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Background: Early bonding by skin-to-skin contact (SSC) is considered to be beneficial following vaginal delivery. Aim: We aimed to examine the impact of intraoperative bonding during caesarean section on maternal oxytocin levels, newborn feeding outcomes and maternal emotional wellbeing.Methods: We performed a prospective, randomized-controlled pilot study, which took place at a single academic tertiary hospital between September 2013 and January 2014. Pregnant women were recruited and randomly assigned to intraoperative (“early”) SCC (n=17) versus postoperative (“late”) SCC (n=18). We investigated maternal oxytocin levels, breastfeeding and newborn feeding outcomes as well as maternal emotional wellbeing.Findings: We found, that maternal oxytocin levels were comparable between the ‘Early SSC Group’ and the ‘Late SSC Group’ at each time point. Newborn drinking volume did not differ significantly on the second (p=0.213) and fourth (p=0.986) day after birth and the necessity of formula supplementation was similar in both groups (p=0.1). There were no significant differences in depressive symptoms and bonding behavior between the ‘Early SSC Group’ and the ‘Late SSC Group’. Discussion: Our study did not reveal significant differences regarding the investigated parameters. However, this needs to be further evaluated in a larger prospective randomized trial.Conclusion: Maternal oxytocin levels, breastfeeding and newborn feeding outcomes, and maternal emotional wellbeing seem to be unvaried by early SSC after caesarean section. TRIAL REGISTRATIONClinicalTrials.gov (10/07/2013; NCT01894880)review board approved the protocol (25-425 ex 12/13)

Background Bronchopulmonary dysplasia (BPD) is the most frequent chronic lung disease in infancy and is associated with neonatal comorbidity and impairment in pulmonary and neurodevelopmental (ND) long‐term outcome. Methods This was a retrospective, single‐center, cohort study to compare a cohort of very preterm infants (gestational age [GA], 24+0–28+6 weeks) with BPD (n = 44), with a cohort of GA‐matched preterm infants without BPD (n = 44) with regard to neonatal morbidity, incidence of lower respiratory tract infection (LRTI), ND outcome and growth to 2 years' corrected age (CA) and preschool age. Results Bronchopulmonary dysplasia (incidence, 11.3%) was associated with a higher rate of neonatal pneumonia (26% vs 7%, P = 0.001), longer total duration of mechanical ventilation (mean days, 21 vs 13, P < 0.001), and a higher rate of pulmonary hypertension (20.5% vs 0%, P = 0.002) and of severe retinopathy of prematurity (13.6% vs 0%, P = 0.026). Incidence of LRTI was significantly higher in the BPD infants (50% vs 26%, P = 0.025). ND outcome did not differ between the two groups. Growth at neonatal intensive care unit discharge was similar. In the BPD cohort, rate of weight < 10th percentile was higher at 2 years' CA (52% vs 30%, P = 0.041) and rate of head circumference < 10th percentile was higher at preschool age (59% vs 27%, P = 0.028). Conclusion Neonatal respiratory morbidity was significantly higher in the BPD cohort, but long‐term ND outcome did not differ. Infants with BPD had poorer growth.

AIM To compare neonatal morbidities in moderate and late preterm infants and to analyze rates and causes for rehospitalizations during the first year of life. METHODS Prospective follow-up of a group of moderate and late preterm infants at a tertiary care hospital. RESULTS The study population comprised 215 infants (58% males; 60% singletons; 99 moderate and 116 late preterm infants) with a median gestational age of 34 weeks and birth weight of 2100 grams; 20% of them were small for gestational age. Moderate preterm infants more often had a diagnosis of mild respiratory distress syndrome (26% vs. 13%, p

The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3&ndash, 5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant&rsquo, s later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS &gt, 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS &gt, 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III&ndash, V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.

Objectives: The aetiology of polycystic ovary syndrome (PCOS) is not particularly mapped, however, a complex interaction of various factors, such as genetic, environmental and intrauterine factors, can be assumed. Experimental animal studies and clinical observations support the hypothesis that developmental programming by excess intrauterine steroid is relevant. The aim of the study was to investigate whether mothers with and without PCOS exhibit different androgen and anti-Mullerian hormone (AMH) levels at the end of pregnancy and how maternal hormone levels are reflected in their offspring. Methods: Between March 2013 and December 2015, we performed a prospective cross-sectional study at the Medical University of Graz. We included 79 women with PCOS according to the ESHRE/ASRM 2003 definition and 354 women without PCOS, both with an ongoing pregnancy &ge, 37 + 0 weeks of gestation, who gave birth in our institution. Primary outcome parameters were the levels of maternal and neonatal androgens (testosterone, free testosterone, androstenedione) and AMH at delivery. Results: Androgen levels in female offspring of PCOS and non-PCOS women at birth did not differ, while maternal hormone levels differed significantly. Androgen levels in PCOS boys were significantly higher when compared to levels in PCOS girls. Discussion: Our findings do not support the hypothesis that maternal androgen excess contributes to elevated androgen concentrations in the female offspring. Nevertheless, the effects of the increased androgen concentrations in mothers on their offspring have to be investigated in future studies.

AIM: To explore the appropriateness of applying a detailed assessment of general movements and characterize the relationship between global and detailed assessment.METHOD: The analysis was based on 783 video recordings of 233 infants (154 males, 79 females) who had been videoed from 27 to 45 weeks postmenstrual age. Apart from assessing the global general movement categories (normal, poor repertoire, cramped-synchronized, or chaotic general movements), we scored the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities. Applying the optimality concept, the maximum general movement optimality score of 42 indicates the optimal performance.RESULTS: General movement optimality scores (GMOS) differentiated between normal general movements (median 39 [25-75th centile 37-41]), poor repertoire general movements (median 25 [22-29]), and cramped-synchronized general movements (median 12 [10-14]; pINTERPRETATION: Further research might demonstrate that the GMOS provides a solid base for the prediction of improvement versus deterioration within an individual general movement trajectory.

In preterm neonates we investigated cerebral hypoxia assessed with near-infrared-spectroscopy during immediate transition after birth and general movement optimality score assessed before discharge. General movement optimality score decreased with increasing cerebral hypoxia. Burden of cerebral hypoxia during immediate transition might be associated with impaired short-term neurological outcome in preterm neonates.

Einleitung/Zielsetzung: In den letzten Jahrzehnten kam es in Osterreich sowie weltweit zu einem deutlichen Anstieg der Kaiserschnittrate. Unter bonding bzw. early skin-to-skin contact (SSC) versteht man die Phase der Bindungsentwicklung zwischen Mutter und Kind, welche idealerweise gleich nach der Geburt beginnt. Mogliche Bedenken, das bonding auch nach dem Kaiserschnitt im Operationssaal einzufuhren, sind neben Organisatorischen (Anderung des etablierten Ablaufes) auch das veranderte Ambiente im Operationssaal (Temperatur, Helligkeit, Larm). Im Rahmen dieser Studie sollten Effekte des fruhen SSC nach einer Schnittentbindung auf die Mutter und das Neugeborene evaluiert werden. Material & Methoden: Im Rahmen einer prospektiven randomisierten Pilotstudie wurden 35 Frauen eingeschlossen. Randomisiert wurde in eine ‚early bonding‘ Gruppe (n = 17) und eine ‚late bonding‘ Gruppe (n = 18). Evaluiert wurden die kindliche Adaptation, die Ausschuttung von Oxytocin, Cortisol und Chromogranin A bei der Mutter und die Ausschuttung von Cortisol beim Kind, sowie die mutterliche Schmerzverarbeitung und psychische Situation (Edinburgh Postnatal Depression Scale und Postpartum Bonding Questionnaire). Ergebnisse: Die kindliche Adaptation und Temperaturregulation bewegten sich in beiden Gruppen im Normbereich. Die Ausschuttung von Oxytocin, Cortisol und Chromogranin A bei den Muttern war vergleichbar und es gab keinen Unterschied hinsichtlich der mutterlichen Schmerzverarbeitung in den jeweiligen Gruppen. Im Beziehungsverhalten und der Befindlichkeit zwischen den beiden Gruppen konnte kein signifikanter Unterschied festgestellt werden. Zusammenfassung: Sectiobonding kann – falls von den Eltern gewunscht – angeboten werden.

Objective: To determine (1) the association between neonatal morbidity and gestational age and (2) the impact of pre-existing maternal medical conditions, pregnancy and birth complications on neonatal outcome in moderate and late preterm infants (32–36 completed weeks). Methods: Retrospective single-centre cohort study including all moderate and late preterm infants without congenital anomalies born at the Children’s and Maternity Hospital Linz, Austria, between January 2007 and June 2010. Stepwise regression analysis was used to determine significant associations between morbidities, maternal and perinatal complications and the gestational age. Results: Of 870 infants included the incidence of neonatal morbidities increased from 24% at 36 weeks to 43% at 35 weeks’, 55% at 34 weeks’, 75% at 33 weeks’ and 93% at 32 weeks’ gestation. Infants at 32 weeks had a 4-fold (RR: 3.88; 95% CI: 1.87–8.06) increased risk compared with those at 36 weeks, and infants of 32 weeks were 16 times (RR: 16.01; 95% CI: 9.82–26.09) more likely to be admitted to the NICU than infants of 36 weeks’. Hyperbilirubinemia (29%) and respiratory morbidity (14.3%) were the most common neonatal diagnoses. Intrauterine growth restriction, preeclampsia, preterm premature rupture of the membranes, lack of antenatal steroid administration, antepartum hemorrhage, multiple pregnancy and male gender were all associated with any kind of neonatal morbidity, admission rate to the NICU and length of hospital stay (p Conclusion: Nearly half of all infants suffered from any morbidity, and several risk factors were identified being significantly associated with NICU admission rate and length of hospitalization.

Objective The assessment of general movements (GMs) is a widely used technique to evaluate neurological (dys)function and to predict neurodevelopmental outcome in infants. De Vries and Bos (Early Hum Dev 2008, 2010) demonstrated that abnormal GMs are often seen in early recordings in extremely low birth weight (BW) and preterm ( Methods We assessed GMs during the first 2 weeks (Median = 7 days; 5–8 days) of 50 moderate and late preterm infants (31 males). GM quality (global and detailed scoring) was analysed off line and related to neonatal morbidity (mainly IRDS) and other clinical factors (birth weight, need for oxygen and intensive care). Results Mean gestational age (GA) of the infants was 35 weeks’ gestation (SD = 9 days); mean BW was 2207 grams (SD = 400). Abnormal GMs were observed in 23 infants: 19 poor repertoire, 2 infants cramped synchronised, and 2 chaotic. Yet another 10 infants were scored as normal but their detailed GM score revealed a reduced motor optimality. GM abnormalities were not related to perinatal factors, such as GA, birth weight or neonatal morbidity. Conclusion Almost every second infant had abnormal GMs during the first 2 weeks of life. Whether such an early and single GM assessment will be related to the neurodevelopmental outcome has still to remain open, as the individuals of our study group did not yet reach the age of an outcome assessment.

Context Moderately preterm infants (32+0 to 36+6 gestational weeks [GW]) account for an increasing proportion of prematurity-associated short-term morbidities; yet there is a relative paucity of data regarding neonatal outcome in this cohort. Objective To determine the association between neonatal morbidity and gestational age and also maternal and perinatal complications with an adverse impact on the neonatal outcome. Methods In this retrospective cohort study, preterm infants (32+0 to 36+6 GW) without congenital anomalies, born in the Children’s and Maternity Hospital Linz between 2007 and June 2010, were included (n=870). Data about all morbidities (respiratory and gastrointestinal problems, hypoglycemia, hyperbilirubinemia with phototherapy, length of stay in intensive care unit, other relevant problems) during their hospital stay. Stepwise regression analysis was used to determine significant associations between morbidity and the gestational age. Results Overall, the incidence of morbidities increased from 24% at 36 weeks to 43%, 55%, 75% and 93% at 35, 34, 33 and 32 weeks, respectively. The most frequent morbidities were hyperbilirubinemia requiring a treatment (29%) followed by respiratory (14%) and gastrointestinal (14%) problems. Less than 10% of the children had hypoglycemia; cerebral complications were rare. Lower gestational age was an independent risk factor for increased neonatal morbidity and longer hospital and NICU stays (p Conclusion Moderately preterm infants (32+0–36+6 GW) are at higher risks for neonatal morbidities, and the lower the gestational age at birth is the higher is the risk for neonatal morbidities.