Archives of Disease in Childhood - Fetal and Neonatal Edition最新文献

{"title":"Seven-day versus 14-day antibiotic course for culture-proven neonatal sepsis: a multicentre randomised non-inferiority trial in a low and middle-income country.","authors":"Sourabh Dutta, Sushma Nangia, Mamta Jajoo, MangalaBharathi Sundaram, Mala Kumar, Niranjan Shivanna, Geeta Gathwala, Saudamini Nesargi, Suksham Jain, Praveen Kumar, Arvind Saili, Arun Karthik, Shalini Tripathi, Prathik Bandiya, Poonam Dalal, Pallab Ray, Valinderjeet Singh Randhawa, Karnika Saigal, Devasena Radhakrishnan, Vimla Venkatesh, Bhavana Jagannatha, Madhu Sharma, Savitha Nagaraj, Meenakshi Malik, Sarita Dogra, Suruchi Mittal, Anumeet Saini, Nisha Makkar, Maitreyi Dhir, Asmita Chandramohan, R A Pragati, Tanaya Srivastava, Lakshmi Mukundan, Naveen Benakappa, Amlin Shukla, Reeta Rasaily","doi":"10.1136/archdischild-2024-328232","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328232","url":null,"abstract":"<p><strong>Objective: </strong>Definitive guidance regarding the duration of antibiotics for neonatal sepsis is lacking. We hypothesised that a 7-day antibiotic course is non-inferior to a 14-day course for treating culture-proven sepsis.</p><p><strong>Design: </strong>Randomised, controlled, non-inferiority trial with masked outcome assessment in eight centres in a low and middle-income country.</p><p><strong>Patients: </strong>Neonates with a birth weight (BW) ≥1000 g and blood culture-proven sepsis were randomised on day 7 of sensitive antibiotic therapy provided sepsis had clinically remitted.</p><p><strong>Exclusions: </strong><i>Staphylococcus aureus</i> or fungal sepsis, and infections requiring prolonged antibiotics. We planned to enrol 350 per group, assuming 10% rate of primary outcome, +7% non-inferiority margin, one-sided 5% alpha, 90% power, 10% loss to follow-up.</p><p><strong>Intervention: </strong>7 days (no further treatment); comparison: 14 days (7 days postrandomisation).</p><p><strong>Outcomes: </strong>Primary: relapse (definite or probable) within day 21 postantibiotic completion.</p><p><strong>Secondary outcomes: </strong>composite of mortality or definite/probable/secondary sepsis and duration of hospitalisation. One interim analysis (per protocol (PP)) was planned.</p><p><strong>Results: </strong>126 and 135 subjects were recruited in 7-day and 14-day groups, respectively, with mean (SD) birth weight (BW) 2250.9 (741.1) and 2187.8 (718.8) g. The trial was terminated early, based on interim PP analysis. 2/125 and 6/130 subjects had the primary outcome in 7-day and 14-day groups, respectively (risk difference (RD)=-3.0% (99.5% CI -9.2%, +3.1%), below non-inferiority margin). The composite secondary outcome also favoured the 7-day regimen (RD: -3.7% (99.5% CI -12.4% to +5.1%)). Duration of hospitalisation was shorter in 7-day group (median difference: -4 days (95% CI -5 to -3)).</p><p><strong>Conclusions: </strong>A 7-day course of antibiotics may be non-inferior to a 14-day course for uncomplicated bacterial neonatal sepsis.</p><p><strong>Trial registration number: </strong>NCT03280147.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964309","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}

{"title":"Re: Birth weight and head circumference for 22-29 weeks gestation neonates from an international cohort.","authors":"Bradley de Vries, Adrienne Gordon, Farmey Joseph, Jon Hyett","doi":"10.1136/archdischild-2025-328719","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328719","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971017","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}

{"title":"Reduced calf muscle growth in NICU graduates compared with typically developing term infants: 12-month longitudinal study of infant muscle growth.","authors":"Sian A Williams, Malcolm Battin, Alana Cavadino, Ali Mirjalili, Louise Pearce, Amy Mulqueeney, Ngaire Susan Stott","doi":"10.1136/archdischild-2024-328402","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328402","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate growth of the triceps surae muscle over the first 12 months of life in neonatal intensive care unit (NICU) graduates compared with typically developing (TD) infants.</p><p><strong>Design: </strong>Longitudinal, prospective study.</p><p><strong>Participants: </strong>Sixty-one infants, n=24 TD (15 male) and n=37 NICU graduates designated as intermediate-risk (NICU-IR; n=14, 9 male) or higher-risk (NICU-HR; n=23, 11 male) based on additional risk factors (including <28 weeks gestational age; <1000 g; neonatal encephalopathy; abnormal neuroimaging; small for gestational age).</p><p><strong>Outcome measures: </strong>Sequential assessments at corrected ages 3, 6 and 12 months of muscle volume (freehand three-dimensional ultrasound) and gross motor development (Peabody Developmental Motor Scale-2, Gross Motor Quotient (GMQ)). Linear mixed models analysed muscle volume trajectories.</p><p><strong>Results: </strong>Triceps surae growth trajectories differed significantly by group (p<0.001). Between 3 and 12 months, triceps surae increased on average by 18.1 cm³ (95% CI 16.1 to 20.2 cm³), 13.3 cm³ (10.6 to 16.0 cm³) and 12.5 cm³ (10.5 to 14.6 cm³) in TD, NICU-IR and NICU-HR infants, respectively. Soleus was significantly smaller at 6 and 12 months for both NICU groups, and lateral gastrocnemius was smaller at 12 months for NICU-HR (p<0.001). At 12 months of age, 8% of NICU infants and 30% of the TD infants were walking, the GMQ was >90 in all TD infants, and all but 5 (14%) NICU infants. Muscle volumes at 12 months were positively associated with both gestational age and birth weight.</p><p><strong>Conclusion: </strong>Reduced soleus growth from 3 to 12 months led to a 25% smaller triceps surae muscle at 12 months in NICU graduates.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974476","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}

{"title":"Modelling the association of reduction in PM_2.5 with medically attended acute respiratory illness in infants with mild bronchopulmonary dysplasia.","authors":"Timothy Nelin, Joshua K Radack, Sara B DeMauro, Nicolas P Goldstein Novick, Kristan Scott, Allan C Just, Heather H Burris","doi":"10.1136/archdischild-2025-328533","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328533","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960665","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}

{"title":"Congenital laryngocele: a rare cause of neonatal respiratory distress.","authors":"Marion Honnorat, Aurelie Coudert, Marine Butin","doi":"10.1136/archdischild-2024-328182","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328182","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966119","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}

{"title":"Extensive aplasia cutis congenita of the trunk.","authors":"Alexander Höttler, Stephan Forchhammer, Thomas Mentzel, Karen Birgit Kreutzer, Cornelia Wiechers, Alexander Scheu","doi":"10.1136/archdischild-2024-327475","DOIUrl":"10.1136/archdischild-2024-327475","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"247"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035072","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}

{"title":"Clinical and neuroimaging patterns of perinatal intracranial haemorrhage in fetuses and term-born neonates: a prospective observational cohort study.","authors":"Moran Hausman-Kedem, Stephanie Libzon, Aviva Fattal Valevski, Gustavo Malinger, Nina Krajden Haratz, Itay Tokatly Latzer, Amit Blumovich, Jonathan Roth, Shlomi Constantini, Dror Mandel, Liat Ben-Sira, Shelly I Shiran","doi":"10.1136/archdischild-2024-327243","DOIUrl":"10.1136/archdischild-2024-327243","url":null,"abstract":"<p><strong>Objectives: </strong>To characterise perinatal, clinical and neuroimaging patterns and aetiology of perinatal intracranial haemorrhage (pICH), and to assess potential differences between cases diagnosed antenatally and postnatally.</p><p><strong>Methods: </strong>Prospective, observational, single-centre study of 110 consecutive cases of pICH identified in the fetal or neonatal period or diagnosed with presumed pICH between 2014 and 2023. Prematurity-related cases were excluded. Antenatal and postnatal MRI data were analysed for patterns and mechanisms of haemorrhage and their potential aetiology. Potential associations between pICH with perinatal and clinical risk factors were also explored.</p><p><strong>Results: </strong>Fifty-nine of the 110 included cases (53.6%) were diagnosed antenatally (termination of pregnancy, n=22), and postnatal data on 81/88 (92%) children were available. Intraventricular haemorrhage (IVH) was the most common haemorrhage type (83/110 (75.5%)) and was more common prenatally (p=0.004). Subpial haemorrhage was exclusively diagnosed postnatally (p<0.001), and it was more commonly detected in primigravida women (p=0.013). The germinal matrix was the most common origin of IVH (n=56, 50.9%) occuring more frequently prenatally (p<0.001), whereas sinus venous thrombosis-related IVH was more commonly detected postnatally (p=0.002). Subdural haemorrhage was associated with haematological abnormalities (p=0.023). Genetic disorders caused 31.9% of the cases (15 of 47 tested cases). Genetic disorders and associated congenital anomalies were more common in the prenatally diagnosed group (p=0.038 and p=0.04, respectively).</p><p><strong>Conclusions: </strong>The patterns and pathogenesis of pICH appear to be different for prenatally and postnatally diagnosed cases and for types of haemorrhages. Given the important role of genetic factors in prenatal intracranial haemorrhage, next-generation sequencing is indicated in these cases.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"303-312"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543328","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}

{"title":"Premedication for less invasive surfactant administration: a narrative review.","authors":"Claire A Murphy, Kevin Cw Goss, Rebeccah Slater, Shalini Ojha, Peter A Dargaville, Chris Gale","doi":"10.1136/archdischild-2024-326947","DOIUrl":"10.1136/archdischild-2024-326947","url":null,"abstract":"<p><p>Less invasive surfactant administration (LISA) is an increasingly popular technique to deliver surfactant to spontaneously breathing preterm infants with respiratory distress syndrome. The optimal method of alleviating the pain and discomfort associated with LISA, either pharmacological or non-pharmacological, while maintaining spontaneous respiration remains unclear. There is limited evidence to guide clinicians, resulting in wide variations in practice. The aim of this article is to summarise the current knowledge and evidence gaps regarding the use of premedication prior to LISA.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"230-235"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399206","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}

{"title":"Neonatal hyperinsulinism: a retrospective study of presentation and management in a tertiary neonatal intensive care unit in the UK.","authors":"Maria-Sofia Kalogeropoulou, Helen Couch, Ajay Thankamony, Kathy Beardsall","doi":"10.1136/archdischild-2024-327322","DOIUrl":"10.1136/archdischild-2024-327322","url":null,"abstract":"<p><strong>Objective: </strong>Reports of hyperinsulinism typically focus on infants managed by highly specialised services. However, neonates with hyperinsulinism are initially managed by neonatologists and often not referred to specialists. This study aimed to characterise the diversity in presentation and management of these infants.</p><p><strong>Setting: </strong>Level 3 neonatal intensive care.</p><p><strong>Patients: </strong>Neonates with hyperinsulinism, defined as blood glucose <2.8 mmol/mL and insulin level >6 pmol/L.</p><p><strong>Design: </strong>7-year retrospective study (January 2015-December 2021).</p><p><strong>Results: </strong>99 cases were identified: <i>severe</i>-treated with diazoxide (20%), <i>moderate</i>-clinically concerning hyperinsulinism not treated with diazoxide (30%), <i>mild</i>-biochemical hyperinsulinism (50%). Birth weight z-score was -1.02±2.30 (mean±SD), 42% were preterm, but neither variable correlated with clinical severity. The <i>severe</i> group received a higher concentration of intravenous glucose (27±12%) compared with the <i>moderate</i> (15±7%) and <i>mild</i> (16±10%) groups (p<0.001). At diagnosis, the intravenous glucose intake was similar in the <i>severe</i> (7.43±5.95 mg/kg/min) and <i>moderate</i> (5.09±3.86 mg/kg/min) groups, but higher compared with the <i>mild</i> group (3.05+/2.21 mg/kg/min) (p<0.001). In the <i>severe</i> group, term infants started diazoxide earlier (9.9±4.3 days) compared with preterm (37±26 days) (p=0.002). The national congenital hyperinsulinism service was consulted for 23% of infants, and 3% were transferred.</p><p><strong>Conclusions: </strong>This study highlights the diversity in clinical presentation, severity and prognosis of neonatal hyperinsulinism, irrespective of birth weight and gestational age. More infants were small rather than large for gestational age, and the majority had transient hyperinsulinism and were not referred to the national centre, or treated with diazoxide. Further research is required to understand the breadth of neonatal hyperinsulinism and optimal management.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"261-268"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279710","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}

{"title":"Association between early pulmonary arterial pressure measurements and bronchopulmonary dysplasia or mortality in very preterm infants: a prospective cohort study.","authors":"Mustafa Senol Akin, Gökce Kas, Emre Aydin, Aslıhan Kose Cetinkaya, Ibrahim Ece, Fatma Nur Sari, Evrim Alyamac Dizdar","doi":"10.1136/archdischild-2024-327169","DOIUrl":"10.1136/archdischild-2024-327169","url":null,"abstract":"<p><strong>Background: </strong>Prematurity is a significant risk for bronchopulmonary dysplasia related pulmonary artery pressure.</p><p><strong>Objective: </strong>To determine the association between pulmonary artery pressure in the early days of life and the development of bronchopulmonary dysplasia or mortality.</p><p><strong>Methods: </strong>This prospective observational cohort study included infants born at <32 weeks and weighing <1500 g. Pulmonary artery pressure was measured between postnatal days 3 and 7. Pulmonary hypertension was defined as systolic pulmonary artery pressure ≥40 mm Hg or systolic pulmonary artery pressure/systolic blood pressure >0.5 (pulmonary hypertension criterion-1). Infants were categorised into pulmonary hypertension and non-pulmonary hypertension groups. The primary endpoint was bronchopulmonary dysplasia or mortality. Receiver operating characteristic analysis established a new threshold value for predicting bronchopulmonary dysplasia or mortality (pulmonary hypertension criterion-2). Infants were reanalysed according to new criteria.</p><p><strong>Results: </strong>A total of 329 infants were included in this study. Moderate-to-severe pulmonary hypertension was identified in 24% (n=79) of the infants. The pulmonary hypertension group exhibited a significantly lower gestational age, lower birth weight and a higher incidence of small for gestational age. Systolic pulmonary artery pressure >25 mm Hg or systolic pulmonary artery pressure/systolic blood pressure >0.35 was defined as the pulmonary hypertension criterion-2. Logistic regression analysis identified pulmonary hypertension criterion-2 as an independent risk factor for moderate-to-severe bronchopulmonary dysplasia or mortality (OR 2.67, 95% CI 1.3 to 5.51, p<0.01).</p><p><strong>Conclusion: </strong>Pulmonary artery pressure exceeding 25 mm Hg in the early days of life may be considered a potential risk factor for bronchopulmonary dysplasia or mortality.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"291-296"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399205","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}