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Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence. 父母对新生儿护理的体验:一项关于优秀决定因素的全国性研究。
Neonatology Pub Date : 2024-01-01 Epub Date: 2023-10-16 DOI: 10.1159/000533900
Agnes Linnér, Ylva Thernström Blomqvist, Kristina Jonsson, Siri Lilliesköld, Mikael Norman
{"title":"Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence.","authors":"Agnes Linnér, Ylva Thernström Blomqvist, Kristina Jonsson, Siri Lilliesköld, Mikael Norman","doi":"10.1159/000533900","DOIUrl":"10.1159/000533900","url":null,"abstract":"<p><strong>Introduction: </strong>Infant- and family-centered developmental care can reduce adverse outcomes in both infants and parents. Parents' experiences of the care and staff treatment remain to be evaluated.</p><p><strong>Methods: </strong>Parents of infants admitted to neonatal units in Sweden from July 2020 to May 2022 responded to a questionnaire with standardized questions about in-hospital care. Exposures were hospital, gestational age, length of hospital stay, unit level, and bed density. The proportions of parents rating aspects of neonatal care as excellent, defined as five on a Likert scale, and the determinants of excellence were described. The results were benchmarked with ratings in adult somatic care.</p><p><strong>Results: </strong>A total of 4,475/13,108 (34%) parents responded. The ratings of excellent care varied by question from 65% to 90%. The largest variation in excellence between neonatal units (range 43-80%) was found for \"participation and involvement.\" The proportion of excellence was significantly lower among parents of extremely preterm infants. Confidence in the staff was lower in parents of extremely preterm infants than in parents of term infants (56% vs. 83%). Longer hospital stays affected the experience of neonatal care adversely, whereas level of care and bed density were overall unrelated to the parental experience. Parents in neonatal care rated the care as excellent to a higher extent than patients cared for in adult medicine.</p><p><strong>Conclusion: </strong>A majority of parents rated neonatal care in Sweden as excellent. The less frequent ratings of excellence among parents of extremely preterm infants indicate that more could be done to optimize parental involvement and support.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhanced Category-Based Risk Assessment for Neonatal Early-Onset Sepsis: A Prospective Observational Study. 新生儿早期败血症强化分类风险评估:一项前瞻性观察研究。
Neonatology Pub Date : 2024-01-01 Epub Date: 2023-10-31 DOI: 10.1159/000534091
Hoi Ying Sharon Lau, Xuelian Wang, Ho Tsun Michelia Wong, Ka Hei Catherine Lam, Hugh Simon Lam
{"title":"Enhanced Category-Based Risk Assessment for Neonatal Early-Onset Sepsis: A Prospective Observational Study.","authors":"Hoi Ying Sharon Lau, Xuelian Wang, Ho Tsun Michelia Wong, Ka Hei Catherine Lam, Hugh Simon Lam","doi":"10.1159/000534091","DOIUrl":"10.1159/000534091","url":null,"abstract":"<p><strong>Introduction: </strong>Compared with multivariate risk assessment, traditional category-based risk assessment (CRA) approaches for neonatal early-onset sepsis (EOS) screening are usually straightforward to use, do not require electronic devices, but are associated with higher rates of antibiotic use. This study aims to evaluate the performance of a novel enhanced CRA (eCRA) framework on EOS admissions and antibiotic use and to investigate whether a modified version with adjustments in risk factor weighting can allow its performance to match the EOS calculator while remaining easy to implement.</p><p><strong>Method: </strong>This is a prospective, single-center, two-phase observational study. Infants of all gestations delivered in a tertiary hospital in Hong Kong with risk factors or clinical features of EOS were recruited.</p><p><strong>Phase i: </strong>A novel eCRA framework (period 2) was compared with the CDC 2010-based protocol (period 1).</p><p><strong>Phase ii: </strong>A modified eCRA framework was compared theoretically with the EOS calculator. EOS-specific admissions and antibiotic use were measured.</p><p><strong>Results: </strong>Phase I: 1,025 at-risk infants were recruited during period 2 and compared with 757 infants of period 1. Admissions and antibiotic use decreased from 45.8% to 29.4% and 41.1% to 28.2%, respectively. Antibiotics among those at-risk but well-appearing infants decreased from 25.3% to 16.3% (p &lt; 0.001 for all).</p><p><strong>Phase ii: </strong>antibiotic use was similar (7.3 vs. 6.4%, p = 0.42) between the modified eCRA framework and the EOS calculator.</p><p><strong>Conclusions: </strong>An eCRA framework can effectively and safely provide individualized guidance for EOS screening without the need for tools such as the EOS calculator.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"56-64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71430653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic Resonance Imaging-Based Reference Values for Two-Dimensional Quantitative Brain Metrics in a Cohort of Extremely Preterm Infants. 基于磁共振成像的极早产儿队列二维定量脑指标参考值。
Neonatology Pub Date : 2024-01-01 Epub Date: 2023-10-20 DOI: 10.1159/000534009
Julia Buchmayer, Gregor Kasprian, Raphaela Jernej, Sophie Stummer, Victor Schmidbauer, Vito Giordano, Katrin Klebermass-Schrehof, Angelika Berger, Katharina Goeral
{"title":"Magnetic Resonance Imaging-Based Reference Values for Two-Dimensional Quantitative Brain Metrics in a Cohort of Extremely Preterm Infants.","authors":"Julia Buchmayer, Gregor Kasprian, Raphaela Jernej, Sophie Stummer, Victor Schmidbauer, Vito Giordano, Katrin Klebermass-Schrehof, Angelika Berger, Katharina Goeral","doi":"10.1159/000534009","DOIUrl":"10.1159/000534009","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral magnetic resonance imaging (cMRI) is an important diagnostic tool in neonatology. In addition to qualitative analysis, quantitative measurements may help identify infants with impaired brain growth. This study aimed to create reference values for brain metrics of various brain areas in neonates without major brain injuries born before 28 weeks of gestation.</p><p><strong>Methods: </strong>This retrospective study analyzes cMRI imaging data of high-risk patients without severe brain pathologies at term-equivalent age, collected over 4 years since November 2017. Nineteen brain areas were measured, reference values created, and compared to published values from fetal and postnatal MRI. Furthermore, correlations between brain metrics and gestational age at birth were evaluated.</p><p><strong>Results: </strong>A total of 174 cMRI examinations were available for analysis. Reference values including cut-offs for impaired brain growth were established for different gestational age groups. There was a significant correlation between gestational age at birth and larger \"tissue\" parameters, as well as smaller \"fluid\" parameters, including intracerebral and extracerebral spaces.</p><p><strong>Discussion: </strong>With quantitative brain metrics infants with impaired brain growth might be detected earlier. Compared to preexisting reference values, these are the first of a contemporary collective of extremely preterm neonates without severe brain injuries. Measurements can be easily performed by radiologists as well as neonatologists without specialized equipment or computational expertise.</p><p><strong>Conclusion: </strong>Two-dimensional cMRI brain measurements at term-equivalent age represent an easy and reliable approach for the evaluation of brain size and growth in infants at high risk for neurodevelopmental impairment.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"97-105"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49695562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pancreatic Insufficiency, Digestive Enzyme Supplementation, and Postnatal Growth in Preterm Babies. 早产儿胰腺机能不全、消化酶补充剂和产后生长。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000535964
Allan Jenkinson, Narendra Aladangady, Sven Wellmann, Simon Eaton, Christoph Bührer, Paul Fleming, Charles Roehr
{"title":"Pancreatic Insufficiency, Digestive Enzyme Supplementation, and Postnatal Growth in Preterm Babies.","authors":"Allan Jenkinson, Narendra Aladangady, Sven Wellmann, Simon Eaton, Christoph Bührer, Paul Fleming, Charles Roehr","doi":"10.1159/000535964","DOIUrl":"10.1159/000535964","url":null,"abstract":"<p><strong>Background: </strong>Optimising postnatal growth facilitates better long-term neonatal neurodevelopmental outcomes. Early postnatal growth is often hindered by a variety of factors unique to the extrauterine environment and digestive immaturity both contributing to reduced enteral feed tolerance during the first few days and weeks after birth. Preterm infants display varying levels of pancreatic insufficiency that are related to gestational age and providing digestive enzyme supplementation, may be one way in which to improve postnatal growth in enterally fed preterm babies.</p><p><strong>Summary: </strong>In this review, we explore which exocrine pancreatic enzymes are deficient in preterm babies, the methods by which exocrine pancreatic function is measured, potential avenues by which digestive enzyme replacement might improve postnatal growth failure, and which babies might benefit most from this intervention.</p><p><strong>Key messages: </strong>Pancreatic exocrine function exhibits developmental immaturity in extremely preterm infants and may contribute to postnatal growth failure. Stool elastase is a simple, non-invasive method of assessing pancreatic function in preterm infants. Available evidence does not currently support routine use of digestive enzyme supplementation in preterm infants.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"283-287"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514461","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 Antenatal Antibiotic Exposure and Bronchopulmonary Dysplasia: A Systematic Review and Bayesian Model-Averaged Meta-Analysis. 产前抗生素暴露与支气管肺发育不良之间的关系:系统回顾与贝叶斯模型平均荟萃分析》(Association between Antenatal Antibiotic Exposure and Bronchopulmonary Dysplasia: A Systematic Review and Bayesian Model-Averaged Meta-Analysis)。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-02-02 DOI: 10.1159/000536220
Karen Van Mechelen, Tamara M Hundscheid, Elke van Westering-Kroon, František Bartoš, Eduardo Villamor
{"title":"Association between Antenatal Antibiotic Exposure and Bronchopulmonary Dysplasia: A Systematic Review and Bayesian Model-Averaged Meta-Analysis.","authors":"Karen Van Mechelen, Tamara M Hundscheid, Elke van Westering-Kroon, František Bartoš, Eduardo Villamor","doi":"10.1159/000536220","DOIUrl":"10.1159/000536220","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal antibiotic exposure has been suggested as a risk factor for bronchopulmonary dysplasia (BPD). We aimed to summarize the evidence from randomized controlled trials (RCTs) and observational studies on this potential association.</p><p><strong>Methods: </strong>PubMed/Medline and Embase databases were searched. BPD was classified as BPD28 (supplemental oxygen during 28 days or at postnatal day 28), BPD36 (supplemental oxygen at 36 weeks postmenstrual age), BPD36 or death, and BPD-associated pulmonary hypertension (BPD-PH). Bayesian model-averaged (BMA) meta-analysis was used to calculate Bayes factors (BFs). The BF10 is the ratio of the probability of the data under the alternative hypothesis (H1) over the probability of the data under the null hypothesis (H0).</p><p><strong>Results: </strong>We included 6 RCTs and 27 observational studies (126,614 infants). Regarding BPD28, BMA showed that the evidence in favor of H0 (lack of association with antenatal antibiotics) was weak for the RCTS (BF10 = 0.506, 6 studies) and moderate for the observational studies (BF10 = 0.286, 10 studies). Regarding BPD36, the evidence in favor of H0 was moderate for the RCTs (BF10 = 0.127, 2 studies) and weak for the observational studies (BF10 = 0.895, 14 studies). Evidence in favor of H0 was also weak for the associations with BPD36 or death (BF10 = 0.429, 2 studies) and BPD-PH (BF10 = 0.384, 2 studies). None of the meta-analyses showed evidence in favor of H1.</p><p><strong>Conclusions: </strong>The currently available evidence suggests a lack of association between antenatal antibiotics and BPD. However, our results should not be interpreted as an argument for widespread use of antibiotics in the setting of preterm delivery.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"378-387"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139682228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
European Training Requirements in Neonatology 2021: The ESPR, EAP, and UEMS Accredited European Syllabus for Neonatal Training. 2021 年欧洲新生儿学培训要求:ESPR、EAP 和 UEMS 认可的欧洲新生儿培训大纲。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-03-22 DOI: 10.1159/000536247
Charles Christoph Roehr, Tomasz Szczapa, Tom Stiris, Adamos Hadjipanayis, Berthold Koletzko, Rob Ross-Russell, Petra Hüppi, Sven Wellmann, Maximo Vento
{"title":"European Training Requirements in Neonatology 2021: The ESPR, EAP, and UEMS Accredited European Syllabus for Neonatal Training.","authors":"Charles Christoph Roehr, Tomasz Szczapa, Tom Stiris, Adamos Hadjipanayis, Berthold Koletzko, Rob Ross-Russell, Petra Hüppi, Sven Wellmann, Maximo Vento","doi":"10.1159/000536247","DOIUrl":"10.1159/000536247","url":null,"abstract":"<p><strong>Introduction: </strong>The European Union stipulates transnational recognition of professional qualifications for several sectoral professions, including medical doctors. The Union of European Medical Specialists (UEMS), in its \"Charter on Training of Medical Specialists,\" defines the principles for high-level medical training. These principles are manifested in the framework for European Training Requirements (ETR), ensuring medical training reflects modern medical practice and current scientific findings. In 1998, the European Society for Paediatric Research developed the first ETR for Neonatology. We present the ETR Neonatology in its third iteration (ETR III), ratified by the European Academy of Paediatrics (EAP), and approved by UEMS in 2021.</p><p><strong>Methods: </strong>In generating the ETR III, existing European policy documents on training requirements, including national syllabi and the European Standards of Care for Newborn Health were considered. To ensure the ETR III meets a pan-European standard of expertise in Neonatology, input from representatives from 27 European national paediatric/neonatal societies, and a European parent organisation, was sought.</p><p><strong>Results: </strong>The ETR III summarises the requirements of contemporary training programs in Neonatology and offers a system for accrediting trainers and training centres. We describe the content of the ETR III training syllabus and means of gaining and assessing competency as a medical care provider in Neonatology.</p><p><strong>Conclusion: </strong>Graduates of courses following the ETR III Neonatology will obtain a certificate of satisfactory training completion which should be accepted by all European member states as a baseline qualification to practice as a specialist in neonatal medicine, enabling mutual recognition of status throughout Europe.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"519-526"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recent Advances in Neonatal Medicine: An International Scientific and Educational Forum. 新生儿医学的最新进展:国际科学和教育论坛。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-08-05 DOI: 10.1159/000540482
Christian P Speer, Ola Didrik Saugstad
{"title":"Recent Advances in Neonatal Medicine: An International Scientific and Educational Forum.","authors":"Christian P Speer, Ola Didrik Saugstad","doi":"10.1159/000540482","DOIUrl":"10.1159/000540482","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"543"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895122","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
Erratum. 勘误。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-01-19 DOI: 10.1159/000536208
{"title":"Erratum.","authors":"","doi":"10.1159/000536208","DOIUrl":"10.1159/000536208","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"406"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514459","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
Positive Pressure Ventilation in Preterm Infants in the Delivery Room: A Review of Current Practices, Challenges, and Emerging Technologies. 产房早产儿正压通气:当前做法、挑战和新兴技术综述》。
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-03-11 DOI: 10.1159/000537800
Shivashankar Diggikar, Viraraghavan V Ramaswamy, Jenny Koo, Arun Prasath, Georg M Schmölzer
{"title":"Positive Pressure Ventilation in Preterm Infants in the Delivery Room: A Review of Current Practices, Challenges, and Emerging Technologies.","authors":"Shivashankar Diggikar, Viraraghavan V Ramaswamy, Jenny Koo, Arun Prasath, Georg M Schmölzer","doi":"10.1159/000537800","DOIUrl":"10.1159/000537800","url":null,"abstract":"<p><strong>Background: </strong>A major proportion of preterm neonates require positive pressure ventilation (PPV) immediately after delivery. PPV may be administered through a face mask (FM) or nasal prongs. Current literature indicates that either of these are associated with similar outcomes.</p><p><strong>Summary: </strong>Nonetheless, FM remains the most utilized and the best choice. However, most available FM sizes are too large for extremely preterm infants, which leads to mask leak and ineffective PPV. Challenges to providing effective PPV include poor respiratory drive, complaint chest wall, weak thoracic muscle, delayed liquid clearance, and surfactant deficiency in preterm infants. Mask leak, airway obstruction, poor technique, and inappropriate size are correctable causes of ineffective PPV. Visual assessment of chest rise is often used to assess the efficacy of PPV. However, its accuracy is debatable. Though end tidal CO2 may adjudge the effectiveness of PPV, clinical studies are limited. The compliance of a preterm lung is highly dynamic. The inflating pressure set on T-piece is constant throughout the resuscitation, but the lung volume and dynamics changes with every breath. This leads to huge fluctuations of tidal volume delivery and can trigger inflammatory cascade in preterm infants leading to brain and lung injury. Respiratory function monitoring in the delivery room has potential for guiding and optimizing delivery room resuscitation. This is, however, limited by high costs, complex information that is difficult to interpret during resuscitation, and absence of clinical trials.</p><p><strong>Key messages: </strong>This review summarizes the existing literature on PPV in preterm infants, the various aspects related to it such as the pathophysiology, interfaces, devices utilized to deliver it, appropriate technique, emerging technologies, and future directions.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"288-297"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103112","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
Brain MRI Injury Patterns across Gestational Age among Preterm Infants with Perinatal Asphyxia. 围产期窒息早产儿不同胎龄的脑磁共振成像损伤模式
Neonatology Pub Date : 2024-01-01 Epub Date: 2024-06-05 DOI: 10.1159/000538986
Corline E J Parmentier, Loubna El Bakkali, Elise A Verhagen, Sylke J Steggerda, Thomas Alderliesten, Maarten H Lequin, Laura A van de Pol, Manon J N L Benders, Frank van Bel, Corine Koopman-Esseboom, Timo R de Haan, Linda S de Vries, Floris Groenendaal
{"title":"Brain MRI Injury Patterns across Gestational Age among Preterm Infants with Perinatal Asphyxia.","authors":"Corline E J Parmentier, Loubna El Bakkali, Elise A Verhagen, Sylke J Steggerda, Thomas Alderliesten, Maarten H Lequin, Laura A van de Pol, Manon J N L Benders, Frank van Bel, Corine Koopman-Esseboom, Timo R de Haan, Linda S de Vries, Floris Groenendaal","doi":"10.1159/000538986","DOIUrl":"10.1159/000538986","url":null,"abstract":"<p><strong>Introduction: </strong>Brain injury patterns of preterm infants with perinatal asphyxia (PA) are underreported. We aimed to explore brain magnetic resonance imaging (MRI) findings and associated neurodevelopmental outcomes in these newborns.</p><p><strong>Methods: </strong>Retrospective multicenter study included infants with gestational age (GA) 24.0-36.0 weeks and PA, defined as ≥2 of the following: (1) umbilical cord pH ≤7.0, (2) 5-min Apgar score ≤5, and (3) fetal distress or systemic effects of PA. Findings were compared between GA &lt;28.0 (group 1), 28.0-31.9 (group 2), and 32.0-36.0 weeks (group 3). Early MRI (&lt;36 weeks postmenstrual age or &lt;10 postnatal days) was categorized according to predominant injury pattern, and MRI around term-equivalent age (TEA, 36.0-44.0 weeks and ≥10 postnatal days) using the Kidokoro score. Adverse outcomes included death, cerebral palsy, epilepsy, severe hearing/visual impairment, or neurodevelopment &lt;-1 SD at 18-24 months corrected age.</p><p><strong>Results: </strong>One hundred nineteen infants with early MRI (n = 94) and/or MRI around TEA (n = 66) were included. Early MRI showed predominantly hemorrhagic injury in groups 1 (56%) and 2 (45%), and white matter (WM)/watershed injury in group 3 (43%). Around TEA, WM scores were highest in groups 2 and 3. Deep gray matter (DGM) (aOR 15.0, 95% CI: 3.8-58.9) and hemorrhagic injury on early MRI (aOR 2.5, 95% CI: 1.3-4.6) and Kidokoro WM (aOR 1.3, 95% CI: 1.0-1.6) and DGM sub-scores (aOR 4.8, 95% CI: 1.1-21.7) around TEA were associated with adverse neurodevelopmental outcomes.</p><p><strong>Conclusion: </strong>The brain injury patterns following PA in preterm infants differ across GA. Particularly DGM abnormalities are associated with adverse neurodevelopmental outcomes.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"616-626"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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