Archives of Disease in Childhood - Fetal and Neonatal Edition This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

National priority setting partnership using a Delphi consensus process to develop neonatal research questions suitable for practice-changing randomised trials in the UK
Conclusions We have identified and prioritised research questions suitable for practice-changing interventional trials in neonatal medicine in the UK at the present time. Trials targeting these uncertainties have potential to reduce research waste and improve neonatal care. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 19, 2023 Category: Perinatology & Neonatology Authors: Evans, K., Battersby, C., Boardman, J. P., Boyle, E., Carroll, W., Dinwiddy, K., Dorling, J., Gallagher, K., Hardy, P., Johnston, E., Mactier, H., Marcroft, C., Webbe, J. W. H., Gale, C. Tags: Open access Original research Source Type: research

Estimated neonatal survival of very preterm births across the care pathway: a UK cohort 2016-2020
Conclusions Survival estimates are a vital tool to support and supplement clinical judgement within perinatal care. These up-to-date, national estimates of survival to 28 days are provided based on three stages of the perinatal care pathway to support ongoing clinical care. These novel results are a key resource for policy and practice including counselling parents and informing care provision. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 19, 2023 Category: Perinatology & Neonatology Authors: Seaton, S. E., Agarwal, R., Draper, E. S., Fenton, A. C., Kurinczuk, J. J., Manktelow, B. N., Smith, L. K. Tags: Editor's choice Original research Source Type: research

Subcortical bruising in the preterm infant
A cranial ultrasound (CUS) was performed on day 2 of a 27-week, 3-day gestational age newborn, with no external clinical signs or history of trauma during delivery nor concerns of significant thrombocytopenia or coagulopathy, prompted by acute drop in haematocrit (from 17.5 to 11.4 g/dL). Perinatal history was significant for in vitro fertilisation pregnancy, cervical cerclage, pregestational diabetes mellitus, gestational hypertension and premature prolonged membrane rupture, followed by a course of betamethasone and magnesium sulfate, then delivery by stat section for prolapsed cord. Resuscitation was uneventful except f...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 19, 2023 Category: Perinatology & Neonatology Authors: Roychaudhuri, S., Benson, C., El-Dib, M. Tags: Images in neonatal medicine Source Type: research

Can we balance early exogenous surfactant therapy and non-invasive respiratory support to optimise outcomes in extremely preterm infants? A nuanced review of the current literature
Therapeutic advances have significantly improved the survival of premature infants. However, a high burden of bronchopulmonary dysplasia (BPD) persists. Aiming at prevention of neonatal lung injury, continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) strategies have replaced mechanical ventilation for early respiratory support and treatment of respiratory distress syndrome. Multiple randomised controlled trials have demonstrated that broad application of CPAP/NIV decreases exposure to mechanical ventilation and reduces rates of BPD. Here, we explore why this treatment effect is not larger. We disc...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 19, 2023 Category: Perinatology & Neonatology Authors: Glaser, K., Bamat, N. A., Wright, C. J. Tags: Reviews Source Type: research

Neonatal seizures. Treat! But when, with what and for how long?
Neonatal seizures remain a complex challenge for those of us involved in these babies’ care. While relatively common, our approaches to these patients vary between clinicians, subspecialties and centres. Nearly every facet of detection, investigation, treatment and follow-up of these patients is subject to some variation in practice. Sewell et al, on behalf of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, provide more evidence on the enormous variation in practice that exists for these infants, with an observational study on antiseizure medication (ASM) use after discharge for i...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 19, 2023 Category: Perinatology & Neonatology Authors: Hunt, R. W. Tags: Editorials Source Type: research

Fantoms
Estimated neonatal survival for very preterm births in the UK Sarah Seaton et al have provided valuable new outcome information about extremely preterm babies born in the UK between 2016 and 2020. These data will be highly valuable in discussions with families. We have been relying on evidence from earlier years and from other health systems. They report neonatal survival figures. This means the proportion of babies who are still alive 28 days after birth. Outcomes of more than 43 000 pregnancies are reported. The data exclude babies whose deaths were considered to be caused by congenital anomalies. The data do not include...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - October 19, 2023 Category: Perinatology & Neonatology Authors: Stenson, B. J. Tags: Highlights from this issue Source Type: research

Resuscitation of a preterm infant with massive air embolism
The imaging report provided by Hentschel et al is titled ‘Resuscitation of a preterm infant with massive air embolism’.1 The authors cite papers by Lee and Tanswell2 and Richter et al,3 the titles of which also both refer to air embolism. However, in the report by Lee and Tanswell, the majority of babies in their series were receiving high concentrations of oxygen; for the 27 babies where the information was available, the mean inspired oxygen concentration was 90%, and the majority of the 23 others were receiving mechanical ventilation at high pressures, suggesting that they also were receiving high concentrat...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Hall, M. Tags: PostScript Source Type: research

Respiratory and cardiovascular stabilisation prior to deferred umbilical cord clamping in premature infants: a feasibility and safety study
The World Health Organisation recommends deferred umbilical cord clamping (performed 1–3 min after birth) for all births (including preterm), while initiating simultaneous essential neonatal care.1 The optimal time for cord clamping has not been established, but respiratory and haemodynamic transition after birth are interlinked2 and the Resuscitation Council UK advocates cord clamping after the lungs are inflated.3 Despite this, the recommendation of at least 60 seconds deferred cord clamping (DCC) is not universally achieved in preterm infants because of the challenges of providing necessary respiratory and thermal...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Heuchan, A. M., OShea, J. E., Aitken, J. Tags: PostScript Source Type: research

Neonatal jaundice in infants born at 37 weeks: is NICE treating too many?
Neonatal jaundice affects approximately 60% of term and 80% of preterm infants within the first week of life. Gestation-based treatment threshold graphs by the National Institute of Health and Care Excellence are used to guide jaundice management in the UK.1 NICE treatment thresholds at 37-week gestation are much lower compared with ≥38 weeks and also when compared with the previous and recently updated American Academy of Paediatrics guidelines.1–3 This results in an increased treatment burden and hospitalisation of 37-week infants, including mother–baby separation. Infants born at 37 weeks usually are grou...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Noureldein, M., Hill, C., Ali, A., Gbenga-Ojo, S., Adewuyi, M., Fradd, V., Surana, P. Tags: PostScript Source Type: research

Rescue high-frequency oscillatory ventilation in UK neonatal intensive care units
Observational studies demonstrated improvements in gas exchange in infants who were placed on high-frequency oscillation (HFO) following failure of conventional ventilation (rescue HFO), but the few randomised controlled trials did not demonstrate important clinical benefits.1 2 Indeed, subsequent meta-analyses did not recommend routine use of rescue high-frequency oscillatory ventilation (HFOV) in infants with respiratory failure of any gestational age.3 4 Considering that data are limited, our aim was to explore use of rescue HFOV in UK neonatal units. A questionnaire was sent to all 189 UK neonatal units between May 202...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Kaltsogianni, O., Howells, A., Dassios, T., Greenough, A. Tags: PostScript Source Type: research

Long QT syndrome presenting as fetal bradycardia and 2:1 atrioventricular block in a preterm infant
We present a case of a male infant born by emergency caesarean section for fetal bradycardia detected in the context of a maternal intercurrent illness at 31+5 weeks’ gestation. He was born vigorous despite a heart rate of 65–80 beats/min. ECG at birth (figure 1) demonstrates a ‘pseudo-block’ phenomenon arising from a profoundly prolonged QT interval (633 ms). Non-conducted P waves occur before the T wave of the preceding QRS as the ventricles have not repolarised before the atria contract for the second time (figure 2). On diagnosis of long QT syndrome (LQTS), propranolol was started. No ventricula...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Kelleher, S. T., Prendiville, T., Carroll, A. Tags: Images in neonatal medicine Source Type: research

Data-driven approach to understanding neonatal palliative care needs in England and Wales: a population-based study 2015-2020
Conclusions At least 2% of babies admitted to neonatal units had palliative care needs according to existing BAPM categories; most survived to discharge. Of deaths, 51% were not captured by the BAPM categories; most were extremely preterm. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Harnden, F., Lanoue, J., Modi, N., Uthaya, S. N., Battersby, C., on behalf of the UK Neonatal Collaborative Tags: Original research Source Type: research

Respiratory function after birth in infants with congenital diaphragmatic hernia
Conclusion Respiratory function immediately after birth is heterogeneous for infants with CDH. Lung aeration, as evidenced by expired TV and ETCO2, appears to be ongoing throughout the first 10 min after birth during invasive positive pressure ventilation. Close attention to expired TV and ETCO2 levels by 10 min after birth may provide an opportunity to optimise and individualise ventilatory support for this high-risk population. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Wild, K. T., Mathew, L., Hedrick, H. L., Rintoul, N. E., Ades, A., Soorikian, L., Matthews, K., Posencheg, M. A., Kesler, E., Van Hoose, K. T., Panitch, H. B., Flibotte, J., Foglia, E. E. Tags: Original research Source Type: research

Late permissive hypercapnia and respiratory stability among very preterm infants: a pilot randomised trial
Conclusion Targeting 5 mm Hg (0.67 kPa) changes in transcutaneous carbon dioxide did not improve respiratory stability among very preterm infants on ventilatory support but the intended carbon dioxide separation was difficult to achieve and maintain. Trial registration number NCT03333161. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Travers, C. P., Carlo, W. A., Nakhmani, A., Laney, D., Chahine, R. A., Aban, I., Ambalavanan, N. Tags: Original research Source Type: research

Mucous fistula refeeding in neonates: a systematic review and meta-analysis
Conclusion Low certainty of evidence suggests that MFR is associated with shorter duration of parenteral nutrition in neonates following abdominal surgery and stoma creation. Results of ongoing and future randomised trials may help to corroborate these findings. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Solis-Garcia, G., Jasani, B. Tags: Original research Source Type: research