PE) is among the causes of serious morbidity and mortality for the mother and fetus. The most common consequences of intrauterine hypoxemia in the newborn are intrauterine growth retardation (IUGR), premature labor, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and perinatal death. The systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI), which is used as an indicator of inflammation, can be used to examine the effect of the immune status of babies of PE mothers on their prognosis.<b>Methods</b>: A retrospective cohort study was conducted on 148 newborns of PE mothers who received treatment in our NICU between November 2022 and July 2024. Hematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, SII, and PNI were calculated for all patients. Subgroups were created for complications and analyses were performed.<b>Results</b>: For all preeclamptic mothers' babies, the mean SII and PNI were 387.69 ± 348.13 and 49.08 ± 7.59, respectively. The SII for prematurity produced an area under the curveReceiver operating characteristic (ROC) of 0.76 (0.59-0.92) (88.4% sensitivity, 70% specificity). The PNI for prematurity produced an area under the curve ROC of 0.72 (0.57-0.86) (63% sensitivity, 70% specificity). That was found that the SII has more sensitivity than the PNI for detecting prematurity in preeclamptic mothers' babies. Low PNI and SII were independent predictors of mortality (<i>p</i> < 0.01).<b>Conclusion</b>: We found that it is significant for SII and NLR to be low at the time of admission to predict mortality in infants of preeclamptic mothers.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"119-125"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458446","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":"Impact of dexmedetomidine during hypothermia on initiation of enteral feeding in newborns with hypoxic-ischemic encephalopathy.","authors":"Kimberly R Marsh, Eric S Peeples","doi":"10.1177/19345798251318601","DOIUrl":"10.1177/19345798251318601","url":null,"abstract":"<p><p>BackgroundAfter early studies suggested safety and potential for benefit of dexmedetomidine use in neonatal hypoxic-ischemic encephalopathy (HIE), our neonatal intensive care unit (NICU) decided to transition from morphine to dexmedetomidine as our standard sedative during therapeutic hypothermia (TH). The primary aim was to monitor the possible side effects of transitioning from morphine to dexmedetomidine with a primary goal of reducing the days to initiation of enteral feeds to less than 3 days, with the hypothesis that the gastrointestinal motility effects of morphine may have been hindering feeding progress during TH. The secondary aim was to determine rates of hemodynamically significant bradycardia.MethodsThis was a prospective quality improvement study using a retrospective comparison group to determine the comfort, hemodynamic, and early feeding effects of a clinical change in sedation management from morphine to dexmedetomidine. We included infants born at ≥35 weeks of gestation receiving hypothermia for hypoxic-ischemic encephalopathy (HIE) from 2017 to 2023.ResultsData were collected from 107 infants: 48 morphine, 35 dexmedetomidine, and 24 neither. Heart rate was lower in the morphine and dexmedetomidine groups compared to no sedation. Blood pressures, pain scores, and blanket temperatures were not different between groups. Infants receiving dexmedetomidine initiated enteral feeds earlier than either of the other groups and reached full enteral feeds earlier than the no treatment group but not the morphine group.ConclusionsThis study supports a growing body of literature suggesting dexmedetomidine is a well-tolerated alternative to opioids during hypothermia for HIE.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"101-109"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458384","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":"POCUS using the neo-ECHOTIP protocol plus the retract, advance, and position (RAP) technique to improve lower extremity catheter positioning in neonates.","authors":"M Ostroff, J Abu-Ali, V DeBari, F Kiblawi, A Zauk, S Datta-Bhutada, Z Pua","doi":"10.1177/19345798251318585","DOIUrl":"10.1177/19345798251318585","url":null,"abstract":"<p><p>BackgroundInternational guidelines recommend point-of-care ultrasonography (POCUS) in neonatology for diagnostic, therapeutic, and procedural purposes. However, there are few standard protocols for using POCUS to confirm lower extremity catheter tip positioning.MethodsIn this prospective study, subcutaneously tunneled femorally inserted central catheters (ST-FICCs) were placed in eligible neonates according to physician orders. In line with the Neo-ECHOTIP (NE) protocol, a subcostal longitudinal view was used to identify the catheter, and saline flush test (SFT) was performed to confirm catheter tip placement below the right atrium. During the study, a novel \"retract, advance, and position (RAP)\" technique was added to the existing NE-SFT protocol to improve catheter positioning. Two-view radiographs of the chest and abdomen were obtained to verify catheter tip position for all subjects. The agreement rate with post-procedural radiographs and the total number of radiographs needed to achieve proper catheter positioning were assessed.ResultsThe agreement rate of POCUS with radiographs for catheter terminal tip position was 75% (39/52) for the NE-SFT group compared to 100% (48/48) for the NE-SFT + RAP group (<i>p</i> < 0.001). Catheters in the NE-SFT group required repositioning (25%); no malpositioned catheters were observed in the NE-SFT + RAP group. Repositioning of the catheter in the NE-SFT group resulted in 22 repeat radiographs in the NE-SFT group; none were required in the NE-SFT + RAP group (<i>p</i> < 0.0001).ConclusionsThis single-center study demonstrated that applying the RAP technique to the Neo-ECHOTIP protocol improved the ease and accuracy of lower extremity catheter tip position localization in neonates, thus eliminating the use of radiography.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458443","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":"Point of care v/s central lab automated blood culture system in decreasing antibiotic usage in NICU: A randomized controlled trial.","authors":"R Vogeti, S K Choudhary, A K Singh, N Gupta, V Tak, U Sunda","doi":"10.1177/19345798251318588","DOIUrl":"https://doi.org/10.1177/19345798251318588","url":null,"abstract":"<p><p>BackgroundAntibiotic usage is rampant in NICUs. The time of stoppage of antibiotics depends predominantly on clinical condition of the neonate and final blood culture report. Delay in availability of report due to lab logistics might delay the stoppage of antibiotic. Hence, we hypothesized that having a point of care BACTEC system in NICU premises might reduce the delay, allowing earlier stoppage of antibiotics when no more warranted.ObjectiveTo compare the antibiotic usage (number of antibiotic doses) in neonates warranting antibiotics for suspected sepsis (both early onset and late onset sepsis) when the point of care blood culture system (BACTEC) has been used as compared to the central lab system.Design, Setting, and ParticipantsThis open labelled randomized controlled trial was conducted in a tertiary care NICU from November 2021 to April 2023. Inborn neonates with suspected sepsis in whom antibiotics were considered first time were participants.InterventionsFirst blood cultures in neonates with suspected sepsis were placed in NICU BACTEC or sent to the central lab as per randomization.Main Outcome MeasuresBoth the groups were compared for number of antibiotic doses.Results268 eligible neonates were randomized, 132 in point of care and 136 in central lab arm. Median antibiotic doses in neonates with suspected sepsis were 13 (7,25) versus 12 (8,29) in NICU versus central lab BACTEC arm (<i>p</i> = 0.501). Antibiotics were stopped in ≤48 hours in 25% neonates and 19.9% in NICU and central lab BACTEC, respectively. The mean antibiotic doses of the neonates whose antibiotics were stopped before 48 hours is 5.6 +/- 0.9 versus 6.3 +/- 1.5 in NICU versus central lab BACTEC arm (<i>p</i> = 0.042). There was no significant difference in mortality, necrotizing enterocolitis (NEC), subsequent culture-positive sepsis, fungal sepsis, and duration of hospital stay in both groups. In the central lab group, the mean time taken for the final report to be uploaded was 131 +/- 43 hours.ConclusionsThere was no significant difference in number of antibiotic doses among NICU and central lab arms. However, antibiotics were stopped early (<48 hours) in more neonates when point of care BACTEC was used. Establishing the effect of point of care blood culture system in reducing antibiotic use requires further studies with a larger sample size.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 2","pages":"157-164"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996925","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":"Colonization of extended-spectrum beta-lactamase-producing bacteria in healthy pregnant women and its impact on perinatal care: A cross-sectional study.","authors":"Shigekatsu Hatanaka, Yukiko Ohashi, Tamae Mitsuhashi, Rie Imada, Misato Kawamura, Shigemi Okusa, Yuriko Takenaka, Yoko Ichikawa, Michiya Kobayashi","doi":"10.1177/19345798251318610","DOIUrl":"10.1177/19345798251318610","url":null,"abstract":"<p><p>BackgroundColonization of extended-spectrum beta-lactamase (ESBL)-producing organisms is increasing becoming more frequent not only in hospitalized patients but also in healthy individuals. Although these bacteria are thought to be transmitted to newborns on their way through the birth canal, molecular evidence for this is scarce. In this study, we aimed to survey the current prevalence of resistant bacterial colonization in this area by examining the colonization carriage of this organism before and after delivery.MethodsWe examined the colonization rate of ESBL-producing bacteria in healthy pregnant women, the colonization rate in newborns, and the transmission rate from pregnant women who are carriers of the bacteria to their newborns. We also performed resistance gene and similarity analyses for each strain in pairs of mother-child carriers.ResultsOf 494 pregnant women, 33 carried ESBL-producing bacteria, all of whom were identified as Escherichia coli. The colonization carriage rate among pregnant women was 6.7%. Among newborns, the rate rose from 1.0% immediately after birth to 6.9% at the one-month checkup. Furthermore, of the 13 strains detected among mothers and children, 10 pairs had matching resistance genes.ConclusionsSome ESBL-producing bacterial carriers exist even among healthy pregnant women, and about half of them go on to infect their newborns. However, routes of transmission beyond vertical transmission cannot be ruled out. Therefore, it is important to promote infection control in the healthcare environment and in the families of newborns, as well as antimicrobial stewardship among pregnant women.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"142-149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735914","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":"Does oral care with mother's colostrum reduce the risk of late-onset sepsis in preterm infants? A randomized clinical trial.","authors":"Marwa Taha, Mai Mohamed Mostafa, Fifi Helmy, Sohaila Ali Abd El-Halim","doi":"10.1177/19345798241310739","DOIUrl":"10.1177/19345798241310739","url":null,"abstract":"<p><p>BackgroundOral care with mother's colostrum (OCC) for very-low-birth-weight (VLBW) preterm newborns may provide immune-protective effects that potentially reduce the risk of late-onset sepsis (LOS) and death. Our objective was to assess the effect of OCC on the risk of LOS and mortality in VLBW premature neonates.MethodsA single-center randomized clinical trial was conducted on 65 VLBW preterm neonates. The intervention was oral care administrated every 6 hours, starting in the first 24 hours of life and lasting for 5 days, using either own mother's colostrum (colostrum group) or sterile water (placebo group).ResultsNeonates in the colostrum group were significantly less likely to have LOS (62.5% vs 93.9%, RR = 0.66, <i>p</i> = 0.002), ventilator-associated pneumonia (VAP) (21.9% vs 48.5%, RR = 0.45, <i>p</i> = 0.025), feeding intolerance (56.3% vs 84.3%, RR = 0.66, <i>p</i> = 0.01), and mortality (18.8% vs 57.6%, RR = 0.3, <i>p</i> = 0.001). The time to start enteral nutrition in the colostrum group was shorter (<i>p</i> = 0.04) than in the placebo group. In multivariate analysis, OCC decreased the risk of LOS (OR = 0.12, <i>p</i> = 0.01) and death (OR = 0.14, <i>p</i> = 0.004). Moreover, OCC practice was associated with a faster time to regain birth weight (<i>p</i> = 0.027) and a shorter duration of hospitalization (<i>p</i> = 0.04) in surviving preterm infants.ConclusionOCC is a simple and safe practice that may yield a significant impact in reducing the risk of LOS, VAP, feeding intolerance, and mortality; can shorten time to start enteral feeding with faster regain to birth weight; and can shorten the length of hospital stay in VLBW preterm infants.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458361","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}