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

{"title":"Increasing availability of active therapeutic hypothermia for neonatal hypoxic ischaemic encephalopathy in the UK.","authors":"Aarti Mistry, Rosalind B Simpson, Shalini Ojha, Don Sharkey","doi":"10.1136/archdischild-2024-328119","DOIUrl":"10.1136/archdischild-2024-328119","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"430-431"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811860","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":"Pulmonary hypertension in preterm neonates with bronchopulmonary dysplasia: a meta-analysis.","authors":"Dwayne Mascarenhas, Marwa Al-Balushi, Aida Al-Sabahi, Dany E Weisz, Amish Jain, Bonny Jasani","doi":"10.1136/archdischild-2024-327547","DOIUrl":"10.1136/archdischild-2024-327547","url":null,"abstract":"<p><strong>Context: </strong>Knowledge gaps exist on the incidence and risk factors for developing pulmonary hypertension (PH) in preterm infants with bronchopulmonary dysplasia (BPD) and its impact on outcomes.</p><p><strong>Objective: </strong>To systematically review and meta-analyse the incidence, risk factors and short- and long-term outcomes of BPD-PH in preterm infants.</p><p><strong>Design: </strong>PubMed, Embase, Cochrane CENTRAL and CINAHL were searched for studies including infants<37 weeks gestational age (GA) or birth weight<2500 g with BPD-PH versus BPD-no PH from inception until 5 April 2023.</p><p><strong>Main outcome measures: </strong>Incidence, risk factors and short- and long-term outcomes.</p><p><strong>Results: </strong>44 observational studies evaluating 7677 preterm infants were included. The incidence of PH in mild, moderate and severe BPD was 5%, 18% and 41%, respectively. Small for GA (25 studies; N=5814; OR 1.8; 95% CI 1.3, 2.5), necrotising enterocolitis (22 studies; N=3387; OR 1.6; 95% CI 1.3, 2.2), early PH (four studies; N=820 OR 2.2; 95% CI 1.5, 3.3) and severe BPD (20 studies; N=2587; OR 5.4; 95% CI 3.2, 9.1) were significant risk factors for BPD-PH. Compared with BPD-no PH, the BPD-PH group had significantly higher mortality (22 studies; N=4882; OR 6.4; 95% CI 4.7, 8.6), longer duration of mechanical ventilation, oxygen supplementation, length of hospital stay, need for home oxygen and tracheostomy requirement. The BPD-PH infants also had a significantly higher risk of neurodevelopmental impairment in the motor domain.</p><p><strong>Conclusions: </strong>PH increases across the severity of BPD and is associated with higher odds of mortality and adverse short-term and neurodevelopmental outcomes.</p><p><strong>Prospero registration number: </strong>CRD42023413119.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"344-352"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738232","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":"Red blood cell transfusions in neonatal intensive care units: a nationwide observational cohort study.","authors":"Lisanne Elise Heeger, Camila Caram-Deelder, Suzanne Gunnink, F Cassel, Esther J d'Haens, Christian V Hulzebos, Ellen de Kort, Wes Onland, S Prins, Daniel C Vijlbrief, Sabine L Vrancken, Elke van Westering-Kroon, Johanna G van der Bom, Enrico Lopriore","doi":"10.1136/archdischild-2024-327441","DOIUrl":"10.1136/archdischild-2024-327441","url":null,"abstract":"<p><strong>Objective: </strong>To describe the use and nationwide variation of red blood cell (RBC) transfusions in neonatal intensive care units (NICUs) following the introduction of the revised national transfusion guideline in 2019.</p><p><strong>Design and patients: </strong>We randomly selected neonates born below 32 weeks' gestation admitted to any NICU in the Netherlands in 2020 to include in our retrospective observational cohort study.</p><p><strong>Main outcome measures: </strong>Main outcome measures were the number of neonates receiving at least one transfusion, and the number of transfusions per transfused neonate.</p><p><strong>Results: </strong>Of 762 neonates included, 34% (257/762) received at least one RBC transfusion, varying between centres from 20% (12/61) to 50% (39/77). Median phlebotomy loss during admission was 8.2 mL/kg (IQR 4.5-17.3 mL/kg), equating to 54.3% of the median transfusion volume. Of 770 transfusions, 358 (47%) were administered above the recommended threshold, and the proportion of transfusions given above the threshold varied between centres from 15% to 719%. Median transfusion dosage and mean infusion duration were 15.1 mL/kg (IQR 15.0-16.7 mL/kg) and 3.9 hours (SD 1.1 hour) and varied from 14.8 mL/kg to 18.9 mL/kg and from 2.5 hours to 5.5 hours between centres. Blood transfusion volume was positively correlated with cumulative volume of blood draws (Pearson correlation coefficient 0.84, 95% CI 0.82 to 0.86) and lower gestation.</p><p><strong>Conclusions: </strong>Large variation in transfusion practice remains between Dutch NICUs despite a national guideline. Extreme prematurity and cumulative blood draws were associated with increased use of RBC transfusions. Benchmarking will yield leverage points to understand and potentially prevent unwarranted variation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"422-427"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998970","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":"Birth weight and head circumference for 22-29 weeks gestation neonates from an international cohort.","authors":"Tanis R Fenton, Belal Alshaikh, Satoshi Kusuda, Kjell Helenius, Neena Modi, Mikael Norman, Kei Lui, Liisa Lehtonen, Malcolm Battin, Gil Klinger, Maximo Vento, Vieri Lastrucci, Luigi Gagliardi, Mark Adams, Sérgio T M Marba, Tetsuya Isayama, Stellan Hakansson, Dirk Bassler, Prakesh S Shah","doi":"10.1136/archdischild-2024-327845","DOIUrl":"10.1136/archdischild-2024-327845","url":null,"abstract":"<p><strong>Objective: </strong>Size at birth is a key indicator of in utero growth. Our objective was to generate sex-specific percentiles for birth weight and head circumference in neonates born between 22 and 29 weeks gestation from pregnancies without hypertension or diabetes and assess differences between vaginal and caesarean births and between singletons and twins.</p><p><strong>Methods: </strong>We used data from 12 countries participating in the International Network for Evaluating Outcomes in Neonates database from 2007 to 2021. We excluded data that were influenced by truncation with 1500g birth weight cut-offs in databases and neonates with major congenital anomalies or born to mothers with hypertension or diabetes.</p><p><strong>Results: </strong>After exclusions, 132 727 neonates contributed to birth weight and 65 406 contributed to head circumference. The percentiles of birth weight were similar between countries at the 50th and 90th percentiles, though variability was noted in the lower percentiles from countries with smaller sample sizes. Head circumference percentiles were comparable between countries. Caesarean births had birth weights similar to vaginal births until 26 weeks after which the weight at 10th percentile diverged by approximately 239 g at 29 weeks. Vaginal births had birth weights very similar to Hadlock's intrauterine estimated fetal weights. There were no differences in head circumference between vaginal and caesarean births and between singletons and twins.</p><p><strong>Conclusions: </strong>We present updated information on weight and head circumference at birth for preterm neonates of 22-29 weeks gestation born to mothers without hypertension or diabetes derived from a large multicountry cohort. Research is needed to explore the predictive value of these birth size data for health and developmental outcomes.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":"110 4","pages":"401-408"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332377","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":"School outcomes after HIE: a population-based cohort study.","authors":"Philippa Rees, Mithilesh Dronavalli, Ben Carter, Barbara Bajuk, Lucinda Burns, Michelle Dickson, John Eastwood, Sadia Hossain, Kate Lawler, Evelyn Lee, Sithum Munasinghe, Andrew Page, Hannah Uebel, Lauren Dicair, Charles Green, Chris Gale, Ju Lee Oei","doi":"10.1136/archdischild-2024-328346","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328346","url":null,"abstract":"<p><strong>Objective: </strong>To study the school performance of children with hypoxic ischaemic encephalopathy (HIE) relative to population controls from childhood to early adolescence.</p><p><strong>Design: </strong>Population-based cohort study.</p><p><strong>Setting: </strong>New South Wales, Australia.</p><p><strong>Patients: </strong>All 564 159 live-born infants ≥35 weeks' gestation born between 2008 and 2013 were eligible; 550 with HIE and 558 355 population controls.</p><p><strong>Exposure: </strong>Mild, moderate-severe HIE.</p><p><strong>Main outcome measures: </strong>National school assessment performance at 8-9, 10-11 and 12-13 years.</p><p><strong>Secondary outcomes: </strong>reading, writing, spelling, grammar and numeracy scores at these ages. Linear regression models estimated the adjusted mean difference (aMD) at each timepoint. Hierarchical growth-curve modelling assessed academic trajectories (adjusted β).</p><p><strong>Results: </strong>Children with moderate-severe HIE had significantly lower total z-scores compared with controls at 8-9 years (aMD -0.70; 95% CI -0.84 to -0.52), 10-11 years (aMD -0.96; 95% CI -1.19 to -0.57) and 12-13 years (aMD -0.82; 95% CI -1.12 to -0.53), especially in reading and writing. The gap in overall mean scores remained fixed over time. Despite a lower likelihood of passing each year compared with controls, most infants with moderate-severe HIE passed each year (n=103, 62.4%). Children with mild HIE did not perform significantly differently from controls at 8-9 years (aMD -0.09; 95% CI -0.32 to 0.15), although there was a signal of worsening performance with age (β=13.54; 95% CI -21 to -6.07).</p><p><strong>Conclusions: </strong>Children with moderate-severe HIE perform at a lower academic level than their peers, yet most meet national standards up to early adolescence. In contrast, children with mild HIE perform on par with their peers. This information is crucial for families: providing reassurance and a basis for needed support.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246140","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":"Evaluation of infants born to a parent with gene-positive long QT syndrome: a retrospective single-centre review.","authors":"Claire Margaret Lawley, Bernadette Khodaghalian, Nichola French, Stephanie Oates, Juan Pablo Kaski, Luke Starling","doi":"10.1136/archdischild-2024-327666","DOIUrl":"https://doi.org/10.1136/archdischild-2024-327666","url":null,"abstract":"<p><strong>Objective: </strong>To describe early management of infants born to a parent with gene-positive long QT syndrome (LQTS) referred for specialist review. Review the diagnostic utility of the early neonatal and first clinic ECG.</p><p><strong>Design: </strong>Retrospective cohort study, including a review of the first neonatal and first clinic ECG.</p><p><strong>Setting: </strong>Quaternary paediatric-only referral hospital with specialised unit for the management of paediatric inherited cardiovascular diseases.</p><p><strong>Patients: </strong>Infants born 2015-2022 referred in the setting of parental LQTS who subsequently underwent predictive genetic testing for a parental LQTS-causative genetic variant.</p><p><strong>Main outcome measures: </strong>Age (at first early neonatal ECG, referral, first clinic attendance), genetic testing data, clinical course, exposure to QT-prolonging medications, neonatal hypoxia-ischaemia and cardiac events (cardiac arrest or death) in the infant's first year.The first neonatal and first clinic ECGs were evaluated for QTc and T-wave morphology, by two observers.</p><p><strong>Results: </strong>Twenty-six infants met inclusion criteria. Eighteen (69%) were referred in the first month of life. Twelve (46%) inherited the familial LQTS variant. Fourteen (54%) commenced beta-blocker therapy to treat suspected or genetically confirmed LQTS, two subsequently ceased treatment due to a negative genetic result. There were no cardiac events. For the ECG analysis, 40 ECGs from 26 infants were reviewed (early neonatal n=14 (54%)). The first clinic ECG allowed more accurate determination of genetic status with better interobserver variability. Inclusion of T-wave morphology assessment improved its sensitivity.</p><p><strong>Conclusions: </strong>Streamlined pathways to manage families with LQTS across institutions need to be firmly established to permit a timely diagnosis. Incorporation of formalised T-wave morphology assessment adds value.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246139","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":"Electronic monitoring of infants at home: for many families a questionable practice that may come at a cost.","authors":"Christian F Poets, Mirja Quante","doi":"10.1136/archdischild-2025-328983","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328983","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246138","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":"Volume of umbilical cord blood collection in the era of delayed cord clamping: a multicentre, prospective, feasibility study.","authors":"Lianne Verbeek, Valeria Cortesi, Jip van Daelen, Thomas Klei, Nina A M Houben, Elise J Huisman, Pauline Snijder, Sophie J E Cramer, Irwin Reiss, Enrico Lopriore","doi":"10.1136/archdischild-2025-328598","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328598","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the percentage of adequate umbilical cord blood (UCB) collections defined as ≥70 mL of UCB after delayed cord clamping for 3 min was applied. Second, to correlate the UCB volume to gestational age at birth, birth weight and sex.</p><p><strong>Design: </strong>We conducted a multicentre, prospective, feasibility study in near-term infants delivered through caesarean section between November 2023 and December 2024. UCB was collected ex-utero, immediately after the placenta was removed from the womb.</p><p><strong>Results: </strong>A total of 195 UCB collections were attempted. In 11 cases (5.6%), the attempt failed due to rupture of the umbilical cord or damaged placenta by removal of the placenta from the uterus. The median volume of the remaining 184 UCB collections was 72 mL (IQR 56-86 mL). In only 54% (100/184), the UCB volume reached the target volume of ≥70 mL. We found that UCB volume was positively associated with birth weight (R²=0.0813, F(1181)=16.02, p value <0.001) but not with gestational age at birth (R²=0.0014, F(1181)=0.2553, p value=0.614).</p><p><strong>Conclusions: </strong>A sufficient UCB volume (≥70 mL) was obtained in approximately half of the attempts. A higher birth weight was associated with a larger volume of UCB collection.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232974","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":"Distraction in neonatal resuscitation and the human factors' 'Dirty Dozen'.","authors":"Alexander Wilson, Georg M Schmölzer, Jonathan Davis","doi":"10.1136/archdischild-2025-328565","DOIUrl":"10.1136/archdischild-2025-328565","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155951","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":"Postnatal dexamethasone treatment for preterm infants at high risk for bronchopulmonary dysplasia is associated with improved regional brain volumes: a prospective cohort study.","authors":"Rahul Chandwani, Julia Kline, Mekibib Altaye, Nehal Parikh","doi":"10.1136/archdischild-2024-328438","DOIUrl":"10.1136/archdischild-2024-328438","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of low-dose postnatal dexamethasone therapy for bronchopulmonary dysplasia (BPD) prevention/treatment on MRI-derived regional brain volumes at term-equivalent age (TEA) and neurodevelopmental outcomes in a regional cohort of preterm infants.</p><p><strong>Study design: </strong>We prospectively recruited 392 preterm infants (≤32 weeks gestational age (GA)), who underwent structural MRI (3T Philips Ingenia) at TEA. We automatically segmented T2-weighted MRI scans using the Developing Human Connectome Project pipeline to derive a priori selected, two primary outcomes of interest: volumes of the cerebellum and subcortical grey matter. We estimated propensity scores for subjects with a logistic regression model and used weighted linear regression to determine the independent effects of dexamethasone on primary and two secondary outcomes: cortical surface area at TEA and motor scores at 2 years corrected age.</p><p><strong>Results: </strong>Of 392 infants, 41 were treated with low cumulative dose dexamethasone (total 0.89 mg/kg) initiated at 36 days (median) of age for evolving BPD: 21 males; mean (SD) GA was 25.5 (1.6) weeks; postmenstrual age at MRI was 43.7 (1.2) weeks; and 33 had severe BPD. In multivariable linear regression, dexamethasone was significantly correlated with larger cerebellar (difference=0.510; 95% CI: 0.079 to 0.941) and subcortical grey matter volume (difference=0.138; 95% CI: 0.014 to 0.263). Dexamethasone was also positively correlated with motor scores (difference=5.220; 95% CI: 0.845 to 9.594).</p><p><strong>Conclusion: </strong>Low-dose dexamethasone therapy after the first postnatal week for evolving/established BPD did not result in adverse macrostructural effects and may have a protective effect on motor development in preterm infants.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966121","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}