630 e-Letters

  • Re: Logistic regression equation and (co)variance matrix for estimating developmental outcome in very preterm infants

    Dear Dr. Degraeuwe,

    We thank you very much for your question and we would appreciate having the opportunity to share the full results of the regression analyses for our 3 outcomes: neurodevelopmental impairment, significant neurodevelopmental impairment and significant neurodevelopmental impairment or death. The omission of this information was due solely to the manuscript restrictions on words and tables. We agree with you that this information is useful. As we are not able to provide tables in an e-letter, we would be happy to share this information via e-mail with any interested reader.


    Anne Synnes, MDCM, MHSC, FRCPC
    Neonatologist, BC Women’s Hospital and Health Centre,
    Clinical Professor, Department of Pediatrics, University of British Columbia
    Director, Canadian Neonatal Follow-Up Network
    Vancouver, Canada

  • Haemoglobin discordances in twins: is "really" due to differences in timing of cord clamping? A consideration to Verbeek L and co-authors
    Maria Pia De Carolis

    Dear Editor, We read with interest the article by Verbeek L. et al [1], showing that the second-born twin has higher levels of hemoglobin (Hb) than first-born co-twins after vaginal delivery (VD; Hb differential effect does not occur in twins delivered by Caesarean section. Since Hb difference is present in both uncomplicated monochorionic (MC) and dichorionic (DC) twin pairs, authors focused on the time difference of umbi...

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  • Logistic regression equation and (co)variance matrix for estimating developmental outcome in very preterm infants
    Pieter L. Degraeuwe

    Neonatal health-care providers have the duty to fully inform parents about the prognosis of their sick, extremely preterm infant. Prognostication is however difficult since survival and long-term outcome are multifactorially influenced, and the quality of prognosis research is often poor. [1] By reporting "Determinants of developmental outcomes in a very preterm Canadian cohort" [2], Synnes et al. extend the previous wor...

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  • Congenital intraoral Fordyce spots misdiagnosis
    Thamer M. Musbah

    Dear editor, We read with interest the report by Arun Babu and colleagues1 and have concern with the diagnosis of "congenital intraoral Fordyce spots" that was rendered in this case. Fordyce spots/granules in the oral cavity are considered ectopic holocrine glands, and they differ considerably from those shown in the mentioned article. Fordyce spots usually appear as asymptomatic, multiple yellowish raised papules with...

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  • Re: Neonatal antibiotics; a response to White and co-authors
    Alice E. White

    We appreciate the comments regarding our manuscript on the association between epidural analgesia, maternal fever and neonatal antibiotics in Colorado. With regards to the writer's observation about the likelihood of underestimating the primary outcome, we acknowledge that underreporting is an issue in the Colorado birth certificate database, as with most large administrative datasets. As stated in the manuscript: "Incidence...

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  • Current UK practice: Infant Car Seat Challenges
    Rebecca C H Towler

    This paper highlights some limitations in the use of infant car-seat challenges (ICSCs) to monitor for abnormal cardiorespiratory events prior to hospital discharge[1]. Current practice is non-standardised and unlikely to replicate actual infant experience.

    In the USA it is recommended that all infants born <37 weeks gestation or birth-weight <2500g should have a period of observation in a car-seat prior t...

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  • Response to the article by Zanardo et al
    Stefano Ghirardello

    We read with interest the article by Zanardo et al (1). The authors found a lower pre-ductal SpO2, a higher hearth rate (HR) and hematocrit in term infants born by cesarean delivery (CD) compared to those born by vaginal delivery (VD), similarly to the findings by Dawson et al (2) but not confirmed by others (3). The authors did not mentioned if a different management of cord clamping was performed between vaginal and ce...

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  • How a Belgian daily paper informed its readers about the contents of the review on waterbirth
    Sophie Alexander

    Le Soir, one of Belgium's leading French language newspapers (1), headlined the front page of its 23 May 2016 edition with "Birth in water: a dangerous new fashion." Page 6 was devoted to the review by Taylor et al; the subtitle said "New study underlines the dangers of drowning and pulmonary infection for babies; no benefit from this fashionable birthing technique". I was asked that afternoon, in my capacity of advise...

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  • Re: Handheld Doppler use for measuring newborn HR has been described in the literature
    Amanda Dyson

    We thank Dr Hutchon for his interest in our article and acknowledge his contribution to developing this technique of measuring heart rate rapidly and efficiently in newborns. We were particularly interested to hear of his experience with a Doppler that displays an averaged heart rate. We can see that having a displayed rather than counted Doppler heart rate would be highly practical in the delivery room providing that...

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  • Re:End of Life Decisions - Do we make them wisely?
    Praeksh S Shah

    Reply to End of Life Decisions - Do we make them wisely?: End of life decisions: How do we improve process? We thank Dr Cohn for his response to our paper and for voicing the issues it raised for him. Certainly one of the objectives of the study was to explore whether there were differences in approach to similar medical disorders in NICUs across Canada. We hoped that our finding of differences in what appear to be medical...

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