Relationship between insulin-like growth factor I levels, early insulin treatment, and clinical outcomes of very low birth weight infants.

Objectives: Insulin regulates the secretion of insulin-like growth factor I (IGF-I) in the newborn, and low levels of IGF-I have been linked to neonatal morbidity. As part of the Neonatal Insulin Replacement Therapy in Europe Trial, we investigated the impact of early insulin treatment on IGF-I levels and their relationship with morbidity and growth.

Study Design: Prospective cohort analyses of data collected as part of an international randomized controlled trial.

Prevalence and determinants of hyperglycemia in very low birth weight infants: cohort analyses of the NIRTURE study.

Objectives: To investigate the prevalence and determinants of hyperglycemia in the preterm population, as part of the Neonatal Insulin Therapy in Europe (NIRTURE) Trial.

Study Design: We conducted prospective cohort analyses of continuous glucose monitoring data from control infants participating in an international randomized controlled trial. Data were collected from 188 very low birth weight infants (<1500 g).

Establishing neonatal networks: the reality.

Managed clinical networks for neonatal care were established in England from 2004. Their structure and effectiveness varies widely over the country. Changes in medical manpower and the scarcity of neonatal nurses make the move towards networks urgent, but there is little evidence of a coordinated approach to improving capacity in the tertiary centres, who will have to absorb the activity that follows reconfiguration.

CBF reactivity in hypotensive and normotensive preterm infants.

Perinatal distress in the preterm neonate, and the consequent loss of cerebrovascular autoregulation, has been implicated in the pathogenesis of neonatal cerebral lesions. A component of this distress is thought to be hypotension. We examined the autoregulatory capacity of hypotensive and normotensive infants using the 133Xe technique to measure cerebral blood flow.