Question: Is there any risk of vertical transmission of coronavirus disease 2019 (COVID-19), and what is its neonatal profile? Finding: Biological samples for vertical transmission were negative in all deliveries; however, 2 neonates tested positive for nasopharyngeal COVID-19 reverse transcription-polymerase chain reaction. No significant neonatal morbidity was observed. Meaning: COVID-19 does not increase adverse neonatal outcomes and shows a negligible risk of vertical transmission; however, horizontal transmission cannot be underestimated. |
Question: What is the most important factor that increases mortality in infants with hypoxic-ischemic encephalopathy (HIE) who receive selective head cooling? Finding: All cases of neonatal mortality were severe HIE (stage 3), and a severely abnormal amplitude-integrated electroencephalography and mortality were increased with the need for advanced neonatal resuscitation upon delivery. Meaning: Advanced neonatal resuscitation affects HIE outcomes, and medical personnel should be prepared to provide the best intervention. |
· Mortality is decreased significantly in meta-analysis of studies in different regimen of fluconazole prophylaxis. · Significant decrease was seen in incidence of invasive candidiasis-associated mortality in extremely low birth weight infants in same schedules of prophylaxis. · More studies required to relief the concerns. |
Determining the therapeutic hypothermia and predict long-term prognosis quickly and accurately in infants with moderate to severe hypoxic-ischemic encephalopathy requires a thorough history taking, physical examination, amplitude-integrated electroencephalography, brain magnetic resonance imaging with diffusion-weighted imaging and proton magnetic resonance spectroscopy, heart evaluation (cardiac enzymes, electrocardiography, and echocardiography), and several other biomarkers. |
• Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) was detected in approximately 3% of neonates of mothers with coronavirus disease 2019 (COVID-19). • Neonatal COVID-19 is relatively benign with 16%–22.4% cases asymptomatic. • Neonates with pre-existing medical conditions and preterm infants are at a higher risk of severe COVID-19. • Requirement for neonatal mechanical ventilation is 20%–22.4% (vs. 4% in children) • Low birth weight (13.9%) and premature birth (22.2%) affect neonates of mothers with COVID-19. |
Question: The use of renin-angiotensin system (RAS) blockers during pregnancy causes lethal neonatal complications. Finding: A neonate, whose mother took a RAS blocker during pregnancy, was diagnosed with renal tubular dysgenesis. He presented with respiratory failure, severe refractory hypotension, and anuria requiring continuous dialysis. Meaning: Physicians should consider any degree of RAS fetopathy in a newborn born to a hypertensive mother who had use of RAS blockers during her pregnancy. |
Question: Can CD11b detect sepsis in full-term infants with suspected sepsis? Finding: The percentage of neutrophils expressing CD11b was significantly upregulated in the sepsis and suspected sepsis groups versus the control group. Meaning: CD11b is a sensitive marker for sepsis and suspected sepsis in full-term neonates and it may be added to sepsis markers. This information would allow the neonatologist to confidently discontinue antibiotic use as long as the neonate is clinically stable. |
Question: Can CXC chemokine receptor 2 (CXCR2) antagonist preserve alveolarization by attenuating the inflammation induced by systemic lipopolysaccharide (LPS) administration in a rat model of bronchopulmonary dysplasia (BPD)? Finding: CXCR2 antagonist significantly decreased neutrophil counts in bronchoalveolar lavage fluid and peripheral blood induced by systemic LPS administration and restored alveolarization in newborn rats. Meaning: CXCR2 antagonist protected the lungs from the inflammation in a rat model of BPD. |
· Neonatal sepsis is a global problem and significant cause of neonatal mortality and adverse short- and long-term outcomes. · Due to severe limitations diagnosing neonatal sepsis, there is a critical need to identify reliable specific biomarkers for early detection. · nCD11b might be an accurate and rapid biomarker for the early detection of neonatal sepsis. |
Question: What are health providers’ knowledge and perceptions of Kangaroo mother care (KMC)? Finding: Health providers’ knowledge of KMC was sufficient; however, some of their perceptions about it could create barriers to the successful implementation of hospital KMC programs. Meaning: Health providers’ perceptions about KMC should be considered to ensure successful KMC implementation. Locally designed on-site training programs could overcome the challenges. |
Question: To what extent does risk-based Group B Streptococcus (GBS) screening influence management recommendations by the early-onset sepsis (EOS) calculator? Finding: In 97% of the newborn infants, the EOS calculator recommendation remained unchanged after the GBS status at birth was updated to the definitive GBS status. Meaning: Risk-based GBS screening results are compatible with EOS calculator recommendations. |
Questions: This study aimed to describe the survival of premature infants with critical congenital heart disease (CHD) and to identify the risk factors including the new modified version of the Risk Adjustment for Congenital Heart Surgery (M-RACHS) associated with mortality. Finding: For premature infants with critical CHD, survival rate was 76.9% and very low birth weight (VLBW), persistent pulmonary hypertension of the newborn (PPHN), bronchopulmonary dysplasia (BPD), and M-RACHS 5 or more were associated with in-hospital mortality. Meaning: VLBW, PPHN and BPD, as well as M-RACHS≥5, were risk factors for mortality among premature infants with critical CHD. |
· Evaluation of the risk factors for early-onset sepsis (EOS) is important to optimal prevention and treatment. · The EOS calculator is still valid as part of the risk-based group B Streptococcus (GBS) screening approach. · The risk factor assessment using the EOS calculator is worth use before the introduction of universal GBS screening. |
The incidence and mortality rates of critical congenital heart disease (CHD) are higher in preterm than in term infants. The risk factors for in-hospital mortality in premature infants with critical CHD are unclear. However, the mortality of preterm infants with critical CHD may be related to CHD complexity as well as gestational age, birth weight, the presence of prematurity-associated comorbidities, and the treatment itself. |
Question: How to manage the newborn born to the coronavirus disease 2019 (COVID-19) pregnant? Finding: Medical staff managed the delivery and neonatal care of a COVID-19 pregnant patient was based on the “Guidelines for COVID-19 response.” Meaning: We desire that our management will help treat for subsequent patients and there should be updated continuously the prevention and control consensus strategies for newborn COVID-19. |
Question: What is the value of ischemia modified albumin (IMA) as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE)? Finding: IMA levels were significantly higher (nearly double elevation) in hypoxic than healthy newborns in the first few hours after birth in the full-term neonates. Meaning: IMA can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity. |
The Korean Neonatal Network (KNN) has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. The survival rate of all VLBWIs was 86% in Korea. The overall prevalence of cerebral palsy was 6.2%–6.6%. Bilateral blindness and hearing loss were reported in 0.2%–0.3%, 0.8%–1.9%, respectively. The KNN has published annual reports and papers for facilitating the improvement of VLBWIs outcome in Korea. |
Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.
Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis... |
Question: Infants born at moderate to late preterm gestations are known to have little problem later on, but is that really true? Finding: At school age, cognitive problem was observed in about a quarter of the children. In addition, more than half of the children was suspected of having attention problems. Meaning: Moderate to late preterm infants are at risk of developing abnormal intelligence and attention problems at early school age, therefore they should not be neglected on longterm follow-up evaluation. |
Question: Which factors can predict BiPAP failure as the initial management approach for moderate to late preterm infants with respiratory distress? Finding: RDS aggravation and increased oxygen and frequency requirements during BiPAP support were associated with BiPAP failure. Meaning: Early changes to invasive ventilator care should be considered for moderate to late preterm infants showing RDS aggravation and increased oxygen and frequency requirements during BiPAP support. |
Question: Does RBC transfusion affect the short-term outcomes of VLBW infants? Finding: The results showed that RBC transfusion was significantly related to the incidence of BPD (OR, 5.42; P<0.001) and NEC (OR, 3.40; P=0.009). Meaning: Careful consideration of the patient’s clinical condition and appropriate guidelines is required before administering RBC transfusions. |
Question: Placental histopathology and its clinical implications in late preterm infants. Finding: Placental vascular anomalies are more, and placental inflammation less common in late preterm infants compared to term. Higher maternal age, magnesium sulfate therapy and hypertension are clinical risk factors associated with late preterm delivery. Meaning: Prevention and aggressive management of hypertension, and conception before 30 years of age might be effective in preventing late preterm births. |
Question: Can nonpharmacological methods be used for neonatal pain management. Finding: Nonpharmacological methods like Sucrose, breastfeeding etc have shown to significantly reduce the pain caused by intramuscular hepatitis B vaccination. Meaning: Nonpharmacological methods are the safe and cheap potential modalities of analgesia which can be used during mild to moderate pain in newborns. |