November 29, 2021
- Original researchSingle versus continuous sustained inflations during chest compressions and physiological-based cord clamping in asystolic lambs
In this study of resuscitation from asystole in newborn lambs there was no advantage to the use of continual sustained inflations as part of the cardiopulmonary resuscitation (CPR) strategy. Some haemodynamic measures were improved when CPR was provided with the umbilical cord intact in comparison with CPR after cord clamping.
- Original researchPredicting neurodevelopmental outcomes in fetuses with isolated mild ventriculomegaly
Amongst 42 fetuses with isolated mild ventriculomegaly, all 23 fetuses with unilateral dilatation had normal neurodevelopmental outcome. Normal outcome was observed in 12/19 fetuses where the ventriculomegaly was bilateral.
November 25, 2021
November 24, 2021
- Original researchRandomised crossover trial comparing algorithms and averaging times for automatic oxygen control in preterm infants
In this randomised crossover study in 24 oxygen dependent preterm infants on non-invasive respiratory support, modifications to an established automated oxygen controller did not improve time in intended SpO₂ range. There was no difference in performance whether the oximeter SpO₂ averaging time was set to 2 seconds or 8 seconds.
November 23, 2021
- Original researchParental perspective on important health outcomes of extremely preterm infants
Parents of extremely preterm born children undergoing follow up rated their children's health as 9/10. Parental priorities for health improvement were related to behaviour, emotional health and language communication, respiratory health and feeding/growth issues.
November 22, 2021
- Original researchCerebral perfusion and neurological examination characterise neonatal opioid withdrawal syndrome: a prospective cohort study
This prospective cohort study found that 30 infants with neonatal opioid withdrawal syndrome had higher global cerebral blood flow and more neurological exam abnormalities than 31 unexposed controls. Follow-up to determine these infants’ neurodevelopmental courses is required.
- Original researchNeonatal arterial stroke location is associated with outcome at 2 years: a voxel-based lesion-symptom mapping study
In a prospective observational multicenter study of neonatal stroke, lesion location identified by MRI is associated with language, motor, and cognitive outcomes at two years of age.
November 18, 2021
- Original researchEarly versus later initiation of parenteral nutrition for very preterm infants: a propensity score-matched observational study
This large observational study of over 65,000 infants uses propensity matching to assess the impact of early (<2 days of age) and late (>2 days) commencement of parenteral nutrition in preterm infants born before 31 weeks gestation.
November 17, 2021
- Original researchImpact of maternal obesity on neonatal heart rate and cardiac size
This manuscript examines the impact of preconception maternal obesity on measures of cardiac size and function assessed by MRI. The authors compared ECG findings and cardiac MRI findings in infants delivered to normal BMI and obese women. They found a higher resting heart rate and lower LV end diastolic volume and stroke volumes in infants who were born to obese women. They speculate that these findings may be related to increased CV risk in offspring of obese mothers.
November 15, 2021
- Original researchFive-minute Apgar score and outcomes in neonates of 24–28 weeks’ gestation
In a large multicenter retrospective study of extremely preterm infants, increasing 5-minute Apgar scores were associated with decreasing mortality but low scores did not predict severe neurologic injury in survivors.
November 09, 2021
- Original researchDual-site blood culture yield and time to positivity in neonatal late-onset sepsis
Observational, single-centre study questioning the need to obtain both, peripheral and catheter-based, blood cultures in infants with suspected sepsis - the answer is yes, we need both if we do not want to miss a positive result in a significant proportion of infants.
November 01, 2021
- Original researchNeurodevelopmental outcomes of preterm infants after randomisation to initial resuscitation with lower (FiO2 <0.3) or higher (FiO2 >0.6) initial oxygen levels. An individual patient meta-analysis
In an individual patient meta-analysis of infants less than 32 weeks gestation, resuscitation with lower (<0.3) or higher (>0.6) initial FiO2 was not associated with risk of death or disability at 2 years.
- Original researchOutcome of infants with 10 min Apgar scores of 0–1 in a low-resource setting
This observational study of 49 newborns, Apgar score of 0-1 after 10 mins’ resuscitation was conducted in Uganda. Resuscitation continued for median (IQR) of 32 (17-37) min, 1 infant survived to 7 days. Policies around discontinuing resuscitation should vary according to setting.
October 25, 2021
- Original researchReduced health-related quality of life in children born extremely preterm in 2006 compared with 1995: the EPICure Studies
Parent-reported health-related quality of life information was obtained for children born <26 weeks gestation in England at 11 years in two birth cohorts (1995 and 2006). Mean utility scores were significantly lower for 2006 vs. 1995 cohorts, while control groups were similar.
October 22, 2021
- Original researchTemporal trends in routine predischarge pulse oximetry screening: 6 years’ experience in a UK regional neonatal unit
This large retrospective review of over 49,000 infants examines the impact of routine pulse oximetry screening in a regional neonatal unit. Improvements in detection rates of congenital heart disease were seen, together with a reduction in the admission of healthy babies.
- Original researchSurfactant therapy in late preterm and term neonates with respiratory distress syndrome: a systematic review and meta-analysis
Uncertainty exists on surfactant in late preterm and term infants with RDS. Surfactant therapy in neonates ≥340/7 weeks may be associated with decreased risk of mortality and short-term respiratory morbidities. However, there is wide variation in thresholds for surfactant therapy.
October 19, 2021
October 16, 2021
- Original researchSocial inequalities in access to care at birth and neonatal mortality: an observational study
This manuscript examines all live births in France from 2012 - 2014 to assess the association between socioeconomic status and delivery of preterm infants in the appropriate level of maternity and neonatal care. The authors found such an association, as well as a higher risk of neonatal mortality.
October 07, 2021
- Original researchNeonatal-onset mitochondrial disease: clinical features, molecular diagnosis and prognosis
The authors analyzed neonatal-onset mitochondrial disease in Japan via a retrospective observational study to clarify its clinical features, molecular diagnosis, and prognosis. The heterogeneous aetiology if the group is outlined.
October 04, 2021
- Original researchPrenatal ultrasonographic markers for prediction of complex gastroschisis and adverse perinatal outcomes: a systematic review and meta-analysis
Based on a systematic review, it was concluded that observed bowel dilatation in the second trimester of pregnancy was significantly associated with the development of complex gastroschisis, postnatal short bowel syndrome and length of stay.
September 29, 2021
- Original researchComparison of intraosseous and intravenous epinephrine administration during resuscitation of asphyxiated newborn lambs
When intravenous access is not easily attainable, recommendations are to use intra-osseus as an alternative route for adrenaline administration in neonatal resuscitation. In an non-randomized trial in a lamb model, these two delivery routes were equivalent in terms of success in resuscitation and serum adrenaline levels.
- Original researchAntenatal corticosteroids and neurodevelopmental outcomes in late preterm births
In a large population-based dataset of live births at 34-36 weeks' gestation born 2006-2011, exposure to antenatal corticosteroids earlier in gestation may be associated with an increased risk for neurodevelopmental concerns and healthcare utilization at 5-9 years.
September 23, 2021
September 22, 2021
- Original researchImplementation of an adapted Sepsis Risk Calculator algorithm to reduce antibiotic usage in the management of early onset neonatal sepsis: a multicentre initiative in Wales, UK
Antibiotic use in the newborn may have long lasting impact. Neonatal sepsis is relatively rare but one which causes concern, investigation and treatment. This paper describes the implementation of an sepsis risk calculator to reduce antibiotic use in a safe and sustainable way.
September 21, 2021
- Original researchOutcomes in relation to early parenteral nutrition use in preterm neonates born between 30 and 33 weeks’ gestation: a propensity score matched observational study
This is large study of over 16,000 infants born between 30 and 32+6 weeks gestation. It compares those who received parenteral nutrition compared to those who did not and explores the risk and benefit of this intervention.
September 20, 2021
- Original researchSafety and efficacy of low-dose diazoxide in small-for-gestational-age infants with hyperinsulinaemic hypoglycaemia
SGA infants are at risk of hyperinsulinaemic hypoglycaemia and neuronal injury. We report that low dose diazoxide (3-5 mg/kg/day) effectively treats hyperinsulinaemic hypoglycaemia in these SGA infants. Its safety profile was excellent, but adverse events were still observed.
September 11, 2021
- Original researchSARS-CoV-2 RNA and antibody detection in breast milk from a prospective multicentre study in Spain
ARS-CoV-2 antibodies but not RNA are found in breast milk from COVID-19 infected mothers.
- Original researchMortality and significant neurosensory impairment in preterm infants: an international comparison
The composite outcome of mortality and significant neurodisability in extremely low birth weight infants is compared across 3 different international cohorts (Canada, Australia/New Zealand, France). The composite outcome was higher in the French cohort, driven by a higher mortality.
September 07, 2021
September 06, 2021
- Original researchImpact of personal protective equipment on neonatal resuscitation procedures: a randomised, cross-over, simulation study
Unique study of neonatal resuscitation in PPE using a simulation model which identified small but potentially important differences in timings of key resus events. Also shows the inevitable discomfort and inconvenience of PPE in this scenario.
August 30, 2021
- Original researchNeonates with mild hypoxic–ischaemic encephalopathy receiving supportive care versus therapeutic hypothermia in California
This manuscript reports trends in the use of therapeutic hypothermia for babies with mild HIE in the NICUs in the CPQCC catchment, and assesses odds ratios for maternal and infant factors associated with the use of TH. There was an increase in the use of TH for mild HIE increased over time as a form of therapeutic creep.
August 25, 2021
- ReviewManipulating the neonatal gut microbiome: current understanding and future perspectives
This review summarises current understanding regarding how modern birth influence neonatal gut microbiome development together with potential methods of microbiome engineering that might encourage the development of a microbiome that promote long term health.
- Original researchNecrotising enterocolitis, late-onset sepsis and mortality after routine probiotic introduction in the UK
In this single-centre retrospective review of more than 1000 infants born before 32 week's gestation. The routine introduction of multi-strain probiotics was not associated with changes in the risk of mortality or necrotising enterocolitis.
August 23, 2021
- Original researchIdentification of treatment-warranted retinopathy of prematurity by neonatal nurse specialist
This study demonstrates that screening for retinopathy of prematurity treatment can be performed by a specialist nurse practitioner obtaining and interpreting digital retinal images, with excellent agreement with treating ophthalmologists.
August 19, 2021
- Original researchObservational cohort study of changing trends in non-invasive ventilation in very preterm infants and associations with clinical outcomes
This analysis of the National Neonatal Research Database from 2010-17 shows that the use of high-flow nasal cannula quadrupled, particularly as initial respiratory support, but was associated with adverse outcomes including BPD.
- Images in neonatal medicineResuscitation of a preterm infant with massive air embolism
- Original researchIndividualised decision making: interpretation of risk for extremely preterm infants—a survey of UK neonatal professionals
Topical and important insight into the current state of play in the UK regarding active management at the limit of viability.
- Original researchVideo-based reflection on neonatal interventions during COVID-19 using eye-tracking glasses: an observational study
Single centre evaluation of the use of eye-tracking glasses during neonatal procedures as an additional tool for outside teaching and video-based reflection. The feasibility and potential benefit during a pandemic is reported.
- Original researchCharacteristics of neonatal herpes simplex virus infections in Germany: results of a 2-year prospective nationwide surveillance study
This two-year prospective nationwide surveillance study of neonatal HSV infections finds few cases in Germany. Most children had few symptoms and good outcomes, but five infants had significant sequelae. Orofacial HSV infection was present in one or more family members for 20/23 babies where data was available, but it is not clear if this was the mode of transmission.