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Previous studies showed that increased urinary Beta 2-microglobulin (β2-M) level is associated with fetal inflammatory response and successfully predict bronchopulmonary dysplasia (BPD). We aimed to investigate the clinical utility of serum β2-M levels to predict BPD in preterm infants.

Objective: This study aimed to examine the association between hypo/hypercapnia and fluctuations in carbon dioxide (CO2) levels and severe intraventricular hemorrhage (IVH) during the initial 72 hours of life among preterm infants. Material and Methods: A retrospective study of premature infants with birth weights between 750 and 1.250 g and gestational ages of 30 weeks who required respiratory support. Blood gas measurements were collected during the first 3 days of life. Multivariate analyses were performed to assess the association between hypercapnia and carbon dioxide pressure (pCO2) fluctuations and IVH. Results: Our cohort included 376 patients with a median gestational age of 28 weeks and a median birth weight of 920 g. After controlling for gestational age and birth weight, histologic chorioamnionitis and pCO2 fluctuations remained significantly associated with severe IVH. Conclusion: Fluctuations in pCO2 over a short period may have a stronger association with severe IVH than the mere occurrence of hypo- or hypercapnia. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Current Pediatrics / Guncel Pediatri is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective There is an ongoing debate about the best and comfortable way to administer surfactant. We hypothesized that uninterrupted respiratory support and continuous PEEP implementation while instilling surfactant via endotracheal tube (ETT) with side port will result in higher regional cerebral tissue oxygenation (rcSO2) and the alterations in cerebral hemodynamics will be minimal. Study Design Preterm infants who required intubation in the delivery room and/or in the first 24 hours of life with gestational age <32 were enrolled. Patients were intubated either via conventional ETT or ETT with side port (Vygon) with appropriate sizes. Following neonatal intensive care unit admission a near-infrared spectroscopy (NIRS) probe was placed on the forehead and each infant was started to be monitored with NIRS. In conventional ETT group, patients separated from the ventilator while surfactant was instilled. In ETT with side port group, respiratory support was not interrupted during instillation. Heart rate, oxygen saturation, rcSO 2 , cerebral fractional tissue oxygen extraction (cFTOE), and blood pressures were recorded. Results A total of 46 infants were analyzed. Surfactant was instilled with conventional ETT in 23 and ETT with side port in 23 infants. Birth weights (1,037 ± 238 vs. 1,152 ± 277 g) and gestational ages (28 ± 2.3 vs. 29 ± 1.6 weeks) did not differ between groups. During instillation of surfactant, rcSO2 levels [61.5 (49–90) vs. 70 (48–85)] and cFTOE levels 0.28 (0.10–0.44) vs. 0.23 (0.03–0.44)] were similar (p = 0.58 and 0.82, respectively). Conclusion Interruption of respiratory support during surfactant instillation did not significantly alter the cerebral tissue oxygenation. These results did not support our hypothesis and should be confirmed with further studies. Key Points Monitoring intracerebral oxygenation changes during surfactant administration with NIRS is feasible. The surfactant administration method does not significantly alter the cerebral oxygenation. Surfactant administration itself rather than the method caused a transient drop in cerebral NIRS readings. [ABSTRACT FROM AUTHOR]

We evaluated what placental pathologies were associated with adverse preterm births. Placental findings, classified according to the Amsterdam criteria, were correlated with infant outcomes. The fetal vascular lesions, inflammatory responses other than histological chorioamnionitis (HCA), and placentas with combined maternal vascular malperfusion (MVM) and HCA were excluded. A total of 772 placentas were evaluated. MVM was present in 394 placentas, HCA in 378. Early neonatal sepsis, retinopathy of prematurity, necrotizing enterocolitis, and neonatal death occurred more often in the MVM-only group than HCA-only group. The frequency of bronchopulmonary dysplasia (BPD) was 38.6% in the HCA-only group, and it was 20.3% in the MVM-only group (p < 0.001). HCA was the most important independent risk factor for BPD (OR 3.877, 95% CI 2.831–5.312). Inflammation in the placenta influences fetal and neonatal outcomes. HCA is an independent risk factor for BPD. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)