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Urine metabolomics is gaining attention as a means of identifying metabolic signatures associated with health and disease states.Thirty-one(31) late preterm (LP) neonates admitted to the NICU and 23 age-matched healthy LPs admitted to the maternity ward of a tertiary hospital were included into the study. Proton nuclear magnetic resonance (1H NMR) spectroscopy was used for urine metabolomic analysis on the 1stand 3rdday of life of the neonates. Data were analyzed by univariate and multivariate statistical analysis. A unique metabolic pattern of enhanced metabolites was identified in the NICU-admitted LPs from the 1stday of life. Differences in the metabolic profile were also identified in LPs with respiratory distress syndrome (RDS) compared to those without. The discrepancies may reflect differences in the gut microbiota due to the differential nutrition between the different neonatal groups or to medical interventions, such as administration of antibiotics and other medications. The altered metabolites could also serve as biomarkers for identifying critically ill LP neonates or those at risk of adverse outcomes in later life, including metabolic risks. The discovery of novel biomarkers may also offer windows of opportunity for intervention and may reveal potential targets for drug discovery, offering a personalized approach.&nbsp

Background Evidence suggests that neonates born at 34-36 weeks should not be considered full-term neonates, given the magnitude of morbidities they experience compared with term infants. Neonates born at 34 to 36 weeks are at increased risk for early illness such as hypoglycemia and hyperbilirubinemia compared to term infants. Objective This study's objective was to determine the frequency of immediate neonatal complications (hypoglycemia and neonatal jaundice) in late preterm and term neonates. Subjects and methods A serial descriptive case study was conducted at the private tertiary care hospital. Random samplings were taken, and the sample size was calculated on Epi Info software (Centers for Disease Control and Prevention, Atlanta, GA). All the eligible samples were taken into confidence following approval by the College of Physicians and Surgeons Pakistan's institutional review board. A structured questionnaire was used in which demographic information of the patient was collected, and all neonates were closely observed for early targeted morbidities (hypoglycemia, hyperbilirubinemia) Results A total of 215 neonates were born during the study period, of whom 108 (50.2%) were term babies and 107 (49.8%) late preterm babies. There were 122 (56.7%) male infants and 93 (43.3%) female infants. Jaundice was observed in 6.5% (n=7) of term neonates and 22.4% (n=24) of late preterm neonates (p

Late preterm (LPT) neonates are at a high risk for respiratory distress soon after birth due to respiratory distress syndrome (RDS), transient tachypnea of the newborn, persistent pulmonary hypertension, and pneumonia along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support when compared with the term neonates. In the past, studies on outcomes of infants with respiratory distress have primarily focused on extremely premature infants, leading to a gap in knowledge and understanding of the developmental biology and mechanism of pulmonary diseases in LPT neonates. Surfactant deficiency is the most frequent etiology of RDS in very preterm and moderately preterm infants, while cesarean section and lung infection play major roles in RDS development in LPT infants. The clinical presentation and the response to surfactant therapy in LPT infants may be different than that seen in very preterm infants. Incidence of pneumonia and occurrence of pneumothorax are significantly higher in LPT and term infants. High rates of pneumonia in these infants may result in direct injury to the type II alveolar cells of the lung with decreasing synthesis, release, and processing of surfactant. Increased permeability of the alveolar capillary membrane to both fluid and solutes is known to result in entry of plasma proteins into the alveolar hypophase, further inhibiting the surface properties of surfactant. However, the oxygenation index value do not change dramatically after ventilation or surfactant administration in LPT infants with RDS compared to very preterm infants. These finding may indicate a different pathogenesis of RDS in late preterm and term infants. In conclusion, surfactant therapy may be of significant benefit in LPT infants with serious respiratory failure secondary to a number of insults. However, optimal timing and dose of administration are not so clear in this group. Additional randomized, controlled studies and evidence-based guidelines are needed for optimal surfactant therapy in these infants. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy) · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research