Publications by authors named "Aya Okahashi"

This multicenter study evaluated the efficacy and safety of a novel cranial remolding helmet (baby band2), which is completely custom-made based on the shape of an infant's cranium. The study included 224 full-term infants from moderate to very severe positional plagiocephaly in Japan. Cranial geometry was assessed before and after helmet therapy using a three-dimensional scanner, and changes in the cranial vault asymmetry index (CVAI) were analyzed.

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Article Synopsis
  • Congenital cytomegalovirus (cCMV) infection is the most prevalent congenital infection in developed nations, and while there’s no established standard therapy yet, management evidence is growing.
  • The first edition of the "Clinical Practice Guidelines for the Management of Congenital Cytomegalovirus Infection" was published in Japan in 2023, outlining key clinical questions related to cCMV.
  • The guidelines cover 20 clinical questions on aspects like prenatal risk assessment, diagnosis, treatment, and follow-up, along with recommendations and consensus rates to aid healthcare providers in managing cCMV patients.
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We aimed to characterize the metabolomic profiles in preterm small-for-gestational age (SGA) infants using cord blood. We conducted a gestational age (GA)-matched case-control study that included 30 preterm infants who were categorized into two groups: SGA infants, with a birth weight (BW) < 10th percentile for GA (n = 15) and non-SGA infants, with BW ≥ 10th percentile for GA (n = 15). SGA infants with chromosomal or genetic abnormalities were excluded.

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Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) infections are common in children worldwide. However, the clinical factors related to extended hospitalization in Japanese patients aged ≥3 years remain elusive. We aimed to elucidate the clinical risk factors contributing to hospital stays ≥7 days in patients with RSV and hMPV infections.

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We previously reported the 95th percentile cutoff value of the serum procalcitonin (PCT) reference curve for diagnosing early-onset bacterial infection. We aimed to verify the effectivity of these novel diagnostic criteria by comparing antibiotic use and incidence of early-onset bacterial infection between pre- and post-introduction periods. We included newborns admitted to our neonatal intensive care unit who underwent blood tests within 72 h after birth between 2018 and 2022.

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Background: An objective screening tool for autism spectrum disorder (ASD), also known as an eye-tracking tool, assesses the patient's abnormal gaze patterns and detects the risk of ASD. As this tool is generally used for children born at term, this study aimed to clarify the appropriate timing for using the tool for preterm children, factors that influence the timing, and evaluate their gaze characteristics using the Gazefinder®.

Method: In 90 preterm children, a total of 125 eye-tracking tasks were completed and analyzed in 3-6, 7-9, 10-12, 13-18, and 19-32 months of corrected age (CA).

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The purpose of this study was to investigate changes in cranial shape among preterm neonates aged 1-6 months and the relationship between developmental quotient (DQ) and cranial shape at 6 months of age. Preterm infants who were hospitalized in our hospital were prospectively followed for 6 months. The cephalic index (CI) and cranial vault asymmetry index (CVAI) were evaluated at 1 (T1), 3 (T2), and 6 months (T3) of age and compared with those of the full-term infants.

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Background: The association between umbilical cord blood insulin-like growth factor 1 (IGF-1) levels and retinopathy of prematurity (ROP) remains unclear. This study aimed to investigate whether umbilical cord blood IGF-1 levels can predict the development of severe ROP in extremely preterm infants.

Methods: This hospital-based retrospective cohort study included infants born at <37 weeks gestational age (GA) between 2019 and 2021 and then classified them into the two GA groups: extremely preterm, <28 weeks and preterm infants, 28-36 weeks.

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Article Synopsis
  • The study found that while SARS-CoV-2 can infect human placental tissue, vertical transmission to the fetus is rare, suggesting the placenta acts as a barrier against the virus.
  • Researchers confirmed the presence of the virus's genome in placental tissue using in situ hybridization techniques, showing less presence when using probes that target the virus's spike protein.
  • This research provides the first direct evidence that the virus does not replicate efficiently in the infected placenta, highlighting the need for further studies to understand the underlying mechanisms.
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Background: The best approach to reduce congenital cytomegalovirus infection (cCMVi) is to practice behaviors that reduce cytomegalovirus (CMV) transmission during pregnancy. Expanding awareness and knowledge of CMV is expected to result in increased practice of preventative behaviors. To this end, it is necessary to understand current awareness and knowledge of CMV.

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Introduction: The aims were to investigate the clinical characteristics of Toxoplasma gondii (T. gondii) immunoglobulin (Ig) M-positive mothers and to clarify the incidences of serum T. gondii IgM or blood T.

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Congenital cytomegalovirus infection (cCMVi) can cause serious and long-term effects in newborns. Without available vaccines or antiviral prophylaxis, prevention strategies for cCMVi and cytomegalovirus disease during pregnancy are limited to hygiene and behavioral interventions to prevent transmission. The objective of this study was to assess cCMVi-related awareness, knowledge, and physicians' actual and preferred clinical practices in Japan.

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Article Synopsis
  • Urine bags, while standard for collecting urine samples from neonates, face issues like contamination and detachment due to movement, leading to collection failures.
  • A new urine collection kit featuring ten filter papers was tested on 138 neonates, achieving a 96% success rate in capturing urine during a diaper change, where the filter paper turned from blue to white.
  • The study found the collection method's effectiveness was unaffected by variables like sex or birth weight, and it also demonstrated similar rates of dermatitis compared to traditional urine bags.
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This study aimed to devise a novel physique index and investigate its accuracy in identifying newborns with skeletal dysplasia in comparison with head circumference (HC)/height (HT) ratio. The birth weight (W), HT, and HC at birth of 1500 newborns were retrospectively collected. The linear regression equations and coefficients of determination (R) were determined.

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Women with congenital amino acid disorders, including maple syrup urine disease (MSUD), are at risk of metabolic crisis at delivery. There are still only a few case reports of maternal MSUD globally, and we are the first to report the successful perinatal management of a woman with classical MSUD in Japan. A healthy baby was delivered by scheduled cesarean section despite the presence of several uterine fibroids.

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Background: Bacterial infections and some antibiotics show displacer effects on bilirubin-albumin binding and increase unbound bilirubin (UB) but not total bilirubin (TB) in serum.

Methods: A case study was conducted to show a successful treatment of hyperbilirubinemia by monitoring UB.

Results: In an extremely preterm infant with bloodstream bacterial infection caused by methicillin-resistant coagulase-negative staphylococci, 2 days after high-dose ampicillin and regular-dose amikacin were initiated, UB markedly increased, but TB did not.

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In 1985, a hepatitis B (HB) vaccination strategy against vertical HB virus transmission was introduced in Japan that recommended vaccination of infants at two, three, and five months of age (delayed strategy). This schedule was revised in 2013, recommending to vaccinate at birth and at 1 and 6 months of age (non-delayed strategy). We aimed to compare the vertical HB virus transmission rates and immunogenic responses between these two vaccination strategies.

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To date, no clinical studies have compared the accuracy of serum procalcitonin (PCT) reference curves. We aimed to validate the diagnostic accuracy of previously reported serum PCT reference curves and to determine which biomarkers among a cut-off value over the 95th percentile in the serum PCT reference curve, white blood cell (WBC) count, and C-reactive protein (CRP) and immunoglobulin M (IgM) levels, have the highest diagnostic accuracy for early-onset neonatal bacterial infections. This retrospective cohort study assessed 16 preterm and 23 term infants with suspected bacterial infections within 72 h after birth.

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The clinical characteristics of congenital toxoplasmosis cases with poor outcomes in Japan were analyzed. Ten cases were selected, identified from a nationwide survey by the Japan Society for Neonatal Health and Development and a literature review. Based on outcomes, two fatal cases showed generalized symptoms at birth; four cases with neurological sequelae showed the three main congenital toxoplasmosis manifestations (chorioretinitis, intracranial calcification, hydrocephalus); four cases with ophthalmological sequelae showed only one or two of the three main manifestations.

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