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Compassion fatigue is a common complication in nurses, which can lead to burnout, job dissatisfaction, and a decline in the quality of patient care. This study aimed to investigate the impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit (NICU). This cluster-blinded randomized clinical trial study was conducted on 66 NICU nurses in 2 educational hospitals selected. The intervention group received a 1-month online program for daily training and practice of loving-kindness meditation. The control group received miscellaneous files on mental health during the COVID-19 pandemic period. The Nursing Compassion Fatigue Inventory (NCFI) was filled out by the 2 groups, before and after the intervention. The results showed that the mean scores of the NCFI in the intervention group decreased significantly compared with before the intervention (P =.002). In comparison with the control group, there was a significant difference between the mean scores of the 2 groups after the intervention (P =.034). Among nurses working in NICU, loving-kindness meditation significantly reduces compassion fatigue after 1 month. These findings support the use of this intervention for nurses. [ABSTRACT FROM AUTHOR]

Background. Premature birth, in addition to causing health problems in infants, increases stress in the mother and reduces attachment between mother and baby. Therefore, the present study was conducted to determine the effect of guided visualization on stress and attachment of mothers of preterm infants in the neonatal intensive care unit (NICU). Methods. This quasi-experimental study was performed on 35 mothers with premature infants admitted to the NICU of Mahdieh Hospital of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mothers were selected by available sampling method and randomly assigned into intervention and control groups. For mothers in the intervention group, the intervention was performed from the first to the fifth day of birth through training and sending guided imagery files. On the day of admission and discharge, the parental stress questionnaire and the postpartum attachment questionnaire were completed by the mother. SPSS software (version 20) was used to analyze the data. Results. The mean total score of maternal attachment on the fifth day of the intervention was significantly higher in the intervention group (P<0.001). Also, the mean total score of mothers' attachment status on the day of discharge was significantly higher in the intervention group (P<0.001). Conclusion. Implementation of guided visualization program reduced stress in mothers with premature infants admitted to the NICU, and consequently increased the level of attachment. [ABSTRACT FROM AUTHOR]

Background and Objective: Neonatal thrombocytopenia (NTP) is one of the most common neonatal hematological disorders. The causes of NTP are very various, leading to large differences in the clinical profile of the affected neonates. Therefore, the aim of this study was to investigate the characteristics, clinical diagnoses and short-term outcomes of NTP in Bahrami Children's Hospital, Iran. Methods: This descriptive retrospective cross-sectional study was conducted on all neonates admitted to the neonatal intensive care unit (NICU) of Bahrami Children's Hospital in 2017-2019. The infants diagnosed with NTP, defined as a platelet count of <150000 on at least 2 occasions, were retrospectively evaluated. Data on patients' NTP and short-term outcomes were reported. Incomplete medical records were excluded from the study. Findings: Out of 2000 neonates, 210 patients were diagnosed with NTP with a prevalence of 10.5%. Totally, 60% and 71.4% of infants were premature and underweight, respectively. Moreover, 30 and 20.9% of infants had premature and severe NTP, respectively. The most common clinical diagnosis was sepsis (68.1%). The mean length of stay in NICU was 12.3±9.5 days. Additionally, 20.9% of infants had at least one episode of severe hemorrhage, received a platelet transfusion, and 10.4% of infants expired during their NICU stay. Conclusion: The prevalence of NTP was 10.5%. Despite the relatively high prevalence of preterm birth, low-birth weight and sepsis, the majority of our neonates recovered. Prospective studies are recommended to investigate the role of each predisposing factor in the development and outcome of NTP. [ABSTRACT FROM AUTHOR]

Background: The WHO and UNICEF have suggested pasteurized donor milk (PDM) as the best alternative for infants who do not receive enough milk from their mothers. Objective: This study aimed to assess the short-term outcomes of launching the first mother's milk bank in North-West of Iran. Methods: The present retrospective study included 366 premature infants (181 pre-launch and 185 post-launch) who were hospitalized in Al-Zahra Hospital of Tabriz, Iran. The study included infants with birth weight <2000 g and/or gestation age <32 weeks who were born before and after the launch of mother's milk bank. Frequency of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), late onset sepsis (LOS) and mortality rate were compared. Data were analyzed using SPSS 23 with the chi- square test, Fisher exact test, independent t test, and logistic regression test. Results: In total, NEC grade ≥ 2 was reported in 9 cases; 8 cases (4.41%) in pre-launch and one case (0.54%) in post-launch (adjusted OR = 0.091; 95% CI = 0.010 to 0.849, P = 0.035). ROP was reported in 21 cases in two groups. Nineteen cases (10.5%) belonged to the pre-launch group and 2 cases (3.7%) to the post-launch group (adjusted OR = 0.105; 95% CI = 0.022 to 0.488, P = 0.004). LOS was also found in 17 cases (9.39%) in the pre-launch group and 4 cases (2.16%) in the post-launch period, suggesting a significant difference between the two groups (adjusted OR = 0.297; 95%CI = 0.089 to 0.995, P = 0.049). There was no significant difference in mortality of infants during hospitalization between the two groups (P = 0.789); however, it was decreased from 15 to 8. Conclusion: Launching the human milk bank significantly improved the outcomes of premature infants. [ABSTRACT FROM AUTHOR]

Background: Preterm deliveries and premature babies are among challenges for families and communities. A familycentered care model is a model that helps families become less challenged by preterm birth and learn how to care for their premature infants. The aim of this study was to evaluate the implementation of family-centered care in the Iranian neonatal intensive care units (NICUs). Methods: This national cross-sectional study was conducted on a total of 23 NICUs of 9 universities of medical sciences, where students were trained in the neonatology fellowship course, in seven provinces of Iran. Family-centered developmental care was assessed in six different domains, including the philosophy of nursery, family communication, family support, family resources, admission and discharge planning, and decision-making. In addition, a total of 29 items were asked. The data were analyzed using Stata software (version 13) using descriptive statistical tests. Results: The mean scores in all domains were weak, and the total score for all domains was 34.18 (95% CI: 33.75- 34.60) out of 100. The mean scores were 30 in the philosophy of nursery, 43.47 in family communication, 26.71 in family support, 35 in family resources, 45 in admission and discharge planning, and 25 in decision-making. The lowest score was reported for decision-making, and the highest score was reported for admission and discharge planning. Conclusion: Since family-centered developmental care in Iran is not favorable, the obtained findings suggest the development of a suitable plan to upgrade family-centered developmental care as well as comprehensive NICU care, including developmental care, with regard to other domains. [ABSTRACT FROM AUTHOR]

Background: Premature birth and hospitalization in Neonatal Intensive Care Units (NICUs) is a critical issue for parents, especially mothers. The present study aimed to investigate the effect of spiritual care on hope and selftranscendence in mothers with premature newborns hospitalized in the NICUs. Methods: This quasi-experimental, single-group study was conducted using time series analysis. The sample consisted of 30 mothers with premature neonates hospitalized in Shahid Beheshti Hospital, Maraqeh, Iran. The participants were selected through a convenience sampling method following the inclusion criteria. The data were collected using the demographic characteristic forms of mothers and the clinical status of infants, as well as the hope and self-transcendence scales of the mothers with premature neonates admitted to the NICU. The data were analyzed in SPSS software (version 19) through descriptive statistics (i.e., frequency distribution, mean and standard deviation) and repeated measures analysis of variance (ANOVA). Results: The findings show a significant difference among the pre-test, post-test, and follow-up stages in terms of the mean scores of hope and self-transcendence using repeated measure ANOVA (P<0.001). Moreover, in examining the effect of spiritual care on hope and self-transcendence in mothers, the results of repeated measures ANOVA showed that there was a difference among the pre-test, post-test and follow-up stages in terms of the mean scores of mothers’ hope, (P<0.001, F=53.133, and Eta-squared=0.639). Moreover, a significant difference was observed among the pretest, post-test, and follow-up phases regarding the mean scores of self-transcendence (P<0.001, F=131.239, and Etasquared=0.814). Conclusion: Since spirituality can lead to an increase in hope and self-transcendence of mothers with premature infants hospitalized in the NICUs, this approach can be used as an appropriate intervention method to help improve their adaptation and peace of mind. Therefore, barriers to providing these types of care and managing them must be identified so that nurses in the NICUs can use them. [ABSTRACT FROM AUTHOR]

Background: Infections are one of the most important causes of death in infants, especially in developing countries. Inappropriate use and administration of antibiotics can contribute to the resistance and spread of infection. In this study, we determined the antibiotic resistance pattern of the bacteria isolated from clinical samples of blood, cerebrospinal fluid, and urine in the neonatal intensive care unit (NICU) of Ali Asghar Hospital, Iran during 2013-2015. Methods: For the purposes of the study, clinical samples of blood, cerebrospinal fluid, and urine were collected from the NICU of Ali Asghar Hospital during 2013-15. The type of bacterial strain and antibiotic susceptibility pattern was determined by routine microbiological tests. The collected data were analysed in SPSS software (version 19), using χ2, Student's t-test, and ANOVA test for comparison. Results: In total, 240 positive culture samples (118 blood, 117 urine, and 5 cerebrospinal fluid samples) were collected for this research. The most common isolates in the blood, urine, and cerebrospinal fluid samples were Staphylococcus epidermidis (63.6%), Klebsiella (35%), and Acinetobacter Baumannii (40%), respectively. The highest antibiotic resistance in S. epidermidis isolated from blood samples was found against amikacin and cefotaxime, while linezolid and vancomycin were the most effective antibiotics against S. epidermidis. Moreover, ciprofloxacin and nitrofurantoin were the most effective antibiotics against Klebsiella isolated from urine samples, while this bacterial strain had the highest resistance to imipenem and ampicillin. Despite the fact that A. Baumannii strains were resistant to most studied antibiotics, ceftazidime and ceftriaxone had an acceptable antibacterial effect against these isolates. Conclusion: Continuous surveillance for antibiotic susceptibility, rational use of antibiotics, and the strategy of antibiotic cycling can provide some answers to the emerging problem of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the effect of providing massage (tactile and kinesthetic stimulation) on behavioural responses for preterm infants. Background: These infants have immature central nervous systems. Sleep–wake states during infancy have been shown to reflect severity of disease developments, and the nervous system and brain maturation. Methods: This study is a quasi-experimental study with before and after design conducted on 45 preterm infants who were admitted in neonatal intensive care unit (NICU). The subjects received massage 15 min per day for 5 days using field massage technique. Behavioural responses were measured by behavioural state, motor activity and behavioural distress. Data were obtained 10 min before and 10 min after the providing massage period. Results: An increase was observed in sleep state score after providing massage. And also, the awake, fidgeting and motor activity scores reduced after providing massage. No significant change was seen in the total behavioural distress. Conclusion: The findings suggest that providing field massage had soothing and calming effect on preterm infants and could be beneficial in nursing intervention. Nurses working in neonatal intensive care unit need to be educated on how to performing the massage on preterm infants. Abbreviation: NICU: Neonatal Intensive Care Unit [ABSTRACT FROM AUTHOR]

Background: Regarding improvements in preterm infants' survival rates, it is necessary the improvement of Neonatal Intensive Care Unit (NICUs) status in order to provide comprehensive care. The aim of this study was to assess the aspects of staffing-oriented neonatal care in NICUs affiliated to Universities of Medical Sciences in Iran.Methods: This survey is a cross-sectional study which was conducted in 23 NICUs of nine type-1 Universities of Medical Sciences across country. The study checklist contained 39 items in four domains, including "Composition, Philosophy, Training, and Support", "Management", "Resources", and "Transition Systems". Data were gathered through observation and analyzed using Stata software, version 13.Results: In this study, the mean score of staffing-oriented care was 43.5 of 100. In none of the studied domains, the mean score obtained was not above 50. Among the four domains studied, the highest score was related to "Management", (the mean score of 50 of 100) and the lowest score related to "Resources" (the mean score of 35 of 100).Conclusions: Considering the importance of the role of health professionals in the neonatal comprehensive care, and also the low mean score of staffing-oriented care (43.51 out of 100) and also its items in NICUs in this study, it is concluded that more attention is needed for staff-oriented care as well as the strengthening of this dimension of developmental care along with other dimensions, through designing of appropriate interventions to improve the health outcomes of preterm infants. [ABSTRACT FROM AUTHOR]

Introduction: Developmental care program is a comprehensive program to reduce secondary effects of NICU and special care on brain development in premature infants. This study aimed to assess neonatal care situation in Iranian NICUs based on developmental approach to design and provide clinical guidelines for daily care for the caregivers and the infant's family.Methods: This was a cross-sectional study conducted in NICUS in Iran. A total of 23 NICUs of 9 Universities of Medical Sciences were investigated. The checklist contains 30 items in 6 domains. Data were analyzed using STATA software, version 13.Results: The total mean score obtained from all six domains was 31.29 of 100, and in all domains, the mean scores calculated were not above 50. In "supporting infant," "developmental caregiving activities," "supporting the infants' state organization," "providing neonatal pain management," "developmental care approaches in documentation," and "developmental care approaches in NICU staffing," the total mean scores were 34.76, 21.6, 20, 30.18, 31.30, and 50, respectively.Conclusion: The low mean score of infant-centered developmental care implies health staff's focus on neonatal care with at least the quality of care and its impact on development in preterm infants, and inadequate attention to the infant as an active member in care. [ABSTRACT FROM AUTHOR]

Introduction: Developmental care provided to infants hospitalized at neonatal intensive care units (NICU) help weaken environmental stressors and reduce infant morbidity rates. Assessments are the first step to improving the quality of any type of care. Therefore, this study was conducted to design and assess the psychometric features of a scale designed for measuring quality of developmental care in the NICU in Iran. Methods: This study was conducted from December 2014 through September 2015 in Tehran, Iran. The present mixed-methods sequential exploratory (quantitative-qualitative) study used the Delphi method to design an initial questionnaire through a review of the literature and by using the input of experts. The validity of the questionnaire was ensured by assessing then validity of its content (qualitative-quantitative), face (qualitativequantitative), and construct (exploratory factor analysis with 500 NICU personnel from 34 hospitals in Tehran), and its reliability was ensured by assessing its internal consistency (using Cronbach's alpha) and by assessing its stability through the test-retest method. Results: The qualitative stage of the study resulted in a 93-item questionnaire with eight domains. After performing the content and face analyses, a factor analysis was performed on 90 items of the questionnaire, yielding a 76-item questionnaire with five domains, including "sleep, pain and stress management," "routine care," "the family," "management," and "sensory care," which explained 62.5% of the variance. The reliability of the questionnaire was confirmed with a Cronbach's alpha of 0.9 and its stability was confirmed by an Intraclass Correlation Coefficient (ICC) of 0.93. Conclusion: The questionnaire developed for the assessment of developmental care in the NICU covered all of the dimensions of this type of care, and it is a valid and reliable tool for assessing and improving developmental care in the NICU. [ABSTRACT FROM AUTHOR]

Objectives Premature birth of neonates leads to anticipatory grief ( AG) reaction in parents and make them vulnerable to mental health disorders. The present study aimed to determine and compare the AG reaction in mothers and fathers of premature infants hospitalized in the neonatal intensive care unit. Methods This comparative descriptive design was conducted among 40 pairs of mothers and fathers selected by convenience sampling method. The study was performed in 2011 using the Anticipatory Grief Scale. Data were analysed with ' Wilcoxon ranks test' using SPSS. Results The AG mean scores of fathers and mothers were 1.55 ± 0.55 and 1.68 ± 0.63, respectively. The Wilcoxon test did not show any statistically significant difference between mothers' and fathers' AG reaction (p = 0.12). Conclusion Despite expectations, the AG reaction in mothers and fathers showed no difference in this study. It seems necessary to pay more attention to the fathers in addition to mothers to be supported and consulted by the healthcare providers. [ABSTRACT FROM AUTHOR]

Objective: Very low birth weight (VLBW) infants are at high risk for morbidity and mortality. This article determines the frequency of disease, rate od survival, complications and risk factors for morbidity and mortality in VLBW neonates admitted to a level III neonatal intensive care unit (NICU) at Mahdieh Hospital in Tehran. Methods: This cross-sectional retrospective study was performed from April 2007 to March 2010 on all hospitalized VLBW neonates. Relevant pre- and peri-natal data up to the time of discharge from the hospital or death, including complications during the course of hospitalization, were collected from the case notes, documented on a pre-designed questionnaire and analyzed. Findings: Out of 13197 neonates, 564 (4.3%) were VLBW with 51.4% males. Mean gestational age was 29.6±2.5 weeks; mean birth weight 1179±257 grams. Mean birth weight, gestational age and Apgar scores were significantly higher in babies who survived than in those who died, (1275±189 vs. 944±253 grams; 30.5±2.2 vs. 27.5±2 weeks and 6.9±1.7 vs. 5±2.1 respectively, P<0.001 in all instances). Overall survival was 70.9%; in extremely low birth weight (ELBW) newborns this figure was 33.3% rising to 84.1% in infants weighing between 1001-1500 grams. Respiratory failure resulting from RDS in ELBW babies was the major factor leading to death. Need for mechanical ventilation, pulmonary hemorrhage and gastro-intestinal bleeding were also significant predictive factors for mortality. Conclusion: Birth weight and mechanical ventilation are the major factors predicting VLBW survival. [ABSTRACT FROM AUTHOR]

Background & Aims : Neonate is a vulnerable being and its death depends on neonatal risk factors during and after delivery. The first step in reduction of mortality rate is to recognize the causes. This present study was designed to determine the effect of neonatal risk factors and effective treatment measures on neonatal death. Materials & Methods : This case-control study was carried out on 250 cases of dead neonates admitted in NICU during 2007 - 2009 years and the control group also was 250 neonates who were admitted during the same ward and year and after necessary treatments were discharged alive. To collect data, a questionnaire was provided including mother's &neonates demographic features, hospitalized & deathcauses, treatment measures and its complications. Chi-squared test, odds ratio and logistic regression were used to determine the relationship between variables in which p<0. 05 was significant. Result : The results of logistic regression by forward selection method showed that apgar less than 6 (O. R=4. 02), birth asphyxia (O. R=6. 16), HMB (O. R =4. 06) and sepsis (O. R =6. 42) cause to increase the neonates death in NICU but use N. CPAP and increasing of number of pregnancy cause to reduce the neonates death. There was no significant relation on variables such as low birth weight, family history, blood group preterm labor and neonate's gender. Conclusion: The results of this studyrevealed that the neonatal deaths are associated with low Apgar, birth asphyxia, HMD, sepsis, premature and congenital abnormality, it will be effective to reduce the neonatal mortality with management and doing the proper treatment & care measures. [ABSTRACT FROM AUTHOR]

Background & Aims: In NICU some painful procedures can be happened for neonates. Neonates pain is a stressful experience to their parents. This research was done to determine the effect of mother presence on their views to pain control in neonates in Intensive care units. Materials & Methods: This research was a quasi experimental study. The sample based on pilot study on 20 mother was 150. The instrument for data gathering was a questionnaire including demographic variables and 24 MCQ questions that measured mothers' views about neonates pain control before and after their presence in NICU. To analyze the data, SPSS 18 was used and significant difference was lower than 0. 05. Result: There was significant difference in views before and after intervention (p<0. 001). Results showed a relation between mothers age (21-30) and their views (p<0. 05). Linear regression results showed visit times had affect on views (p<0. 002). Conclusion: Mothers want to stay near their children if painful procedures decrease. Therefore, we should try to limit invasive techniques and because of their important role in care, we can encourage them to cooperate doing procedures. [ABSTRACT FROM AUTHOR]

Background: Advances in perinatal care have increased the number of premature babies who survive. We investigated the frequency of preterm delivery and its influence on the neonatal outcome in pregnancies at a perinatal center in Isfahan, Iran. Methods: This study was done among the preterm deliveries at a Shahid-Beheshti perinatal center in Isfahan, Iran. The data collected in checklists and were analyzed by Student-t, Mann-Whitneyt, and chi-square tests via SPSS software. Finding: In this study we evaluate 1402 delivery. There were 233 preterm deliveries (less than 37 weeks gestational age). Among 248 live preterm deliveries, 123 cases (49%) need NICU cares. The mean of NICU administration was 10.1 days. The rate of mortality in NICU was 25% (32 cases). Conclusion: Preterm deliveries are at a higher risk for an adverse neonatal outcome and thereby cause considerable costs. In this study, our findings were in the range of other studies; but more attention to premature neonates is recommended. [ABSTRACT FROM AUTHOR]

Background: American pediatric Association proposes to screen all neonates with Oto-Acoustic Emission (OAE). In developing countries, because of several limitations, health policy makers recommend to screen only in high risk patients. This study is performed with the aim to screen hearing loss in 950 high risk newborns hospitalized in hospitals affiliated to Tehran University using the OAE test. Methods: A total of 950 neonates hospitalized in the Neonatal and NICU wards of Valie- Asr, Shariati, Medical Center and Bahrami Hospitals during the years 2004-2006 who showed at least one risk factor using TEOAE hearing test were enrolled into this crosssectional descriptive analytical study and were diagnosed with mild deafness and total deafness. Blood exchange due to hyperbillirubinemia, septicemia, congenital heart disease, the fifth minute apgar scores below six, PROM more than six hours, epilepsia, need to NICU more than five hours, pneumonia and Oto-Toxic drugs were considered as risk factors. Data was past medical history, current disease, admission cause, sign & symptoms and complications of disease. Results: Multivariate logistic regression and paired t-test showed that blood exchange, low birth weight and low first minute Apgar scores had the highest independent risk for hearing loss among newborn. Conclusion: Despite of the low prevalence of neonatal hearing loss, screening of hearing loss at early stages is important. [ABSTRACT FROM AUTHOR]

Background: Premature birth can affect maternal mental health. Considering that the mental health disorder in mothers may play a vital role in the growth and development of their children, therefore, this study was conducted to determine the effect of supportive counseling on mental health (primary outcome), mother-child bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants., Methods: This randomized controlled clinical trial was carried out on 66 mothers with hospitalized neonates in the NICU of Alzahra hospital in Tabriz- Iran. Participants were randomly allocated into two groups of intervention (n = 34) and control (n = 32) through a block randomization method. The intervention group received 6 sessions of supportive counseling (45-60 minutes each session) by the researcher, and the control group received routine care. Questionnaires of Goldberg General Health and the postpartum bonding were completed before the intervention (first 72 hours postpartum) and 8 weeks postpartum. Also, the anthropometric index of newborns were measured at the same time., Results: There was no statistically significant difference between the two groups in terms of socio-demographic characteristics. After the intervention, based on ANCOVA with adjusting the baseline score, mean score of mental health (AMD: -9.8; 95% Confident Interval (95% CI): -12.5 to -7.1; P < 0.001) and postpartum bonding (AMD: -10.0; 95% CI: -0.6 to 13.9; P < 0.001) in the counseling group was significantly lower than those of the control group; however, in terms of weight (P = 0.536), height (P = 0.429) and head circumference (P = 0.129), there was no significant difference between the two groups., Conclusions: Supportive counseling may improve mental health and postpartum bonding in mothers of premature infants. Thus, it may be recommendable for health care providers to offer it to mothers., Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45 . Date of registration: October 29, 2018.

Purpose: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) provides comprehensive newborn focused family-centered care in the Neonatal Intensive Care Unit (NICU). The purpose of this study was to investigate nurses' and physicians' experiences of implementing the NIDCAP model to optimize its implementation for both caregivers, infants, and families in the NICU., Design & Methods: A purposes sample of 11 nurses and four physicians participated in this qualitative study. Data were collected by face-to-face and semi-structured interviews and analysis were guided by principles of thematic analysis as per Graneheim and Lundman (2004)., Results: Six themes and 20 sub-themes were constructed during data analysis. These included; NIDCAP as a milestone, Helping to rebuild the core of the family, Caregiver excellence, Realism towards the feasibility of NIDCAP, Proper managerial position of NIDCAP specialists in the health system, and Caring for the caregiver., Conclusions: The findings of this study highlight how NIDCAP provides a comprehensive and effective care model for premature infants, with the goal to promote neonatal growth and development while also facilitating the self-efficacy of caregivers. Implementation of the NIDCAP model requires attention to be paid to social context, infrastructure, adjustment of the program according to the facilities and resources of each country, and the needs of caregivers., Practice Implications: Health care resources are required to sustain NIDCAP specialists and a favorable environment as the necessary conditions for its multidimensional application across NICU units around the world., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Many newborns may need to be hospitalized and receive drugs during the first days of their lives. These drugs are fundamentally prescribed as off-label and unlicensed. This study aimed to investigate the amount of these kinds of drugs administered in the Neonatal Intensive Care Units (NICUs) of Abuzar and Imam Khomeini Teaching Hospitals in Ahvaz, Iran.Methods: This was a 3-month descriptive, cross-sectional study with retrospective nature in which 193 hospitalized newborns were studied. Demographic data were extracted from the patients' files. The drugs were classified as off-label, unlicensed or licensed according to the Pediatric & Neonatal Dosage Handbook (Lexicomp®, 22nd Edition).Results: In total, 1049 prescriptions were registered for the 193 hospitalized newborns (term and preterm). For each newborn, the mean numbers of prescriptions and drugs received were 5.4 and 4.5, respectively. The mean numbers of prescriptions and drugs were greater for preterm newborns. Of the total 1049 prescriptions, 38.1% were off-label and 1.9% were unlicensed. Of the 193 newborns, 85% received at least one off-label or unlicensed prescription. Off-label prescriptions were mostly related to dose (44.8%) and dosing interval (36.5%). Most off-label drugs were antibiotics (mainly Gentamicin). Albuterol was used off-label in 100% of the cases.Conclusions: The results of the present study show that the prescription of off-label and unlicensed drugs in NICUs is as high in Iran as in other countries. This suggests that it is necessary to provide information to neonatologists to decrease the prescription of off-label and unlicensed drugs. [ABSTRACT FROM AUTHOR]