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Introduction: Pierre Robin sequence is characterized by the classic triad of congenital micrognathia, glossoptosis, and airway obstruction. It is caused by various etiologies, including cortical development malformations as seen in congenital perisylvian syndrome. Clinical Case Presentation: We report a case of a 31-week preterm newborn girl who exhibited the classic triad of Pierre Robin sequence during physical examination, later developing complications such as epileptic seizures, airway obstruction, and swallowing disorder. During the etiological investigation, cerebral magnetic resonance imaging revealed bilateral polymicrogyria, confirming a diagnosis of bilateral perisylvian syndrome. Conclusions: Cortical development malformations, such as congenital bilateral perisylvian syndrome, are part of the etiological spectrum in Pierre Robin sequence, especially those presenting with pseudobulbar paralysis, epileptic seizures, and central origin hypotonia.

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The aim was to describe the prevalence of exclusive breastfeeding among mothers of premature infants and investigate the extent to which breastfeeding self-efficacy is associated with early cessation of exclusive breastfeeding. The study population consisted of 136 mother-infant dyads with information on the outcome of exclusive breastfeeding and exposure of self-efficacy, recruited between September 2016 and February 2018. Data were collected via questionnaires with follow-up at 6 months. The statistical analysis included descriptive analysis with survival curves and logistic regression analysis. At 2 months, 101 (74%) premature infants were exclusively breastfed; at 4 and 6 months, 82 (60%) and 41 (30%), respectively. Higher levels of self-efficacy were significantly associated with breastfeeding exclusively for 2 months (P = .03). In multivariate analysis, mothers who had a low level of early self-efficacy toward breastfeeding had 212 times higher odds of breastfeeding cessation before 2 months (odds ratio = 2.63, 95% confidence interval: 1.16-5.96). The risk did not change when adjusted for potential confounders. Breastfeeding self-efficacy is an early predictor of exclusive breastfeeding for 2 months of the premature infant. Health professionals should use self-efficacy as a prognostic factor to identify mothers at risk of early cessation of breastfeeding and support those with low self-efficacy to increase duration of exclusive breastfeeding. [ABSTRACT FROM AUTHOR]

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Introduction: Necrotizing enterocolitis (NEC) is a fatal disease with up to 20% mortality rates. Identifying risk factors for NEC may reduce NEC incidences. This study aims to investigate NEC-related risk factors in preterm infants. Methods: We included 27 preterm infants with NEC and 35 infants without NEC among the preterm newborns (n=1669) hospitalized in the Duzce University School of Medicine neonatal intensive care unit between 2009 and 2021. Parametric numeric data were calculated using the independent sample's t-test. Two-sample comparisons of nonparametric data were performed using the Mann-Whitney test. Pearson chi-square, Yates correction, and Fisher's exact test were also used to evaluate the categorical data. Results: Our results agree with previous studies regarding some of these findings: birth weight is lower in the NEC group (1.37±0.49 kg) than in the non-NEC group (18.3±6.5 kg) (p=0.009), with statistically similar gestational age. We couldn't show the association between NEC and multiple gestations, chorioamnionitis, preeclampsia, Apgar scores, patent ductus arteriosus, mechanical ventilation, pre-NEC red blood cell, or fresh frozen plasma transfusions. In the NEC group, thrombocyte levels before NEC were significantly lower (98 [9-2253]) (/x10³ mm³) than in the control group (222 [17-345]) (/x10³ mm³) (p=0.012). In addition, mortality rates (22.2% vs. 2.9%, respectively) (p=0.037), use of vasopressors (29.6% vs. 2.9%, respectively) (p=0.008) were markedly higher in the NEC group than in the non-NEC group. Additionally, lower birth weight (NEC group: 1367.25±493.62 vs. non-NEC group: 1831.71±651.62) (p=0.009), prolonged use of antibiotics (NEC group: 24% vs. non-NEC group: 0%) (p=0.004), and poor circulation (NEC group: 84% vs. non-NEC group: 3%) (p<0.001) were statistically significant variables. Discussion and Conclusion: NEC increases the mortality rates in preterm infants. The use of vasopressors, low birth weight, poor circulation, and antibiotics are significant risk factors for NEC, and low thrombocyte levels can lead to the prediction of NEC. [ABSTRACT FROM AUTHOR]

Abstract Objectives: to evaluate the effect of oropharyngeal colostrum immunotherapy on the length of hospital stay in preterm newborns with very low birth weight. Methods: interventional ambispective study, which consisted of eight daily administrations of 0.2 ml (four drops) of colostrum, totaling up to 56 syringes (for up to seven days). The control was historic. The main independent variable: length of hospital stay (days). Survival analysis was performed using the Kaplan-Meier Method and the survival effect was estimated - Log Rank Test (Mantel-Cox) and Breslow Test (Generalized Wilcoxon). A significance level of 5% was adopted. Results: of the 109 mother/child pairs, 56 were part of the treatment and 53 were part of the control group. There was no association between oropharyngeal colostrum immunotherapy and length of stay for preterm newborns with very low birth weight in the general sample. However, after stratification, a shorter hospital stay (42 versus 51 days, HR= 1.78, CI95%=1.02-3.09, p=0.04) was demonstrated among premature infants with ≥28 gestational weeks undergoing oropharyngeal colostrum immunotherapy. Conclusions: we found an association between oropharyngeal colostrum immunotherapy and shorter median length of hospital stay in the subgroup of premature infants ≥ 28 weeks of gestational age, but we did not find significant differences in those

Objective: To evaluate the rates of exclusive breastfeeding (EBF) and growth of preterm and/or low birth weight newborns during the third stage of the Kangaroo Method (TSKM), at discharge. Methods: Retrospective study in a reference public maternity hospital between Jan/2014 and Dec/2017, including the preterm (less than 37 weeks) and/or low birth weight (less than 2500 g) newborn infants. Information was collected from medical records. Statistics analysis was done in SPSS software. Results: 482 infants were included and followed up at the TSKM ambulatory. The average gestational age was 33 weeks (variation: 24-39 weeks) and birth weight, 1715g (variation: 455–2830 g). EBF occurred in 336 (70.1%) infants at hospital discharge, and in 291 (60.4%) at TSKM discharge. Each additional day of hospital stay increased the chance of infant formula (IF) use by 9.3% at hospital discharge and by 10.3% at TSKM discharge. Staying in the Kangaroo Neonatal Intermediate Care Unit (KNICU) favored EBF at hospital discharge and TSKM discharge (p

Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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ABSTRACT Objective: To identify and analyze the scientific literature, both national and international, concerning the primary maternal concerns about caring for premature newborns at home. Methods: This integrative review is based on the guiding question: “What scientific publications from 2012 to 2021 address maternal concerns about the care of premature newborns at home?”. Searches were conducted in the electronic databases: Embase, Medline, Web of Science, Lilacs, Scielo, and Cochrane Library. Results: A total of 21 articles were identified. The qualitative analysis showed that maternal concerns pertained to breastfeeding, hygiene, sunbathing practices, managing infant colic, identifying signs, symptoms, and clinical changes, temperature control, and the third phase of the kangaroo method. Conclusions: Maternal uncertainties underscore the importance of enhancing strategies focused on supporting families and ensuring continued care for neonates at home.

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Introducción. En este artículo se presenta una reflexión sobre la necesidad de tener una visión holística en la problemática de la prematurez, para que los equipos del área de salud puedan tener una comprensión de la multiplicidad de factores presentes en el parto prematuro, y sus consecuencias para el menor, la madre, los familiares y el personal de salud involucrado. Tema de reflexión. El tema se sustenta en dos investigaciones realizadas con las madres, los padres y los niños beneficiarios del Programa Madre Canguro en un hospital del Estado, en dos momentos, 2012 y 2014, con algunos de los autores del presente artículo. Conclusiones. Además de la revisión de la literatura científica relacionada con el tema y la problemática, se concluye que, bajo una mirada holística, se comprende de manera integral la problemática y se propicia una mejor comunicación con los padres; con el equipo de la atención en salud, se logra un manejo transdisciplinario, superando los objetos de estudios aislados. Se da así un abordaje integrador y significativo en la cotidianidad de cada actor, desde la piel, con el Programa Madre Canguro, hasta la racionalidad de la ciencia. Introduction. This article presents a reflection on the need for a holistic view of the problem of premature births, so that healthcare teams can understand the multiplicity of factors present in premature births, and its consequences for the minor, the mother, the family members, and the healthcare staff involved. Topic of reflection. The topic is based on two investigations carried out with mothers, fathers, and children’s beneficiaries of the Mother Kangaroo Program in a State hospital, at two moments, 2012 and 2014, with some of the authors of this article. Conclusions. In addition to the review of the scientific literature related to the topic and the problem, it is concluded that, under a holistic view, the problem is understood in a comprehensive way and better communication with the parents is encouraged. With the healthcare team, cross-disciplinary handling is achieved, overcoming the objects of isolated studies. As such, there is an integrative and significant approach in the daily life of each actor, from the skin, with the Mother Kangaroo Program, to the rationality of science. Introdução. Este artigo apresenta uma reflexão sobre a necessidade de se ter uma visão holística da problemática da prematuridade, para que as equipes da área da saúde possam ter uma compreensão da multiplicidade de fatores presentes no parto prematuro, e suas consequências para a criança, a mãe, os familiares e o pessoal de saúde envolvido. Tópico de reflexão. O tema é baseado em duas pesquisas realizadas com mães, pais e filhos beneficiários do Programa Mãe Canguru em um hospital estadual, em dois momentos, 2012 e 2014, com alguns dos autores deste artigo. Conclusões. Além da revisão da literatura científica relacionada ao tópico e ao problema, conclui-se que, sob uma visão holística, o problema é plenamente compreendido e incentiva-se uma melhor comunicação com os pais; com a equipe de saúde, consegue-se uma gestão transdisciplinar, superando os objetos de estudos isolados. Isto proporciona uma abordagem integradora e significativa no cotidiano de cada ator, desde a pele, com o Programa Mãe Canguru, até a racionalidade da ciência.

Objective: to understand the perception of nurses about the complexity of care for thermal control of the premature infant. Methods: qualitative study conducted with 13 nurses from a public maternity hospital, through virtual interviews, with semi-structured script, submitted to Content Analysis and interpreted by the theoretical support of the complex adaptive care system model. Results: the factors present in nurses' care in thermal control of premature infants are related to the complexity permeated by environmental factors such as the temperature of the unit and distribution of air conditioning currents; institutional factors such as the availability and correct use of technologies, and those related to the professional, such as performance, training, and qualification. Conclusion: adjusting the temperature of the unit; better distribution of the air conditioning currents;availability of technologies; a policy of continued education in the service; training in handling the equipment; supervision and requirement for preventive and corrective maintenance of the devices can influence the reduction of thermal instability events in premature infants. Contributions to practice: stimulating professional qualification, planning of intersectoral actions for technological structuring and preventive maintenance of the units, systematization of assistance to premature infants in thermal control minimizing risk of neonatal morbimortality due to thermal instability.

The Korean Neonatal Network (KNN), which is celebrating its 10th anniversary, currently has more than 100 staff and researchers from >70 neonatal intensive care units nationwide in Korea. More than 85% to 90% of the population of very low birth weight infants in Korea are registered yearly, and more than half are followed up for up to 3 years at the KNN. A total of >19,000 cases have been accumulated through a strict data quality management process of the KNN. Based on this, >100 research projects have been proposed, >70 peer-reviewed papers have been published in leading international journals, and the cornerstone of the quality improvement project has been launched. In addition, we recently expanded the number of subjects for registration to very premature infants <32 weeks of age and continue to provide essential evidence data for establishing national health policies, such as linking with government policy projects of the Ministry of Health and Welfare for preterm infants. In such manner, the KNN is confident to be successfully and actively moving toward reaching the ultimate goal of standardizing neonatal intensive care and management of preterm infants in Korea by providing essential data for national health policy establishment along with quality improvement through evidence-based interactive data. [ABSTRACT FROM AUTHOR]

Objective: To describe the type of milk used to feed infants seen in private pediatric practices in Brazil. To evaluate the relationship between breastfeeding, type of delivery, and history of prematurity. Methods: This is a cross-sectional and observational study that included 4929 infants in the first year of life seen in private pediatric practices in the five geographic regions of Brazil. Mothers provided information about the type of milk used by their infant, the type of delivery (vaginal or cesarean), and whether the birth was premature. Results: Breastfeeding was the only source of milk for 56.1% (1546/2755) of infants in the first six months of life and 32.9% (716/2174) in the second. Of the infants who received other types of milk besides breastfeeding, there was a predominance of infant formula in 98.6% and 93.8% of the infants, respectively, in the first and in the second six months of life. Whole cow's milk was used by 0.7% (20/2755) of infants in the first six months and by 4.1% (90/2174) of infants in the second (p

Objective: To relate three adverse perinatal outcomes and maternal migratory status, Perú 2018. Material and methods: Secondary analysis of 484,533 data from the Vital Facts Registration System of Peru (RHV) of the year 2018, of which 476,471 were Peruvian and 8,062 migrants. The dependent variables were preterm delivery, cesarean section, and low birth weight; which were associated with the main independent variable (nationality of the mother) and with three sociodemographic variables (age, educational level and occupation of the mother) and duration of pregnancy is included as an independent variable. Results: The migrants were younger (26.92±5.97 years), with better education (82.7% of ≥10 years of study) and mostly housewives (88.2%). The adjusted model found a statistically significant association between preterm birth and being a migrant (RPa 1,29; IC95% 1,15- 1,34), elderly (RPa 1,45; IC95% 1,41-1,49) and professional (RPa 1,26; IC95% 1,21-1,31). Between the cesarean section and being a migrant (RPa 1,17; IC95% 1,14-1,20), elderly (RPa 1,26; IC95% 1,25-1,27), professional (RPa 1,62; IC95% 1,60-1,63) and with preterm pregnancy (RPa: 1,61; IC95% (1,60-1,63). Between low birth weight and being a migrant (RPa: 1,40; IC95% 1,32-1,50), adolescent (RPa: 1,26; IC95% 1,22-1,29), having less than 6 years of study (RPa: 1,33; IC95% 1,30-1,40) and with preterm pregnancy (RPa: 24,98; IC95% 24,42-25,55). Conclusions: the nationality of the mother was associated with the three outcome variables. Being a migrant mother in Peru gives a greater probability of having preterm labor, cesarean delivery and newborns with low birth weight; adjusted for age group, level of education, occupation of the mother and duration of pregnancy. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Científica de Enfermería (2071-5080) is the property of Colegio de Enfermeros del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Espaço Para a Saúde is the property of Faculdades Pequeno Principe and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The prevalence of postnatal growth faltering (PGF) in preterm infants with very low birth weight (VLBW) (<1500 g) is a universal problem. Growth improvement is expected as neonatal care is optimized. Objectives: To determine if there has been a decrease in the prevalence of PGF and an improvement in height at 2 years in appropriate for gestational age VLBW children in the last two decades. Methods: Clinical descriptive retrospective analysis of neonatal somatometry at birth and at two-year corrected age in VLBW preterm infants. Small for gestational age were excluded. Two cohorts (2002–2006, n = 112; and 2013–2017, n = 92) were compared. Results. In the second five-year period, a decrease in prevalence of PGF was observed (36.6% vs. 22.8%, p = 0.033), an increase in growth rate in the first 28 days (5.22 (4.35–6.09) g/kg/day vs. 11.38 (10.61–12.15) g/kg/day, p < 0.0001) and an increase in height standard deviation (SD) at 2 years (−1.12 (−1.35–−0.91) vs. −0.74 (−0.99–−0.49) p = 0.023). Probability of short stature at 2 years was directly related to daily weight gain in the first 28 days. Conclusions: when comparing two five-year periods in the last two decades, growth in VLBW preterm infants has improved, both during neonatal period and at two years of age. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Autistic Spectrum Disorders (ASDs) are neurodevelopmental disorders characterized by persistent deficits in communication and social interaction, associated with repetitive and restricted patterns of behavior, activities and interests. The etiology of TEAs remains undetermined, being associated with a multifactorial pathogenesis that may be related to genetic factors, alterations during intrauterine brain development and birth, and environmental factors. Within this context, two factors are considered consistent predictors of ASD: birth weight and gestational age. OBJECTIVE: Thus, this study aimed to carry out a literature review to verify if there were reports of a significant relationship between ASD and birth weight and low gestational age. METHODS: A search was carried out between 2010 and 2020 using the following databases: (SciELO, PubMed, PsycINFO, Lilacs, Medline, Google Scholar, BVS and CAPES). RESULTS: 14 articles were selected for full reading and, of these, 35.71% (n=5) with a significant association between low birth weight and ASD. CONCLUSION: The review concluded that the appearance of autism spectrum disorders has a multifactorial influence.

ABSTRACT Objective To describe and compare the physiological signs presented by premature infants in traditional and humanized weighing. Method A quasi-experimental crossover study, with a sample of 30 premature infants randomly assigned and allocated to the control group (traditional) and the intervention group (humanized), from March 2019 to March 2020, with the collection of general data, vital signs before and after the procedures. Statistical analyses included description of relative and absolute frequencies, measure of central tendency and dispersion. Results Premature infants showed less increase in heart rate (53.3%) and respiratory rate (43%) in the verification of humanized weighing than in the traditional way, with 83.3% of neonates and 80%, respectively. Conclusion It was observed that the humanized form provided less physiological instability, especially in heart and respiratory rates, making it necessary to encourage discussions about the humanization of care and perform this practice routinely in health units.

Abstract Background Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects the premature lung, and to reduce its incidence has been used non-invasive ventilatory support, such as continuous positive airway (CPAP) and high-flow nasal cannula (HFNC). Thus, the objective of this review was to assess whether the use of high flow nasal cannula (HFNC) compared to continuous positive airway pressure (CPAP) decreases the risk of bronchopulmonary dysplasia (BPD) in premature newborns. Methods The protocol was registered (Prospero: CRD42019136631) and the search was conducted in the MEDLINE, PEDro, Cochrane Library, CINAHL, Embase, and LILACS databases, and in the clinical trials registries, until July 2020. We included randomized clinical trials comparing HFNC versus CPAP use in premature infants born at less than 37 weeks of gestational age. The main outcome measures were the development of BPD, air leak syndrome, and nasal injury. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool and the GRADE system was used to summarize the evidence recommendations. Meta-analyses were performed using software R. Results No difference was found between HFNC or CPAP for the risk of BPD (RR: 1.10; 95% CI: 0.90–1.34), air leak syndrome (RR: 1.06; 95% CI: 0.52–2.14), and nasal trauma (RR: 2.00; 95% CI: 0.64–6.25), with a very low level of evidence. Conclusion(s) The HFNC showed similar results when compared to CPAP in relation to the risk of BPD, air leak syndrome, and nasal injury. In the literature, no randomized clinical trial has been found with BPD as the primary outcome to support possible outcomes.

Abstract Background Haemophilia A is an X-linked genetic condition which manifests itself mainly in male children in the first 2 years of life, during gross motor skill development. This disorder is rare in females. The clinical manifestation of severe haemophilia in preterm infants poses a great challenge to the therapeutic team. As extreme prematurity is linked to an increased risk of central nervous system or gastrointestinal bleeding, a well-informed and balanced treatment from the first days of life is crucial to prevent long-term damage. Haemophilia is most commonly caused by inheriting defective genes, and can also be linked to skewed X inactivation and Turner syndrome. The coincidental occurrence of haemophilia A and Turner syndrome is extremely rare, with only isolated cases described to date. Hence, a multidisciplinary approach is needed. Case presentation The authors report on a preterm girl (gestational age 28 weeks) diagnosed with haemophilia and Turner syndrome. The first manifestation of haemophilia was prolonged bleeding from injection sites on the second day of life. Indeterminate aPTT and factor VIII level

The study aimed to determine the incidence, clinical characteristics, and outcomes of the preterm infants treated at the Paediatric Intensive Care Unit of the Paediatric Clinic, Clinical Hospital Centre Rijeka, from 2014 to 2018. Patients and methods: Respondents were all preterm infants treated in the Paediatric Intensive Care Unit of the Paediatric Clinic, Clinical Hospital Centre Rijeka, from 2014 to 2018. Observed preterm infants were divided into four groups based on their gestational age (extremely prematurely born, very prematurely born, moderately prematurely born, late prematurely born). These groups were observed and compared with their individual clinical characteristics. Results: The study included a total of 176 premature infants. In the group of extremely premature infants, the reasons for hospitalization in 90.3% of cases were complications of premature birth, which caused hospitalizations in the group of very premature infants by 62.1%, among moderate infants by 35%, and in the group of late preterm infants by 22.4%. Of the total number of observed hospitalized preterm infants, 79 of them (44.9%) had 1-2 complications, 35 (19.9%) had 3-4 complications, and 15 of them (8.5%) had five or more complications. Out of the total of 176 observed preterm infants in this period, 14 (8%) died during the hospitalization. Conclusions: Based on literature sources, the most common reasons for hospitalization of preterm infants are infections – often directly related to complications of premature birth – the attempts to reduce the number of hospitalizations should focus on the reduction of infections. Besides that, more coordination between care and monitoring would probably ensure more positive outcomes. [ABSTRACT FROM AUTHOR]

Objective: To describe the type of milk used to feed infants seen in private pediatric practices in Brazil. To evaluate the relationship between breastfeeding, type of delivery, and history of prematurity. Methods: This is a cross-sectional and observational study that included 4929 infants in the first year of life seen in private pediatric practices in the five geographic regions of Brazil. Mothers provided information about the type of milk used by their infant, the type of delivery (vaginal or cesarean), and whether the birth was premature. Results: Breastfeeding was the only source of milk for 56.1% (1546/2755) of infants in the first six months of life and 32.9% (716/2174) in the second. Of the infants who received other types of milk besides breastfeeding, there was a predominance of infant formula in 98.6% and 93.8% of the infants, respectively, in the first and in the second six months of life. Whole cow's milk was used by 0.7% (20/2755) of infants in the first six months and by 4.1% (90/2174) of infants in the second (p < 0.001). In the first six months of life, breastfeeding as the only type of milk was associated with vaginal delivery (OR = 1.79; p < 0.001) and not having a history of prematurity (OR = 2.48; p < 0.001). Conclusion: Breastfeeding was the only milk source for more than half of infants before 180 days of life. Birth by cesarean section and history of prematurity were negatively associated with breastfeeding as the only source of milk used in infant feeding. [ABSTRACT FROM AUTHOR]

Objective: The objective is to determine if children born preterm were at increased risk of influenza hospitalization up to age five. Methods: National registry data on all children born in Norway between 2008 and 2011 were used in Cox regression models to estimate adjusted hazard ratios (aHRs) for influenza hospitalizations up to age five in children born preterm (<37 pregnancy weeks). HRs were also estimated separately for very preterm (<32 weeks), early term (37–38 weeks), and post‐term (≥42 weeks) children. Results: Among 238,628 children born in Norway from January 2008 to December 2011, 15,086 (6.3%) were born preterm. There were 754 (0.3%) children hospitalized with influenza before age five. The rate of hospitalizations in children born preterm was 13.8 per 10,000 person‐years (95% confidence interval [CI] [11.3, 16.7]), and 5.9 per 10,000 person‐years (95% CI [5.5, 6.4]) in children born at term (≥37 weeks). Children born preterm had a higher risk of influenza hospitalization before age 5: aHR 2.33 (95% CI [1.85, 2.93]). The risk increased with decreasing gestational age and was highest among those born extremely/very preterm; aHR 4.07 (95% CI [2.63, 6.31]). Compared with children born at 40–41 weeks, children born early term also had an elevated risk of influenza hospitalization; aHR (37 weeks) 1.89 (95% CI [1.43, 2.50]), aHR (38 weeks) 1.43 (95% CI [1.15, 1.78]). Conclusion: Children born preterm had a higher risk of influenza hospitalizations before age five. An elevated risk was also present among children born at an early term. Children born preterm could benefit from influenza vaccinations. [ABSTRACT FROM AUTHOR]

Neonatal sepsis is an important risk factor for lesions in the brain of preterm newborns (PTNB) and the most effective strategies to minimize its deleterious effects are early detection and intervention. To investigate the presence of neurological abnormalities in PTNBs after neonatal sepsis. This was a prospective cross-sectional study with 100 PTNBs selected at random, 50 of the study group (sepsis) and 50 of the control group (non-sepsis). The neurological evaluation protocol adopted was the Hammersmith Neonatal Neurological Examination (HNNE). The PTNBs of the sepsis group had total HNNE scores lower than expected for normality in 86% of the cases, and the non-sepsis group in 26% (p <.001). Higher prevalence levels of altered scores in tone category (p <.001), tone patterns (p =.026), reflexes (p =.002), movements (p <.001), abnormal signs (p <.001) and behavior (p <.001). The neurological dysfunctions after neonatal sepsis could be identified by clinical neonatal neurological evaluation. [ABSTRACT FROM AUTHOR]

Abstract Background Bleedings are more frequent in the population of preterm children than among those born at term, much less in older children. The reasons for such bleedings in preterms include plasma factor deficiencies, immaturity of small vessels in the germinal matrix region, prenatal hypoxia or sepsis. They affect the brain tissue, the gastrointestinal tract and the respiratory system, or are manifested by prolonged bleedings from injection sites. Haemophilia is a rare cause of haemorrhages in the neonatal period, and in the female population it is even seen as an extremely rare disorder. Its aetiology in girls is diverse: inheriting defective genes from their parents, skewed X inactivation or a single X chromosome. Case presentation The article presents a case of a preterm girl born in the 28th week of pregnancy, who was diagnosed with severe haemophilia A stemming from the absence of the X chromosome. The girl’s father is healthy, but her mother’s brother suffers from haemophilia. On the second day of the child’s life, a prolonged bleeding from the injection site was observed. A coagulation profile revealed prolonged APTT which pointed to haemophilia A diagnosis. Moreover, a marked clinical dysmorphy, female sex and a negative family history on the father’s side led the treating team to extend the diagnostic procedures to encompass karyotype evaluation. The girl was diagnosed with Turner syndrome. No bleeding to the central nervous system was observed during her hospital stay. Conclusions Preterm children belong to the risk group of bleeding into the central nervous system or haemorrhages in the course of sepsis. Rare causes of such bleedings should also be borne in mind, including haemophilia. The initial symptoms of haemophilia in preterm children occur in the first days of their lives, which is connected with a number of invasive procedures required in that period. Genetic conditions may coexist with one another. Arriving at one diagnosis does not mean one should abandon further diagnostic procedures in cases where additional atypical symptoms are present which do not match the clinical image of a primary disease.

Background and Objective: Some studies have shown that abnormal levels of biomarkers may be associated with adverse pregnancy outcomes. This study aimed to investigate the association between serum levels of Inhibin A and the outcomes of pregnancy. Materials and Methods: This retrospective cohort study was conducted on the data obtained from the Inhibin A of 560 pregnant women at 15 to 20 weeks of gestation in Hamadan, Iran. The levels of Inhibin A less than 0.5 and higher than 2 mmol were considered below and high, respectively. The patients were assessed in terms of birth weight, gestational age, Apgar score, preeclampsia, intrauterine fetal death, and cesarean section. The receiver operating characteristic curve level was calculated to detect adverse pregnancy complications. The data were statistically analyzed in STATA software (version 14). Results: Out of the pregnant women eligible for the study, 33 (5.9%) cases were excluded due to incomplete medical record files and unavailability. Of the remaining 527 patients, 378 (71.7%), 26 (4.9%), and 123 (23.3%) ones had normal, low, had high Inhibin A levels, respectively. Patients with higher serum Inhibin A levels had a higher risk of preeclampsia, low birth weight, and prematurity, compared to those with normal or low levels (P˂0.05). Conclusion: Based on the findings of the present study, high levels of Inhibin A at 15 to 20 weeks of gestation can be associated with the risk of preeclampsia, low birth weight, and prematurity.

Objective: To determine if performing heel stick procedures for capillary blood sampling without prior heel warming is noninferior to the standard practice of warming the heel in very-low-birth-weight newborns., Design: Noninferiority randomized control trial., Setting: The study took place in two Level 3 NICUs in The Netherlands., Participants: Newborns born at less than 32 weeks gestation in their second or third week of life without an arterial line in situ or known coagulopathy (N = 100)., Methods: We randomized participants to undergo a heel stick procedure in one of two groups: without heel warming (n = 50) and heel warming with a washcloth warmed with 37 °C tap water (n = 25) or with a microwaved hot pack (n = 25). The primary outcome was length of time for obtaining the required blood sample. The secondary outcomes were number of attempts, reliability of the blood sample, newborn comfort, and adverse events., Results: We observed no differences in background characteristics between groups and found no statistically significant or clinically relevant differences in primary or secondary outcomes., Conclusion: Among participants, not warming the heel before a heel stick was noninferior to warming the heel. Therefore, preheating the heel as a standard of care may be an unnecessary nursing intervention., Competing Interests: Conflict of Interest The authors report no conflicts of interest or relevant financial relationships., (Copyright © 2024 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Purpose: Predicting bronchopulmonary dysplasia (BPD) to assess the risk-benefit of therapy is necessary considering the side effects of medications. We developed and validated an instrument for predicting BPD and compared it with an instrument currently used for neonates born in a Brazilian hospital., Methods: This was a retrospective cohort study of patients born between 2016 and 2020 with a gestational age (GA) between 23 and 30 weeks. Predictive equations were elaborated using methods of component variable selection collected on the 14th day of life; 70% of the sample was randomly selected for the construction of risk prediction equations and the remaining 30% for their validation, application, and comparison with the National Institute of Child Health and Human Development (NICHD) instrument. The sensitivity, specificity, and predictive values of the equations were calculated., Results: The equation that used variables with p < 5% in Fisher's exact test presented the best results: specificity of 98% and positive predictive value of 93% and could be used for BPD prediction of all small-for-gestational-age (SGA) infants. The NICHD calculator applied to our population had a specificity of 93% and a positive predictive value of 75% and could not be applied to extremely SGA infants., Conclusion: Our tool can predict the risk of BPD on the 14th day of life, has higher specificity and positive predictive value to our population than the NICHD instrument, and can be suitable for SGA infants. The results must be confirmed by applying it to other populations to validate our tool., (© 2024 Wiley Periodicals LLC.)

The objective of this study was to verify the existence of a relationship between premature births and early pregnancies in the municipality of Ponte Nova - MG. For this, secondary data from SINASC was used, consisting of the number of babies born alive to teenage mothers, based on the total records of live births from the years 2008/2018. A total of 2.958 adolescent mothers were observed, analyzing term and preterm births, it was found that most adolescents became pregnant between the ages of 15 and 19, in addition to not having a partner, low education and being predominantly black and brown, demonstrating a family, emotional, economic and social vulnerability. Furthermore, it was observed that the number of prenatal consultations was lower in mothers of premature babies, as for the type of delivery, vaginal was the most common. Using Pearson's correlation coefficient, the existence of a correlation between teenage pregnancy and prematurity was found to be highly significant given 0.82. Therefore, the present study proved to be necessary, since it evidenced the need to evaluate, discuss and propose intervention measures regarding the early pregnancy of adolescents. [ABSTRACT FROM AUTHOR]

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The prevalence of postnatal growth faltering (PGF) in preterm infants with very low birth weight (VLBW) (n = 112; and 2013–2017, n = 92) were compared. Results. In the second five-year period, a decrease in prevalence of PGF was observed (36.6% vs. 22.8%, p = 0.033), an increase in growth rate in the first 28 days (5.22 (4.35–6.09) g/kg/day vs. 11.38 (10.61–12.15) g/kg/day, p < 0.0001) and an increase in height standard deviation (SD) at 2 years (−1.12 (−1.35–−0.91) vs. −0.74 (−0.99–−0.49) p = 0.023). Probability of short stature at 2 years was directly related to daily weight gain in the first 28 days. Conclusions: when comparing two five-year periods in the last two decades, growth in VLBW preterm infants has improved, both during neonatal period and at two years of age.

ABSTRACT Objective: To learn the experiences of mothers of infants who were born premature in the Covid-19 pandemic. Method: Qualitative study based on the Bioecological Theory of Human Development, developed in a public maternity hospital in Paraíba, Brazil, between June and July 2020 with 21 mothers of infants who were born premature, through semi-structured interview. The data were submitted to inductive thematic analysis. Results: Mothers know the measures for prevention, transmission, and symptoms of the disease, as reported in the media, but have different perceptions about social isolation. Their experiences were permeated by financial difficulties, reduced social support and emotional stress. Final considerations: It is recommended to monitor child health and provide social support to the mother-child binomial remotely, so that there is no break in the continuity of the bond and care for the family in this moment of vulnerability.

Background: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects the premature lung, and to reduce its incidence has been used non-invasive ventilatory support, such as continuous positive airway (CPAP) and high-flow nasal cannula (HFNC). Thus, the objective of this review was to assess whether the use of high flow nasal cannula (HFNC) compared to continuous positive airway pressure (CPAP) decreases the risk of bronchopulmonary dysplasia (BPD) in premature newborns.Methods: The protocol was registered (Prospero: CRD42019136631) and the search was conducted in the MEDLINE, PEDro, Cochrane Library, CINAHL, Embase, and LILACS databases, and in the clinical trials registries, until July 2020. We included randomized clinical trials comparing HFNC versus CPAP use in premature infants born at less than 37 weeks of gestational age. The main outcome measures were the development of BPD, air leak syndrome, and nasal injury. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool and the GRADE system was used to summarize the evidence recommendations. Meta-analyses were performed using software R.Results: No difference was found between HFNC or CPAP for the risk of BPD (RR: 1.10; 95% CI: 0.90-1.34), air leak syndrome (RR: 1.06; 95% CI: 0.52-2.14), and nasal trauma (RR: 2.00; 95% CI: 0.64-6.25), with a very low level of evidence.Conclusion(s): The HFNC showed similar results when compared to CPAP in relation to the risk of BPD, air leak syndrome, and nasal injury. In the literature, no randomized clinical trial has been found with BPD as the primary outcome to support possible outcomes. [ABSTRACT FROM AUTHOR]

Understand the experience of parents of premature newborns admitted to the Neonatal Intensive Care Unit. Descriptive study, with a qualitative approach carried out between June and July 2019, with parents and children were admitted to the Intensive Care Unit of a maternity hospital in the metropolitan region of Natal, Rio Grande do Norte. Data were collected through a sociodemographic questionnaire and semi-structured interview and imposed from the perspective of Content Analysis. The following categories were extracted from the statements: Feelings experienced during hospitalization; During hospitalization challenges; and The nursing team as a strength during hospitalization. The parents' experience in a Neonatal Intensive Care Unit is permeated by suffering. The length of hospitalization of newborns and doubts about the prognosis make it difficult for parents to experience it. However, family and nursing support were listed as facilitators during the hospitalization process. [ABSTRACT FROM AUTHOR]

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Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Haemophilia A is an X-linked genetic condition which manifests itself mainly in male children in the first 2 years of life, during gross motor skill development. This disorder is rare in females. The clinical manifestation of severe haemophilia in preterm infants poses a great challenge to the therapeutic team. As extreme prematurity is linked to an increased risk of central nervous system or gastrointestinal bleeding, a well-informed and balanced treatment from the first days of life is crucial to prevent long-term damage. Haemophilia is most commonly caused by inheriting defective genes, and can also be linked to skewed X inactivation and Turner syndrome. The coincidental occurrence of haemophilia A and Turner syndrome is extremely rare, with only isolated cases described to date. Hence, a multidisciplinary approach is needed. Case presentation: The authors report on a preterm girl (gestational age 28 weeks) diagnosed with haemophilia and Turner syndrome. The first manifestation of haemophilia was prolonged bleeding from injection sites on the second day of life. Indeterminate aPTT and factor VIII level < 1% confirmed the diagnosis of haemophilia A. Dysmorphic features which did not match the typical clinical picture of haemophilia, the female sex, and a negative paternal family history led to the diagnosis of Turner syndrome. While in hospital, the girl received multiple doses of recombinant factor VIII in response to prolonged bleedings from the injection sites and from a nodule on the girl's head, and before and after retinal laser photocoagulation. No central nervous system or abdominal cavity bleeding was observed. The substitutive therapy was complicated by the development of factor VIII inhibitor (anti-factor VIII (FVIII) antibodies). Treatment was continued with recombinant factor VIIa. This article aims at demonstrating the complexity of the diagnostics and treatment of a preterm child with two genetic disorders. Conclusions: Haemophilia should always be considered in the differential diagnosis of prolonged bleeding, even in patients with a negative family history. In the case of coinciding atypical phenotypic features, further diagnostics for another genetic disease are recommended. Infant care should follow current care standards, while considering certain individual features. [ABSTRACT FROM AUTHOR]

Aim: The first dedicated neonatal continuous positive airway pressure (CPAP) device using variable flow was the Infant Flow. The system was pressure stable with a low resistance to breathing. The aim of this study was to describe the flow and function of the Infant Flow geometry using simulated breathing and computational fluid dynamics. Method: The original Infant Flow geometry was used with simulated term infant breathing at three levels of CPAP. The large eddy simulation methodology was applied in combination with the WALE sub‐grid scale model. Results: The simulation fully resolved the flow phenomena in the Infant Flow geometry. The main flow feature during inspiration was support by gas entrainment and mixing. During expiration, the jet deflected towards the outlet with unstable impingement of the jet at the opposing edge. Conclusion: The proposed mechanism has previously been based on theoretical reasoning, and our results present the first detailed description of the Infant Flow. The pressure stability was based on a jet supporting inspiration by gas entrainment and then being deflected during exhalation. This confirmed previously assumed principles of function and flows within the geometry and provided a base for further developments. [ABSTRACT FROM AUTHOR]

Objective: To report ophthalmological findings of premature children. Methods: Observational, descriptive, retrospective and cross-sectional study of premature children born at the Hospital Geral de Fortaleza and attended at the ophthalmopediatrics clinic of this service from July to December 2017. Results: 30 children aged 4 to 18 months were evaluated, with gestational age of birth between 26 and 36weeks and 6 days. Twenty-one children (66.7%) had an appropriate ophthalmologic evaluation for their age. Strabismus was the main eye disorder, found in 5 (16.67%) children. The most common refractive error was hyperopia and astigmatism. Conclusion: Most of the children evaluated had an eye examination suitable for their age. Further studies are needed to validate the hypothesis that prematurity alone is not a risk factor for ophthalmic diseases. It is necessary to raise awareness about the importance of the first complete eye evaluation between 6 months and 1 year of life for children. [ABSTRACT FROM AUTHOR]

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Abstract Objective: To analyze the prevalence of hypothermia in the first hour of life of preterm infants with birth weight 1,500 g or less. Method: A cross-sectional study performed in a Neonatal Intensive Care Unit. Data obtained from 359 computerized records of premature infants admitted between 2012 and 2016. Descriptive Statistics and Poisson Regression were used. Results: Premature infants (66.9%) presented hypothermia in the first hour of life, with axillary temperature of 36.2ºC (35.7-36.6), associated with: diagnosis of preeclampsia (p = 0.001), small for gestational age (p = 0.029), and the need for chest compression in the delivery room (p = 0.001). In cases of peri-intraventricular hemorrhage grade III (75%) and death (78.9%), there was a prevalence of premature infants with hypothermia in the first hour of life. Conclusion: Hypothermia in the first hour of life was prevalent in preter m infants, being associated with clinical complications. The prevention of hypothermia in the first hour of life is fundamental in the reduction of diseases related to prematurity.