Neonatology最新文献_第4页

The Association of Dexamethasone and Hydrocortisone with Cerebellar Growth in Premature Infants. 地塞米松和氢化可的松与早产儿小脑生长的关系。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 Epub Date: 2023-06-28 DOI: 10.1159/000531075

Laura A Warmerdam, Gerda van Wezel-Meijler, Linda S de Vries, Floris Groenendaal, Sylke J Steggerda

{"title":"The Association of Dexamethasone and Hydrocortisone with Cerebellar Growth in Premature Infants.","authors":"Laura A Warmerdam, Gerda van Wezel-Meijler, Linda S de Vries, Floris Groenendaal, Sylke J Steggerda","doi":"10.1159/000531075","DOIUrl":"10.1159/000531075","url":null,"abstract":"Objectives: Corticosteroids are used to prevent or treat lung disease of prematurity. While neurological side effects have been reported, detailed effects on cerebellar growth are unknown. This study aimed to compare cerebellar growth in premature infants who received dexamethasone or hydrocortisone to premature infants who did not receive postnatal corticosteroids.Study design: Retrospective case-control study in infants born at a gestational age of <29 weeks and admitted to two level 3 neonatal intensive care units. Exclusion criteria were severe congenital anomalies and cerebellar or severe supratentorial lesions. Infants were treated with dexamethasone (unit 1) or hydrocortisone (unit 2) for chronic lung disease. Controls (unit 1) did not receive postnatal corticosteroids. Sequential head circumference (HC) and ultrasound measurements of transcerebellar diameter (TCD), biparietal diameter (BPD), and corpus callosum-fastigium length (CCFL) were performed until 40 weeks' postmenstrual age (PMA). Growth was assessed using linear mixed models correcting for PMA at measurement, sex, HC z-score at birth, and a propensity score indicating illness severity. Group differences before treatment were assessed using linear regression.Results: 346 infants were included (68 dexamethasone, 37 hydrocortisone, 241 controls). Before starting corticosteroids, TCD, BPD, and HC measurements did not differ between patients and controls at a comparable PMA. After starting treatment, both types of corticosteroid had a negative association with TCD growth. BPD, CCFL, and HC growth were not negatively affected.Conclusion: Administration of dexamethasone and hydrocortisone are both associated with impaired cerebellar growth in premature infants without evident negative associations with cerebral growth.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":" ","pages":"615-623"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10070127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cerebral Oxygenation during Neonatal Intubation with Nasal High Flow: A Sub-Study of the SHINE Randomized Trial. 新生儿鼻高流量插管期间脑氧合:SHINE随机试验的一项亚研究。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 DOI: 10.1159/000529870

Ellyn Van Der Veeken, Brett James Manley, Louise Owen, Omar Kamlin, Calum Roberts, Sophie Newman, Kate Francis, Susan Donath, Peter Davis, Rocco Cuzzilla, Kate Alison Hodgson

{"title":"Cerebral Oxygenation during Neonatal Intubation with Nasal High Flow: A Sub-Study of the SHINE Randomized Trial.","authors":"Ellyn Van Der Veeken, Brett James Manley, Louise Owen, Omar Kamlin, Calum Roberts, Sophie Newman, Kate Francis, Susan Donath, Peter Davis, Rocco Cuzzilla, Kate Alison Hodgson","doi":"10.1159/000529870","DOIUrl":"https://doi.org/10.1159/000529870","url":null,"abstract":"Introduction: Nasal high flow (nHF) improves the likelihood of successful neonatal intubation on the first attempt without physiological instability. The effect of nHF on cerebral oxygenation is unknown. The aim of this study was to compare cerebral oxygenation during endotracheal intubation in neonates receiving nHF and those receiving standard care. Methods: A sub-study of a multicentre randomized trial of nHF during neonatal endotracheal intubation. A subset of infants had near-infrared spectroscopy (NIRS) monitoring. Eligible infants were randomly assigned to nHF or standard care during the first intubation attempt. NIRS sensors provided continuous regional cerebral oxygen saturation (rScO2) monitoring. The procedure was video recorded, and peripheral oxygen saturation and rScO2 data were extracted at 2-second intervals. The primary outcome was the average difference in rScO2 from baseline during the first intubation attempt. Secondary outcomes included average rScO2 and rate of change of rScO2. Results: Nineteen intubations were analyzed (11 nHF; 8 standard care). Median (interquartile range [IQR]) postmenstrual age was 27 (26.5–29) weeks, and weight was 828 (716–1,135) g. Median change in rScO2 from baseline was −1.5% (−5.3 to 0.0) in the nHF group and −9.4% (−19.6 to −4.5) in the standard care group. rScO2 fell more slowly in infants managed with nHF compared with standard care: median (IQR) rScO2 change −0.08 (−0.13 to 0.00) % per second and −0.36 (−0.66 to −0.22) % per second, respectively. Conclusions: In this small sub-study, regional cerebral oxygen saturation was more stable in neonates who received nHF during intubation compared with standard care.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 4","pages":"458-464"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10090388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 DOI: 10.1159/000529842

Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Anna Axelsson Raja, Anna Sellmer, Signe Levring Skjellerup, Raheel Altaf Raja, Johan Navne, Anne-Sophie Sillesen, Niels Vejlstrup, Henning Bundgaard, Kasper Karmark Iversen, Ester Garne, Dorthe Lisbeth Jeppesen

{"title":"Age-Related Prevalence of Open Ductus Arteriosus in Full-Term Newborns.","authors":"Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Anna Axelsson Raja, Anna Sellmer, Signe Levring Skjellerup, Raheel Altaf Raja, Johan Navne, Anne-Sophie Sillesen, Niels Vejlstrup, Henning Bundgaard, Kasper Karmark Iversen, Ester Garne, Dorthe Lisbeth Jeppesen","doi":"10.1159/000529842","DOIUrl":"https://doi.org/10.1159/000529842","url":null,"abstract":"Background: The ductus arteriosus is part of the fetal circulation. Normally, the vessel closes during the cardiac transition. Delayed closure is associated with complications. The aim of this study was to evaluate the age-related prevalence of open ductus arteriosus in full-term neonates.Methods: Echocardiograms were collected in the population study, the Copenhagen Baby Heart Study. The present study included full-term neonates with an echocardiogram performed within 28 days after birth. All echocardiograms were reviewed to assess ductus arteriosus patency.Results: A total of 21,649 neonates were included. In neonates examined at day zero and day seven, an open ductus arteriosus was found in 36% and 0.6%, respectively. Beyond day seven, the prevalence remained stable at 0.6%.Conclusion: More than one-third of full-term neonates had an open ductus arteriosus on the first day of life, declining rapidly within the first week and stabilizing below 1% after day seven.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 4","pages":"527-531"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10090907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of Meningococcal Invasive Disease in Neonates and Virulence of the Corresponding Isolates. 新生儿脑膜炎球菌侵袭性疾病的特点及其分离株的毒力。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 DOI: 10.1159/000530151

Melissa Beggaz, Tamazoust Guiddir, Eva Hong, Ala-Eddine Deghmane, Muhamed-Kheir Taha

{"title":"Characteristics of Meningococcal Invasive Disease in Neonates and Virulence of the Corresponding Isolates.","authors":"Melissa Beggaz, Tamazoust Guiddir, Eva Hong, Ala-Eddine Deghmane, Muhamed-Kheir Taha","doi":"10.1159/000530151","DOIUrl":"https://doi.org/10.1159/000530151","url":null,"abstract":"Background: The highest incidence of invasive meningococcal disease (IMD) is observed in infants. However, its prevalence in neonates (≤28 days of age) and the characteristics of the corresponding isolates are less described. This report aimed to analyze meningococcal isolates from neonates.Methods: We first screened the database of the national reference center for meningococci in France for confirmed neonatal IMD cases between 1999 and 2019. We then performed whole-genome sequencing on all cultured isolates, and we evaluated their virulence in a mouse model.Results: Fifty-three neonatal cases of IMD (mainly bacteremia) were identified (50 culture-confirmed cases and 3 PCR-confirmed cases) of a total of 10,149 cases (0.5%) but represented 11% of cases among infants of under 1 year of age. Nine cases (17%) occurred among neonates of 3 days of age and younger (early onset). The neonate isolates were often of serogroup B (73.6%) and belonged to the clonal complex CC41/44 (29.4%) with at least 68.5% of coverage by vaccines against serogroup B isolates. The neonatal isolates were able to infect mice although to variable levels.Conclusion: IMD in neonates is not rare and can be of early or late onsets suggesting that anti-meningococcal vaccination can target women planning to have a baby.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 4","pages":"417-423"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10100474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resonance Raman Spectroscopy Tissue Oxygenation Measurements in Neonates. 新生儿的共振拉曼光谱组织氧合测量。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 DOI: 10.1159/000529624

Tazuddin Azmi Mohammed, Russell Ray Moores, Karen D Hendricks-Muñoz, Padraic Romfh, Henry J Rozycki

{"title":"Resonance Raman Spectroscopy Tissue Oxygenation Measurements in Neonates.","authors":"Tazuddin Azmi Mohammed, Russell Ray Moores, Karen D Hendricks-Muñoz, Padraic Romfh, Henry J Rozycki","doi":"10.1159/000529624","DOIUrl":"https://doi.org/10.1159/000529624","url":null,"abstract":"Introduction: Current oxygen monitoring by pulse oximetry has limitations and cannot provide estimates of the oxygen content in the microvasculature, where oxygen is used. Resonance Raman spectroscopy (RRS) provides noninvasive microvascular oxygen measurement. The objectives of this study were to (i) measure the correlation between preductal RRS microvascular oxygen saturations (RRS-StO2) and central venous oxygen saturation (SCVO2), (ii) develop normative data for RRS-StO2 measurements in healthy preterm infants, and (iii) determine the effect of blood transfusion on RRS-StO2.Methods: Thirty-three buccal and thenar RRS-StO2 measurements were performed in 26 subjects to correlate RRS-StO2 with SCVO2. Thirty-one measurements were performed in 28 subjects to develop normative RRS-StO2 values, and eight subjects were enrolled in the transfusion group to assess changes in RRS-StO2 with blood transfusion.Results: There were good correlations for buccal (r = 0.692) and thenar (r = 0.768) RRS-StO2 versus SCVO2. The median RRS-StO2 in healthy subjects was 76% (IQR 68.7-80.8). There was a significant increase of 7.8 ± 4.6% in the thenar RRS-StO2 after blood transfusion.Conclusions: RRS appears to be a safe and noninvasive means of monitoring microvascular oxygenation. Thenar RRS-StO2 measurements are more feasible and practical to use than buccal. In healthy preterm infants, the median RRS-StO2 was calculated based on measurements across various gestational age and gender. More studies evaluating the effects of gestational age of RRS-StO2 in various critical clinical settings are needed to confirm the findings.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 3","pages":"363-370"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10165744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","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 Cystic Periventricular Leukomalacia and Postnatal Epilepsy in Very Preterm Infants. 囊性脑室周围白质软化与极早产儿产后癫痫的关系。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 DOI: 10.1159/000529998

Po-Ming Wu, Chen-Yu Wu, Chung-I Li, Chao-Ching Huang, Yi-Fang Tu

{"title":"Association of Cystic Periventricular Leukomalacia and Postnatal Epilepsy in Very Preterm Infants.","authors":"Po-Ming Wu, Chen-Yu Wu, Chung-I Li, Chao-Ching Huang, Yi-Fang Tu","doi":"10.1159/000529998","DOIUrl":"https://doi.org/10.1159/000529998","url":null,"abstract":"Introduction: Cystic periventricular leukomalacia (PVL) is the most common white matter injury and a common cause of cerebral palsy in preterm infants. Postnatal epilepsy may occur after cystic PVL, but their causal relationship remains uncertain. Our aim was to validate the contribution of cystic PVL to postnatal epilepsy in very preterm infants and demonstrate their seizure characteristics.Methods: This prospective cohort study enrolled 1,342 preterm infants (birth weight <1,500 g and gestational age <32 weeks) from 2003 to 2015. Cystic PVL was diagnosed by serial cerebral ultrasound, and other comorbidities were recorded during hospitalization. Neurological developments and consequences, including epilepsy, were serially accessed until the age of 5.Results: A total of 976 preterm infants completed a 5-year neurological follow-up; 47 (4.8%) had cystic PVL. Preterm infants with cystic PVL were commonly associated with other comorbidities, including necrotizing enterocolitis stage III, neonatal seizures, and intraventricular hemorrhage during hospitalization. At age 5, 14 of the 47 (29.8%) preterm infants with cystic PVL had postnatal epilepsy. After adjusting for gender, gestational age, and three common comorbidities, cystic PVL was an independent risk factor for postnatal epilepsy (adjust OR: 16.2; 95% CI: 6.8-38.4; p < 0.001). Postnatal epilepsy after cystic PVL was commonly the generalized type (13 of 14, 92.9%), not intractable and most occurred after 1 year of age.Discussion/conclusion: Cystic PVL would independently lead to postnatal epilepsy. Preterm infants with cystic PVL are at risk of postnatal epilepsy after age 1 in addition to cerebral palsy.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 4","pages":"500-507"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10472409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Ending Preventable Neonatal Deaths: Multicountry Evidence to Inform Accelerated Progress to the Sustainable Development Goal by 2030. 终止可预防的新生儿死亡：到2030年加速实现可持续发展目标的多国证据。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 Epub Date: 2023-05-16 DOI: 10.1159/000530496

Joy E Lawn, Zulfiqar A Bhutta, Chinyere Ezeaka, Ola Saugstad

{"title":"Ending Preventable Neonatal Deaths: Multicountry Evidence to Inform Accelerated Progress to the Sustainable Development Goal by 2030.","authors":"Joy E Lawn, Zulfiqar A Bhutta, Chinyere Ezeaka, Ola Saugstad","doi":"10.1159/000530496","DOIUrl":"10.1159/000530496","url":null,"abstract":"Introduction: The Sustainable Development Goal (SDG) 3.2 aims for every country to reach a neonatal mortality rate (NMR) of ≤12/1,000 live births by 2030. More than 60 countries are off track, and 2.3 million newborns still die each year. Urgent action is needed, but varies by context, notably mortality level.Methods: We applied a five-phase NMR transition model based on national analyses for 195 UN member states: I (NMR >45), II (30-<45), III (15-<30), IV (5-<15), and V (<5). We analyzed data over the last century from selected countries to inform strategies to reach SDG3.2. We also undertook impact analyses for packages of care using the Lives Saved Tool software.Results: An NMR of <15/1,000 requires firstly wide-scale access to maternity care and hospital care for small and sick newborns, including skilled nurses and doctors, safe oxygen use, and respiratory support, such as CPAP. Neonatal mortality could be reduced to the SDG target of ≤12/1,000 with further scale-up of small and sick newborn care. To reduce neonatal mortality further, more investment is required in infrastructure, device bundles (e.g., phototherapy, ventilation), and careful attention to infection prevention. To reach phase V (NMR <5), which is closer to ending preventable newborn deaths, additional technologies and therapies such as mechanical ventilation and surfactant replacement therapy are needed, as well as higher staffing ratios.Conclusions: Learning from high-income country is important, including what not to do. Introduction of new technologies should be according to the country's phase. Early focus on disability-free survival and family involvement is also crucial.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 4","pages":"491-499"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10097161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of a New PCR-Based Screening Method for Prevention of Serratia marcescens Outbreaks in the Neonatal Intensive Care Unit. 一种新的基于聚合酶链反应的筛查方法在新生儿重症监护室预防粘质沙雷菌爆发的验证。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 DOI: 10.1159/000526836

Lina K Sciesielski, Luisa K M Osang, Nicole Dinse, Anna Weber, Christoph Bührer, Axel Kola, Christof Dame

{"title":"Validation of a New PCR-Based Screening Method for Prevention of Serratia marcescens Outbreaks in the Neonatal Intensive Care Unit.","authors":"Lina K Sciesielski, Luisa K M Osang, Nicole Dinse, Anna Weber, Christoph Bührer, Axel Kola, Christof Dame","doi":"10.1159/000526836","DOIUrl":"https://doi.org/10.1159/000526836","url":null,"abstract":"Background: Serratia marcescens may cause severe nosocomial infections, mostly in very low birth weight infants. Since S. marcescens exhibits by far the highest adjusted incidence rate for horizontal transmission, it can cause complex outbreak situations in neonatal intensive care units.Objective: The aim of this study was to establish a fast and highly sensitive colonization screening for prompt cohorting and barrier nursing strategies.Methods: A probe-based duplex PCR assay targeting the 16S rRNA gene of S. marcescens was developed and validated by using 36 reference strains, 14 S. marcescens outbreak- and nonoutbreak isolates, defined by epidemiological linkage and molecular typing, and applied in 1,347 clinical specimens from 505 patients.Results and conclusions: The novel PCR assay proved to be highly specific and had an in vitro sensitivity of 100 gene copies per reaction (∼15 bacteria). It showed a similar (in laryngeal/tracheal specimens) or even higher (in rectal/stoma swabs) in vivo sensitivity in comparison to routine microbial culture and was much quicker (<24 h vs. 2 days). By combining different oligonucleotide primers, there was robust detection of genetic variants of S. marcescens strains. PCR inhibition was low (1.6%) and observed with rectal swabs only. Cohort analysis illustrated applicability of the PCR assay as a quick tool to prevent outbreak scenarios by allowing rapid decisions on cohorting and barrier nursing. In summary, this novel molecular screening for colonization by S. marcescens is specific, highly sensitive, and substantially accelerates detection.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 2","pages":"176-184"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","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 Maternal Cigarette Smoking with Neonatal Death: A Population-Based Cohort Study. 孕产妇吸烟与新生儿死亡的关系:一项基于人群的队列研究

IF 4.6 3区医学

Neonatology Pub Date : 2023-01-01 Epub Date: 2023-08-11 DOI: 10.1159/000531887

Ran Wang, Xia Han, Bingxue Zhu, Ming Ye, Qiqi Shi

{"title":"Association of Maternal Cigarette Smoking with Neonatal Death: A Population-Based Cohort Study.","authors":"Ran Wang, Xia Han, Bingxue Zhu, Ming Ye, Qiqi Shi","doi":"10.1159/000531887","DOIUrl":"10.1159/000531887","url":null,"abstract":"Introduction: Maternal pregnancy smoking has adverse perinatal outcomes and the relationship between maternal smoking and neonatal death has not been fully elucidated. We aimed to examine the risk of neonatal death in relation to maternal smoking and to quantify potential mediators of these associations.Methods: We did a population-based cohort study using Period Linked Birth-Infant Death data from 2016 to 2019 in the US National Vital Statistics System. The exposure was maternal smoking status. The main outcome was neonatal death. Association between maternal smoking and neonatal death was estimated through logistic regression. Mediation analysis was performed to assess the extent to which the association between maternal smoking and neonatal death was mediated by neonatal complications.Results: The final sample consisted of 14,717,020 mothers with live singleton births. The overall neonatal mortality rate was 2.2 per 1,000 live births. Maternal pregnancy smoking was associated with an increased risk of neonatal death {adjusted odds ratio (aOR, 1.33 [95% CI, 1.28-1.38]; p < 0.001)}, while smoking cessation during the whole pregnancy showed a comparable risk of neonatal death with nonsmokers (aOR, 1.06 [95% CI, 0.99-1.14]; p = 0.116). Mediation analysis indicated that the association between pregnancy smoking and neonatal death might be mainly mediated by preterm birth and low Apgar score at 5 min.Conclusions: Maternal pregnancy smoking, regardless of pregnancy trimester and intensity, was associated with increased risk of neonatal death. Efforts are needed for policymakers to promote smoking cessation before pregnancy, and professional perinatal care should be provided for those who smoked during pregnancy.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":" ","pages":"699-708"},"PeriodicalIF":4.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9987905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment of Comfort during Less Invasive Surfactant Administration in Very Preterm Infants: A Multicenter Study. 极早产儿服用微创表面活性剂期间的舒适性评估：一项多中心研究。

IF 2.5 3区医学

Neonatology Pub Date : 2023-01-01 Epub Date: 2023-06-13 DOI: 10.1159/000530333

Karin Pichler, Benjamin Kuehne, Janneke Dekker, Sophie Stummer, Vito Giordano, Angelika Berger, Angela Kribs, Katrin Klebermass-Schrehof

{"title":"Assessment of Comfort during Less Invasive Surfactant Administration in Very Preterm Infants: A Multicenter Study.","authors":"Karin Pichler, Benjamin Kuehne, Janneke Dekker, Sophie Stummer, Vito Giordano, Angelika Berger, Angela Kribs, Katrin Klebermass-Schrehof","doi":"10.1159/000530333","DOIUrl":"10.1159/000530333","url":null,"abstract":"Introduction: This study was set up to investigate if and to what extent non-pharmacological analgesia is able to provide comfort to very preterm infants (VPI) during less invasive surfactant administration (LISA).Methods: This was a prospective non-randomized multicenter observational study performed in level IV NICUs. Inborn VPI with a gestational age between 220/7 and 316/7 weeks, signs of respiratory distress syndrome, and the need for surfactant replacement were included. Non-pharmacological analgesia was performed in all infants during LISA. In case of failure of the first LISA attempt, additional analgosedation could be administered. COMFORTneo scores during LISA were assessed.Results: 113 VPI with a mean gestational age of 27 weeks (+/- 2.3 weeks) and mean birth weight of 946 g (+/- 33 g) were included. LISA was successful at the first laryngoscopy attempt in 81%. COMFORTneo scores were highest during laryngoscopy. At this time point, non-pharmacological analgesia provided adequate comfort in 61% of the infants. 74.4% of lower gestational aged infants (i.e., 220-266 weeks) were within the comfort zone during laryngoscopy compared to 51.6% of higher gestational aged infants (i.e., 270-320 weeks) (p = 0.016). The time point of surfactant administration did not influence the COMFORTneo scores during the LISA procedure.Conclusion: Non-pharmacological analgesia provided comfort in as much as 61% of the included VPI during LISA. Further research is needed to both develop strategies to identify infants who, despite receiving non-pharmacological analgesia, are at high risk for experiencing discomfort during LISA and define patient-tailored dosage and choice of analgosedative drugs.","PeriodicalId":18924,"journal":{"name":"Neonatology","volume":"120 4","pages":"473-481"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2