{"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}
Marwa Taha, Mai Mohamed Mostafa, Fifi Helmy, Sohaila Ali Abd El-Halim
{"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}
Joaquin A Calderon, Ahmed M Ebeid, Sean M Lee, Homa K Ahmadzia
{"title":"Correlation of predelivery Rotational Thromboelastometry readings with the risk of postpartum hemorrhage during delivery: The ROTEM Study.","authors":"Joaquin A Calderon, Ahmed M Ebeid, Sean M Lee, Homa K Ahmadzia","doi":"10.1177/19345798241291327","DOIUrl":"10.1177/19345798241291327","url":null,"abstract":"<p><p>BackgroundInconsistency in defining postpartum hemorrhage (PPH), and the inability of current tools and approaches to accurately predict PPH have led to the exploration of innovative methods. Rotational thromboelastometry (ROTEM) point-of-care technology provides real-time assessment of the clotting process facilitating time-efficient hemostatic interventions. Our study investigates the utility of ROTEM parameters for predicting individual risk of PPH.MethodsThis multi-site, prospective observational cohort study recruited 92 women who underwent scheduled cesarean delivery and normal spontaneous vaginal delivery at university-affiliated hospitals from 2018 to 2023. We included women between 18 and 50 years old at ≥34 weeks of gestation. Subjects were approached in the hospital pre-admission testing unit during their routine pre-operative blood draws, typically at least 72 h in advance of their planned cesarean delivery. Participants were also enrolled at the hospital once they arrived for admission a few hours before their procedure. ROTEM parameters EXTEM clotting time (CT), clot formation time (CFT), alpha angle, A10, A20, maximum clot formation (MCF), maximum lysis, were measured preoperative.ResultsWe found significant effects of age, blood loss type, delivery mode, gestational age, and maximum lysis on blood loss. The reduced model predicted that every one-percent increase in maximum lysis was associated with a 44-milliliter increase in blood loss and every one-year increase in age was associated with a 19-milliliter increase in blood loss. On average, cesarean deliveries resulted in 522 more milliliters of blood loss than normal spontaneous vaginal delivery.ConclusionThe ROTEM EXTEM maximum lysis parameter has a significant effect on blood loss. Larger prospective clinical trials in conjunction with a prompt definition of the ranges of reference values will strengthen these advances to provide a rapid assessment and guide early interventions to prevent severe obstetric bleeding.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458286","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":"Atypical presentation of a common condition.","authors":"Mariana Oliveira Pereira, Rita Lages Pereira, Fábia Carvalho, Liliana Pinheiro, Filipa Neiva","doi":"10.1177/19345798251315389","DOIUrl":"10.1177/19345798251315389","url":null,"abstract":"<p><p>Cow's milk protein allergy (CMPA) presents a wide range of clinical manifestations. Although gastrointestinal symptoms are common, they are not always present. In this report, we present two cases of infants with atypical CMPA presentations. Case 1 involves a male newborn who was admitted with polyarthritis and a target-shaped rash, while case 2 features a female newborn who presented with soft swelling of extremities. Both infants had recently started using infant formula, which raised CMPA's suspicion. An extensively hydrolyzed formula (eHF) was introduced, resulting in the resolution of symptoms, with positive specific IgE measurements supporting the diagnosis. Further, in case 2, she underwent an oral provocation test that confirmed the diagnosis. These cases underscore the clinical variability of CMPA, which can present diagnostic challenges. While specific IgE measurements can offer valuable supporting information, a clinical diagnosis remains indispensable. Awareness of the diverse presentations and a thorough patient history are critical for accurate diagnosis and the prevention of unnecessary treatments.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"94-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458318","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}
Gladys Rojas, Aarti Jain, Fayez Bany-Mohammed, Philip Felgner, Muhammad Aslam, Cherry C Uy
{"title":"Concordance of maternal and cord blood SARS-COV-2 immunoglobulin seropositivity after COVID-19 infection or vaccination in pregnancy.","authors":"Gladys Rojas, Aarti Jain, Fayez Bany-Mohammed, Philip Felgner, Muhammad Aslam, Cherry C Uy","doi":"10.1177/19345798251315385","DOIUrl":"10.1177/19345798251315385","url":null,"abstract":"<p><p>ObjectiveTo assess maternal antibody response to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection during pregnancy and subsequent transplacental antibody transfer in cord blood.Study DesignThis is a prospective cohort study of Coronavirus Disease 2019 (COVID-19) polymerase chain reaction (PCR) positive pregnant women and their newborns. SARS-CoV-2 PCR (+) women were enrolled, with SARS-CoV-2 PCR (-) as control. Maternal blood was obtained at enrollment and cord blood collected at delivery. Baseline maternal and infant characteristics and neonatal outcomes were collected. Samples were analyzed using coronavirus antigen microarray containing immunologically significant antigens from SARS-CoV-2 (including nucleocapsid protein [NP], spike protein [S], S1, S2, receptor-binding domain [RBD]) which can detect SARS-CoV-2 immunoglobulin G (IgG) and immunoglobulin M (IgM).ResultsThirty-seven maternal-cord blood paired samples were analyzed for SARS-CoV-2 IgG or IgM antibodies; 15 out of 20 samples from SARS-CoV-2 PCR (+) and 14 out of 17 from SARS-CoV-2 PCR (-) mothers were IgG positive. 14 out of the 17 SARS-CoV-2 PCR (-) mothers received COVID-19 vaccine during pregnancy. Difference between IgG seropositivity of naturally infected versus vaccinated mothers were significant, 75% versus 100% (<i>p</i> = 0.043). IgM antibodies were detected in 10 out of 20 SARS-CoV-2 PCR (+) women but none were detected in cord blood.ConclusionsExcellent concordance of SARS-CoV-2 IgG antibodies exist between maternal and cord blood. Significantly higher SARS-COV-2 cord blood IgG seropositivity was found in vaccinated versus naturally infected mothers.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458322","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}
Leandro Cordero, Michael R Stenger, Mark B Landon, Bradley J Needleman, Sabrena Noria, Craig A Nankervis
{"title":"Breastfeeding initiation according to the severity of Class 3 obesity.","authors":"Leandro Cordero, Michael R Stenger, Mark B Landon, Bradley J Needleman, Sabrena Noria, Craig A Nankervis","doi":"10.1177/19345798241296331","DOIUrl":"10.1177/19345798241296331","url":null,"abstract":"<p><p><b>Background:</b> Class 3 obesity is composed of <i>morbid</i> (BMI 40-49 kg/m<sup>2</sup>) and <i>extreme</i> (BMI ≥ 50 kg/m<sup>2</sup>) subgroups. Adverse perinatal outcomes have been associated with obesity; however, data on breastfeeding (BF) initiation for women in either group remains limited.<b>Objective:</b> To compare BF initiation rates (exclusive or partial BF) and related comorbidities of 890 women with <i>morbid</i> and 890 with <i>extreme</i> obesity matched by race, parity, and year of delivery.<b>Methods:</b> Retrospective cohort study of women who delivered singletons at ≥ 34 weeks gestation (2013-2021). Those who had bariatric surgery or infants with major malformations were excluded.<b>Results:</b> Both groups were similar in: primiparity (38%), age (29y), white race (58%), African American (36%), current (10 vs 12%) and former (25 vs 27%) smokers, gestational hypertension (15 vs 16%), polycystic ovary syndrome (5 vs 7%), gastroesophageal reflux disease (10 vs 10%), and anemia (17 vs 17%). Women in the <i>extreme</i> group had a higher prevalence of gestational (17 vs 12%) and pregestational diabetes (12 vs 6%), chronic hypertension (41 vs 17%), severe preeclampsia (18 vs 12%), obstructive sleep apnea (12 vs 3%), asthma (22 vs 16%), and cesarean deliveries (62 vs 44%). Intention to BF (64 vs 71%), exclusive BF (23 vs 34%), and BF initiation (57 vs 64%) rates were lower in the <i>extreme</i> obesity group at discharge.<b>Conclusion:</b> Higher frequency of comorbidities in the <i>extreme</i> obesity group highlights the need for antenatal, intrapartum, and postpartum targeted interventions if the benefits of BF to mothers and infants are to be realized.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"70-78"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458305","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":"Role of lung ultrasound score in early prediction of bronchopulmonary dysplasia in preterm neonates.","authors":"Shikha Khandelwal, Vikram Datta, Rama Anand, Narendra Babu Devabathina","doi":"10.1177/19345798241296329","DOIUrl":"10.1177/19345798241296329","url":null,"abstract":"<p><p>BackgroundThe use of lung ultrasound score (LUS) to predict bronchopulmonary dysplasia (BPD) is still evolving. While LUS is widely available and accurate, there is limited evidence from low- and middle-income countries. We aim to assess LUS's predictive ability for BPD in preterm neonates less than 30 weeks gestation.Material and methodsWe enrolled 160 neonates born at <30 weeks of gestation, who required any form of respiratory support at least for 24 h. Six zone LUS was calculated for all the neonates first within 72 h and then weekly till 36 weeks of post-menstrual age (PMA) or discharge, whichever was earlier. After excluding death and missed scans, 112 neonates were categorized as BPD or non-BPD and were analysed for their LUS.ResultNeonates who developed BPD (<i>n</i> = 33) had higher LUS from the first assessment up to nine weeks. An LUS >5 could predict the development of BPD at one week with a sensitivity of 87.88%, specificity 89.87%, and area under ROC Curve (AUC) 0.93, and at two weeks with a sensitivity of 78.79%, specificity of 96.2%, and AUC 0.95. Likewise, at three and four weeks of life, the optimum cutoff of LUS >3 and >2, respectively, predicted the development of BPD with sensitivity 93.99%, specificity 94.94%, and AUC 0.97 at three weeks and sensitivity 87.88%, specificity 92.41 %, and AUC 91.07% at four weeks. Prediction for moderate-severe BPD was also reliable at all scan time points with AUC 0.84 at 1-3 days, 0.91 at one week, 0.92 at two weeks, 0.95 at three weeks, and 0.97 at four weeks, with LUS cutoff >8, >5, >6, >4, and >3, respectively.ConclusionLUS can reliably predict the future development of BPD as early as one week of life and can play an important role in optimizing BPD preventive strategies.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"52-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458346","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":"Extremely preterm infant with double aortic arch presenting with severe tracheal obstruction and devastating esophageal hemorrhage.","authors":"Ryosuke Kanamori, Tomoaki Nomura, Akira Hirose, Hiroki Ito, Masaya Yamoto, Norie Mitsushita, Reiji Nakano","doi":"10.1177/19345798251315387","DOIUrl":"10.1177/19345798251315387","url":null,"abstract":"<p><p><b>Background:</b> Double aortic arch is the most constrictive type of vascular ring, completely encircling the trachea and esophagus, and can cause severe respiratory failure, dysphagia, or devastating esophageal hemorrhage. Although surgical repair is usually recommended shortly after diagnosis, surgery in extremely preterm infants presents significant challenges. The optimal timing of surgery and the management of complications that arise while awaiting surgery are not well understood.<b>Case presentation:</b> We report the case of an Asian female infant weighing 509 g at 24 + 5 weeks of gestation with a double aortic arch. Initially managed conservatively to allow for growth, the patient developed progressive tracheal granulation and recurrent, life-threatening esophageal hemorrhage. Gastrostomy and division of the vascular ring were successfully performed on days 65 and 66 (postmenstrual age 33 weeks; weight 1126 g), and tracheal granulation was managed conservatively. Despite mild respiratory symptoms persisting, the patient survived until discharge without any recurrence of esophageal bleeding.<b>Conclusion:</b> The management of double aortic arch in extremely preterm infants is particularly challenging. In this case, surgical repair was successfully performed at a weight of 1126 g without lethal postoperative complications. Early gastrostomy before the surgical repair of the double aortic arch may be advantageous in preventing devastating esophageal hemorrhage, especially in patients with severe tracheal narrowing indicative of a tight vascular ring and significant esophageal compression.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"89-93"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458379","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 vasopressin infusion in refractory neonatal shock.","authors":"Anup Thakur, Sachin Dangi, Rohit Gehlawat, Neelam Kler, Pankaj Garg, Anurag Fursule","doi":"10.1177/19345798241296327","DOIUrl":"10.1177/19345798241296327","url":null,"abstract":"<p><p><b>Background</b>To evaluate the effect of vasopressin infusion in refractory neonatal shock.MethodThis was a cohort study involving retrospective review of medical records of all neonates who received intravenous vasopressin infusion for at least 6 h for treatment of refractory shock in a level 3B neonatal intensive care unit of northern India between Jan 2016 to May 2021. Outcome measures assessed were systolic, diastolic, and mean blood pressure, heart rate, urine output, serum sodium level, inotrope score, and oxygenation index at 6, 12, 24, 48, and 72 h of vasopressin therapy. Outcome measures were compared before (T1) and 48 h (T2) after initiation of vasopressin.ResultsA total of 32 neonates received vasopressin. The mean (SD) systolic, diastolic, and mean blood pressure improved significantly between T1 and T2 from 54 (9) to 64 (11) mm Hg (MD (95% CI) = 10.3 (4.2-16.6), <i>p</i> = 0.003), 36 (8) to 42 (10) mm Hg (MD (95% CI) = 6.2 (1.3-11.3), <i>p</i> = 0.01), and 43 (8) to 51 (10) mm Hg (MD (95% CI) = 8.5 (2.3-14.6), <i>p</i> = 0.01), respectively. Median (IQR) urine output improved from 1.25 (0-3.2) to 2.1 (1.6-7) ml/kg/hr, <i>p</i> = 0.004. There was a significant fall in serum sodium from 139 (9) to 134 (8) mEq/l, <i>p</i> = 0.01. Out of 32 infants, 19 (59.4%) survived, while 6 (18.8 %) were transferred out and 7 (21.8%) died.ConclusionVasopressin improved hemodynamic parameters in refractory neonatal shock and can be used as a rescue therapy. Vasopressin therapy is associated with a fall in serum sodium.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"86-88"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458310","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}
Katherine Nyman, Elyse Decker, Kristin Ronan, Mathangi Gopalakrishnan, Dina El-Metwally
{"title":"Effect of neonatal intensive care unit design on infants with Neonatal Opioid Withdrawal Syndrome.","authors":"Katherine Nyman, Elyse Decker, Kristin Ronan, Mathangi Gopalakrishnan, Dina El-Metwally","doi":"10.1177/19345798241296324","DOIUrl":"10.1177/19345798241296324","url":null,"abstract":"<p><p>Background/ObjectiveNeonatal Opioid Withdrawal Syndrome (NOWS) requires advanced and often prolonged medical care in the neonatal intensive care unit (NICU). We examined the effect of NICU design on treatment and NICU length of stay (NICU-LOS) for infants with NOWS.MethodsA retrospective chart review of eligible infants with NOWS was conducted from 2013 to 2018. We collected and analyzed data on demographics, medication, and NICU-LOS characteristics. A multivariable linear regression on log-transformed NICU-LOS was performed for comparison between the open-bay design (OBD) for 2013-2015 (August) and the new single-family-room (SFR) NICU for September 2015-2018.ResultsThere were 118 neonates analyzed in OBD and 138 neonates in the SFR. Among infants in the SFR NICU, 86% received pharmacotherapy, compared to 76% of infants in the OBD (<i>p</i> = 0.059). The breastfeeding rate was 26% in the SFR and 6% in the OBD (<i>p</i> =< 0.001 ). Infants in the SFR NICU had 1.3 times longer mean NICU-LOS (<i>p</i> = 0.0163) than infants in OBD after adjusting for covariates including small for gestational age. The median (1Q, 3Q) cumulative doses of morphine (mg/kg) among the SFR and OBD groups were 6.4 (2.3,17.3) and 8.7 (3.2,19.3) <i>p</i>: NS, respectively.ConclusionsThe SFR NICU was associated with longer NICU-LOS for infants with NOWS despite higher rates of breastfeeding and no difference in morphine dosage. While providing more privacy and possible improved patient satisfaction, there may be unintended consequences of the SFR design.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458219","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}