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Icterus is the most common medical problem in neonates and photo-therapy is the standard treatment for neonatal hyperbilirubinemia. This study aimed to compare the efficacy and length of hospital stay of double and triple phototherapy in newborns with indirect hyperbilirubinemia. Methods: In a clinical trial, 40 healthy term newborns (gestational age > 37 weeks) with bilirubin 3 12 and 3 15 mg/dL in the second and third day, respectively, were randomly assigned to triple (n = 20) or double phototherapy (n = 20) groups. Total and direct serum bilirubin were measured at admission, 8, 16, and 24 hours after beginning of phototherapy, and every 12 hours thereafter until discharge (when bilirubin levels reached £ 10 mg/dL). Results: There were 21 male (52%) and 19 female (48%) term neonates, with significant difference between patients' age, weight, and age of icterus. There was no significant difference in the rate of bilirubin decline between the two groups within the first 8, 16 and 24 hours. There was no significant difference in mean length of hospital stay between the two groups. Analysis of complications showed no difference between triple and double groups. Conclusion: Triple phototherapy failed to reduce total serum bilirubin and shorten length of hospitalization more rapidly than double phototherapy.

Background Hyperbilirubinemia is the most common problem in term newborns during the first week of life. Hyperbilirubinemia in term newborns without other risk factors is usually caused by dehydration and reduced calorie intake that is marked by excessive weight loss. Objective To determine the relationship between percentage birth weight loss and hyperbilirubinemia during the first week of life in term newborns. Methods A cross sectional study was conducted at the Department of Child Health, Medical School, Udayana University, Sanglah Hospital, Denpasar, Indonesia. The weight of term newborns was measured on the first, third, and seventh day after birth. In addition, a complete blood count, reticulocyte count, and peripheral blood smear, were carried out on the first day. Serum bilirubin level was measured on the first, third, and seventh day. Clinical signs, jaundice, type and frequency of intake, and time of meconium transit were followed during the stay in hospital. Linear regression, correlation, and logistic regression analysis were performed to determine variables related to hyperbilirubinemia. Results 68 newborns were enrolled in this study, with 7 developed hyperbilirubinemia by the third day. There was a significant (P

When the mother's own human milk is unavailable or limited, pasteurized human milk from milk banks is preferentially administered instead of infant formula, especially for vulnerable hospitalized neonates. Holder pasteurization (62.5 °C, 30 min) may alter human milk composition and structure, which may modulate its digestive behavior. An in vitro dynamic system was set up to simulate the gastrointestinal digestion of term newborns in order to compare the kinetics of lipolysis, proteolysis and structural disintegration of raw versus pasteurized human milk. Human milk from 5 donors was pooled. Half of the pool was either administrated raw (RHM) or pasteurized (PHM). Digestions were conducted at least in duplicate for RHM and PHM. Heat-induced protein aggregation was observed in PHM. During gastric digestion, β-casein was proteolyzed significantly faster for PHM than for RHM (p < 0.05), whereas lactoferrin tended to be proteolyzed slower (p = 0.07) for PHM. Pasteurization selectively affected the intestinal release of some amino acids. At any time of the gastrointestinal digestion, the lipolysis of PHM was significantly lower than that of RHM, but no impact was observed on the profile of released fatty acids. RHM presented a structural destabilization after 60 min of gastric digestion, while there was no large variation for PHM. In the intestinal phase, the evolution of the particle sizes was rather similar. Overall, Holder pasteurization impacted the proteolysis, lipolysis and disintegration of human milk. However, this impact was limited and the physiologic and metabolic consequences remain to be investigated. [ABSTRACT FROM AUTHOR]

Background: The Japan Resuscitation Council (JRC) updated the guidelines for neonatal cardiopulmonary resuscitation in 2010, which recommended appropriate oxygen supplementation under the assessment of oximetry, with continuous positive airway pressure (CPAP) as a consideration in the delivery room. Whether this update has resulted in an improvement of respiratory stabilization in term neonates has not been well investigated to date. Objectives: The aim of this study is to evaluate the impact of the update of the JRC Guidelines in 2010 on the frequency of respiratory support for term neonates within 24 h of life in the nursery or neonatal intensive care unit (NICU). Methods: We conducted a retrospective, single-center study using data of term neonates born between 2008 and 2009 (defined as 'group 1', before the update of the guidelines), and between 2011 and 2012 (defined as 'group 2', after the update of the guidelines). We compared resuscitation procedures in the delivery room and respiratory support in the nursery or NICU within 24 h of life between the two groups. Respiratory support included oxygen therapy, nasal CPAP and mechanical ventilation. Results: A total of 5,036 infants were analyzed. In group 2, oxygen administration in the delivery room was significantly decreased (38.9 vs. 22.1%, p < 0.001) and face mask CPAP in the delivery room increased (1.7 vs. 11.1%, p < 0.001). The prevalence of respiratory support within 24 h of life in the nursery or NICU increased significantly in group 2 (group 1, 6.8% vs. group 2, 16.6%, p < 0.001). Conclusions: The update of the JRC Guidelines in 2010 resulted in an increase of respiratory support for term infants within 24 h of life. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Due to excessive production of free radicals and antioxidants evolved mechanisms against oxidative stress, infants are very vulnerable. As there was a significant relation between antioxidant levels and birth weight, we aimed verify this relationship. MATERIALS & METHODS: In this descriptive analytical study we evaluated the antioxidant status of 40 healthy term newborns (gestation age 38-42 wk) with weight >2500 g (AGA) and 40 healthy term newborns (gestation age 38-42 wk) with LBW babies (weight < 2500 g) (SGA) in Ardabil Buali Hospital, Ardabil, northwest Iran in 2014. About 15 Ml of cord blood was collected after the second stage of labor. The levels of vitamin A, E, and C, catalase, glutathione peroxidase (GPX), bilirubin and serum uric acid were measured by standard methods. Informed consent was obtained from newborn mothers and study protocol was approved by university Ethics Committee. Data were analyzed using SPSS.19. RESULTS: The mean levels of bilirubin, vitamin C, E, catalase and GPX in AGA group were significantly higher than SGA group but the mean of serum uric acid in SGA group was more than AGA. In addition, the mean of vitamin A was similar in two groups. There was a significant relation between antioxidant levels and birth weight in term newborns. CONCLUSION: In line with other studies the amounts of antioxidant levels except serum uric acid in AGA group was significantly more than SGA group. [ABSTRACT FROM AUTHOR]

The progressive behavior of the blood pressure of term newborns during the first week of life was assessed by the simultaneous use of oscillometric and Doppler methods. A total of 174 term neonates born at the Municipal Hospital Odilon Behrens in Belo Horizonte, from March 1996 to February 1997, were prospectively assessed. The oscillometric and Doppler ultrasonic methods were simultaneously used for four consecutive recordings obtained at 12 ± 6, 24 ± 6 and 72 ± 24 h and on the 7th ± 1 day of life. The combined use of the two methods simplified the procedure, with automatic cuff inflation and deflation, and speed was properly controlled with an automatic pressure monitor. The procedure was performed using a Y-connection to the mercury sphygmomanometer, with blood pressure being recorded with an automatic device and systolic blood pressure being measured simultaneously by Doppler ultrasound. The newborns were awake, not crying and in the supine position. A statistically significant increase in systolic and diastolic blood pressure was observed between the first and second, and the third and fourth measurements by Doppler and oscillometric methods. No significant correlation between birth weight, length, ponderal index and blood pressure was observed. The technique used represents a simpler and more accurate procedure for blood pressure measurement.

The one of most common problems of the newborn baby is indirect hyperbilirubinemia. In this retrospective study; the etiology, clinical and demographic features, treatment methods, and the complications in pathological indirect hyperbilirubinemia and prolonged jaundice were evaluated. 237 cases of pathological indirect hyperbilirubinemia and prolonged jaundice that were viewed in Yüzüncü Yıl University Hospital Neonatology Unit between January 2013 - December 2014 were included in this study. All neonates in the study with following characteristics: 57.8% of patients were male, the mean gestational age of 38.4 ± 1 weeks, mean birth weight of 2870 ± 505 g , mean bilirubin level on admission of 21.6 ± 5.6 mg/dL (13-49), vaginal delivery ratio of 55.7%, first time mother ratio of 34.2%, breastfeeding ratio of 98%. While in 95 (40.1 %) neonates the etiology of hyperbilirubinemia could not be found, urinary tract infection in 34 (14.3%), ABO incompatability in 72 (30.4%) and Rh incompatability in 24 (% 10.1) patients were found. The average length of stay in the hospital and duration of phototherapy were 4 ± 2.9 days and 37.2 ± 14.2 hours, respectively. All of the cases were given phototherapy, but 44 infants were done exchange transfusions. We found that bilurubin induced neurological disorder in 23 newborn had undergone exchange transfusion, and its the most important risk factorwas ABO incompatability (43.2 %). Urinary tract infection (30.8%), and idiopathic causes (42.3 %) were found as the most important risk factors for prolonged jaundice.Pathological indirect hyperbilirubinemia is a major cause of morbidity and mortality in the newborn period. We think that newborns with jaundice should be diagnosis, treatment, and close follow-up in order to prevent development of bilirubin-induced neurologic dysfunction. [ABSTRACT FROM AUTHOR]

Objective: The aim of the current study was to determine any relationship between the timing of clamping of the umbilical cord and the lipid levels circulating in umbilical artery and vein. Methods: We studied a clinical trial with systematic assignment in 229 single-fetus full-term deliveries with normal gestational course and spontaneous delivery; out of these, 111 were subjected to early clamping (EC, within 10 s of delivery) and 118 to late clamping (LC, at 2 min). In all cases, total cholesterol (TC), triglycerides (TG), and phospholipids were measured in sera from umbilical artery and vein. Results: TC and TG values were significantly higher in the EC group than in the LC group in both umbilical artery and vein. Comparing values between umbilical artery and vein in the two clamping groups, in the EC group, all studied lipids TC, TG and phospholipids were significantly higher in vein than in artery. In the LC group, only TC was higher in vein. Conclusion: Umbilical cord lipid levels are related to the timing of umbilical cord clamping, finding which is noteworthy, because they are essential component of postnatal development. Our study confirms that delivery acts as an important modifier of fetal lipid levels. [ABSTRACT FROM AUTHOR]

The shock of birth is a transient depression of muscle tone and deep tendon reflexes seen in newborn babies shortly after birth. We evaluated the shock of birth in a sample of 313 consecutive term newborns at 4, 24 and 48 hours of life. We correlated neurologic findings on examination with maternal, obstetric and perinatal data. Special attention was given to the relationship between the mode of delivery and shock of birth. Of the maternal data, factors associated with the shock of birth were obstetric gestational age, previous gestations, abortions or previous vaginal deliveries. Presence of stained amniotic fluid at birth was associated with the shock of birth. There was also a correlation between shock of birth and newborn sex, birth weight, thoracic circumference and the Battaglia and Lubchenco classification. The shock of birth lasted less than 24 hours in 70% of the newborns and less than 48 hours in 84.3%. We conclude that the mode of delivery, vaginal or cesarean section, did not influence the shock of birth. We also established the duration and factors associated with this phenomenon.O choque do nascimento é uma depressão temporária do tono muscular e reflexos em recém-nascidos. Nós o avaliamos em uma amostra de 313 recém-nascidos a termo, de partos consecutivos, examinados com 4,24 e 48 horas de vida. Correlacionamos os achados do exame neurológico com dados maternos, do parto e do recém-nascido, com ênfase na relação entre o tipo de parto e o choque do nascimento. Dentre os dados maternos, estiveram associados com o choque do nascimento: idade gestacional obstétrica, gestações, abortamentos e partos vaginais prévios. O único dado do parto que esteve associado foi a presença de líquido amniótico não claro. Sexo, peso ao nascimento, perímetro torácico e classificação de Battaglia & Lubchenco foram os dados do recém-nascido que estiveram associados com o evento. O choque do nascimento durou menos de 24 horas em 70% dos recém-nascidos e até 48 horas em 84,3% deles. Concluímos que o tipo de parto, se vaginal ou cesáreo, não exerce influência no choque do nascimento. Também estabelecemos sua duração e os fatores que estão associados com este fenômeno.

Background and purpose: Anogenital distance is an accepted indicator for endogenous or environmental effects of androgens on development of reproductive system in fetus and newborns. This study was done to determine the relationship between penile length and anogenital distance in Iranian newborns. Material and Methods: In this cross-sectional study stretched penile length (PL) and anogenital distance (AGD) were measured in 427 healthy male newborn infants born in a Teaching Hospital (in north of Iran). Other variables included the age of mothers, and weight, height, and head circumference of neonates. Normal distribution of variables was measured by Shapiro-Wilk and data was analyzed using Pearson Correlation tests Results: The mean of PL was 32.1±3.5 mm and the mean of AGD was 24.5±2.5mm. A weak correlation was observed between PL and AGD (r=0.097, p=0.046). Conclusion: The correlation between penile length and AGD showed that, AGD could be also used in assessing the genital system and even as a common indicator to assess the genital system in both sexes [ABSTRACT FROM AUTHOR]

Objective: To determine cerebral regional tissue oxygen saturation (CrSO2), renal regional tissue oxygen saturation (RrSO2), and splanchnic regional tissue oxygen saturation (SrSO2) values in healthy term infants. Study Design: Near-infrared spectroscopy was used to simultaneously measure CrSO2, RrSO2, and SrSO2 continuously for a 1-hour period on the first and second days of life. Results: A total of 41 subjects were monitored out of which complete data were available for 38 subjects. Mean CrSO2 was 78.2 ± 7.9% on first day; 78.3 ± 6.1% on second day (p = 0.95). Mean RrSO2 was 92.1 ± 5.3% on first day; 88.9 ± 5.9% on second day (p < 0.01). Mean SrSO2 was 69.9 ± 12.1% on first day and 75.3 ± 12.4% on second day (p = 0.02). Conclusion: There appears to be consistency in rSO2 values in healthy newborns. CrSO2 was similar on both days. Differences observed in RrSO2 and SrSO2 between days may represent a shift in somatic blood flow distribution taking place during the first day of life. [ABSTRACT FROM AUTHOR]

Congenital heart disease is a major risk factor for the development of necrotising enterocolitis (NEC), although its pathophysiology remains incompletely understood. NEC is a multifactorial disease that occurs in a high risk newborn. NEC incidence is inversely proportional to gestational age, only 10% of term infants develop disease. We present the case of a term newborn with intrauterine growth restriction and complex congenital heart disease (CHD), who developed in the underlying disease, enterocolitis at 10 days of life. Early diagnosis was established using near-infrared spectroscopy (NIRS) which showed significant mesenteric oxygen desaturation secondary to significant decrease in aortic blood flow. The standard treatment of NEC with antibiotics, enteral feeding cessation and cardio-circulatory support did not work in this newborn due to decreased mesenteric blood flow and significant ischemia. CHD that caused extremely low blood flow in mesenteric territory and which could not be surgically corrected caused child's death. NIRS is a noninvasive diagnostic method that monitors highly accurate regional tissue oxygenation and could detect mesenteric ischemia in early stages. The authors want to emphasize through this rare case of CHD, that any heart disease with decreased aortic flow lead to impaired mesenteric oxygen delivery beeing a risk factor for NEC. Tissue hypoxia secondary to decreases in mesenteric blood flow is the central pathophysiological cause of NEC in this term infant. We also want to highlight the usefulness of NIRS for noninvasive measurement of tissue perfusion in all high risk neonates. [ABSTRACT FROM AUTHOR]

Background: Infection-inflammation combined with hypoxia-ischemia (HI) is the most prevalent pathological scenario involved in perinatal brain damage leading to life-long neurological disabilities. Following lipopolysaccharide (LPS) and/or HI aggression, different patterns of inflammatory responses have been uncovered according to the brain differentiation stage. In fact, LPS pre-exposure has been reported to aggravate HI brain lesions in post-natal day 1 (P1) and P7 rat models that are respectively equivalent - in terms of brain development - to early and late human preterm newborns. However, little is known about the innate immune response in LPS plus HI-induced lesions of the full-term newborn forebrain and the associated neuropathological and neurobehavioral outcomes.Methods: An original preclinical rat model has been previously documented for the innate neuroimmune response at different post-natal ages. It was used in the present study to investigate the neuroinflammatory mechanisms that underline neurological impairments after pathogen-induced inflammation and HI in term newborns.Results: LPS and HI exerted a synergistic detrimental effect on rat brain. Their effect led to a peculiar pattern of parasagittal cortical-subcortical infarcts mimicking those in the human full-term newborn with subsequent severe neurodevelopmental impairments. An increased IL-1β response in neocortical and basal gray neurons was demonstrated at 4 h after LPS + HI-exposure and preceded other neuroinflammatory responses such as microglial and astroglial cell activation. Neurological deficits were observed during the acute phase of injury followed by a recovery, then by a delayed onset of profound motor behavior impairment, reminiscent of the delayed clinical onset of motor system impairments observed in humans. Interleukin-1 receptor antagonist (IL-1ra) reduced the extent of brain lesions confirming the involvement of IL-1β response in their pathophysiology.Conclusion: In rat pups at a neurodevelopmental age corresponding to full-term human newborns, a systemic pre-exposure to a pathogen component amplified HI-induced mortality and morbidities that are relevant to human pathology. Neuronal cells were the first cells to produce IL-1β in LPS + HI-exposed full-term brains. Such IL-1β production might be responsible for neuronal self-injuries via well-described neurotoxic mechanisms such as IL-1β-induced nitric oxide production, or IL-1β-dependent exacerbation of excitotoxic damage. [ABSTRACT FROM AUTHOR]

Abstract: Background: There is still no study evaluating the influence of gestational age (GA) per se on C reactive protein (CRP) and procalcitonin (PCT) reference intervals. We therefore investigated how length of gestation, age (hours), and prenatal and perinatal variables might influence the levels of CRP and PCT. We also determined 95% age-specific reference intervals for CRP and PCT in healthy preterm and term babies during the early neonatal period. Methods: One blood sample (one observation per neonate) was taken for CRP and PCT from each newborn between birth and the first 4 (for term), or 5days (for preterm newborns) of life by using a high-sensitive CRP and PCT assays. Results: Independently of gender and sampling time, GA had a significantly positive effect on CRP, and a significantly negative effect on PCT. Compared with healthy term babies, healthy preterm babies had a lower and shorter CRP response, and, conversely, an earlier, higher, and longer PCT response. CRP reference intervals were affected by a number of pro-inflammatory risk factors. Conclusions: Age- and GA-specific reference ranges for both CRP and PCT should be taken into account to optimize their use in the diagnosis of early-onset neonatal sepsis. [Copyright &y& Elsevier]

Aim: To evaluate the clinical and demographic features, duration of treatment and risk factors in term newborns hospitalized with a diagnosis of indirect hyperbilirubinemia. Materials and Method: All term neonates, hospitalized with a diagnosis of indirect hyperbilirubinemia between January 2008 - December 2008 were included in the study. The patients in the study group were followed up for a year in respect to the complications of hyperbilirubinemia. Results: Two hundred and forty eight neonates, who met the inclusion criteria were evaluated. One hundred and forty five (58.5 %) neonates were males. The average gestational age and birth weight were found to be 38.1±1.0 weeks and 3025±509 g respectively. Of the 248 neonates, 136 (55.6 %) were the first child of the family and 198 (80 %) were exclusively breast fed. The average postnatal age at admission and total bilirubin level were 4.6±2.6 days and 18.7±4.5 mg/dL respectively. In 98 (39.5 %) neonates the etiology of hyperbilirubinemia could not be found. Dehydration was found in 33 (13.3 %), ABO incompatability in 75 (30.2 %) and Rh incompatability in 19 (7.2 %) patients. The average length of stay and duration of phototherapy were 3.1±2.2 days and 44.8±22.8 hours respectively. Nine patients received IVIG; of which 6 had Rh incompatability, 2 ABO incompatability and 1 subgorup incompatability. Exchange transfusion was performed in 8 patients. Two patients receiving IVIG had to be treated with exchange transfusion. During 1 year follow up any bilirubin encephalopathy, hearing loss or neuromotor developmental delay was not observed. Conclusion: Birth weight less than 2500 g, postnatal pathological weight loss and exclusive breastfeeding (p<0.05) were found to be the risk factors related with high total serum bilirubin levels. During one year follow up, absence of any developmental delay, hearing problem or bilirubin encephalopathy may indicate that optimum treatment and follow up have been accomplished for these newborns. [ABSTRACT FROM AUTHOR]

We present an autopsy case of intrauterine pneumonia in a term newborn in whom Ureaplasma parvum was confirmed by PCR examinations, including a novel diagnostic tool for detecting pathogens that caused neonatal infections using multiplex PCR. This is the first report of U. parvum being implicated in the pathogenesis of congenital pneumonia with sepsis in a term newborn. [ABSTRACT FROM AUTHOR]

In the development of the foetal immune system, cytokines play an important role in its function. Therefore, we sought to determine whether the mode of delivery affects the expression of leptin, IL-6 and TNF-α in umbilical cord blood in healthy term newborns. We collected 125 samples of umbilical cord blood to analyse leptin, IL-6 y TNF-α levels with multiplex immunoassay (MIA). The samples were classified according to mode of delivery: vaginal delivery (VD) and caesarean section (CS). Leptin and IL-6 had higher concentrations in umbilical cord blood in VD than in CS: 42.55 ng/ml (11.92-104.28) versus 35.20 ng/ml (3.26-9326.76), p  =  0.039; 9.32 pg/ml (1.13-2020.31) versus 3.81 pg/ml (0.52-834.69) p < 0.001, respectively. Also, a weak correlation between TNF-α and IL-6 was found (r = 0.238, p = 0.007). The most important finding in our study was the differential concentrations of leptin and IL-6 according to mode of delivery. [ABSTRACT FROM AUTHOR]

Background: Icterus is the most common medical problem in neonates and photo-therapy is the standard treatment for neonatal hyperbilirubinemia. This study aimed to compare the efficacy and length of hospital stay of double and triple phototherapy in newborns with indirect hyperbilirubinemia. Methods: In a clinical trial, 40 healthy term newborns (gestational age > 37 weeks) with bilirubin 3 12 and 3 15 mg/dL in the second and third day, respectively, were randomly assigned to triple (n = 20) or double phototherapy (n = 20) groups. Total and direct serum bilirubin were measured at admission, 8, 16, and 24 hours after beginning of phototherapy, and every 12 hours thereafter until discharge (when bilirubin levels reached £ 10 mg/dL). Results: There were 21 male (52%) and 19 female (48%) term neonates, with significant difference between patients'' age, weight, and age of icterus. There was no significant difference in the rate of bilirubin decline between the two groups within the first 8, 16 and 24 hours. There was no significant difference in mean length of hospital stay between the two groups. Analysis of complications showed no difference between triple and double groups. Conclusion: Triple phototherapy failed to reduce total serum bilirubin and shorten length of hospitalization more rapidly than double phototherapy. [Copyright &y& Elsevier]

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The article presents abstracts of pediatrics. They include "Language Barriers to Prescriptions for Patients With Limited English Proficiency: A Survey of Pharmacies," "Measuring Primary Care of Children in Pediatric Resident Continuity Practices: A Continuity Research Network Study," and "Risk Factors for Persistent Pulmonary Hypertension of the Newborn."

Background: Hypernatremic dehydration due to inadequate fluid intake can be a significant problem during the neonatal period and thereafter. The objective of the present study was to evaluate the term newborn infants admitted to Gazi University Hospital neonatal intensive care unit (NICU) for hypernatremic dehydration between June 2001 and June 2003 and compare the results with those of the literature search performed via MEDLINE for infants with the same diagnosis. Methods: Infants with weight loss ≥10% were evaluated for hypernatremia and the ones with serum Na level ≥150 mEq/L were admitted to NICU. Long-term follow-up evaluations were performed using Bayley Scales of Infant Development I (BSID I) and Bayley Infant Neurodevelopmental Screener (BINS) tests. Results: Between June 2001 and June 2003, 28 newborns were admitted to NICU with hypernatremic dehydration. Literature review found 178 newborns with the same diagnosis since 1979 and detailed information was available for 150 patients. In the study and MEDLINE groups, respectively mean days of admission were 3.39 and 11.7; mean serum sodium, 156.5 and 178.6 mEq/L; and mean % weight loss, 11.5 and 25.7. Long-term follow up was performed in 15 patients from the study group, and two patients were found to be severely neurologically delayed. Five patients were found to have moderate risk scores by BINS tests. Conclusions: Early follow-up visits of newborns soon after discharge are important to determine risk for hypernatremic dehydration. Long-term follow up of this group of babies is also required to gather knowledge about the repercussions of early hypernatremic dehydration later in life. [ABSTRACT FROM AUTHOR]

The causes and risk factors of symptomatic spontaneous pneumothorax in term newborns are not completely understood. In the present study, our aim was to investigate the risk factors for and clinical and laboratory characteristics of term newborns with spontaneous symptomatic pneumothorax and to evaluate the outcome of management in this condition. A total of 11 term newborns admitted to the newborn intensive care unit with a diagnosis of symptomatic spontaneous pneumothorax were included during a 22-month period. Female to male ratio was 4:7, mean gestational age was 39.5 weeks, and 63% were delivered with a cesarean section, 18% of patients had renal and 55% had congenital cardiac anomalies. Rate of cardiac anomalies was more frequent in the study group compared to control group. Echocardiography in addition to renal ultrasonography may also be needed in term newborns with spontaneous symptomatic pneumothorax and further studies may be warranted to evaluate this association. [ABSTRACT FROM AUTHOR]

A recently isolated peptide hormone, hepcidin, is thought to be the principal regulator of iron homeostasis. Hepcidin acts by limiting intestinal iron absorption and promoting iron retention in reticuloendothelial cells. Its precursor peptide form is called pro-hepcidin. The aims of this study were to determine serum pro-hepcidin levels in healthy preterm and term newborns, and to assess possible relationships between pro-hepcidin and serum iron, serum ferritin, and transferrin. A serum sample was collected from each of 26 healthy preterm (gestational age [ABSTRACT FROM AUTHOR]

Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother's own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns. Methods: Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM (n = 2440) and prolonged PDM use among those who used PDM (n = 566). Results: Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28). Conclusions: The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time. [ABSTRACT FROM AUTHOR]

Human milk provides optimal nutrition for term newborns, but the prevalence of its use is below target, and risks have been identified. Infants of black mothers as well as term newborns admitted to the neonatal intensive care unit are at risk for not receiving human milk. To improve human milk intake, multiple individual-level interventions have been shown to be effective, but some popular system-level interventions are ineffective or harmful. Expressed milk and donor milk may be less beneficial than direct breastfeeding. Nuanced public policies can help support lactation while promoting individual choice and equity., Competing Interests: Disclosure The authors have no conflicts of interest to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The present overview is aimed at reporting the standard primary investigations that are mandatory in preterm and term newborns at admission to neonatal unit in the first hours after birth. Herein, the main neonatal screening tests for early detection of metabolic diseases are described as well as laboratory standard procedures (glycaemia, bilirubin, blood gas, infectious diseases analyses) monitoring parameters (vital signs recordings, blood and transcutaneous gas assessment, blood pressure recordings) and ultrasound pattern (cranial and cardiac). [ABSTRACT FROM AUTHOR]

Objective: To compare the course of the transcutaneous bilirubin (TcB) values of early-term newborns with those of term newborns in the first month of life and to investigate whether early-term newborns have an increased risk of significant hyperbilirubinemia requiring treatment., Design: A prospective, controlled cohort analysis., Setting: A tertiary level mother-child birth and health care center., Participants: Four hundred early-term (37 0/7 to 38 6/7 weeks) and 320 term (39 0/7 to 41 6/7 weeks) newborns born during a 27-month period., Methods: A total of six TcB measurements in a longitudinal manner were made in early-term and term newborns: the first two at 6 and 48 hours after birth and the next four on routine examination days (Days 4, 7, 15, and 30). Demographic characteristics, values of daily TcB measurements, number of newborns with significant hyperbilirubinemia, and risk of jaundice requiring treatment were compared between the two groups., Results: All six TcB values were significantly greater in the early-term group than in the term group (p < .001 for each). Early-term newborns had a statistically significant increased risk of jaundice requiring treatment compared to term newborns (risk ratio = 1.91; 95% confidence interval [1.23-2.96]; p = .0046). Results of the repeated-measures analysis of variance and post hoc adjusted multiple comparison analysis showed that TcB levels increased to and peaked at 96 hours after birth and then gradually decreased to baseline (first measurement) levels at 30 days after birth in each group., Conclusions: Early-term newborns should not be treated as full-term newborns because they have significantly higher TcB levels. These newborns should be closely monitored for pathologic jaundice because they have increased risk for significant hyperbilirubinemia requiring phototherapy., Competing Interests: Conflict of Interest The authors report no conflict of interest or relevant financial relationships., (Copyright © 2021 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of the study was to identify the features of both the labor and the assisting physicians when evaluating the newborn according to the Apgar score and how these correlate with the biochemical markers of fetal well-being in order to make the Apgar score more objective., Material and Methods: A prospective observational clinical study conducted in a 3 rd reference level center between 1 st April 2014 and 31 st March 2015. The study enrolled 17 neonatologists and 1527 term newborns., Results: The Apgar score is highest after natural vaginal delivery, lower after instrumental labor (p <0.001). The pH of the umbilical cord blood and lactate concentration correlate better with a high score than with a lowered one. The young age of a physician does not reduce Apgar score reliability. There were no differences in Apgar assessment according to physicians' training and the time of labor. There were no correlations between abnormalities in postnatal central nervous system ultrasound and the Apgar score., Conclusion: Biochemical tests of umbilical cord blood significantly increase the Apgar score reliability., (© 2018 Maria Kostro, Natalia Jacyna, Ewa Głuszczak-Idziakowska, Katarzyna Sułek-Kamas, Grzegorz Jakiel, Maria Wilińska, published by Sciendo.)