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.

Fantoms
Two-year outcomes following a randomised platelet-transfusion trial in preterm infants It is great to see the 2 year outcomes of the PlaNeT-2/MATISSE (Platelets for Neonatal Transfusion-2/Management of Thrombocytopenia in Special Subgroup) study in the journal. This randomised-controlled trial examined the outcomes of 660 preterm infants<34 weeks’ gestation with severe thrombocytopenia who were randomised to receive platelet transfusions if their platelet count fell below 50x109 /L (high threshold, liberal transfusion) or below 25x109 /L (low threshold, restrictive transfusion. Transfusion at a count below 50 was ...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - August 17, 2023 Category: Perinatology & Neonatology Authors: Stenson, B. J. Tags: Highlights from this issue Source Type: research

Congenital cytomegalovirus infection is associated with congenital rickets: a retrospective autopsy cohort study
Congenital rickets is characterised by deficient bone mineralisation at the growth plate in utero. A review of published cases of congenital rickets found that maternal vitamin D deficiency likely contributes to its pathogenesis.1 Two recent studies showed that human cytomegalovirus (CMV) led to a rapid, pronounced and persistent reduction of vitamin D receptor (VDR) mRNA expression in vitro and in vivo.2 3 This effect was specific to CMV and was not observed for other common viruses.2 VDR is essential for mediating the biological function of vitamin D and for bone development.4 Therefore, we hypothesised that congenital r...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Chan, E. S., Haider, S., Subramanian, S., Yu, W., Nohr, E. W., de Koning, L. Tags: PostScript Source Type: research

Exploring the risk of hyperoxia in oxygen-dependent very low birthweight infants in the first week of life to plan future trials of oxygen targeting
The practice of titrating supplemental oxygen to target levels of pulse oximeter saturation (SpO2) evolved with little supporting evidence. Before this, the recommended practice was to target transcutaneous or arterial PO2 to 6.7–10.7 kPa (50–80 mm Hg).1 2 Recent evidence shows that SpO2 targets below 90% increase mortality and necrotising enterocolitis and higher targets increase retinopathy of prematurity treatment, but not blindness or disability.3 4 The optimal SpO2 target range for preterm infants is unknown. Trials of higher SpO2 targets are needed to determine any further survival advantage to be gained....
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Kelly, R., Quine, D., Stenson, B. J. Tags: PostScript Source Type: research

Tributyrin ester-impregnated pH strips for confirming neonatal feeding tube placement: a diagnostic test accuracy study
Nasogastric (NGT) or orogastric (OGT) tubes are the primary mode of feeding in term born sick infants and preterm infants during the postnatal period. Incorrect tube placement in the respiratory tract can lead to life-threatening aspiration. Following the UK National Patient Safety Agency1 and American Society for parenteral and enteral nutrition (ASPEN)2 guidance, current best practice relies on a pH ≤5.5 of the gastric aspirate to confirm gastric placement and requires a chest radiograph if pH is >5.5. A new pH strip augmented with human gastric lipase (HGL) detection has been developed to improve the sensitivity o...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Banerjee, J., McLister, A., Gourin, B., McClure, Z., Mariampillai, K., Boyle, R. J., Hanna, G. B., Ni, M. Z. Tags: PostScript Source Type: research

Kernicterus in neonates from ethnic minorities in the UK
Kernicterus (bilirubin encephalopathy) is an important cause of lifelong neurodisability, with UK incidence of 0.9/100 000 live births.1 It causes painful dystonia, limits voluntary movements and affects speech and hearing, though often preserving cognition. The impact is reflected in the high cost of successful claims.2 Disturbingly, non-white ethnic groups are disproportionately affected in the UK. Neonates from UK ethnic minority groups are at high risk of hyperbilirubinaemia. General risk factors include gestational age <38 weeks, intention to solely breast feed, jaundice with onset in the first 24 hours and/or prog...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Baskaran, D., Gale, C., Jawad, S., Oughham, K., Pang, K., Basu, A. P. Tags: PostScript Source Type: research

Neonatal point-of-care lung ultrasound: a UK-wide survey and the way forward
Point-of-care lung ultrasound (LU) is gaining interest in neonatal intensive care and international recommendations now support its use in practice.1 It can provide rapid diagnostic confirmation in emergency situations, for example, tension pneumothorax,2 and enhances the diagnostic accuracy of neonatal respiratory disorders allowing targeted treatment. Increasingly, LU has been shown to accurately predict the need for surfactant and decrease time to its delivery,3 potentially reducing lung injury. For neonates, LU possesses attractive characteristics including the absence of radiation, non-invasive technique, accessibilit...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Montasser, M., Kirolos, S., Milan, A., Meau-Petit, V. Tags: PostScript Source Type: research

Assessing variation in neonatal sepsis screening across England
Early-onset neonatal sepsis (EOS) is associated with serious adverse outcomes. Current screening for clinical signs of sepsis in England typically involves one of two approaches: guidelines issued by the National Institute of Clinical Excellence (NICE) or a risk-based tool developed in the USA, the Kaiser Permanente Sepsis Risk Calculator (KP SRC). An update to the 2012 NICE guidelines in April 2021 permitted the alternative use of the KP SRC with prospective audit.1 The application of the KP SRC has been consistently shown to reduce antibiotic usage2 3; however, uncertainty exists among clinicians as to whether this comes...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Moore, H. L., Battersby, C., Piyasena, C., Demirjian, A., Lamagni, T. Tags: PostScript Source Type: research

Eosinophilic pustular folliculitis of infancy
A 3-week-old male neonate presented to the dermatology department with 5 days of progressively increasing pustules on the scalp and face. The mother was in good condition during pregnancy and had no history of varicella, syphilis, genital herpes or vaginal candidiasis. The baby was irritable, afebrile and without lymphadenopathy. A large number of isolated or clustered pustules on an erythematous background were found on the scalp and face (figure 1). Immediate Gram stain and potassium hydroxide preparation of the pustular contents, including cultures for bacteria and fungi, were negative. Wright stain showed a number of e...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Guo, W., Qian, G., Zhang, C. Tags: Images in neonatal medicine Source Type: research

Antiseizure medication at discharge in infants with hypoxic-ischaemic encephalopathy: an observational study
Conclusions In infants with HIE and seizures, continuation of ASM at discharge varies substantially among centres and may be associated with a higher risk of death or disability at 18–22 months of age. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Sewell, E. K., Shankaran, S., McDonald, S. A., Hamrick, S., Wusthoff, C. J., Adams-Chapman, I., Chalak, L. F., Davis, A. S., Van Meurs, K., Das, A., Maitre, N., Laptook, A., Patel, R. M., National Institute of Child Health and Human Development Neonatal R Tags: Original research Source Type: research

Parents Experiences of Communication in Neonatal Care (PEC): a neonatal survey refined for real-time parent feedback
Conclusion Revised from the original 61-question Picker survey, the 28-question PEC survey is the first UK instrument formally evaluated to assess parent experience while infants are still receiving neonatal care. Developed with parents, it focuses on communication and parent involvement, enabling continuous assessment and iterative improvement of family-centred interventions in neonatal care. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Sakonidou, S., Kotzamanis, S., Tallett, A., Poots, A. J., Modi, N., Bell, D., Gale, C. Tags: Open access Original research Source Type: research

Supporting all breaths versus supporting some breaths during synchronised mechanical ventilation in neonates: a systematic review and meta-analysis
Conclusion Compared with SIMV, synchronised modes supporting all breaths are associated with a shorter weaning duration with no statistically significant difference in mortality, BPD at 36 weeks or other outcomes. Larger studies with explicit ventilator and weaning protocols are needed to compare these modes in the current neonatal population. PROSPERO registration number The review was prospectively registered with PROSPERO: CRD42020207601. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Batra, D., Jaysainghe, D., Batra, N. Tags: Original research Source Type: research

Variation in hospital morbidities in an Australian neonatal intensive care unit network
Conclusions Hierarchical model-based risk-adjusted estimates of morbidity rates plotted on funnel plots provide a robust and straightforward visual graphical tool for presenting variations in outcome performance to detect aberrations in healthcare delivery and guide timely intervention. We propose using hierarchical model-based risk adjustment and funnel plots in real or near real-time to detect aberrations and start timely intervention. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Abdel-Latif, M. E., Adegboye, O., Nowak, G., Elfaki, F., Bajuk, B., Glass, K., Harley, D. Tags: Open access Original research Source Type: research

Comparison of two automated oxygen controllers in oxygen targeting in preterm infants during admission: an observational study
Conclusions Oxygen saturation targeting was significantly different in the OxyGenie epoch in preterm infants, with less time in hypoxic and hyperoxic SpO2 ranges during their stay in the NICU. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Salverda, H. H., Dekker, J., Lopriore, E., Dargaville, P. A., Pauws, S. C., te Pas, A. B. Tags: Original research Source Type: research

Association of nurse staffing and unit occupancy with mortality and morbidity among very preterm infants: a multicentre study
Conclusions NICU occupancy is associated with mortality/morbidity among very preterm infants and may reflect lack of adequate resources in periods of high activity. Interventions aimed at reducing occupancy and maintaining adequate resources need to be considered as strategies to improve patient outcomes. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Beltempo, M., Patel, S., Platt, R. W., Julien, A.-S., Blais, R., Bertelle, V., Lapointe, A., Lacroix, G., Gravel, S., Cabot, M., Piedboeuf, B., on behalf of the Quebec investigators of the Canadian Neonatal Network Tags: Original research Source Type: research

Low dose or very low dose phenylephrine and cyclopentolate microdrops for retinopathy of prematurity eye examinations (The Little Eye Drop Study): a randomised controlled non-inferiority trial
Conclusion VLD microdrops enable safe and effective screening for ROPEE in both Māori and non-Māori preterm infants. Trial registration number ACTRN12619000795190. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - June 19, 2023 Category: Perinatology & Neonatology Authors: Kremer, L. J., Medlicott, N., Sime, M. J., Broadbent, R., Edmonds, L., Berry, M. J., Austin, N. C., Alsweiler, J. M., Reith, D. M. Tags: Open access Original research Source Type: research