{"title":"Survival and unique clinical practices of extremely preterm infants born at 22-23 weeks' gestation in Japan: a national survey.","authors":"Tetsuya Isayama, Kei Miyakoshi, Fumihiko Namba, Mariko Hida, Ichiro Morioka, Keisuke Ishii, Susumu Miyashita, Shuichiro Uehara, Yoshiaki Kinoshita, Sachie Suga, Katsutoshi Nakahata, Atsushi Uchiyama, Katsufumi Otsuki","doi":"10.1136/archdischild-2023-326355","DOIUrl":"10.1136/archdischild-2023-326355","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate prognosis and clinical practices of infants born at 22-23 weeks' gestational age (wkGA) in Japan.</p><p><strong>Design: </strong>A national institutional-level electronic questionnaire surveys performed in September 2021.</p><p><strong>Setting: </strong>All perinatal centres across Japan.</p><p><strong>Patients: </strong>Infants born at 22-23 wkGA in 2018-2020.</p><p><strong>Main outcome measures: </strong>Proportion of active resuscitation and survival at neonatal intensive care unit (NICU) discharge, and various clinical practices.</p><p><strong>Results: </strong>In total, 255 of 295 NICUs (86%) responded. Among them, 145 took care of infants born at 22-23 wkGA and answered the questions regarding their outcomes and care. In most NICUs (129 of 145 (89%)), infants born at 22<sup>+0</sup> wkGA can be actively resuscitated. In almost half of the NICUs (79 of 145 (54%)), infants born at ≥22<sup>+0</sup> wkGA were always actively resuscitated. Among 341 and 757 infants born alive at 22 and 23 wkGA, respectively, 85% (291 of 341) and 98% (745 of 757) received active resuscitation after birth. Among infants actively resuscitated at birth, 63% (183 of 291) and 80% (594 of 745) of infants born at 22 and 23 wkGA survived, respectively. The survey revealed unique clinical management for these infants in Japan, including delivery with caul in caesarean section, cut-cord milking after clamping cord, immediate intubation at birth, hydrocortisone use for chronic lung disease, analgesia/sedation use for infants on mechanical ventilation, routine echocardiography and brain ultrasound, probiotics administration, routine glycerin enema and skin dressing to prevent pressure ulcers.</p><p><strong>Conclusions: </strong>Many 22-23 wkGA infants were actively resuscitated in Japan and had a high survival rate. Various unique clinical practices were highlighted.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"17-22"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141079678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Graciaa Singhal, Rema Ramakrishnan, Raph Goldacre, Cheryl Battersby, Nigel J Hall, Chris Gale, Marian Knight, Nick Lansdale
{"title":"UK neonatal stoma practice: a population study.","authors":"Graciaa Singhal, Rema Ramakrishnan, Raph Goldacre, Cheryl Battersby, Nigel J Hall, Chris Gale, Marian Knight, Nick Lansdale","doi":"10.1136/archdischild-2024-327020","DOIUrl":"10.1136/archdischild-2024-327020","url":null,"abstract":"<p><strong>Objective: </strong>The optimal time for neonatal stoma closure is unclear and there have been calls for a trial to compare early and late surgery. The feasibility of such a trial will depend on the population of eligible infants and acceptability to families and health professionals. In this study, we aimed to determine current UK practice and characteristics of those undergoing stoma surgery.</p><p><strong>Design: </strong>A retrospective cohort study of neonates who had undergone stoma surgery (excluding anorectal malformations and Hirschsprung's disease) using three national databases: the National Neonatal Research Database (NNRD, 2012-2019), British Association of Paediatric Surgeons Congenital Anomalies Surveillance System (BAPS-CASS, 2013-2014) and Hospital Episode Statistics-Admitted Patient Care (HES-APC, 2011-2018).</p><p><strong>Results: </strong>1830 eligible neonates were identified from NNRD, 163 from BAPS-CASS, 2477 from HES-APC. Median (IQR) duration of stoma in days was 57 (36-80) in NNRD, 63 (41-130) in BAPS-CASS and 78 (55-122) for neonates identified from HES-APC. At the time of closure, there were low rates of invasive ventilation (13%), inotrope use (5%) and recent steroids use (4%). Infants who underwent earlier closure (<9 weeks) were less preterm (median 28 weeks vs 25 weeks), have higher birth weight (median 986 g vs 764 g) and more likely to have stoma complications (29% vs 5%).</p><p><strong>Conclusion: </strong>There are sufficient UK neonates undergoing stoma formation for a trial. Stoma closure is performed at around 2 months, with clinical stability, gestation, weight and stoma complications appearing to influence timing. The variation in practice we document indicates there is opportunity to optimise practice through a trial.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"79-84"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Corder, Timothy Nelin, Anne M Ades, John Flibotte, Elizabeth Laverriere, Rodrigo Daly Guris, Leane Soorikian, Elizabeth E Foglia
{"title":"Association between video laryngoscopy characteristics and successful neonatal tracheal intubation: a prospective study.","authors":"William Corder, Timothy Nelin, Anne M Ades, John Flibotte, Elizabeth Laverriere, Rodrigo Daly Guris, Leane Soorikian, Elizabeth E Foglia","doi":"10.1136/archdischild-2024-326992","DOIUrl":"10.1136/archdischild-2024-326992","url":null,"abstract":"<p><strong>Objective: </strong>To identify associations between procedural characteristics and success of neonatal tracheal intubation (NTI) using video laryngoscopy (VL).</p><p><strong>Design: </strong>Prospective single-centre observational study.</p><p><strong>Setting: </strong>Quaternary neonatal intensive care unit.</p><p><strong>Patients: </strong>Infants requiring NTI at the Children's Hospital of Philadelphia.</p><p><strong>Interventions: </strong>VL NTI recordings were evaluated to assess 11 observable procedural characteristics hypothesised to be associated with VL NTI success. These characteristics included measures of procedural time and performance, glottic exposure and position, and laryngoscope blade tip location.</p><p><strong>Main outcome measure: </strong>VL NTI attempt success.</p><p><strong>Results: </strong>A total of 109 patients underwent 109 intubation encounters with 164 intubation attempts. The first attempt success rate was 65%, and the overall encounter success rate was 100%. Successful VL NTI attempts were associated with shorter procedural duration (36 s vs 60 s, p<0.001) and improved Cormack-Lehane grade (63% grade I vs 49% grade II, p<0.001) compared with unsuccessful NTIs. Other factors more common in successful NTI attempts than unsuccessful attempts were laryngoscope blade placement to lift the epiglottis (45% vs 29%, p=0.002), fewer tracheal tube manoeuvres (3 vs 8, p<0.001) and a left-sided or non-visualised tongue location (76% vs 56%, p=0.009).</p><p><strong>Conclusion: </strong>We identified procedural characteristics visible on the VL screen that are associated with NTI procedural success. Study results may improve how VL is used to teach and perform neonatal intubation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"91-95"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orla Walsh, Ross Anthony, Zeke Wang, Barbara Elizabeth Cormack, Frank Harry Bloomfield
{"title":"Case-control study of milk curd obstruction in newborn infants in a tertiary surgical neonatal intensive care unit.","authors":"Orla Walsh, Ross Anthony, Zeke Wang, Barbara Elizabeth Cormack, Frank Harry Bloomfield","doi":"10.1136/archdischild-2024-327565","DOIUrl":"10.1136/archdischild-2024-327565","url":null,"abstract":"<p><strong>Background: </strong>Milk curd obstruction (MCO), in which milk becomes inspissated, is a rare, serious, complication of preterm birth. Case reports implicate male sex and bovine-derived human milk fortifier (HMF) use as predisposing factors. We investigated this through a case-control study.</p><p><strong>Methods: </strong>MCO cases in the Starship Child Health neonatal database between 2008 and 2020 were matched with controls in a 1:2 ratio based on gestational age (±1 week), birth weight (±200 g) and date of birth (±1 month). Data were analysed using the Student's t-test, Mann-Whitney U-test or χ² test as appropriate. Data are median (IQR) or n (%).</p><p><strong>Results: </strong>Of 20 MCO cases, gestation was 26.1 (24.5-28.1) weeks, birth weight was 822 (713-961) g, 15 (75%) were male. 40 controls were well-matched for gestation (26.1 (24.8-27.9) weeks) and birth weight (849 (690-1066) g) but only 18 (45%) were male (p=0.05). MCO occurred at 21 (15-33) days; 6 (30%) cases died compared with 3 (7.5%) controls (p=0.06). HMF was commenced at 243 (150-309) hours in cases and 224 (172-321) hours in controls (p=0.95); full-fortification (manufacturer's recommended dose) was achieved in 8 (40%) cases and 27 (68%) controls (p=0.08). In cases, MCO occurred 10 (7-17) days after commencing HMF. Medically/surgically-managed gut pathology occurred in 7 (35%) cases prior to MCO but in no controls (p<0.001).</p><p><strong>Conclusions: </strong>Our data support male sex but not HMF use as a predisposition to MCO. Evidence of prior medical/surgical gut pathology may be a premonition for MCO; however, further research is required to confirm this.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"102-106"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dagny Hemmingsen, Dag Moster, Bo Lars Engdahl, Claus Klingenberg
{"title":"Sensorineural hearing impairment among preterm children: a Norwegian population-based study.","authors":"Dagny Hemmingsen, Dag Moster, Bo Lars Engdahl, Claus Klingenberg","doi":"10.1136/archdischild-2024-326870","DOIUrl":"10.1136/archdischild-2024-326870","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk for sensorineural hearing impairment (SNHI) in preterm infants, and to what extent the risk is attributed to perinatal morbidities and therapies.</p><p><strong>Design: </strong>Population-based cohort study using data from several nationwide registries.</p><p><strong>Setting: </strong>Norwegian birth cohort 1999-2014, with data on SNHI until 2019.</p><p><strong>Participants: </strong>60 023 live-born preterm infants, divided in moderate-late preterm (MLP) infants (32-36 weeks), very preterm (VP) infants (28-31 weeks) and extremely preterm (EP) infants (22-27 weeks), and a reference group with all 869 797 term-born infants from the study period.</p><p><strong>Main outcome measures: </strong>SNHI defined by selected ICD-10 codes, recorded during minimum 5-year observation period after birth.</p><p><strong>Results: </strong>The overall SNHI prevalence in the preterm cohort was 1.4% compared with 0.7% in the reference group. The adjusted risk ratios (95% CIs) for SNHI were 1.7 (1.5-1.8) in MLP infants, 3.3 (2.8-3.9) in VP infants and 7.6 (6.3-9.1) in EP infants. Among EP infants, decreasing gestational age was associated with a steep increase in the risk ratio of SNHI reaching 14.8 (7.7-28.7) if born at 22-23 weeks gestation. Among the VP and MLP infants, mechanical ventilation and antibiotic therapy had strongest association with increased risk of SNHI, but infants not receiving these therapies remained at increased risk. Among EP infants intracranial haemorrhage increased the already high risk for SNHI. We found no signs of delayed or late-onset SNHI in preterm infants.</p><p><strong>Conclusion: </strong>Preterm birth is an independent risk factor for SNHI. Invasive therapies and comorbidities increase the risk, predominantly in infants born after 28 weeks gestation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"68-74"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Morris, Alex Harris, Michael Stewart, Rosemarie Boland, Arun Sett
{"title":"Efficacy of refrigerated gel packs for therapeutic hypothermia in neonatal retrieval: a retrospective cohort study.","authors":"Rachel Morris, Alex Harris, Michael Stewart, Rosemarie Boland, Arun Sett","doi":"10.1136/archdischild-2024-327094","DOIUrl":"10.1136/archdischild-2024-327094","url":null,"abstract":"<p><strong>Objective: </strong>To determine the efficacy of refrigerated gel packs in achieving and maintaining target temperature in neonates receiving therapeutic hypothermia (TH) for hypoxic ischaemic encephalopathy during neonatal retrieval.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Paediatric Infant Perinatal Emergency Retrieval, Victoria, Australia.</p><p><strong>Patients: </strong>200 neonates treated with TH during retrieval between 1 January 2015 and 31 December 2020.</p><p><strong>Interventions: </strong>Active cooling with refrigerated gel packs or passive cooling.</p><p><strong>Main outcome measures: </strong>The primary outcomes were the proportion of neonates who achieved therapeutic cooling rectal temperature (33-34°C) within 6 hours of birth and maintained target temperature range once TH was achieved. Secondary outcomes included need for respiratory support, inotropes, anticonvulsant therapy, sedation and survival at 7 days of life.</p><p><strong>Results: </strong>200 neonates received TH. Median gestational age was 39 weeks and median birth weight 3300 g. 120 (60%) were actively cooled with refrigerated gel packs and the remainder passively cooled. 121 neonates (61%) reached target temperature within 6 hours and 14 (7%) after 6 hours of birth. Of those who achieved target temperature, 38% were maintained in therapeutic cooling range for the remainder of the retrieval.</p><p><strong>Conclusions: </strong>Achieving and maintaining TH during neonatal retrieval with gel packs is challenging. Target temperature was not maintained in most neonates in this study. These findings support existing evidence favouring the use of servo-controlled cooling devices to optimise TH in the retrieval setting.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"96-101"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kate Alison Hodgson, Sharoan Selvakumaran, Kate Louise Francis, Louise S Owen, Sophie E Newman, Camille Omar Farouk Kamlin, Susan Donath, Calum T Roberts, Peter G Davis, Brett James Manley
{"title":"Predictors of successful neonatal intubation in inexperienced operators: a secondary, non-randomised analysis of the SHINE trial.","authors":"Kate Alison Hodgson, Sharoan Selvakumaran, Kate Louise Francis, Louise S Owen, Sophie E Newman, Camille Omar Farouk Kamlin, Susan Donath, Calum T Roberts, Peter G Davis, Brett James Manley","doi":"10.1136/archdischild-2024-327081","DOIUrl":"10.1136/archdischild-2024-327081","url":null,"abstract":"<p><strong>Objective: </strong>Neonatal endotracheal intubation is a lifesaving but technically difficult procedure, particularly for inexperienced operators. This secondary analysis in a subgroup of inexperienced operators of the Stabilization with nasal High flow during Intubation of NEonates randomised trial aimed to identify the factors associated with successful intubation on the first attempt without physiological stability of the infant.</p><p><strong>Methods: </strong>In this secondary analysis, demographic factors were compared between infants intubated by inexperienced operators and those intubated by experienced operators. Following this, for inexperienced operators only, predictors of successful intubation without physiological instability were analysed.</p><p><strong>Results: </strong>A total of 251 intubations in 202 infants were included in the primary intention-to-treat analysis of the main trial. Inexperienced operators were more likely to perform intubations in larger and more mature infants in the neonatal intensive care unit where premedications were used. When intubations were performed by inexperienced operators, the use of nasal high flow therapy (nHF) and a higher starting fraction of inspired oxygen were associated with a higher rate of safe, successful intubation on the first attempt. There was a weaker association between premedication use and first attempt success.</p><p><strong>Conclusions: </strong>In inexperienced operators, this secondary, non-randomised analysis suggests that the use of nHF and premedications, and matching the operator to the infant and setting, may be important to optimise neonatal intubation success.</p><p><strong>Trial registration number: </strong>ACTRN12618001498280.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"75-78"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tim U Krohne, Alexandra T Camp, Johanna M Pfeil, Andreas Müller, Andreas Stahl, Wolf A Lagrèze, Jeany Q Li
{"title":"Retinopathy of prematurity in Germany over 13 years: incidences, treatment preferences and effects of national guideline changes.","authors":"Tim U Krohne, Alexandra T Camp, Johanna M Pfeil, Andreas Müller, Andreas Stahl, Wolf A Lagrèze, Jeany Q Li","doi":"10.1136/archdischild-2024-327133","DOIUrl":"10.1136/archdischild-2024-327133","url":null,"abstract":"<p><strong>Objective: </strong>Retinopathy of prematurity (ROP) is a leading yet avoidable cause of childhood blindness. Screening for ROP is highly effective in preventing blindness secondary to ROP. We provide epidemiological data on ROP screening and treatment in Germany since 2010 and evaluate the effects of recently adopted as well as potential future screening guideline adaptations.</p><p><strong>Methods: </strong>Data sets of the German Quality Assurance Procedure in Neonatology, the ROP screening programme of two German university hospitals, and the German section of the EU-ROP Registry were analysed.</p><p><strong>Results: </strong>Over the 13-year period from 2010 to 2022, 141 550 infants received ROP screening in Germany. Mean annual incidences of ROP were 3.5% (±0.2%) in premature infants and 19.6% (±2.3%) in screened infants. Of screened infants, 2.0% (±0.3%) received treatment for ROP. Treatment preferences shifted from laser coagulation (46.2% in 2015) to anti-vascular endothelial growth factor therapy (83.7% in 2022). A revision of national screening criteria in 2020 with a reduction of the gestational age limit from <32 to <31 weeks resulted in a decrease of the annual number of infants requiring screening by 25.8% (p<0.001). Infants with a birth weight ≥1500 g accounted for 35.2% of the screening population but only for 0.4% of ROP stage 3-5 cases.</p><p><strong>Conclusions: </strong>Collection of epidemiological data on ROP in national and international registries enables the continuous surveillance and adaptation of ROP screening and treatment criteria. In Germany, infants with a birth weight ≥1500 g have a very low risk of developing treatment-requiring ROP, supporting an upper birth weight limit for ROP screening.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"37-42"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gemma Sullivan, Alan J Quigley, Samantha Choi, Rory Teed, Manuel Blesa Cabez, Kadi Vaher, Amy Corrigan, David Q Stoye, Michael J Thrippleton, Mark Bastin, James P Boardman
{"title":"Brain 3T magnetic resonance imaging in neonates: features and incidental findings from a research cohort enriched for preterm birth.","authors":"Gemma Sullivan, Alan J Quigley, Samantha Choi, Rory Teed, Manuel Blesa Cabez, Kadi Vaher, Amy Corrigan, David Q Stoye, Michael J Thrippleton, Mark Bastin, James P Boardman","doi":"10.1136/archdischild-2024-326960","DOIUrl":"10.1136/archdischild-2024-326960","url":null,"abstract":"<p><strong>Background and objectives: </strong>The survival rate and patterns of brain injury after very preterm birth are evolving with changes in clinical practices. Additionally, incidental findings can present legal, ethical and practical considerations. Here, we report MRI features and incidental findings from a large, contemporary research cohort of very preterm infants and term controls.</p><p><strong>Methods: </strong>288 infants had 3T MRI at term-equivalent age: 187 infants born <32 weeks without major parenchymal lesions, and 101 term-born controls. T1-weighted, T2-weighted and susceptibility-weighted imaging were used to classify white and grey matter injury according to a structured system, and incidental findings described.</p><p><strong>Results: </strong><i>Preterm infants</i>: 34 (18%) had white matter injury and 4 (2%) had grey matter injury. 51 (27%) infants had evidence of intracranial haemorrhage and 34 (18%) had punctate white matter lesions (PWMLs). Incidental findings were detected in 12 (6%) preterm infants. <i>Term infants</i>: no term infants had white or grey matter injury. Incidental findings were detected in 35 (35%); these included intracranial haemorrhage in 22 (22%), periventricular pseudocysts in 5 (5%) and PWMLs in 4 (4%) infants. From the whole cohort, 10 (3%) infants required referral to specialist services.</p><p><strong>Conclusions: </strong>One-fifth of very preterm infants without major parenchymal lesions have white or grey matter abnormalities at term-equivalent age. Incidental findings are seen in 6% of preterm and 35% of term infants. Overall, 3% of infants undergoing MRI for research require follow-up due to incidental findings. These data should help inform consent procedures for research and assist service planning for centres using 3T neonatal brain MRI for clinical purposes.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"85-90"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vikrant Sharma, Steven J Barker, Augusto Sola, Daniel Cantillon, Rebecca Sorci, William C Wilson
{"title":"Response to 'Randomised crossover study on pulse oximeter readings from different sensors in very preterm infants' by Maiwald <i>et al</i>.","authors":"Vikrant Sharma, Steven J Barker, Augusto Sola, Daniel Cantillon, Rebecca Sorci, William C Wilson","doi":"10.1136/archdischild-2024-327165","DOIUrl":"10.1136/archdischild-2024-327165","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"110-111"},"PeriodicalIF":3.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}