Neonatology最新文献

{"title":"The Effectiveness of Regionalization of Perinatal Care and Specific Facility-Based Interventions: A Systematic Review.","authors":"Ayesha Arshad Ali, Hamna Amir Naseem, Zoha Allahuddin, Rahima Yasin, Maha Azhar, Sawera Hanif, Jai K Das, Zulfiqar A Bhutta","doi":"10.1159/000541384","DOIUrl":"10.1159/000541384","url":null,"abstract":"<p><strong>Introduction: </strong>Appropriate perinatal care provision and utilization is crucial to improve maternal and newborn survival and potentially meet Sustainable Development Goal 3. Ensuring availability of healthcare infrastructure as well as skilled personnel can potentially help improve maternal and neonatal outcomes globally as well as in resource-limited settings.</p><p><strong>Methods: </strong>A systematic review on effectiveness of perinatal care regionalization was updated, and a new review on facility-based interventions to improve postnatal care coverage and outcomes was conducted. The interventions were identified through literature reviews and included transport, mHealth, telemedicine, maternal education, capacity building, and incentive packages. Search was conducted in relevant databases and meta-analysis conducted on Review Manager 5.4. We conducted subgroup analysis for evidence from low- and middle-income countries (LMICs).</p><p><strong>Results: </strong>Implementation of regionalization programs significantly decreased maternal mortality in LMICs (OR: 0.43; 95% CI: 0.34-0.55, 2 studies), stillbirth overall (OR: 0.70; 95% CI: 0.54-0.89, 5 studies), perinatal mortality overall (OR: 0.54; 95% CI: 0.5-0.58, 2 studies), and LMICs (OR: 0.54; 95% CI: 0.50-0.58, 1 study). Transport-related interventions significantly decreased maternal mortality overall (OR: 0.55; 95% CI: 0.40-0.74, 1 study), neonatal mortality (RR: 0.76; 95% CI: 0.66-0.88, 1 study), perinatal mortality (RR: 0.86; 95% CI: 0.77-0.95, 1 study), and improved postnatal care coverage (OR: 6.89; 95% CI: 5.15-9.21, 1 study) in LMICs. Adding maternity homes/units significantly decreased stillbirth (OR: 0.75; 95% CI: 0.61-0.93, 1 study) in LMICs. Incentives for postnatal care significantly improved infant mortality (RR: 0.79; 95% CI: 0.65-0.96, 1 study), stillbirth (OR: 0.60; 95% CI: 0.44-0.83, 1 study), and postnatal care coverage (RR: 1.13; 95% CI: 1.03-1.25, 1 study) in LMICs. Telemedicine improved postnatal care coverage significantly in LMICs (RR: 2.54; 95% CI: 1.22-5.28, 3 studies) and decreased maternal mortality (OR: 0.46; 95% CI: 0.21-0.98, 1 study) and infant mortality (OR: 0.65; 95% CI: 0.45-0.95) in LMICs. Maternal education significantly decreased neonatal mortality (RR: 0.75; 95% CI: 0.66-0.84, 2 studies), perinatal mortality (RR: 0.86; 95% CI: 0.77-0.95, 1 study), infant mortality (RR: 0.79; 95% CI: 0.65-0.96, 1 study), and stillbirth (RR: 0.61; 95% CI: 0.45-0.82, 1 study). Capacity-building interventions significantly decreased maternal mortality in LMICs (OR: 0.37; 95% CI: 0.29-0.46, 5 studies), neonatal mortality overall (OR: 0.72; 95% CI: 0.53-0.98, 4 studies) and in LMICs (OR: 0.63; 95% CI: 0.54-0.74, 3 studies, and RR: 0.61; 95% CI: 0.48-0.79, 3 studies), perinatal mortality (OR: 0.53; 95% CI: 0.45-0.62, 2 studies, and RR: 0.86; 95% CI: 0.77-0.95, 1 study), infant mortality (OR: 0.50; 95% CI: 0.43-0.59, 1 study, and RR: 0.79; 95% CI: 0.65-0.96, 1","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"245-261"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592312","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}

{"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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>The identified risk factors for delayed ductal closure in term-born neonates may help increase clinical attention and improve neonatal care.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"275-280"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412175","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}

{"title":"Erratum.","authors":"","doi":"10.1159/000541503","DOIUrl":"10.1159/000541503","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"255"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396468","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}

{"title":"No Short-Term Effect of Low-Dose Nicotine on Inflammation after Global Hypoxia in Newborn Piglets.","authors":"Karianne B Volstad, Are H Pripp, Judith A Ludviksen, Tom Stiris, Ola D Saugstad, Tom E Mollnes, Jannicke H Andresen","doi":"10.1159/000541217","DOIUrl":"10.1159/000541217","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Perinatal asphyxia initiates cytokine release and complement activation with risk of brain damage. We assessed the effect of nicotine on innate immunity and hypothesized that nicotine infusion in a newborn piglet model of asphyxia would decrease the immune response and be neuroprotective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Newborn piglets (n = 41) were randomized to one of three groups after hypoxia: two groups receiving nicotine, (1) 18 µg/kg/h (n = 17), (2) 46 µg/kg/h (n = 15), and (3) control group receiving saline (n = 9). C3a, IL-6, TNF, and IL-10 were measured in plasma and IL-6 and IL-8 in microdialysis fluid from cerebral periventricular white matter, using immuno-assays.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Plasma C3a and IL-6 increased significantly from start to end hypoxia (mean 4.4 ± 0.55 to 5.6 ± 0.71 ng/mL and 1.66 ± 1.04 to 2.68 ± 0.71 pg/mL, respectively), while IL-10 and TNF increased significantly after 4 h (mean 1.4 ± 1.08 to 2.9 ± 1.87 and 3.3 ± 0.67 to 4.0 ± 0.58 pg/mL, respectively) (p &lt; 0.001 for all). IL-6 increased significantly (p &lt; 0.001) in microdialysis samples from end hypoxia to end experiment (mean 0.65 ± 0.88 to 2.78 ± 1.84 ng/mL). No significant differences were observed between the nicotine groups and the control group neither in plasma nor in microdialysis samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Hypoxia leads to rapid release of cytokines in plasma and cerebral microdialysis fluid, and complement activation measured on C3a. However, low-dose nicotine administration did not affect the immune response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Perinatal asphyxia initiates cytokine release and complement activation with risk of brain damage. We assessed the effect of nicotine on innate immunity and hypothesized that nicotine infusion in a newborn piglet model of asphyxia would decrease the immune response and be neuroprotective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Newborn piglets (n = 41) were randomized to one of three groups after hypoxia: two groups receiving nicotine, (1) 18 µg/kg/h (n = 17), (2) 46 µg/kg/h (n = 15), and (3) control group receiving saline (n = 9). C3a, IL-6, TNF, and IL-10 were measured in plasma and IL-6 and IL-8 in microdialysis fluid from cerebral periventricular white matter, using immuno-assays.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Plasma C3a and IL-6 increased significantly from start to end hypoxia (mean 4.4 ± 0.55 to 5.6 ± 0.71 ng/mL and 1.66 ± 1.04 to 2.68 ± 0.71 pg/mL, respectively), while IL-10 and TNF increased significantly after 4 h (mean 1.4 ± 1.08 to 2.9 ± 1.87 and 3.3 ± 0.67 to 4.0 ± 0.58 pg/mL, respectively) (p &lt; 0.001 for all). IL-6 increased significantly (p &lt; 0.001) in microdialysis samples from end hypoxia to end experiment (mean 0.65 ± 0.88 to 2.78 ± 1.84 ng/mL). No significant differences were observed between the nicotine groups and the control group neither in plasma nor in microdialysis samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Hypoxia leads to rap","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"171-180"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335369","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}

{"title":"Intravenous Dextrose for the Treatment of Neonatal Hypoglycaemia: A Systematic Review.","authors":"Lily F Roberts, Libby G Lord, Caroline A Crowther, Jane E Harding, Luling Lin","doi":"10.1159/000541471","DOIUrl":"10.1159/000541471","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Hypoglycaemic neonates are usually admitted to neonatal intensive care for intravenous (IV) dextrose infusion if increased feeding and dextrose gel fail to restore normoglycaemia. However, the effectiveness of this intervention is uncertain. This review aimed to assess the evidence for the risks and benefits of IV dextrose for treatment of neonatal hypoglycaemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Four databases and three clinical trial registries were searched from inception to October 5, 2023. Randomised controlled trials (RCTs), non-randomised studies of interventions, cohort studies, and before and after studies were considered for inclusion without language or publication date restrictions. Risk of bias was assessed using Cochrane's Risk of Bias 2 tool or Risk of Bias in Non-Randomized Studies of Interventions tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Meta-analysis was planned but not carried out due to insufficient data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across 6 studies (two RCTs and four cohort), 711 participants were included. Evidence from one cohort study suggests IV dextrose treatment may not be associated with neurodevelopmental impairment at ≥18 months of age (no effect numbers, p &gt; 0.2; very low certainty evidence; 60 infants). Evidence from one RCT suggests IV dextrose treatment may reduce the likelihood of repeated hypoglycaemia (risk ratio [RR]: 0.67 [95% CI: 0.20, 2.18], p = 0.5; low certainty evidence; 80 infants) compared to treatment with oral sucrose bolus. However, the risk of a hyperglycaemic episode may be increased (RR: 2.33 [95% CI: 0.65, 8.39], p = 0.19; 80 infants).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;More evidence is needed to clarify the benefits and risks of IV dextrose for treatment of neonatal hypoglycaemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Hypoglycaemic neonates are usually admitted to neonatal intensive care for intravenous (IV) dextrose infusion if increased feeding and dextrose gel fail to restore normoglycaemia. However, the effectiveness of this intervention is uncertain. This review aimed to assess the evidence for the risks and benefits of IV dextrose for treatment of neonatal hypoglycaemia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Four databases and three clinical trial registries were searched from inception to October 5, 2023. Randomised controlled trials (RCTs), non-randomised studies of interventions, cohort studies, and before and after studies were considered for inclusion without language or publication date restrictions. Risk of bias was assessed using Cochrane's Risk of Bias 2 tool or Risk of Bias in Non-Randomized Studies of Interventions tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Meta-analysis was planned but not carried out due to insufficient data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across 6 studies (two ","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"232-243"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635118","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}

{"title":"Influence of Early Total Enteral Feeding in Preterm Infants with Respiratory Distress Syndrome.","authors":"Rohit Anand, Sushma Nangia","doi":"10.1159/000539544","DOIUrl":"10.1159/000539544","url":null,"abstract":"<p><strong>Introduction: </strong>Providing adequate nutrition in the management of preterm infants has been challenging. The objective of this secondary analysis of data from the randomized trial comparing \"less invasive surfactant therapy (LISA) with InSurE method of surfactant administration\" is to demonstrate the feasibility of early total enteral feeding (ETEF) in hemodynamically stable preterm neonates on respiratory support and to examine the factors associated with failure of ETEF.</p><p><strong>Methods: </strong>Secondary analysis of a randomized controlled trial comparing \"LISA versus InSurE among preterm infants between 26 and 34 weeks of gestation\" enrolled 150 infants with 117 being hemodynamically stable. ETEF without any parenteral supplementation was started on day 1 of life using the mother's own milk (MoM) or donor human milk (<32 weeks of GA) and MoM or preterm formula (33-34 weeks of GA). The data were analyzed to assess the proportion of babies developing feed intolerance and/or necrotizing enterocolitis (NEC) and factors associated with failure of ETEF. All Infants were assessed for the day of attainment of full enteral feeding defined as receiving and tolerating 150 mL/kg of enteral feeds per day.</p><p><strong>Results: </strong>Out of these 117 babies, 102 tolerated ETEF, and 15 had one or more episodes of FI requiring total parenteral nutrition, but none developed NEC till discharge or death. On the assessment of possible factors associated with ETEF failure, there were no differences in baseline characteristics but statistically significantly increased incidence of culture-positive sepsis as well as the requirement of antibiotic therapy for possible sepsis (early as well as late-onset sepsis) in babies with failure of ETEF. The babies who tolerated ETEF achieved full enteral feeding (150 mL/kg/day) significantly earlier (5.48 ± 1.1 days) compared to those with ETEF failure (7 ± 3.4 days) (p 0.001). The time to regain birth weight was earlier in the ETEF group without significant differences in growth parameters. There was also a reduction in the duration of hospital stay in babies who tolerated ETEF, but both these results were not statistically significant.</p><p><strong>Conclusion: </strong>ETEF is feasible in preterm neonates with respiratory distress syndrome who are on respiratory support. It resulted in earlier attainment of full enteral feeds and decreased the incidence of sepsis with reduced antibiotic usage.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"4-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636321","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}

{"title":"Association between Enteral Protein Intake and Fat-Free Mass Accretion in Very Preterm Infants.","authors":"Maggie Jerome, Emily Gunawan, Natalia Aristizabal, Paula Chandler-Laney, Ariel A Salas","doi":"10.1159/000543326","DOIUrl":"10.1159/000543326","url":null,"abstract":"<p><strong>Introduction: </strong>For preterm infants, the first 2 weeks after birth are a time when nutrition and protein intake is variable and often falls below recommended intakes. Our objective was to investigate the relationship between protein intake, including source of protein, during the first 2 weeks after birth and fat-free mass (FFM) accretion in a group of very preterm infants.</p><p><strong>Methods: </strong>In this observational cohort study, body composition was assessed using air displacement plethysmography in eligible infants <32 weeks gestational age at 2 weeks after birth and prior to discharge. FFM accretion was calculated as difference between the two measurements. We collected daily nutrition data for the first 2 weeks. Multivariable linear regression was used to assess the relationship between protein intake and body composition and weight gain.</p><p><strong>Results: </strong>Seventy-eight infants were included (mean birthweight: 1,408±278 g). Mean cumulative protein intake of this cohort in the first 2 weeks was 2.4±0.8 g/kg/day of which 74±19% was enteral (1.7±0.6 g/kg/day). Enteral protein intake was associated with higher FFM while parenteral protein was associated with lower FFM. Total protein intake from both sources during the first 2 weeks after birth was positively associated with greater weight gain.</p><p><strong>Conclusion: </strong>Enteral protein intake during the first 2 weeks after birth is associated with higher FFM and weight in preterm infants. Future interventional studies should investigate the effects of higher enteral protein intake during the first 2 weeks after birth on growth and body composition.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"311-318"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924406","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}

{"title":"The Prevalence of Neonatal Hypoglycemia in Twins versus Singletons following Exposure to Antenatal Steroid Therapy Is Comparable: A Retrospective Study in a Single Center.","authors":"Rakefet Yoeli-Ullman, Roni Zemet, Keren Zloto, Arik Toren, Heli Alexandroni, Irit Schushan Eisen, Shalom Mazaki-Tovi","doi":"10.1159/000542266","DOIUrl":"10.1159/000542266","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal corticosteroids (ACS) administration before anticipated preterm birth is one of the most important interventions available to improve neonatal outcomes. Nevertheless, this treatment is associated with an increased risk of neonatal hypoglycemia. The aim of this study was to determine whether preterm twins who receive ACS are at increased risk for developing neonatal hypoglycemia.</p><p><strong>Methods: </strong>This was a retrospective cohort study of indicated and spontaneous preterm births of twins at a single center between 2011 and 2018. The study population included 3 groups matched for gestational age at delivery and birth weight: (1) Twin neonates who received a course of ACS 1-7 days before birth (n = 532); (2) twins who did not receive ACS at that time interval (n = 532); and (3) singletons receiving ACS 1-7 days before birth (n = 266). The primary outcome was neonatal hypoglycemia (<40 mg/dL/2.2 mmol/L) within the first 24 h and 48 h of life.</p><p><strong>Results: </strong>The rate of neonatal hypoglycemia during the first 24 h of life was significantly higher in singletons exposed to ACS compared to twins not exposed to ACS (p = 0.019) and in twins exposed to ACS compared to twins not exposed to ACS (p = 0.047). The rate of neonatal hypoglycemia was almost identical between twins and singletons exposed to ACS (p = 0.72). Regression analysis revealed that exposure to ACS and birth weight were independently associated with neonatal hypoglycemia after adjustment for maternal age, body mass index, gravidity, gestational diabetes mellitus, and gestational age at delivery.</p><p><strong>Conclusion: </strong>Exposure to ACS, rather than plurality, is associated with short-lived neonatal hypoglycemia.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"257-264"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384580","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}

{"title":"Interventions to Prevent and Manage Infections in Pregnancy.","authors":"Rahima Yasin, Li Jiang, Jai K Das, Zulfiqar A Bhutta","doi":"10.1159/000543690","DOIUrl":"10.1159/000543690","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and lower-middle-income countries (LMICs) for outcomes relevant to neonatal health. Findings from our papers indicate limited evidence from LMICs, highlighting the pressing need for coordinated efforts to close this gap and strengthen the body of inclusive evidence on prevention and treatment of maternal infections during pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;Evidence from LMICs suggests that influenza virus vaccination had no effect on stillbirth, preterm birth, small for gestational age, or low birthweight (LBW). Insecticide-treated bed nets in pregnancy reduced the risk of fetal loss and improved the babies' birthweight. Changing a two-dose intermittent preventive treatment (IPTp) regimen to more frequent IPTp dosing decreased the risk of LBW and significantly improved babies' birthweight. Addition of antibacterial antibiotic to the IPTp regimen significantly reduced the risk of LBW. Antibiotic treatments for syphilis and chlamydia had a significant effect on LBW. Treatment of documented periodontal disease during pregnancy reduced the risk of LBW.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and lower-middle-income countries (LMICs) for outcomes relevant to neonatal health. Findings from our papers indicate limited evidence from LMICs, highlighting the pressing need for coordinated efforts to close this gap and strengthen the body of inclusive evidence on prevention and treatment of maternal infections during pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;Evidence from LMICs suggests th","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061827","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}

{"title":"\"Enriching the Hospital's Scientific Fame\": Research at the Vienna Foundling Hospital.","authors":"Michael Obladen","doi":"10.1159/000543207","DOIUrl":"10.1159/000543207","url":null,"abstract":"<p><strong>Background: </strong>Little is known about medical research at the Vienna Foundling Hospital during the 18th and 19th centuries.</p><p><strong>Summary: </strong>The present article focuses on nutrition, medical care, and research concerning newborn infants. In 1784, Emperor Joseph II merged obstetric and foundling hospitals under common leadership with specific statutes. Admissions rose from 1,704 in 1785 to 9,797 in 1859. A third of all infants born in Vienna in the 1890s were \"foundlings\" - correctly: abandoned infants, illegitimate birth was a prerequisite for admission. Differing from other foundling hospitals, the statutes obliged physicians to research, which focused on the great baby killers of the 18th century: smallpox, puerperal sepsis, connatal syphilis, tuberculosis, and malformations. Researchers included Anton Rechberger, Lucas Boër, Ignaz Semmelweis, Carl Rokitansky, Alois Bednar, and Carl Friedinger. Major scientific achievements were Rechberger's introduction of smallpox inoculation in Austria in 1768; Semmelweis' prevention of puerperal sepsis in 1847, and Bednar's classification of congenital heart malformations in 1852. Mortality statistics were doctored: deaths within 1 year were related to admissions from several years, which yielded maximum \"mortality rates\" of 76% in 1811, and a minimum rate of 13% in 1829. Actual mortality, however, per number of admissions, was over 90% in the first year of life. The institution persisted for 126 years because of the strict anonymity of extramarital birth, faked statistics deceiving supervisors, and esteem for the imperial inaugurator even beyond the end of the Austrian Empire.</p><p><strong>Key message: </strong>Despite appalling mortality, successful research was conducted at the Vienna Foundling Hospital.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"281-289"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879383","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}