Neonatology最新文献_第2页

Deep-Learning-Based Multi-Class Classification for Neonatal Respiratory Diseases on Chest Radiographs in Neonatal Intensive Care Units. 新生儿重症监护病房胸片上基于深度学习的新生儿呼吸系统疾病多类别分类

Neonatology Pub Date : 2025-03-06 DOI: 10.1159/000545107

Hye Won Cho, Sumin Jung, Kyu Hee Park, Jin Wha Choi, Ju Sun Heo, Jaeyoung Kim, Heerim Yun, Donghoon Yu, Jinho Son, Byung Min Choi

{"title":"Deep-Learning-Based Multi-Class Classification for Neonatal Respiratory Diseases on Chest Radiographs in Neonatal Intensive Care Units.","authors":"Hye Won Cho, Sumin Jung, Kyu Hee Park, Jin Wha Choi, Ju Sun Heo, Jaeyoung Kim, Heerim Yun, Donghoon Yu, Jinho Son, Byung Min Choi","doi":"10.1159/000545107","DOIUrl":"10.1159/000545107","url":null,"abstract":"Introduction: Accurate and timely interpretation of chest radiographs is essential for assessing respiratory distress and guiding clinical management to improve outcomes of critically ill newborns. This study aimed to introduce a deep-learning-based automated algorithm designed to classify various neonatal respiratory diseases and healthy lungs using a large dataset of high-quality, multi-class labeled chest X-ray images from neonatal intensive care units.Methods: Portable supine chest X-ray images for six common conditions (healthy lung, respiratory distress syndrome [RDS], transient tachypnea of the newborn [TTN], air leak syndrome [ALS], atelectasis, and bronchopulmonary dysplasia [BPD]) and demographic variables (gestational age and birth weight) were retrospectively collected from 10 university hospitals in Korea. Ground truth for manual classification of these conditions was generated by 20 neonatologists and validated by others from different hospitals. The dataset, consisting 34,598 for training, 4,370 for validation, and 4,370 for testing, was used to train a modified ResNet50-based deep-learning model for automatic classification.Results: The automatic classification algorithm showed high concordance with human-annotated classifications, achieving an overall testing accuracy of 83.96% and an F1 score of 83.68%. The F1 score for each condition was 87.38% for \"healthy lung\" and 92.19% for \"BPD,\" 90.65% for \"ALS,\" 90.30% for \"RDS,\" 86.56% for \"atelectasis,\" and 70.84% for \"TTN.\"Conclusion: We introduced a deep-learning-based automated algorithm to classify neonatal respiratory diseases using a large dataset of high-quality, multi-class labeled chest X-ray images, incorporating non-imaging data, which could support neonatologists in making timely and accurate decisions for critically ill newborns.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electrical Impedance Tomography during the Extubation Phase in Very Preterm Born Infants. 电阻抗断层扫描在极早产儿拔管阶段。

Neonatology Pub Date : 2025-03-03 DOI: 10.1159/000544811

Jantine J Wisse, Tom G Goos, Diederik Gommers, Henrik Endeman, André A Kroon, Irwin K M Reiss, Annemijn H Jonkman

{"title":"Electrical Impedance Tomography during the Extubation Phase in Very Preterm Born Infants.","authors":"Jantine J Wisse, Tom G Goos, Diederik Gommers, Henrik Endeman, André A Kroon, Irwin K M Reiss, Annemijn H Jonkman","doi":"10.1159/000544811","DOIUrl":"10.1159/000544811","url":null,"abstract":"Introduction: Although many preterm born infants require invasive mechanical ventilation, it is also associated with detrimental effects. Early extubation should be pursued, but extubation failure is yet common. The critical transition to noninvasive ventilation is characterized by respiratory physiological changes, warranting noninvasive monitoring. We aimed to determine whether electrical impedance tomography (EIT) could provide insights into the respiratory mechanics of neonates around extubation, and if findings were different between successful and failed extubation.Methods: Single-center observational study where EIT and transcutaneous CO2 measurements were performed in preterm born infants <32 weeks gestational age. Measurements were performed from 24 h before up to 48 h after extubation. EIT parameters extracted from the hour before and after extubation were analyzed to evaluate the short-term physiological changes.Results: Twenty-one patients were included and 6 (29%) were reintubated. End-expiratory lung impedance and tidal impedance variation were stable around extubation (p = 0.86 and p = 0.47, respectively). Compared to successfully extubated patients, reintubated patients showed more lung inhomogeneity (GI index) after extubation (0.75 vs. 0.84, p = 0.03). The percentage of nondependent silent spaces decreased after extubation in successfully extubated patients (p < 0.001). Body position and ventilator mode influenced these findings.Conclusion: EIT measurements in preterm neonates provide valuable insight into the respiratory physiology during the transition from invasive to noninvasive ventilation, with significant differences in ventilation distribution and lung homogeneity between successfully extubated and reintubated patients. EIT has the potential to guide personalized respiratory support by assessing ventilation distribution and quantifying inhomogeneity, aiding in the optimization of ventilation settings.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inhaled Nitric Oxide for Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Systematic Review and Narrative Synthesis. 吸入一氧化氮治疗支气管肺发育不良相关肺动脉高压：系统综述和叙事综合。

Neonatology Pub Date : 2025-03-03 DOI: 10.1159/000545034

Hiroki Kitaoka, Ryota Kobayashi, Kosuke Tanaka, Masahiko Watanabe, Tetsuya Isayama

{"title":"Inhaled Nitric Oxide for Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension: A Systematic Review and Narrative Synthesis.","authors":"Hiroki Kitaoka, Ryota Kobayashi, Kosuke Tanaka, Masahiko Watanabe, Tetsuya Isayama","doi":"10.1159/000545034","DOIUrl":"10.1159/000545034","url":null,"abstract":"Introduction: Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator. However, its effectiveness in the treatment of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) and severe BPD remains uncertain. Here we systematically reviewed whether iNO treatment increased or decreased mortality and morbidity among preterm infants with severe BPD or BPD-PH.Methods: We systematically searched the Ovid MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane CENTRAL, and ICHUSHI databases for randomized and non-randomized studies that compared the effects of iNO in patients with severe BPD or BPD-PH. The primary outcome was mortality. Two authors independently screened the articles and extracted the data. A meta-analysis and certainty of evidence assessment using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation criteria were planned.Results: Among the 1,710 articles, none had a relevant control group and no studies met the eligibility criteria. Using a post hoc analysis, we summarized the ineligible studies that evaluated patients with severe BPD or BPD-PH who received iNO therapy. Although some studies included in the narrative review indicated a decreased pulmonary arterial pressure in patients with severe BPD or BPD-PH at the initiation of iNO therapy, none included a comparator group.Conclusion: Despite the use of iNO in patients with severe BPD and BPD-PH, no published studies compared the outcomes among patients with BPD treated with versus without iNO. Although some studies without comparator groups reported the effectiveness of iNO in patients with severe BPD and BPD-PH, our results suggest that iNO therapy should be initiated with caution and careful consideration of the target population.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ChatGPT-4o in Risk-of-Bias Assessments in Neonatology: A Validity Analysis. 新生儿科偏倚风险评估中的 ChatGPT-4o - 有效性分析。

Neonatology Pub Date : 2025-02-25 DOI: 10.1159/000544857

Ilari Kuitunen, Lauri Nyrhi, Daniele De Luca

{"title":"ChatGPT-4o in Risk-of-Bias Assessments in Neonatology: A Validity Analysis.","authors":"Ilari Kuitunen, Lauri Nyrhi, Daniele De Luca","doi":"10.1159/000544857","DOIUrl":"10.1159/000544857","url":null,"abstract":"Introduction: Only a few studies have addressed the potential of large language models (LLMs) in risk-of-bias assessments and the results have been varying. The aim of this study was to analyze how well ChatGPT performs in risk-of-bias assessments of neonatal studies.Methods: We searched all Cochrane neonatal intervention reviews published in 2024 and extracted all risk-of-bias assessments. Then the full reports were retrieved and uploaded alongside the guidance to perform a Cochrane original risk-of-bias analysis in ChatGPT-4o. The concordance between the original assessment and that provided by ChatGPT-4o was evaluated by inter-class correlation coefficients and Cohen's kappa statistics (with 95% confidence intervals) for each risk-of-bias domain and for the overall assessment.Results: From 9 reviews, a total of 61 randomized studies were analyzed. A total of 427 judgments were compared. The overall κ was 0.43 (95% CI: 0.35-0.51) and the overall intraclass correlation coefficient was 0.65 (95% CI: 0.59-0.70). The Cohen's κ was assessed for each domain and the best agreement was observed in the allocation concealment (κ = 0.73, 95% CI: 0.55-0.90), whereas the poorest agreement was found in incomplete outcome data (κ = -0.03, 95% CI: -0.07-0.02).Conclusion: ChatGPT-4o failed to achieve sufficient agreement in the risk-of-bias assessments. Future studies should examine whether the performance of other LLM would be better or whether the agreement in ChatGPT-4o could be further enhanced by better prompting. Currently, the use of ChatGPT-4o in risk-of-bias assessments should not be promoted.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maternal and Neonatal Factors Associated with Delayed Closure of Ductus Arteriosus in Term-Born Neonates: Insights from the Copenhagen Baby Heart Cohort Study. 与足月新生儿动脉导管延迟闭合有关的母体和新生儿因素：哥本哈根婴儿心脏队列研究的启示》。

Neonatology Pub Date : 2025-02-12 DOI: 10.1159/000543915

Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Raheel Altaf Raja, Anna Sellmer, Johan Navne, Henning Bundgaard, Kasper Karmark Iversen, Dorthe Lisbeth Jeppesen

{"title":"Maternal and Neonatal Factors Associated with Delayed Closure of Ductus Arteriosus in Term-Born Neonates: Insights from the Copenhagen Baby Heart Cohort Study.","authors":"Anton Friis Mariager, Alberte Hammeken, Mikkel Malham, Raheel Altaf Raja, Anna Sellmer, Johan Navne, Henning Bundgaard, Kasper Karmark Iversen, Dorthe Lisbeth Jeppesen","doi":"10.1159/000543915","DOIUrl":"10.1159/000543915","url":null,"abstract":"Introduction: The prenatal shunt, ductus arteriosus (DA), typically closes during the cardio-pulmonary transition at birth. We evaluated maternal and neonatal factors associated with delayed closure of DA in term-born neonates.Methods: We conducted a retrospective cohort study that included full-term neonates from the prospective observational Copenhagen Baby Heart cohort study. We assessed the association between maternal and neonatal factors and delayed ductal closure.Results: We included 19,566 neonates, of whom 48% were female. Echocardiography was performed at a median age of 12 (IQR: 9-15) and 8 (IQR: 2-13) days for neonates with no DA and an open DA, respectively. Associations with delayed ductal closure included maternal obesity adjusted risk ratio = 2 (95% CI: 1-3.8), maternal hypothyroidism during pregnancy aRR = 2.02 (95% CI: 1.2-3.4), low Apgar 2.6 (95% CI: 1.2-6), high weight aRR = 1.81 (95% CI: 1.2-2.6), and length at birth aRR = 1.7 (95% CI: 1.1-2.6).Conclusion: The identified risk factors for delayed ductal closure in term-born neonates may help increase clinical attention and improve neonatal care.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microstructural Maturation of the Splenium of Corpus Callosum and Cognitive and Motor Outcome in Very Preterm Infants. 极早产儿胼胝体脾的微观结构成熟与认知和运动结果。

Neonatology Pub Date : 2025-02-03 DOI: 10.1159/000543328

Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier

{"title":"Microstructural Maturation of the Splenium of Corpus Callosum and Cognitive and Motor Outcome in Very Preterm Infants.","authors":"Ira Winkler, Anna Posod, Elke Ruth Gizewski, Stephanie Mangesius, Vera Neubauer, Ulrike Pupp Peglow, Ursula Kiechl-Kohlendorfer, Elke Griesmaier","doi":"10.1159/000543328","DOIUrl":"10.1159/000543328","url":null,"abstract":"Introduction: Common brain injuries of preterm infants do not entirely explain the incidence of neurodevelopmental impairment observed in this population. Evidence suggests an association with microstructural maturation of the splenium of corpus callosum. This study aimed to investigate a correlation between microstructural maturation of the splenium of corpus callosum and neurodevelopmental outcome in very preterm infants.Method: In a cohort study of 373 very preterm infants, we used fractional anisotropy (FA) and apparent diffusion coefficient (ADC) derived from diffusion tensor imaging at term equivalent age (TEA) to quantitatively reflect microstructural maturation of the splenium of corpus callosum, and standardized follow-up assessments of cognitive and motor function at 24 months corrected age and 5 years chronological age. Correlation was tested by Spearman's rank correlation coefficients and multivariate regression analysis.Results: At 24 months, we found significantly lower FA and higher ADC values in infants with abnormal mental indices, psychomotor developmental indices, and fine motor function. Scores of all three correlated positively with FA and negatively with ADC. Aged 5 years, lower FA values correlated significantly with abnormal overall motor function, and higher ADC values correlated significantly with abnormal full-scale intelligence quotient (FSIQ) and overall motor function. Scores of FSIQ, overall, and fine motor function correlated negatively with ADC.Conclusion: The results emphasize an association between microstructural maturation of the splenium of corpus callosum at TEA and neurodevelopmental outcome, and suggest that ADC may be more strongly linked to these outcomes than FA, especially in the long-term.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Macrogol to Accelerate Feeding Advancement in Extremely Preterm Infants. 使用Macrogol加速极早产儿的喂养进度。

Neonatology Pub Date : 2025-02-03 DOI: 10.1159/000543050

Kirstin Barbara Faust, Mariia Lupatsii, Frederike Römer, Simon Graspeuntner, Silvio Waschina, Sina Zimmermann, Alexander Humberg, Mats Ingmar Fortmann, Kathrin Hanke, Kai Böckenholt, Johannes Dirks, Christine Silwedel, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel

{"title":"Use of Macrogol to Accelerate Feeding Advancement in Extremely Preterm Infants.","authors":"Kirstin Barbara Faust, Mariia Lupatsii, Frederike Römer, Simon Graspeuntner, Silvio Waschina, Sina Zimmermann, Alexander Humberg, Mats Ingmar Fortmann, Kathrin Hanke, Kai Böckenholt, Johannes Dirks, Christine Silwedel, Jan Rupp, Egbert Herting, Wolfgang Göpel, Christoph Härtel","doi":"10.1159/000543050","DOIUrl":"10.1159/000543050","url":null,"abstract":"Introduction: Delayed enteral nutrition is associated with a higher risk for adverse outcomes in extremely preterm infants. Limited evidence exists on therapeutic options to support meconium evacuation and increase gastrointestinal motility. The aim of this study was to determine the effect of macrogol on feeding tolerance and microbiome establishment in preterm infants <27 weeks of gestation.Methods: We investigated the impact of early macrogol administration in two observational cohort studies: the multi-center German-Neonatal-Network (GNN) study comparing extremely preterm infants born in neonatal intensive care units (NICUs) using macrogol in the first week of life in >30% of their infants as compared to the remaining units, and the single-center Immunoregulation-of-the-Newborn (IRoN) study including gut microbiome assessment of infants born before and after implementation of macrogol use in this NICU.Results: In the GNN study cohort including 4,290 infants, advancement to full enteral feedings was significantly faster in macrogol-using NICUs compared to the remaining NICUs (median/IQR: 14/12 vs. 16/14 days, p = 0.001). Risk for short-term outcomes such as sepsis or abdominal complications was not elevated in units with regular use of macrogol. In the IRoN cohort (n = 68), macrogol treated infants had a shorter time to reach full enteral feeding (median/IQR: macrogol 12/6, control 16/6 days, p = 0.004). Higher Bifidobacterium longum abundance in the gut microbiome correlated with acceleration to full enteral nutrition.Conclusion: Our observational data suggests that early off-label use of macrogol may support feeding advancement in highly vulnerable babies. These data provide a basis for a randomized controlled trial.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of a New Classification for Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants: Insights from a Large Japanese Cohort. 极早产儿重度支气管肺发育不良新分类的验证：来自日本大型队列的见解。

Neonatology Pub Date : 2025-01-27 DOI: 10.1159/000543810

Hidehiko Nakanishi, Masato Ito, Shin Kato, Makoto Saito, Naoyuki Miyahara, Hirokazu Arai, Erika Ota, Fumihiko Namba

{"title":"Validation of a New Classification for Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants: Insights from a Large Japanese Cohort.","authors":"Hidehiko Nakanishi, Masato Ito, Shin Kato, Makoto Saito, Naoyuki Miyahara, Hirokazu Arai, Erika Ota, Fumihiko Namba","doi":"10.1159/000543810","DOIUrl":"10.1159/000543810","url":null,"abstract":"Introduction: A recent scoping review identified histological chorioamnionitis (HCA), small for gestational age (SGA), and bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as risk factors for severe bronchopulmonary dysplasia (BPD). To further validate these results, a large-scale database was analyzed.Methods: This retrospective multicenter cohort study included infants born at <28 weeks' gestational age between 2003 and 2016. The validated risk factors identified from the scoping review were analyzed for independent associations with severe BPD using multivariable logistic regression. Additionally, the association of these factors with long-term outcomes at 3 years, including home oxygen therapy (HOT) and neurodevelopmental impairments (NDIs), was analyzed.Results: Among 15,834 extremely preterm infants, HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were significantly and independently associated with severe BPD (adjusted odds ratio, 1.20; 95% confidence interval, 1.06-1.36) (1.73; 1.51-1.98) (1.79; 1.60-2.01), respectively. These three factors were also linked to HOT at 3 years (1.54; 1.14-2.08) (1.70; 1.21-2.39) (2.63; 1.94-3.56), respectively. Their combination significantly increased the prevalence of severe BPD and HOT at 3 years, particularly with bubbly/cystic CXR. Only SGA was independently associated with NDIs in BPD infants (1.55; 1.32-1.83).Conclusions: HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were identified as important risk factors for severe BPD and long-term respiratory outcomes. While further research is needed to validate their role in endotype-specific classification of BPD, these findings may contribute to early prognostic strategies and targeted interventions before 36 weeks' postmenstrual age.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants. 早产儿早期营养与支气管肺发育不良严重程度和MRI肺特征的关系。

Neonatology Pub Date : 2025-01-22 DOI: 10.1159/000543605

Ekaterina Dianova, Nara S Higano, Kera M McNelis, Shelley R Ehrlich, Chunyan Liu, Jason C Woods, Paul S Kingma

{"title":"Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.","authors":"Ekaterina Dianova, Nara S Higano, Kera M McNelis, Shelley R Ehrlich, Chunyan Liu, Jason C Woods, Paul S Kingma","doi":"10.1159/000543605","DOIUrl":"10.1159/000543605","url":null,"abstract":"Introduction: Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates.Methods: In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed.Results: The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p < 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p < 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04).Conclusion: Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between Early Postnatal Hydrocortisone and Retinopathy of Prematurity in Extremely Preterm Infants. 产后早期氢化可的松与极早产儿视网膜病变的关系。

Neonatology Pub Date : 2025-01-21 DOI: 10.1159/000543659

Mariya Petrishka-Lozenska, Aldina Pivodic, Anders Flisberg, Ingrid Hansen-Pupp, Lois E H Smith, Pia Lundgren, Ann Hellström

{"title":"Association between Early Postnatal Hydrocortisone and Retinopathy of Prematurity in Extremely Preterm Infants.","authors":"Mariya Petrishka-Lozenska, Aldina Pivodic, Anders Flisberg, Ingrid Hansen-Pupp, Lois E H Smith, Pia Lundgren, Ann Hellström","doi":"10.1159/000543659","DOIUrl":"10.1159/000543659","url":null,"abstract":"Introduction: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness. We investigated the association of early postnatal low-dose intravenous hydrocortisone used for the prevention of bronchopulmonary dysplasia (BPD) with ROP outcome among extremely preterm infants in a Swedish cohort.Methods: This retrospective cohort study included extremely preterm infants born before 28 weeks of gestational age (GA). Infants born September 2020-August 2022, treated with low-dose intravenous hydrocortisone for prevention of BPD, were compared to untreated controls born September 2016-August 2020. Hydrocortisone was administered postnatally with a dose of 0.5 mg/kg twice daily for 7 days, followed by 0.5 mg/kg per day for 3 days. Logistic regression, adjusted for GA, birth weight (BW), sex, and parenteral nutrition, was used in the primary analysis. For robustness, we performed 1:1 propensity score (PS) matching followed by logistic regression.Results: Of 245 preterm infants included, 65 were treated with low-dose hydrocortisone and 180 were untreated controls. Incidence of ROP treatment was reduced in the hydrocortisone group 18.5% (12/65) versus controls 32.2% (58/180), p = 0.038. One-to-one PS matching (n = 62 + 62) confirmed the reduced incidence of ROP treatment in the hydrocortisone-treated infants (odds ratio [OR]: 0.38, 95% confidence interval [95% CI]: 0.16-0.88, p = 0.025). After adjusting for GA, BW, sex, and parenteral nutrition ≥14 days, the reduced risk of ROP treatment after early hydrocortisone treatment persisted (OR: 0.31, 95% CI: 0.16-0.60, p = 0.0005).Conclusion: Early postnatal low-dose intravenous hydrocortisone used to prevent BPD may reduce the risk of ROP treatment among extremely preterm infants.","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0