Long-term outcomes of saline boluses in very preterm infants

2018 ◽  
Vol 11 (3) ◽  
pp. 317-321
Author(s):  
A. Aslam ◽  
M. Vincer ◽  
A. Allen ◽  
S. Imanullah ◽  
C.M. O’Connell
Keyword(s):  
Preterm Infants ◽  
Long Term Outcomes ◽  
Very Preterm Infants ◽  
Very Preterm

Long-term outcomes of antenatal corticosteroids treatment in very preterm infants after chorioamnionitis

2015 ◽  
Vol 292 (6) ◽  
pp. 1239-1246 ◽  
Author(s):  
Ken Miyazaki ◽  
Madoka Furuhashi ◽  
Kaoru Ishikawa ◽  
Koji Tamakoshi ◽  
Kazutoshi Hayashi ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Long Term Outcomes ◽  
Antenatal Corticosteroids ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Antileukotrienes for the prevention and treatment of chronic lung disease in very preterm newborns: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marlide Jukema ◽  
Franciszek Borys ◽  
Greta Sibrecht ◽  
Karsten Juhl Jørgensen ◽  
Matteo Bruschettini
Keyword(s):  
Lung Disease ◽  
Preterm Infants ◽  
Chronic Lung Disease ◽  
Animal Studies ◽  
Risk Of Bias ◽  
Long Term Outcomes ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Preterm Newborns

Abstract Background Very preterm infants are at high risk of developing chronic lung disease, which requires respiratory support and might have long-term sequelae. As lung inflammation plays an important role in pathogenesis, antileukotrienes have been explored in both clinical and animal studies. We aimed to assess the benefits and harms of antileukotrienes for the prevention and treatment of respiratory morbidity and mortality in very preterm newborns. Methods In this systematic review, we included randomized trials and non-randomized studies in humans and animals reporting the effects of antileukotrienes in very preterm infants or other mammals within 10 days of birth. Our pre-specified primary outcomes were all-cause mortality and any harm, and, for the clinical studies, incidence of chronic lung disease. Included studies underwent risk of bias-assessment and data extraction performed by two authors independently. There were no language restrictions. Results Fifteen studies totally met our inclusion criteria: one randomized trial and four non-randomized studies in humans and 10 animal studies (five in rodents, two in lambs and one in either guinea pigs, rabbits or caprinae). All five clinical studies used montelukast and had a small sample size, ranging from 4 to 77 infants. The randomized trial (n = 60) found no difference in the incidence of chronic lung disease between the groups. Only one clinical study, which enrolled four very preterm infants and had a critical overall risk of bias, reported long-term outcomes. All other studies had unclear or greater overall risk of bias and meta-analyses were therefore deemed unfeasible. Eight of ten animal studies used leukotriene receptor antagonists as antileukotriene (montelukast in three of ten studies) and seven had an experimental study design (i.e. some animals were not exposed to antileukotrienes but no randomization). Three of the ten animal studies assessed different doses. Animal studies found no effect on the outcomes mortality, growth, or lung function related surrogate outcomes. Conclusions Use of antileukotrienes in very preterm infants to prevent or treat chronic lung disease is not supported by the available evidence. Large randomized trials focusing on outcomes relevant to patients, including long-term outcomes, are needed. Studies should also minimize risk of bias.

scholarly journals Maternal Vaginal Ureaplasma spp. Colonization in Early Pregnancy Is Associated with Adverse Short- and Long-Term Outcome of Very Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 276
Author(s):  
Judith Rittenschober-Böhm ◽  
Tanja Habermüller ◽  
Thomas Waldhoer ◽  
Renate Fuiko ◽  
Stefan M. Schulz ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Early Pregnancy ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Vaginal Colonization ◽  
Short And Long Term

Vaginal colonization with Ureaplasma (U.) spp. has been shown to be associated with adverse pregnancy outcome; however, data on neonatal outcome are scarce. The aim of the study was to investigate whether maternal vaginal colonization with U. spp. in early pregnancy represents a risk factor for adverse short- or long-term outcome of preterm infants. Previously, 4330 pregnant women were enrolled in an observational multicenter study, analyzing the association between vaginal U. spp. colonization and spontaneous preterm birth. U. spp. colonization was diagnosed via PCR analysis from vaginal swabs. For this study, data on short-term outcome were collected from medical records and long-term outcome was examined via Bayley Scales of Infant Development at 24 months adjusted age. Two-hundred-and-thirty-eight children were born <33 weeks gestational age. After exclusion due to asphyxia, malformations, and lost-to-follow-up, data on short-term and long-term outcome were available from 222 and 92 infants, respectively. Results show a significant association between vaginal U. spp. colonization and severe intraventricular hemorrhage (10.4% vs. 2.6%, p = 0.03), retinopathy of prematurity (21.7% vs. 10.3%, p = 0.03), and adverse psychomotor outcome (24.3% vs. 1.8%, OR 13.154, 95%CI 1.6,110.2, p = 0.005). The data suggest an association between vaginal U. spp. colonization in early pregnancy and adverse short- and long-term outcome of very preterm infants.

Necrotizing Enterocolitis in a Dutch Cohort of Very Preterm Infants: Prevalence, Mortality, and Long-Term Outcomes

2022 ◽  
Author(s):  
Ceren Imren ◽  
Lotte E. Vlug ◽  
Barbara A. E. de Koning ◽  
Tessa Diertens ◽  
Heleen E. Snel ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Surgical Complication ◽  
Intestinal Failure ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Anastomotic Strictures ◽  
Multidisciplinary Perspective

Abstract Introduction To improve counseling of parents and to guide care strategies, we studied the disease course and outcomes of necrotizing enterocolitis (NEC) up to 2 years of corrected age (CA) from a multidisciplinary perspective. Materials and Methods This was a retrospective cohort study in preterm infants (birth weight < 1,500 g, gestational age < 32 weeks), diagnosed with NEC (Bell's stage ≥ II) from 2008 through 2020. Data on prevalence, mortality, surgery, intestinal failure (IF), growth, and neurodevelopment at 2-year follow-up were separately analyzed for medically and surgically treated children. Results Of 3,456 preterm infants, 200 (6%) were diagnosed with NEC, of whom 135 developed an indication for surgery within 7 days after the diagnosis; 28/135 died before surgery, and 37/107 died after an open-and-close procedure. An enterostomy was constructed in 62 patients and an end-to-end anastomosis in 15. The postoperative course was described for 77 patients, of whom 23 developed surgical complications (12/23 incisional hernias, 9/23 anastomotic strictures), 13/77 a short bowel, and 25/77 IF. Sixty-day survival after birth for medical NEC patients was 88% (hazard ratio [HR]: 0.698; p = 0.318), and for surgically treated NEC patients was 40% (HR: 3.729; p < 0.001). At 2-year follow-up, one patient received parenteral nutrition. Severe delay in weight for age, motor, and cognitive development was seen in 3, 6, and 2%, respectively. Conclusion In this cohort, the mortality rate was high, especially in surgically treated NEC patients. The surgical complication rate is comparable to previous studies, but in surviving patients, persisting IF and severe delay in growth and neurodevelopment at 2 years CA were relatively rare.

Long-term effects of pain in infants

2021 ◽  
pp. 38-46
Author(s):  
Ruth E. Grunau ◽  
Jillian Vinall Miller ◽  
Cecil M. Y. Chau
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Pain Treatment ◽  
Inflammatory Responses ◽  
Imaging Techniques ◽  
Preterm Neonates ◽  
Long Term Effects ◽  
Very Preterm Infants ◽  
Very Preterm

The long-term effects of infant pain are complex, and vary depending on how early in life the exposure occurs, due to differences in developmental maturity of specific systems underway. Changes to later pain sensitivity reflect multiple factors such as age at pain stimulation, extent of tissue damage, type of noxious insult, intensity, and duration. In both full-term and preterm infants exposed to hospitalization, sequelae of early pain are confounded by parental separation and quality of pain treatment. Neonates born very preterm are outside the protective uterine environment, with repeated exposure to pain occurring during fetal life. Especially for infants born in the late second trimester, the cascade of autonomic, hormonal, and inflammatory responses to procedures may induce excitotoxicity with widespread effects on the brain. Quantitative advanced imaging techniques have revealed that neonatal pain in very preterm infants is associated with altered brain development during the neonatal period and beyond. Recent studies now provide evidence of pathways reflecting mechanisms that may underlie the emerging association between cumulative procedural pain exposure and neurodevelopment and behavior in children born very preterm. Owing to immaturity of the central nervous system, repetitive pain in very preterm neonates contributes to alterations in multiple aspects of development. Importantly, there is strong evidence that parental caregiving to reduce pain and stress in preterm infants in the Neonatal Intensive Care Unit (NICU) may prevent adverse effects, and sensitive parenting after NICU discharge may help ameliorate potential long-term effects.

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