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Breastfeeding and it's tolerance are the positive indicators for preterm babies. Placing the preterm infant in the right lateral or prone position after feed had lesser gastric residual volume compared to placing them in left lateral or supine positions. The post-feed position is a vital element in enhancing feeding tolerance, mechanical functions of the gastrointestinal tract and the overall development of preterm infants. |
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Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants? Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants. Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties. |
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· A high prepregnancy body mass index (pre-BMI) is associated with large for gestational age (LGA) and macrosomia, whereas a low pre-BMI is associated with small for gestational age (SGA) and low birth weight (LBW). · The identification of the role of the hypothalamus-pituitary-adrenal axis in the effect of pre-BMI and maternal gestational weight gain on birth weight could reduce the frequency of LGA, macrosomia, SGA, or LBW through maternal diet optimization. |
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· Use conventional and amplitude-integrated electroencephalography to confirm clinical seizures and screen high-risk newborns. · Select an explicit clear elective event to be treated with less toxic and more effective antiepileptics. |
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Question: What is the association between cord blood cortisol and maternal weight, birth weight, and cord blood lipid profile? Finding: Cord blood cortisol levels did not influence the relationship between maternal weight changes or birth weight. Maternal weight changes, birth weight, and cortisol levels altered the cord blood lipid profile. Meaning: Our findings may aid United Nations Sustainable Development Goal 3 (Good Health and Well-Being) achievement by 2030. |
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∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes. ∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%. ∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants. ∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life. ∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring. |
In the rapidly changing environmental situation during the coronavirus disease 2019 outbreak, neonatal centers have developed telemedicine systems with extended coverage for neonatal monitoring and high-risk follow-up programs including neonatal hyperbilirubinemia. At this point, electronic health technology and noncontact medical system increase the effectiveness of rather than replacing the face-to-face visit and the opinions of experienced neonatologists. |
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Question: What is prevalence of bacterial pathogens causing sepsis and their antimicrobial susceptibility over 20 years? Finding: Coagulase-negative remains most common causative organism. The most common gram-negative organism was Klebsiella pneumonia. The susceptibility of staphylococcus aureus and K. pneumonia showed increased susceptability to oxacillin, cefotaxime and amikacin, gentamicin, respectively. Meaning: Answers to the question asked is important in choosing antimicrobials and to monitor emergence of multidrug-resistant organisms. |
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The risk factors and pathogenesis of developmental dysplasia of the hip (DDH) are unclear. Moreover, no universal screening method can entirely eliminate the risk of DDH. However, its incidence is significant and its early detection is critical for improving patient prognosis. Although the ideal evaluation time and risk factors, especially for premature infants, are unclear, the necessity for DDH screening programs for term and preterm infants is emerging. |
Question: How can the management of neonatal jaundice (NJ) be enhanced through telemedicine? Finding: Teleconsultations, drive-through testing, and the use of an application to assess neonatal jaundice at home are being successfully used, but they must be further researched before being implemented on a larger scale. Meaning: Recent technology allows for the treatment of NJ at home with an application that helps reduce hospital burden. |
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Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)? Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects. Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique. |
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· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations. · Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age. · Platelet counts are positively correlated with gestational age at birth and postnatal age. · Thrombocytosis is more common in preterm than in term infants. · Thrombocytosis in newborns is reactive and resolves spontaneously without complications. |
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Question: Is fetal nuchal cord a risk factor for autism spectrum disorder (ASD)? Finding: Five articles (1 cohort, 4 case-control; total 3,088 children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (odds ratio, 1.11; 95% confidence interval, 0.66–1.57). There was homogeneity among studies that reported a risk of ASD (I2=0.0). Meaning: Fetal nuchal cord is not a risk factor for ASD. |
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There have been global tri-phasic epidemic periods of retinopathy of prematurity (ROP). In recent years, its incidence has reportedly been 10%–40% depending on country and study population. Current treatment strategies for ROP include laser photocoagulation, surgical treatment, and anti-vascular endothelial growth factor treatment, the role of which has drawn attention in recent years. |
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∙ The growth of preterm infants is a main focus of neonatology. ∙ Preterm infants in Korea, especially those with a very low birth weight, achieve retarded growth. ∙ Careful growth monitoring and early intervention will contribute to better development outcomes and quality of life for preterm infants and improve public health. |
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Question: How can we further improve the neuroprotective effects of hypothermia in newborns with hypoxic-ischemic (HI) brain injury? Finding: Combination carnosine and hypothermia therapy effectively reduced brain damage in neonatal rats. The in situ zymography, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunofluorescence study results showed that neuroprotective effects were achieved with combination therapy only. Meaning: Carnosine and hypothermia have synergistic neuroprotective effects against brain damage following HI injury |
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· Very low birth weight infants remain at high risk of developing neurodevelopmental impairments in early childhood. · It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants. · All possible strategies should be employed to maintain good compliance after neonatal intensive care unit discharge. |
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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. |
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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. |
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· 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. |
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• 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. |
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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. |
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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. |
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· 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. |
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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. |
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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. |
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