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Objectives: This study aimed to assess the current neonatal nutritional practices in Taiwan and promote consensus on standardized protocols. Methods: An online questionnaire comprising 95 items on parenteral nutrition (PN) and enteral nutrition (EN) practices was distributed to neonatal care units across Taiwan via email between August and December 2022. The responses were compared with the recommendations from the European Society for Pediatric Gastroenterology Hepatology and Nutrition for preterm infant care. Results: Most of the 35 neonatal units, comprising 17 level III and 18 level II units, that participated in this study adhered to standard PN protocols; however, only 30% of units used protein-containing solutions as the initial fluid. Over half of the neonatal units provided calcium, phosphate, and magnesium at less than the recommended dosage. Trophic feeding commenced within 48 h in 88% of the units, with the mother's milk used as the first choice. All the units preferred commencing advanced feeding at <25 mL/kg/day. Conclusions: Most nutrient protocols for preterm infants in neonatal units in Taiwan meet recent guidelines, but discrepancies such as lower mineral supplements in PN and a slower advancement of enteral feeding increase nutritional risk. These issues warrant further research. [ABSTRACT FROM AUTHOR]

Objective. To investigate the relationship of neonatal platelet count and preeclampsia to levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (P1GF), and vascular endothelial growth factor (VEGF) in the cord blood of preterm infants. Methods. Sixty-nine preterm infants with a gestational age between 26 and 37 weeks at birth were enrolled, sFlt-1, P1GF, and VEGF levels in the cord blood of preterm neonates, with or without maternal preeclampsia, were measured using a standardized sandwich enzyme-linked immunosorbent assay method. Results. Infants with maternal preeclampsia had higher cord blood sFlt-1 but lower P1GF and VEGF levels. There was a significantly positive relationship between neonatal platelet count and birth weight and a significantly negative relationship between neonatal platelet count and cord blood sFlt-1 levels. Multiple regression analysis revealed that only birth weight and cord blood sFlt-1 levels were independently related to neonatal platelet count, whereas maternal preeclampsia, gestational age (GA), and small for GA (SGA) were not related. Neonates with thrombocytopenia had higher cord blood sFlt-1 levels but lower birth weight. A significant correlation was also found between birth weight and cord blood sFlt-1 levels. Multiple regression with birth weight as the dependent variable found that only GA and cord blood sFlt-1 levels were independently related. Furthermore, infants with high cord blood sFlt-1 were more likely to have lower platelet count and maternal preeclampsia, be SGA, and have a trend toward lower birth weight. Conclusion. Excess sFlt-1 may play an important role in the development of maternal preeclampsia- induced neonatal thrombocytopenia, and SGA. Pediatrics 2005; 116:468-472; sFlt-1, vascular endothelial growth factor, placenta growth factor, preeclampsia, platelets. ABBREVIATIONS. SGA, small for gestational age; VEGF, vascular endothelial growth factor; P1GF, placenta growth factor; sFlt-1, soluble fms-like tyrosine kinase 1; GA, gestational age; VLBW, very low birth weight; Tpo, thrombopoietin; Mk, megakaryocytic., Infants who are born to preeclamptic mothers have been shown to have higher risk for being small for gestational age (SGA) and having neonatal thrombocytopenia or neutropenia. (1-6) Neonatal thrombocytopenia [...]

Objective. To determine whether an elevated placenta growth factor (PlGF) level in cord blood is associated with increased risk for preterm infants to develop bronchopulmonary dysplasia (BPD). Methods. Sixty-three preterm infants who were born at 34 weeks&apos; gestation or earlier were enrolled. Two infants who died before 28 days&apos; postnatal age could not be assigned a BPD status and were excluded. PlGF levels in cord blood were measured using enzyme-linked immunosorbent assay. Mann-Whitney rank sum test, Spearman correlation coefficients, and multivariable linear or logistic regression analyses were used for statistical analysis. Results. The BPD group had a higher PlGF level, lower gestational age, lower birth weight (BW), higher incidence of endotracheal tube intubation, and longer duration of intubation. The PlGF levels in cord blood correlated negatively with gestational age and BW. However, multivariable logistic regression analyses revealed that only elevated cord blood PlGF levels and BW were associated with BPD after adjusting for all contributing factors. Furthermore, an increased PlGF level in cord blood was significantly correlated with the clinical severity of BPD, as measured by duration of intubation. At 17 mg/dL, the specificity of cord blood PlGF level in predicting BPD was 95%, the sensitivity was 53%, the positive predictive value was 83%, and the negative predictive value was 82%. Conclusions. Measuring cord blood PlGF level at birth might be a biological marker for predicting the occurrence of BPD and allowing early therapeutic intervention. Pediatrics 2004;113:1348-1351; bronchopulmonary dysplasia, cord blood, placenta growth factor. ABBREVIATIONS. BPD, bronchopulmonary dysplasia; PlGF, placenta growth factor; VEGF, vascular endothelial growth factor; GA, gestational age; RDS, respiratory distress syndrome; BW, birth weight., With the widespread use of antenatal steroids, exogenous surfactant therapy, and improvements in neonatal care, the survival rate of very low birth weight infants has increased, but bronchopulmonary dysplasia (BPD) [...]