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Trials 2021 Jun 14;22(1):392. Epub 2021 Jun 14.

Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy.

Background: Non-invasive ventilation (NIV) has been recommended as the best respiratory support for preterm infants with respiratory distress syndrome (RDS). However, the best NIV technique to be used as first intention in RDS management has not yet been established. Nasal intermittent positive pressure ventilation (NIPPV) may be synchronized (SNIPPV) or non-synchronized to the infant's breathing efforts. Read More

JAMA Netw Open 2021 May 3;4(5):e217269. Epub 2021 May 3.

Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Importance: While surfactant therapy for respiratory distress syndrome (RDS) in preterm infants has been evaluated in clinical trials, less is known about how surfactant is used outside such a framework.

Objective: To evaluate registered use, off-label use, and omissions of surfactant treatment by gestational age (GA) and associations with outcomes, mainly among very preterm infants (GA <32 weeks).

Design, Setting, And Participants: This population-based cohort study used registry data for 97 377 infants born in Sweden between 2009 and 2018. Read More

Arch Dis Child Fetal Neonatal Ed 2021 Apr 30. Epub 2021 Apr 30.

Newborn Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia.

Background: Neonatal endotracheal intubation is often associated with physiological instability. The Neonatal Resuscitation Program recommends a time-based limit (30 s) for intubation attempts in the delivery room, but there are limited physiological data to support recommendations in the neonatal intensive care unit (NICU). We aimed to determine the time to desaturation after ceasing spontaneous or assisted breathing in preterm infants undergoing elective endotracheal intubation in the NICU. Read More

Pediatr Pulmonol 2021 Mar 15. Epub 2021 Mar 15.

Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island.

Different types of patient triggered ventilator modes have become the mainstay of ventilation in term and preterm newborn infants. Maintaining spontaneous breathing has allowed for earlier weaning and the additive effects of respiratory efforts combined with pre-set mechanical inflations have reduced mean airway pressures, both of which are important components in trying to avoid lung injury and promote normal lung development. New sophisticated modes of assisted ventilation have been developed during the last decades where the control of ventilator support is turned over to the patient. Read More

Int J Environ Res Public Health 2021 01 12;18(2). Epub 2021 Jan 12.

Second Department of Obstetrics and Gynecology, "Aretaieion Hospital", Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece.

(1) Background: A considerable number of systematic reviews, with substantial heterogeneity regarding their methods and included populations, on the impact of COVID-19 on infected pregnant women and their neonates, has emerged. The aim was to describe the obstetric-perinatal and neonatal outcome of infected pregnant women and their newborns during the COVID-19 pandemic; (2) Methods: Three bibliographical databases were searched (last search: September 10, 2020). Quality assessment was performed using the AMSTAR-2 tool. Read More

Int J Clin Pract 2021 May 27;75(5):e14014. Epub 2021 Jan 27.

MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Aims: The optimal timing of delivery for twin pregnancies remains controversial. This study examined the risks of adverse neonatal outcomes and neonatal deaths according to gestational age at delivery in order to determine the optimal gestational age of delivery for twin pregnancies.

Methods: This is a retrospective study of twin pregnancies delivered between 34 and 40 weeks of gestation from 1995 to 2000 in the United States. Read More

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

Pediatric Pulmonology, Emory University School of Medicine, Atlanta, Georgia, USA

A 7-month-old-term male infant presented with cough, tachypnoea, hypoxaemia and post-tussive emesis. Clinical history was significant for respiratory failure and pulmonary hypertension in the neonatal period requiring assisted ventilation, congenital hypothyroidism, mild hypotonia, recurrent respiratory infections, hypoxaemia requiring supplemental oxygen and nasogastric tube feeds. Physical examination showed tachypnoea, coarse bilateral breath sounds and mild hypotonia. Read More

Pediatrics 2021 01;147(1)

University of Texas Southwestern Medical Center, Dallas, Texas.

Context: The International Liaison Committee on Resuscitation prioritized review of sustained inflation (SI) of the lung at birth.

Objective: To complete a systematic review and meta-analysis comparing strategies using 1 or more SI ≥1 second with intermittent inflations <1 second for newborns at birth.

Data Sources: Medline, Embase, and Evidence-Based Medicine Reviews were searched from January 1, 1946, to July 20, 2020. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2020 Dec;22(12):1267-1272

Department of Neonatology, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics Chongqing 400014, China.

Objective: To investigate the epidemiology, clinical features, treatment, and prognostic factors of neonatal acute respiratory distress syndrome (NARDS) through a retrospective study of NARDS based on the Montreux definition.

Methods: A retrospective analysis was performed on the medical records of neonates who were hospitalized from January 2017 and July 2018, among whom 314 neonates who met the Montreux definition were enrolled as subjects. According to oxygen index, they were divided into a mild NARDS group with 130 neonates, a moderate NARDS group with 117 neonates, and a severe NARDS group with 67 neonates. Read More

JAMA Netw Open 2020 12 1;3(12):e2024589. Epub 2020 Dec 1.

Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Importance: The death of a healthy term infant may signal patient safety and quality issues. Various initiatives aim to encourage clinicians to learn from these events, but little evidence exists regarding how exposure to an unexpected newborn death may alter clinician practice.

Objective: To examine the association between an unexpected newborn death and changes in obstetric and newborn procedures that may be used in response to potential fetal distress or newborn complications. Read More

Semin Fetal Neonatal Med 2020 12 28;25(6):101175. Epub 2020 Oct 28.

Department of Newborn Research, The Royal Women's Hospital, The University of Melbourne, 20 Flemington Rd, Parkville, VIC, 3052, Australia. Electronic address:

Caffeine as tested in the CAP trial is safe and effective for preterm infants with birthweights less than 1250 g. Evidence for its use beyond the indications and timing used in this trial is of low quality and conflicting. Some studies suggest that earlier use of caffeine increases the risk of mortality while others suggest it has important benefits. Read More

Resuscitation 2020 12 28;157:126-132. Epub 2020 Oct 28.

Mater Research, Faculty of Medicine, The University of Queensland, Australia; Mater Mothers' Hospital, Australia. Electronic address:

Objectives: To describe the frequency of neonatal resuscitation interventions implemented for newborn babies in the state of Queensland over a 10-year period and determine if these changes suggest adherence to changes in Australian guidelines.

Study Design: A population-based retrospective cohort study utilising the Queensland Perinatal Data Collection dataset. All liveborn babies ≥23 + 0 weeks + days gestation born between 1 July 2007 and 30 June 2017 were included except those for whom resuscitation was not attempted and those babies <25 + 0 weeks for whom it was unsuccessful. Read More

Semin Fetal Neonatal Med 2020 12 21;25(6):101158. Epub 2020 Oct 21.

Level 7, Dept of Obstetrics & Gynaecology, University of Melbourne, Royal Women's Hospital, 20 Flemington Road, Parkville, VIC 3052, Australia; Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia. Electronic address:

Caffeine to prevent or treat apnea of prematurity in the newborn period is now standard of care for infants born very preterm. It has both short- and longer-term effects on respiratory health. In the short-term it reduces the duration of assisted ventilation and of oxygen therapy. Read More

Neonatology 2021 22;118(1):5-14. Epub 2020 Oct 22.

Department of Development and Regeneration, KU Leuven, Leuven, Belgium,

Introduction: Prematurely born infants regularly develop respiratory distress syndrome and require assisted ventilation. Ventilation may injure the premature lung and increase the risk of bronchopulmonary dysplasia. Continuous positive airway pressure (CPAP), a form of noninvasive ventilation, is commonly used in modern neonatology. Read More

Arch Dis Child Fetal Neonatal Ed 2021 May 20;106(3):238-243. Epub 2020 Oct 20.

Dean's Office, University of Texas Health Science Center at Houston, Houston, Texas, USA.

Objective: To identify sociodemographic and clinical factors associated with withholding or withdrawing life-sustaining treatment (WWLST) for extremely low gestational age neonates.

Design: Observational study of prospectively collected registry data from 19 National Institute of Child Health and Human Development Neonatal Research Network centres on neonates born at 22-28 weeks gestation who died >12 hours through 120 days of age during 2011-2016. Sociodemographic and clinical factors were compared between infants who died following WWLST and without WWLST. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2020 Oct;22(10):1085-1091

Children's Medical Center, Qilu Hospital of Shandong University, Jinan 250012, China.

Objective: To study the duration of automated auditory brainstem response (AABR) test for initial hearing screening and the factors influencing the duration in neonates.

Methods: A total of 472 neonates who were admitted to the neonatal intensive care unit (NICU) were enrolled as the study group and 182 healthy neonates were enrolled as the healthy control group. The influence of the duration of AABR test on the initial screening results was observed in the two groups. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2020 Oct;22(10):1079-1084

Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

Objective: To assess white matter development in preterm infants with bronchopulmonary dysplasia (BPD) using fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of diffusion tensor imaging (DTI).

Methods: Ninety-six infants with a gestational age of ≤32 weeks and a birth weight of <1 500 g who were admitted to the neonatal intensive care unit within 24 hours after birth from August 2016 to April 2019 and underwent head MRI and DTI before discharge were enrolled. According to the discharge diagnosis, they were divided into BPD group with 48 infants and non-BPD group with 48 infants. Read More

Cochrane Database Syst Rev 2020 10 15;10:CD002271. Epub 2020 Oct 15.

Newborn Research Centre and Neonatal Services, The Royal Women's Hospital, Melbourne, Australia.

Background: Respiratory distress, particularly respiratory distress syndrome (RDS), is the single most important cause of morbidity and mortality in preterm infants. In infants with progressive respiratory insufficiency, intermittent positive pressure ventilation (IPPV) with surfactant has been the usual treatment, but it is invasive, potentially resulting in airway and lung injury. Continuous positive airway pressure (CPAP) has been used for the prevention and treatment of respiratory distress, as well as for the prevention of apnoea, and in weaning from IPPV. Read More

Anesthesiology 2021 01;134(1):52-60

Background: Up to 84% of women who undergo operative vaginal delivery receive neuraxial analgesia. However, little is known about the association between neuraxial analgesia and neonatal morbidity in women who undergo operative vaginal delivery. The authors hypothesized that neuraxial analgesia is associated with a reduced risk of neonatal morbidity among women undergoing operative vaginal delivery. Read More

BMC Pregnancy Childbirth 2020 Oct 7;20(1):596. Epub 2020 Oct 7.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.

Background: The correlation between stage of labor and adverse delivery outcomes has been widely studied. Most of studies focused on nulliparous women, it was not very clear what impact the stage of labor duration had on multiparous women.

Methods: A retrospective cohort study was conducted among all the multiparous women of cephalic, term, singleton births, who planned vaginal delivery. Read More

Ital J Pediatr 2020 Oct 6;46(1):145. Epub 2020 Oct 6.

Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.

Objective: To describe a case of thrombophlebitis associated with Candida infection and to analyze other published reports to define clinical characteristics, prognostic data, diagnostic and therapeutic strategies.

Study Design: A computerized search was performed without language restriction using PubMed and Scopus databases. An article was considered eligible for inclusion if it reported cases with Candida thrombophlebitis. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Nov 14;254:141-146. Epub 2020 Sep 14.

Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, United States.

Objective: To evaluate adverse neonatal and maternal outcomes among women with obesity and no additional comorbidities at 37-41 weeks.

Methods: This was a population based retrospective cohort study performed using US vital statistics data from 2014-2017. We included women with body mass index ≥ 30. Read More

JAMA Netw Open 2020 09 1;3(9):e2018119. Epub 2020 Sep 1.

UMR-S INSERM U1139, Faculté de Pharmacie, Université de Paris, Paris, France.

Importance: In very preterm newborns, gut microbiota is highly variable with major dysbiosis. Its association with short-term health is widely studied, but the association with long-term outcomes remains unknown.

Objective: To investigate in preterm newborns the associations among practice strategies in neonatal intensive care units (NICUs), gut microbiota, and outcomes at 2 years. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2020 Jul;22(7):684-689

Department of Neonatology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To compare the efficacy of domestic and imported caffeine citrate in the treatment of apnea in preterm infants.

Methods: A total of 98 preterm infants with a gestational age of 28 - <34 weeks between April 2018 and December 2019 were enrolled. They were randomly administered with domestic (n=48) or imported caffeine citrate (n=50) within 6 hours after birth. Read More

J Infect Public Health 2020 Oct 9;13(10):1556-1561. Epub 2020 Jul 9.

Department of Neonatology, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University, Singapore.

Background: Enterovirus (EV) outbreaks often coincide with seasonal peaks in the community. However, they may also sporadically occur in neonatal units. Identification of EV infection in neonates can be challenging, as they tend to present with mild or nonspecific symptoms. Read More

Obstet Gynecol 2020 11;136(5):962-964

Cascadia Women's Clinic, Legacy Salmon Creek Hospital, Legacy Health, and the Vancouver Clinic, Vancouver, Washington.

Background: In the global coronavirus disease 2019 (COVID-19) pandemic, to date, delivery of critically ill pregnant patients has predominantly been by cesarean.

Case: A 27-year-old pregnant woman was admitted to a 166-bed community hospital at 33 weeks of gestation with acute hypoxemic respiratory failure secondary to COVID-19. She underwent mechanical ventilation for 9 days. Read More

Zhongguo Dang Dai Er Ke Za Zhi 2020 Jun;22(6):543-554

Selective bronchial intubation (SBI) to ventilate a single lung (one-lung ventilation, OLV) or to apply separate lung ventilation (independent-lung ventilation, ILV) can be frequently required under general anesthesia in pediatrics, mainly in video assisted thoracoscopy surgery, in the postoperative care of cardio-thoracic surgery, and for the treatment of lung pathologies with unilateral prevalence in intensive care. In children over 6-8 years of age SBI, OLV and ILV can be performed using marketed double-lumen tubes (DLTs). In neonates, infants and younger children the application of ILV is limited due to the lack of DLTs. Read More

Obstet Gynecol 2020 07;136(1):146-153

Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, Texas.

Objective: To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups.

Methods: This was a retrospective cohort study using the U.S. Read More

Natl Vital Stat Rep 2019 Jun;68(8):1-20

Objectives-A primary goal of the 2003 revision of the U.S. Standard Certificate of Live Birth was to improve data quality. Read More

Obstet Gynecol 2020 06;135(6):1417-1425

Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, the University of Texas Health Science Center at Houston, Houston, Texas.

Objective: To examine risk factors and adverse outcomes for neonatal-maternal dyads among low-risk pregnancies at term with subsequent neonatal seizures.

Methods: United States vital statistics data sets were used for this retrospective study. Inclusion criteria were low-risk women (without hypertensive disease or diabetes) with nonanomalous singleton pregnancies, who delivered after labor at 37-41 weeks of gestation. Read More