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    4068 results match your criteria American Journal of Perinatology[Journal]

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    Past and Present: A Review of Antenatal Corticosteroids and Recommendations for Late Preterm Birth Steroids.
    Am J Perinatol 2018 May 23. Epub 2018 May 23.
    Department of Obstetrics and Gynecology, Columbia University, New York, New York.
    Since 1972, the beneficial neonatal effects of antenatal corticosteroids (ACSs) have been repeatedly demonstrated in pregnancies at risk of preterm birth before 34 weeks' gestation. While ACS utilization before 34 weeks has been high since the 1990s, knowledge gaps regarding the risks and benefits of ACS continue to exist. Recent evidence has been published regarding the benefit of ACS in the late preterm period. Read More

    Skin Punctures in Preterm Infants in the First 2 Weeks of Life.
    Am J Perinatol 2018 May 23. Epub 2018 May 23.
    Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
    Objective:  The objective of this study was to investigate frequency and trends of skin punctures in preterm infants.

    Study Design:  A prospective audit of preterm infants less than 35 weeks admitted over a 6-month period to a tertiary neonatal intensive care unit. Each skin puncture performed in the first 2 weeks of life was documented in a specifically designed audit sheet. Read More

    Reducing Alarm Fatigue in Two Neonatal Intensive Care Units through a Quality Improvement Collaboration.
    Am J Perinatol 2018 May 21. Epub 2018 May 21.
    Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut.
    Objective:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO] ≤ 80%) or hyperoxemic (SpO > 95% while on supplemental oxygen).

    Study Design:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders. Read More

    Adding Paracetamol to Ibuprofen for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Double-Blind, Randomized, Placebo-Controlled Pilot Study.
    Am J Perinatol 2018 May 21. Epub 2018 May 21.
    Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Campus, Rappoart Faculty of Medicine, Technion, Haifa, Israel.
    Objective:  The objective of this study was to compare the closure rate of hemodynamically significant patent ductus arteriosus (hsPDA) of intravenous ibuprofen + paracetamol (acetaminophen) versus ibuprofen + placebo, in preterm infants of 24 to 31 weeks postmenstrual age.

    Study Design:  This is a single-center, double-blind, randomized controlled pilot study. Infants were assigned for treatment with either intravenous ibuprofen + paracetamol ( = 12) or ibuprofen + placebo ( = 12). Read More

    The Efficacy of Neutral Position Beractant Administration in Neonates.
    Am J Perinatol 2018 May 7. Epub 2018 May 7.
    Neonatal Intensive Care Medicine, Parkview Women's and Children's Hospital, Fort Wayne, Indiana.
    Objective:  The objective was to compare the efficacy and adverse effects of beractant administration in neonates via a single aliquot in a neutral position versus positioning the neonates on their left then right side and two aliquots administration.

    Study Design:  This was a retrospective cohort chart review of neonates who were diagnosed with respiratory distress syndrome and received beractant during two 15-month periods between 2013 and 2015 and 2015 and 2016 to compare the change in the fraction of inspired oxygen (FiO) 1 hour after beractant administration.

    Results:  There were no differences in FiO 1 hour after beractant between groups ( = 0. Read More

    Female Physicians in Maternal-Fetal Medicine: A 32-Year Perspective.
    Am J Perinatol 2018 May 7. Epub 2018 May 7.
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, New Mexico.
    Objective:  To examine trends of female physicians either pursuing fellowships or in active practice in maternal-fetal medicine (MFM).

    Methods:  This observational study examined complete sets of MFM fellows and active members of the Society for Maternal-Fetal Medicine (SMFM) between 1985 and 2016. Databases from SMFM, American College of Obstetricians and Gynecologists (ACOG), and Accreditation Council for Graduate Medical Education were used. Read More

    Association between Sonographic Estimated Fetal Weight and the Risk of Cesarean Delivery among Nulliparous Women with Diabetes in Pregnancy.
    Am J Perinatol 2018 May 4. Epub 2018 May 4.
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
    Objective:  The objective of this study was to examine the association between an ultrasound-estimated fetal weight (US-EFW) and mode of delivery among nulliparous diabetic women.

    Study Design:  This is a retrospective cohort study of nulliparous women with medication-requiring gestational or pregestational diabetes who delivered term, singleton gestations following a trial of labor. We determined whether having had an US-EFW within 35 days of delivery was associated with cesarean delivery. Read More

    Nonmedically Indicated Induction of Labor Compared with Expectant Management in Nulliparous Women Aged 35 Years or Older.
    Am J Perinatol 2018 May 3. Epub 2018 May 3.
    Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
    Objective:  This article compares maternal and neonatal outcomes in women aged ≥ 35 years who experienced nonmedically indicated induction of labor (NMII) versus expectant management.

    Study Design:  This was a retrospective cohort study of nulliparas aged ≥ 35 years with a singleton and cephalic presentation who delivered at term. Outcomes were compared between women who underwent NMII at 37, 38, 39, and 40 weeks' gestation and those with expectant management that week. Read More

    Factors Associated with Stillbirth Autopsy in Georgia and Utah, 2010-2014: The Importance of Delivery Location.
    Am J Perinatol 2018 May 3. Epub 2018 May 3.
    University of Utah Health Sciences Center, Salt Lake City, Utah.
    Objective:  This article determines whether demographic, delivery, and medical factors are associated with stillbirth autopsy performance in Georgia and Utah.

    Study Design:  This study used fetal death certificates from 2010 to 2014 to determine which factors are associated with stillbirth autopsy performance in Georgia and Utah. Analyses were conducted using logistic regression with a predicted margins approach. Read More

    Metoclopramide and Diphenhydramine: A Randomized Controlled Trial of a Treatment for Headache in Pregnancy when Acetaminophen Alone Is Ineffective (MAD Headache Study).
    Am J Perinatol 2018 May 3. Epub 2018 May 3.
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, Missouri.
    Objective:  We investigated whether metoclopramide administered with diphenhydramine (MAD) relieves headache in pregnant women when acetaminophen alone is ineffective, using codeine for comparison.

    Study Design:  Normotensive pregnant women in the second or third trimester were randomized to MAD intravenously (10 mg and 25 mg, respectively) or codeine orally (30 mg) for headache after 650 to 1,000 mg of acetaminophen failed to relieve their headaches. Headache severity (pain score 0-10) was noted at intervals over 24 hours. Read More

    Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States.
    Am J Perinatol 2018 May 3. Epub 2018 May 3.
    Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
    Objective:  The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.

    Study Design:  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. Read More

    Application of Stem Cells to Infertility Treatment with Emphasis on Mesenchymal Stem Cells and Ovarian Stem Cells.
    Am J Perinatol 2018 May 1. Epub 2018 May 1.
    Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
    Stem cells are a population of undifferentiated cells that originated from embryonic and fetal stages of development. Stem cells possess the potency to produce cells that ultimately form different tissues and organs. They are considered as potential alternative novel therapeutic agents for patients suffering from infertility due to their unlimited source and high differentiation potency. Read More

    Lung Ultrasound Findings in Congenital Pulmonary Airway Malformation.
    Am J Perinatol 2018 May 1. Epub 2018 May 1.
    Department of Pediatrics and Neonatal Critical Care, Paris-Sud University Hospitals-APHP, A. Béclère Hospital, Paris, France.
    Background And Objective:  Congenital pulmonary airway malformation (CPAM) is a group of rare congenital malformations of the lung and airways. Lung ultrasound (LU) is increasingly used to diagnose neonatal respiratory diseases since it is quick, easy to learn, and radiation-free, but no formal data exist for congenital lung malformations. We aimed to describe LU findings in CPAM neonates needing neonatal intensive care unit (NICU) admission and to compare them with a control population. Read More

    Effect of Gestational and Lactational Exposure to DEHP, DINP, and DEP on Intestinal Morphology, Disaccharidases, and Alkaline Phosphatase in Rats during Postnatal Development.
    Am J Perinatol 2018 May 1. Epub 2018 May 1.
    Department of Biology, Faculty of NLS, University of Mascara, Mascara, Algeria.
    Introduction:  The diesters of 1,2-benzenedicarboxylic acid (phthalic acid), commonly known as phthalates, are used primarily as plasticizers of polyvinyl chloride and as additives in consumer and personal care products.

    Objective:  This study was designed to evaluate the impact of in utero and postnatal exposure to diisononyl phthalate (DINP), diethylhexyl phthalate (DEHP), and diethyl phthalate (DEP) on gut maturation in a Wistar rat model.

    Materials And Methods:  Pregnant females were gavaged from day 8 of gestation through postnatal day (pd) 30 with 0 (vehicle control), DEHP (380 mg/kg/d), DINP (380 mg/kg/d), or DEP (800 mg/kg/d) dissolved in corn oil. Read More

    Antenatal Vitamin D Preserves Placental Vascular and Fetal Growth in Experimental Chorioamnionitis Due to Intra-amniotic Endotoxin Exposure.
    Am J Perinatol 2018 May 1. Epub 2018 May 1.
    Section of Neonatology, The Pediatric Heart Lung Center, University of Colorado Anschutz Medical Center, Aurora, Colorado.
    Background:  Chorioamnionitis (CA) is associated with a high risk for the development of bronchopulmonary dysplasia (BPD) after preterm birth, but mechanisms that increase susceptibility for BPD and strategies to prevent BPD are uncertain. As a model of CA, antenatal intra-amniotic (IA) endotoxin (ETX) exposure alters placental structure, causes fetal growth restriction, increases perinatal mortality, and causes sustained cardiorespiratory abnormalities throughout infancy. Vitamin D (Vit D) has been shown to have both anti-inflammatory and proangiogenic properties. Read More

    Development of a NeuroNICU with a Broader Focus on All Newborns at Risk of Brain Injury: The First 2 Years.
    Am J Perinatol 2018 Apr 27. Epub 2018 Apr 27.
    Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
    Objective:  Many critically ill neonates have an existing brain injury or are at risk of neurologic injury. We developed a "NeuroNICU" (neurologic neonatal intensive care unit) to better provide neurologically focused intensive care.

    Study Design:  Demographic and clinical variables, services delivered, and patient outcomes were recorded in a prospective database for all neonates admitted to the NeuroNICU between April 23, 2013, and June 25, 2015. Read More

    Acute Post-Tracheostomy Clinical Decompensations in Infants-Are There Predictive Markers?
    Am J Perinatol 2018 Apr 27. Epub 2018 Apr 27.
    Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Children's Mercy-Kansas City, Missouri.
    Objective:  To report on the population of infants receiving a tracheostomy, identify acute post-tracheostomy clinical decompensations, and seek predictive markers associated with acute complications following the placement of a tracheostomy.

    Study Design:  Retrospective deidentified clinical data was provided by the Infant Pulmonary Data Repository at Children's Mercy Hospital, Kansas City. Data from infants undergoing tracheostomy from January 1, 2008 through September 30, 2016 were divided into one of two study groups based on clinical correlations: (1) no acute decompensations within 72 hours post-tracheostomy or (2) acute clinical decompensation defined as sustained escalation of respiratory care within the 72 hours following tracheostomy. Read More

    Neonatal Morbidities among Moderately Preterm Infants with and without Exposure to Antenatal Corticosteroids.
    Am J Perinatol 2018 Apr 27. Epub 2018 Apr 27.
    Department of Pediatrics, Children's Hospital of Michigan and Hutzel Women's Hospital, Detroit, Michigan.
    Objective:  We aimed to compare the rates of "surfactant treated respiratory disease" and other neonatal morbidities among moderately preterm (MPT) infants exposed to no, partial, or a complete course of antenatal corticosteroids (ANS).

    Study Design:  This observational cohort study evaluated MPT infants (29-33 weeks' gestational age), born between January 2012 and November 2013 and enrolled in the "MPT Registry" of the National Institute of Child Health and Human Development Neonatal Research Network.

    Results:  Data were available for 5,886 infants, including 676 with no exposure, 1225 with partial, and 3,985 with a complete course of ANS. Read More

    Neonatal Outcomes Based on Duration of Exposure to Antenatal Corticosteroids in Indicated Preterm Deliveries.
    Am J Perinatol 2018 Apr 27. Epub 2018 Apr 27.
    Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
    Objective:  To evaluate how duration of exposure to antenatal corticosteroids (ACSs) prior to delivery affects neonatal outcomes in indicated preterm deliveries.

    Study Design:  This is a retrospective cohort of all indicated singleton preterm deliveries (23-34 weeks) in a single tertiary center from 2011 to 2014 comparing those who received ACS 2 to 7 days versus >7 days prior to delivery. The primary neonatal outcome was a composite of arterial cord pH < 7 or base excess ≤ 12, 5-minute Apgar ≤ 3, cardiopulmonary resuscitation, culture-proven neonatal sepsis, intraventricular hemorrhage grade III/IV, necrotizing enterocolitis, and neonatal death. Read More

    PROLONG Clinical Study Protocol: Hydroxyprogesterone Caproate to Reduce Recurrent Preterm Birth.
    Am J Perinatol 2018 Apr 27. Epub 2018 Apr 27.
    Department of Research and Development, AMAG Pharmaceuticals, Inc., Waltham, Massachusetts.
    The objective of this commentary is to describe the background, rationale, and methods of the PROLONG (Progestin's Role in Optimizing Neonatal Gestation) trial, which is a multicenter, multinational, placebo-controlled, randomized clinical trial (RCT) designed to assess the safety and efficacy of Makena (hydroxyprogesterone caproate injection, 250 mg/mL) in reducing the risk of preterm birth (PTB) and neonatal morbidity/mortality in women pregnant with a singleton gestation who had a previous singleton spontaneous PTB. The total sample size of the RCT will include 1,707 women. The trial has two coprimary outcomes: PTB less than 35 weeks and a composite neonatal morbidity and mortality index. Read More

    Duration of Spontaneous Active Labor and Perinatal Outcomes Using Contemporary Labor Curves.
    Am J Perinatol 2018 Apr 25. Epub 2018 Apr 25.
    Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, Washington.
    Objective:  Evaluate the association between spontaneous active labor duration utilizing contemporary labor curves and risk of adverse outcomes.

    Materials And Methods:  This is a retrospective cohort study from January 2012 to January 2015. Subjects were nulliparous, 18 to 44 years, with a cephalic, singleton ≥37 weeks in spontaneous labor. Read More

    Compliance on Mandatory Data Reporting in Registered Obstetrics Trials.
    Am J Perinatol 2018 Apr 25. Epub 2018 Apr 25.
    Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma.
    Background:  The Food and Drug Administration's (FDA's) Amendments Act established a legal mandate requiring registration of certain drug, device, and biologics trials in ClinicalTrials.gov prior to patient enrollment. One provision of the act requires investigators to report trial results in ClinicalTrials. Read More

    Capacities and Competences for Drug Evaluation in European Neonatal Intensive Care Units: A Survey and Key Issues for Improvement.
    Am J Perinatol 2018 May 25;35(6):589-598. Epub 2018 Apr 25.
    Department of Paediatric Clinical Pharmacology and Pharmacogenetics, Hospital Robert Debré, Assistance Publique-Hopitaux de Paris, Paris, France.
    Background:  Multicenter neonatal clinical trials aim to provide evidence-based drug evaluation, but recruiting neonates requires collaboration, standard procedures, and trained neonatologists.

    Methods:  A questionnaire based on a previous Delphi study was sent to European neonatal intensive care units (NICUs) to collect their research experience and identify areas for improvement.

    Results: Of 247 NICUs,79 (32%) responded: 69 were level III units and 10 were level II units. Read More

    Changes in the Messenger RNA Expression of Toll-Like Receptors 2 and 4 in Healthy Infants According to Age.
    Am J Perinatol 2018 May 25;35(6):583-588. Epub 2018 Apr 25.
    Dipartimento delle Scienze di Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Scuola di Medicina, Turin, Italy.
    Background:  Toll-like receptors (TLRs) are potentially useful indicators of several pediatric disease states. Here, we explore the mechanisms by which inflammation is regulated by interactions between microbiota and the host. Little data are available regarding the expression of TLRs in postnatal healthy infants. Read More

    The Mother-Child Relationship during the First Months of Life: Preliminary Considerations in Preterm as Compared with Term Mother-Infant Dyads.
    Am J Perinatol 2018 May 25;35(6):578-582. Epub 2018 Apr 25.
    Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
    Introduction:  From the prognostic perspective, the quality of the mother-child relationship during the first months of life has been variously associated with different factors such as the child's psychomotor/cognitive development and emotional-behavioral disorders.

    Methods:  The main aim of this study was to describe, at term age and 3 months of corrected age, the features and the prevalent patterns of the mother-child relationship in a group of 20 mother-preterm infant dyads and to compare them with those of a group of 20 mother-term infant dyads.

    Results:  A relatively high rate of inadequate dyadic synchrony was found in our sample of preterms at 40 weeks of gestational age (half of the sample analyzed). Read More

    New Diagnostic Possibilities for Neonatal Sepsis.
    Am J Perinatol 2018 May 25;35(6):575-577. Epub 2018 Apr 25.
    Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico "San Matteo," Pavia, Italy.
    Progress in neonatal care has decrease morbidity and mortality due to neonatal sepsis (NS). Although diagnosis of sepsis continues to rely on blood culture, this method is too slow and limited by false-negative results. There are numerous sepsis biomarkers that have been evaluated for the early diagnosis of NS, but, to date, there is no single ideal biomarker, though novel biomarkers are becoming more sophisticated and specific in their clinical applications. Read More

    Novel Approaches to the Study of Neonatal Infections.
    Am J Perinatol 2018 May 25;35(6):570-574. Epub 2018 Apr 25.
    Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
    The pathogenesis of neonatal infection is incompletely understood. Neonatal immune immaturity and the microbial factors of virulence only partially explain the interindividual differences in the protective responses to the most common neonatal pathogens. Stratification of infants into high- and low-risk groups through epidemiological studies has been invaluable in designing preventive strategies and reducing the burden of neonatal infection. Read More

    Mesenchymal Stromal Cell Therapy for Respiratory Complications of Extreme Prematurity.
    Am J Perinatol 2018 May 25;35(6):566-569. Epub 2018 Apr 25.
    Sinclair Centre for Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
    Bronchopulmonary dysplasia remains the main complication of extreme preterm birth. Research over the past 10 years suggests the potential for stem cell-based therapies to prevent and/or restore organ damage in extreme preterm infants. Mesenchymal stromal cells, in particular, have advanced as the forerunner among various cell therapies based on very promising preclinical studies in animal models of neonatal lung injury. Read More

    Role of Lactoferrin in Neonates and Infants: An Update.
    Am J Perinatol 2018 May 25;35(6):561-565. Epub 2018 Apr 25.
    Department of Women's and Children's Health, ASL Bari, Bari, Italy.
    Lactoferrin is one of the most represented and important bioactive proteins in human and mammal milk. In humans, lactoferrin is responsible for several actions targeting anti-infective, immunological, and gastrointestinal domains in neonates, infants, and young children. Evidence-based data vouch for the ability of supplemented lactoferrin to prevent sepsis and necrotizing enterocolitis in preterm infants and to reduce the burden of morbidity related to gastrointestinal and respiratory pathogens in young children. Read More

    Surgery for Congenital Heart Disease: Improvements in Outcomes.
    Am J Perinatol 2018 May 25;35(6):557-560. Epub 2018 Apr 25.
    Division of Cardiac Surgery, Children's National Heart Institute and the George Washington University School of Medicine, Washington, District of Columbia.
    Cardiac surgery for congenital heart disease has changed dramatically since the first surgery in 1938. During the early era, children underwent surgery at older ages often with palliative procedures before their corrective operation. Not surprisingly, in the early era, there was considerably higher early and late mortality, including the additive risks of having more than one procedure and a long period of living with an unphysiological palliated circulation. Read More

    Respiratory Support in Bronchiolitis: Trial Evidence.
    Am J Perinatol 2018 May 25;35(6):553-556. Epub 2018 Apr 25.
    Department of Paediatric Respiratory Medicine, MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
    Acute viral lower respiratory tract infection is frequently associated with hypoxemia and respiratory distress, sometimes progressing to hypercarbia and respiratory failure. In recent years, trials have assessed the effects of oxygen supplementation and respiratory support with high-flow oxygen therapy. An oxygen saturation target of 90% is as safe and clinically effective as 94% in infants with bronchiolitis. Read More

    Predicting the Future: Delivery Room Planning of Congenital Heart Disease Diagnosed by Fetal Echocardiography.
    Am J Perinatol 2018 May 25;35(6):549-552. Epub 2018 Apr 25.
    Division of Cardiology, Fetal Heart Program, Children's National Health System, Washington, District of Columbia.
    Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan. Read More

    New Ventilator Strategies: High-Frequency Oscillatory Ventilation Combined with Volume Guarantee.
    Am J Perinatol 2018 May 25;35(6):545-548. Epub 2018 Apr 25.
    Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro Majadahonda, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain.
    High-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV-volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations. Read More

    Respiratory Syncytial Virus in Otherwise Healthy Prematurely Born Infants: A Forgotten Majority.
    Am J Perinatol 2018 May 25;35(6):541-544. Epub 2018 Apr 25.
    Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
    Healthy, premature infants ≤35 weeks' gestational age (wGA) are universally recognized to be at an increased risk of perinatal morbidity and mortality. Serious respiratory syncytial virus (RSV) lower respiratory tract infection imposes an additional burden of illness on these infants following hospitalization. Incurred morbidities relative to term infants include longer lengths of hospital stay, admission to intensive care, and need for oxygen and mechanical ventilation, all of which are associated with increased hospital costs. Read More

    Bronchopulmonary Dysplasia: Can We Agree on a Definition?
    Am J Perinatol 2018 May 25;35(6):537-540. Epub 2018 Apr 25.
    Division of Neonatology, Department of Pediatrics, University of Miami Medical School, Miami, Florida.
    The advances in obstetric and neonatal care over the last half century have resulted in changes in pathophysiology and clinical presentation of bronchopulmonary dysplasia (BPD). In contrast to the original description of BPD by Northway et al as a severe lung injury in relatively mature preterm infants, the most common form of BPD currently is characterized by chronic respiratory insufficiency in extremely preterm infants. This evolution in the presentation of BPD, along with changes in respiratory support strategies such as increased use of nasal cannula oxygen, has presented a unique challenge to find a definition that describes the severity of lung damage and predict the long-term respiratory outcomes with some accuracy. Read More

    Respiratory Instability and Hypoxemia Episodes in Preterm Infants.
    Am J Perinatol 2018 May 25;35(6):534-536. Epub 2018 Apr 25.
    Division of Neonatology, Department of Pediatrics, University of Miami Medical School, Miami, Florida.
    Oxygenation instability is a very common problem in the premature infant that manifests as intermittent hypoxemia episodes (HEs). These are particularly frequent in premature infants who are on mechanical ventilation beyond the first weeks after birth. However, they can also occur in spontaneously breathing infants. Read More

    Is Less Invasive Surfactant Administration Necessary or "Only" Helpful or Just a Fashion?
    Am J Perinatol 2018 May 25;35(6):530-533. Epub 2018 Apr 25.
    Global Clinical Development-Neonatology, Chiesi Farmaceutici S.p.A, Parma, Italy.
    In the 1990s, the most relevant pillars in the treatment of neonatal respiratory distress syndrome (RDS) have been improvements in ventilation strategies, the introduction of exogenous surfactant replacement therapy, and the use of antenatal steroids. Lately, in addition to the standard INSURE (INtubation-SURfactant administration-Extubation) method to administer surfactant, a new technique has been gaining increasing popularity. It is the so-called less invasive surfactant administration (LISA) method, which has shown promising results in preventing bronchopulmonary dysplasia development and in reducing mortality in preterm neonates. Read More

    The Role of Lung Ultrasound in Viral Lower Respiratory Tract Infections.
    Am J Perinatol 2018 May 25;35(6):527-529. Epub 2018 Apr 25.
    Department of Pediatrics and Neonatal Critical Care, "A.Béclère" Medical Centre, South Paris University Hospitals, Assistance Publique-Hôpitaux de Paris, Paris, France.
    Despite being a bedside technique under rapid development and diffusion, lung ultrasound has not been often used in the management of viral low respiratory tract infections, although these infections represent a significant burden of care in neonatology and pediatrics. The aim of this article is to review the lung ultrasound findings and the evidence-based data available on this topic. Guidance on bedside imaging interpretation and future research direction are also discussed in this article. Read More

    Normal Cervical Effacement in Term Labor.
    Am J Perinatol 2018 Apr 24. Epub 2018 Apr 24.
    Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
    Objective:  To estimate the natural history of cervical effacement in labor.

    Study Design:  This is a retrospective cohort study of term, vertex, singletons who reached 10 cm of cervical dilation from 2010 to 2014. Interval-censored regression was used to estimate the median number of hours between changes in effacement (measured in centimeters of the residual cervix) and to estimate the median effacement at a given cervical dilation. Read More

    Reevaluation of Protein Intake for Preterm Infants.
    Am J Perinatol 2018 Apr 24. Epub 2018 Apr 24.
    Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
    Growth failure caused by undernutrition is considered one of the major causes for psychomotor delay in extremely preterm infants, and the concept for "aggressive nutritional approach" is widely accepted worldwide. Based on this, postnatal early catch-up growth due to sufficient supply of nutrients including sufficient amounts of amino acids is believed to be essential for a better outcome; however, there is no definitive evidence of aggressive nutrition on better outcomes in mortality, growth, and neurodevelopment. On the contrary, epidemiological evidence suggests that low birth weight and a rapid catch-up growth after birth are major risk factors for insulin resistance and diabetes in later life; higher protein intake during postnatal period relates to higher cardiovascular risk in later life. Read More

    Peripartum Morbidity after Cesarean Delivery for Arrest of Dilation at 4 to 5 cm Compared with 6 to 10 cm.
    Am J Perinatol 2018 Apr 24. Epub 2018 Apr 24.
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
    Objective:  Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm.

    Study Design:  We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation. Read More

    Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants.
    Am J Perinatol 2018 Apr 24. Epub 2018 Apr 24.
    Division of Neonatology, Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
    Objective:  To evaluate the impact of serum insulin-like growth factor-1 (IGF-1) levels on cardiac function in small for gestational age (SGA) infants.

    Study Design:  This is a prospective, observational study. Serum IGF-1 levels at birth and echocardiography measurements at 1 week of age were compared between SGA and appropriate for gestational age (AGA) infants. Read More

    Clinician Perceptions of the NICU Infant Experience: Is the NICU Hospitalization Traumatic?
    Am J Perinatol 2018 Apr 18. Epub 2018 Apr 18.
    Connecticut Children's Medical Center, Hartford, Connecticut.
    Objective:  Infants cared for in a newborn intensive care unit (NICU) experience pain, parental separation, and stress that may approach toxic levels, thus are potentially traumatic. Lack of accepted clinical terminology to describe the infant experience may result in under appreciation of NICU hospitalization on infant and family outcomes. This study explored NICU clinician perceptions of the infant experience and how the terms trauma/traumatic would impact their clinical roles and practices. Read More

    Couples Facing the Birth of a Newborn with a Congenital Anomaly: PTSD Symptoms in the First Year.
    Am J Perinatol 2018 Apr 18. Epub 2018 Apr 18.
    Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
    Objective:  The objective of this study was to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parental couples of newborn requiring early surgery at 6 and 12 months after birth.

    Study Design:  A longitudinal study was set up from January 2014 to June 2015. As a measure of PTSD, we used the Italian version of the Impact of Event Scale-Revised (IES-R). Read More

    Optimal Timing of Delivery in Women with Higher Order Cesareans: A Cohort Study.
    Am J Perinatol 2018 Apr 16. Epub 2018 Apr 16.
    Maternal Fetal Medicine Associates, New York, New York.
    Objective:  To evaluate whether a planned early term delivery or a planned 39-week delivery is associated with differences in perinatal outcomes in women undergoing a higher order cesarean (HOC).

    Study Design:  This cohort study included women with singleton gestations with a history of three or more prior cesareans who delivered at one of two urban tertiary care hospitals. One center routinely delivered HOC at 39 weeks' gestation and the other at 37 weeks. Read More

    The Impact of Hypoxemia on the Development of Retinopathy of Prematurity in Infants Less Than 29 Weeks of Gestation.
    Am J Perinatol 2018 Apr 13. Epub 2018 Apr 13.
    Section of Neonatology, Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
    Objective:  To study the impact of cumulative exposure to hypoxemia on the development of retinopathy of prematurity (ROP) in preterm infants less than 29 weeks' gestation.

    Study Design:  This is a retrospective analysis of the effect of cumulative exposure to hypoxemia during the first 10 weeks of life in preterm infants <29 weeks' gestation. Cumulative time spent at various levels of oxygen saturation was calculated by converting the daily percentage of time to minutes per day. Read More

    Preterm Pulmonary Hemorrhage Is Associated with Multiple Births but Not with Intracytoplasmic Sperm Injection: A Cohort Study on Medical Records.
    Am J Perinatol 2018 Apr 10. Epub 2018 Apr 10.
    Division of Neonatology, Department of Pediatric and Adolescent Medicine, Uniklinik RWTH Aachen, Aachen, Germany.
    Objective:  Pulmonary hemorrhage (PH) is a severe complication in preterm neonates. This study aims to identify risk factors and comorbidities of PH.

    Study Design:  A single-center cohort study on medical records including all preterm neonates of <30 weeks' gestational age was conducted in the neonatal intensive care unit of Universitätsklinikum Aachen, Germany. Read More

    Are Anti-β2 Glycoprotein 1 Antibodies Associated with Placenta-Mediated Pregnancy Complications? A Nested Case-Control Study.
    Am J Perinatol 2018 Apr 10. Epub 2018 Apr 10.
    Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
    Background:  While anti-β2 glycoprotein 1 (anti-β2GP1) antibody positivity is included in the diagnostic criteria for antiphospholipid syndrome (APS), the association between anti-β2GP1 and the obstetrical complications of APS has been inconsistently reported and remains unclear.

    Objective:  We completed a case-control study nested within the Canadian Ottawa and Kingston (OaK) Birth Cohort to evaluate the association between anti-β2GP1 antibody positivity and placenta-mediated pregnancy complications.

    Study Design:  Five hundred cases were randomly selected among pregnant women who experienced any of the following independently adjudicated placenta-mediated pregnancy complications: preeclampsia, placental abruption, late pregnancy loss (≥ 12 weeks' gestation), and birth of a small-for-gestational age (SGA) infant < 10th percentile. Read More

    Acute Hypoxia Induces Enkephalin Production and Release in an Adrenergic Cell Line Model of Neonatal Chromaffin Cell Responses to Hypoxic Stress.
    Am J Perinatol 2018 Apr 10. Epub 2018 Apr 10.
    Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, New York.
    Objective:  Prior to maturation of the human sympathetic nervous system, the neonatal adrenal medulla senses and responds to hypoxia. In addition to catecholamine release, the adrenal medulla synthesizes and stores opioid peptides, notably enkephalin (ENK). However, it is not known whether acute hypoxia evokes adrenal ENK production and release, as seen in the central nervous system (CNS). Read More

    Might Bilirubin Serve as a Natural Antioxidant in Response to Neonatal Encephalopathy?
    Am J Perinatol 2018 Apr 10. Epub 2018 Apr 10.
    Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel.
    Background:  Neonatal asphyxia is often associated with hepatic injury. We hypothesized that this might lead to increased bilirubin concentrations.

    Study Design:  Term neonates admitted between January 2015 and April 2017 who remained hospitalized for ≥ 4 days and who had serial serum bilirubin concentrations recorded were divided into those with neonatal encephalopathy (NE) and controls. Read More

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