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Background: Congenital duodenal obstruction (CDO) is a common cause of intestinal obstruction in newborn infants. There is limited information on growth and neurodevelopmental outcomes of infants with CDO. Recent studies have suggested that early commencement of enteral feeds facilitates early attainment of full feeds in surgical and very premature non-surgical infants. We aimed to describe the physical growth and one-year neurodevelopmental outcomes of infants with CDO, and to explore the association between time of commencement of enteral feeds and time to reach full feeds in CDO. Methods: Retrospective study (2002–2019). Results: A total of 76 infants were included. The median gestational age was 37.2 w (range: 25.7 to 40.8). There were four deaths, not directly related to CDO. The mean Z scores for weight at birth was -0.39 (SD 1.05) vs -1.18 (SD 1.07) at discharge (p

Background: Probiotic supplementation in preterm neonates is standard practice in many centres across the globe. The impact of probiotic supplementation in the neonatal age group on the risk of hospitalisation in infancy has not been reported previously. Methods: Infants born < 32 + 6 weeks of gestation in Western Australia were eligible for inclusion. We conducted a retrospective cohort study comparing data from before probiotic supplementation (Epoch 1: 1 December 2008-30 November 2010, n = 1238) versus after (Epoch 2: 1 June 2012-30 May 2014, n = 1422) on the risks of respiratory- and gastrointestinal infection-related hospitalisation. A subgroup analysis of infants born < 28 weeks of gestation was analysed separately for similar outcomes. Results: Compared to Epoch 1, an 8% reduction in incidence of hospitalisation up to 2 years after birth was observed in Epoch 2 (adjusted incidence rate ratio (IRR) of 0.92; 95% confidence interval (CI); 0.8-0.98), adjusted for gestational age, smoking, socioeconomic status, and maternal age. The rate of hospitalisation for infants born < 28 weeks of gestation was comparable in epochs 1 and 2. Conclusion: Infants exposed to probiotic supplementation in the neonatal period experience a reduced risk of hospitalisation in the first two years after discharge from the neonatal unit. [ABSTRACT FROM AUTHOR]

Background/objectives Necrotizing enterocolitis (NEC [greater than or equal to] Stage II) is associated with high mortality and morbidity in preterm infants. To assess if introduction of standardized feeding regimen (SFR) and routine probiotic supplementation (RPS) was associated with reduced incidence of NEC in preterm infants in our nursery in a resource limited set up. Subjects/methods This was a retrospective cohort study assessing the incidence of NEC [greater than or equal to] Stage II before (Epoch 1: N = 144) vs. after (Epoch 2, N = 144) implementation of SFR and RPS in preterm infants < 35 weeks. Results The median (IQR) gestation and birth weight in epoch 1 and epoch 2 was [32 (30, 33.5) vs. 31.5 (30, 34) weeks, p = 0.829], and [1350 (1100, 1700) vs. 1370 (1110, 1550) g, p = 0.363] respectively. Both groups had predominantly outborn infants (Epoch 1: 79.2% vs. Epoch 2: 78.2%; p = 1.00). Multivariate analysis after adjusting for potential confounders found a significantly lower incidence of NEC [greater than or equal to] Stage II after implementing SFR and RPS (Epoch 1: 17.4% vs. Epoch 2:9.0%, adjusted odds ratio aOR: 0.19; 95% CI: 0.05, 0.71, p = 0.013). The incidence of the composite outcome of 'NEC or Mortality' was also significantly lower after the intervention (Epoch 1: 21.5% vs. Epoch 2: 14.6%; aOR 0.24, 95% CI: 0.07, 0.85, p = 0.027). Conclusions Introduction of SFR and RPS was associated with significant reduction in NEC [greater than or equal to] Stage II and the composite outcome of NEC [greater than or equal to] Stage II /mortality in preterm infants., Author(s): Saurabh Patel [sup.1] , Mayur Chaudhari [sup.1] , Sandeep Kadam [sup.1] , Shripada Rao [sup.2] , Sanjay Patole [sup.2] Author Affiliations: (1) Department of Neonatology, Ratna Memorial Hospital, Pune, [...]

Background: There is limited information about the mortality and neurodevelopmental outcomes of very preterm infants (<32 weeks) with spontaneous intestinal perforation (SIP).Objective: To explore the association between SIP and neurodevelopmental outcomes and mortality in very preterm infants.Data Sources: Medline, EMBASE, Cochrane Library, EMCARE and MedNar.Study Selection: Databases were searched until September 2021. Studies comparing outcomes of 'SIP' versus 'no SIP or necrotising enterocolitis (NEC)' were included.Data Extraction: Neurodevelopmental outcomes at ≥1 year corrected age were extracted as the main outcome measure. Data were pooled separately for adjusted and unadjusted ORs using the random-effects model. The evidence level was assessed using the GRADE (Grading of Recommendations, Assessments, Development and Evaluations) framework.Results: Eighteen cohort studies (13 606 infants) were included. Meta-analysis of unadjusted ORs showed that SIP was significantly associated with increased odds of mortality, cerebral palsy, composite outcome of death or disability, visual impairment and hearing impairment. However, pooling of adjusted ORs (aOR) found significant associations only for mortality (aOR (95% CI) 2.27 (2.07 to 2.49); I2: 0%; four studies (n=10 695)), severe disability (aOR (95% CI) 2.06 (1.38 to 3.08); I2: 0%; two studies (n=321)) and composite outcome of 'death or disability' (aOR (95% CI) 2.18 (1.55 to 3.06); I2: 0%; two studies (n=321)). The level of evidence was 'low' or 'very low'.Limitations: Lack of information on aORs from many studies.Conclusions: SIP in very preterm infants is associated with higher odds of mortality, severe disability, and death or disability. [ABSTRACT FROM AUTHOR]