Impact of fetal growth restriction on neurodevelopmental outcome at 2 years for extremely preterm infants: a single institution study.

Aim: We evaluated the impact of fetal growth restriction on neurodevelopmental outcomes at 2 years corrected age for infants born before 27 weeks gestational age.

Method: Data on infants born before 27 weeks gestational age between 1999 and 2008 (n=463), admitted to a tertiary neonatal unit in Paris, were used to compare neurological outcomes at 2 years for infants with birthweight lower than the 10th centile and birthweight of at least the 10th centile, using intrauterine reference curves. Outcomes were cerebral palsy (CP) and the Brunet-Lézine assessment of cognitive development, which provides age-corrected overall and domain-specific (global and fine motor skills, language and social interaction) developmental quotients.

Development of a questionnaire to assess the impact on parents of their infant's bronchiolitis hospitalization.

Background: Bronchiolitis is a distressing respiratory condition and the most common cause of hospitalization during the first year of life. The hospitalization of an infant is a stressful event for parents and deserves careful consideration. The objective of this work was to develop and validate a self-administered instrument that comprehensively assesses the impact on parents of the hospitalization of their infant for bronchiolitis.

Impact on parents of bronchiolitis hospitalization of full-term, preterm and congenital heart disease infants.

Background: The objective of this work was to explore the impact on parents of the bronchiolitis hospitalization of their infant using the Impact of Bronchiolitis Hospitalization Questionnaire (IBHQ©).

Methods: Four hundred sixty-three infants aged less than 1 year and hospitalized for bronchiolitis were included in a French observational study during the 2008-2009 season. Parents were asked to complete the IBHQ at hospital discharge and 3 months later.

Unbound bilirubin does not increase during ibuprofen treatment of patent ductus arteriosus in preterm infants.

Objective: To determine whether ibuprofen displaces bilirubin from albumin in preterm infants.

Study Design: A total of 34 preterm neonates (<32 weeks gestation) treated by ibuprofen (10-5-5 mg/kg) were included in this prospective open-label study. Total bilirubin (TB), unbound bilirubin (UB), and ibuprofen concentrations were measured before, 1 hour, and 6 hours after the first dose; before and 1 hour after the second dose; and 72 hours after the beginning of treatment.

Capnography in spontaneously breathing preterm infants with bronchopulmonary dysplasia.

Background: In adult patients with chronic obstructive pulmonary disease, there is a gradient between end-tidal carbon dioxide (EtCO(2)) and arterial carbon dioxide pressure (PaCO(2)), and the slope of the ascending phase of the capnogram is decreased due to obstruction. Corresponding data are lacking in infants with bronchopulmonary dysplasia (BPD).

Objectives: To compare PCO(2) -EtCO(2) gradient and capnogram shape in two groups of spontaneously breathing preterm subjects: infants with BPD and infants without respiratory disease (controls).

A conserved switch in sensory processing prepares developing neocortex for vision.

Developing cortex generates endogenous activity that modulates the formation of functional units, but how this activity is altered to support mature function is poorly understood. Using recordings from the visual cortex of preterm human infants and neonatal rats, we report a "bursting" period of visual responsiveness during which the weak retinal output is amplified by endogenous network oscillations, enabling a primitive form of vision. This period ends shortly before delivery in humans and eye opening in rodents with an abrupt switch to the mature visual response.

Detection of carbon dioxide thresholds using low-flow sidestream capnography in ventilated preterm infants.

Background: Monitoring CO2 levels in preterm infants receiving mechanical ventilation is designed to avoid the harmful consequences of hypocapnia or hypercapnia. Capnography is of questionable accuracy for monitoring PCO2 in preterm infants.

Objectives: To determine the accuracy of sidestream capnography in ventilated preterm infants by comparing end-tidal carbon dioxide (EtCO2) values to mixed venous carbon dioxide pressure (PvCO2) and to transcutaneous carbon dioxide pressure (TcPCO2).

Fecal calprotectin: cutoff values for identifying intestinal distress in preterm infants.

This study aimed to determine cutoff levels for fecal calprotectin as a marker of intestinal distress in preterm neonates. A total of 126 infants born at a median gestational age of 33 weeks (range 25.7-35 weeks) were enrolled.

[Analysis of the concept of risk in a medical teaching program].

The concept of risk has acquired an extremely important place in medical care in the course of various social developments. This concept plays a role in the physician-patient relationship, especially as the form in which the physician provides information to the patient; it is also a form of medical knowledge. We propose a cross-sectional medical course module on this concept of risk, intended for medical students; it can be included in module 1 of the curriculum for the national ranking examination.

Evidence for transmission of Escherichia coli from mother to child in late-onset neonatal infection.

Genetic characterization of non-K1 Escherichia coli strains isolated from a mother and her neonate allowed us to provide evidence of the maternal origin of a late-onset neonatal infection. The use of ante- and peripartum antimicrobial prophylaxis with amoxicillin may have promoted the vertical transmission of this amoxicillin-resistant E. coli from mother to newborn.

Positive slow waves in the EEG of premature infants between 24 and 36 weeks of conceptional age.

Objective: The aim of this prospective and longitudinal study was to characterize EEG patterns during the first weeks of life in extremely premature infants.

Methods: Twenty-five extremely premature infants were included and weekly EEG recordings were obtained between 24 and 36 weeks of conceptional age (CA).

Results: Central (rolandic) positive slow waves (CPSW) were found to be the most reliable and characteristic pattern.

Neuromotor outcome at 2 years of very preterm infants who were treated with high-frequency oscillatory ventilation or conventional ventilation for neonatal respiratory distress syndrome.

Objective: In a previous multicenter, randomized trial, elective use of high-frequency oscillatory ventilation was compared with the use of conventional ventilation in the management of respiratory distress syndrome in preterm infants <30 weeks. No difference in terms of respiratory outcome was observed, but concerns were raised about an increased rate of severe intraventricular hemorrhage in the high-frequency ventilation group. To evaluate outcome, a follow-up study was conducted until a corrected age of 2 years.

Increased incidence of necrotizing enterocolitis in premature infants born to HIV-positive mothers.

Objective: To examine if being born to an HIV-positive mother may increase the risk of necrotizing enterocolitis in premature infants.

Design: Case-control study.

Setting: Neonatal unit of a level 3 perinatal centre.