Publications by authors named "Jean-Charles Picaud"

Article Synopsis
  • Late postnatal steroids, specifically betamethasone (BTM), are given to extremely preterm infants to help them transition from invasive ventilation and reduce the risk of developing bronchopulmonary dysplasia (BPD), while also addressing patent ductus arteriosus (PDA).
  • In a study of 51 infants born before 29 weeks gestation, most were successfully extubated after receiving BTM, with nearly all showing closure or improved PDA status post-treatment.
  • Although BTM treatment resulted in some transient side effects like hypertension and hyperglycemia, the findings suggest it may reduce the need for more invasive surgical options in this vulnerable population.
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Aim: The aim of this French study was to determine the neonatal morbidity, mortality and neurodevelopmental outcomes when infants born at the limit of viability reached 2 years of corrected age. We then compared the results with national and international cohorts.

Methods: This study focused on 294 French infants born from 22 to 25 weeks of gestation in a single tertiary perinatal centre from January 2010 to December 2019.

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Infectious and toxicological risks are the main potential hazards that operators of Human Milk Banks (HMBs) encounter and must eliminate. HMBs are trying to implement procedures that allow to manage and sanitize human milk without altering significantly its nutritional and biologically protective components, obtaining a product characterized by a valid balance between safety and biological quality. The history of human milk processing is linked to the origins of HMBs themselves.

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Purpose: The primary objective was to evaluate the impact of necrotising enterocolitis (NEC) and spontaneous intestinal perforation (SIP) on mortality and neurodevelopmental outcomes at 2 years' corrected age (CA) in infants born before 32 weeks' gestation (WG).

Methods: We studied neurodevelopment at 2 years' CA of infants with NEC or SIP who were born before 32 WG from the EPIPAGE-2 cohort study. The primary outcome was death or the presence of moderate-to-severe motor or sensory disability defined by moderate-to-severe cerebral palsy or hearing or visual disability.

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Introduction: The use of different growth charts can lead to confusion in discussions between professionals. There are obstetric charts (of fetal growth) and neonatal charts (of measurements at birth and of postnatal growth). These charts can be descriptive (derived from an unselected population) or prescriptive (derived from of a population at low risk and with optimal conditions for growth).

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Article Synopsis
  • - The study examines the impact of high early amino acid intake on the development of high blood pressure (HBP) in children born extremely premature (24-29 weeks gestation), analyzing data from the EPIPAGE-2 birth cohort at age 5 years.
  • - Findings indicate that 18% of children exposed to high amino acid intake had systolic HBP compared to 13.3% in non-exposed preterm infants and 8.5% in term-born controls, highlighting a potential link between early nutrition and later hypertension.
  • - High amino acid intake and elevated serum creatinine levels in neonatal days 3 to 7 were identified as independent risk factors for systolic HBP, suggesting a potential relationship between early
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Pregnancy is a risk factor for acute respiratory failure (ARF) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We hypothesised that SARS-CoV-2 viral load in the respiratory tract might be higher in pregnant intensive care unit (ICU) patients with ARF than in non-pregnant ICU patients with ARF as a consequence of immunological adaptation during pregnancy. Single-centre, retrospective observational case-control study.

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The administration of dexamethasone has been associated with suboptimal neurodevelopment. We aimed to compare the development of extremely premature infants treated or not with alternatives to dexamethasone: betamethasone, hydrocortisone hemisuccinate. This retrospective cohort study included infants born before 29 weeks of gestational age, treated or not with late (day ≥ 7) postnatal steroids (betamethasone, hydrocortisone hemisuccinate).

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This study aimed at evaluating the 7-year outcomes of 118 very preterm newborns (VPNs, gestational age = 26 ± 1.4 w) involved in a randomized controlled trial. They presented neonatal respiratory distress (RDS), requiring ventilation for 14 ± 2 days post-natal age (PNA).

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The nutritional adequacy of human milk (HM) from vegan/vegetarian mothers has been a matter of debate, and a variety of recommendations regarding the eligibility of these mothers as human milk donors exists. According to the latest evidence, HM from vegans/vegetarians is similar in its composition to that from omnivores, however, some differences may be observed regarding vitamin B and omega-3 fatty acids concentrations. Maternal supplementation of these compounds has been proven effective in increasing their HM concentration.

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This cohort study aimed to evaluate the impact of an individualised nutritional care approach combining standardised fortification with adjustable fortification on postnatal growth and body composition in extremely low birth weight (ELBW) infants. We included ELBW infants admitted to a neonatal intensive care unit and still hospitalised at 35 weeks postmenstrual age (PMA). The fortification of human milk was standardised (multicomponent fortifier) between 70 mL/kg/day and full enteral feeding, and then individualised using adjustable fortification.

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Subclinical mastitis (SCM) is an inflammatory state of the lactating mammary gland, which is asymptomatic and may have negative consequences for child growth. The objectives of this study were to: (1) test the association between the dietary inflammatory index (DII®) and SCM and (2) assess the differences in nutrient intakes between women without SCM and those with SCM. One hundred and seventy-seven women with available data on human milk (HM) sodium potassium ratio (Na:K) and dietary intake data were included for analysis.

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Objectives: The evidence that risks of morbidity and mortality are higher when very premature newborns are born during the on-call period is inconsistent. This study aimed to assess the impact of this situation among other determinants of outcomes, particularly newborn characteristics and care organization.

Methods: Observational study including all infants born < 30 weeks' gestation in a French tertiary perinatal center between 2007 and 2020.

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Article Synopsis
  • Preterm infants are vulnerable to lower respiratory tract infections, particularly severe cases of RSV, and the study aimed to identify risk factors for severe RSV disease in infants born before 34 weeks of gestation.
  • Among 2,101 preterm infants studied, 86 were hospitalized due to RSV, and 31 of those experienced very severe lower respiratory tract infections requiring ventilation support.
  • The key finding was that a younger corrected age for prematurity at the time of infection was strongly associated with a higher risk of severe RSV disease, suggesting that targeting prophylaxis and interventions for these infants could help reduce the severity of their condition.
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Exclusive breastfeeding until the age of six months is the recommended feeding method for all infants. However, this is not possible for every infant. Therefore, a second choice of feeding, as close as possible to the gold standard, is needed.

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Background: The effect of the mode of neonatal delivery (cesarean or vaginal) on the nutrient composition of human milk (HM) has rarely been studied. Given the increasing prevalence of cesarean section (C-section) globally, understanding the impact of C-section vs. vaginal delivery on the nutrient composition of HM is fundamental when HM is the preferred source of infant food during the first 4 postnatal months.

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Background: Preterm kidney is exposed to various exogenous factors that may impact its function such as nephrotoxic drugs or nephrocalcinosis. We investigated prevalence and risk factors of nephrocalcinosis (NC) in recently born very low birth weight (VLBW) infants submitted to improved biological monitoring.

Methods: Retrospective, case-control study in very preterm infants (< 32 + 6 weeks, ≤ 1500 g) admitted to a tertiary care unit during a 6-year period.

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Article Synopsis
  • Neonatal nutritional supplements are used to improve growth in premature or small-for-gestational-age infants, but their long-term effects on cognitive and metabolic health are unclear.
  • Analysis of various trials showed that while these supplements did not significantly impact cognitive impairment or metabolic risk after 3 years, they reduced motor impairment in toddlers and had better outcomes for girls.
  • Additionally, while supplementation lowered triglyceride levels, it didn't change other metabolic factors, suggesting potential benefits in early motor skills without major risks to cognitive or long-term metabolic health.
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  • - The paper reviews the importance of donor human milk in caring for very low birth weight (VLBW) infants, emphasizing its role in facilitating successful breastfeeding and preventing complications related to prematurity.
  • - Donor human milk shows no negative impact on breastfeeding rates and, when fortified, supports the growth of preterm infants, making it preferable over cow's milk formulas.
  • - Organizing and providing access to human milk banks is crucial for ensuring that the most vulnerable hospitalized infants receive the necessary donor human milk for their health benefits.
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  • The study investigates how maternal fatty acid (FA) status affects the composition of human milk (HM) by analyzing the correlation between FAs in HM and various maternal tissues, such as plasma and adipose tissue.
  • A total of 223 European women provided HM samples in the first four months of lactation, with blood and adipose tissue collected at delivery for FA analysis, leading to insights about changes in FA levels over time and correlations between different sources.
  • Findings suggest that maternal adipose tissue is a key reservoir for polyunsaturated fatty acids (PUFAs) in HM and highlight the importance of proper dietary intake of PUFAs and long-chain polyunsaturated fatty acids (LCPUFAs) during pregnancy and lact
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Article Synopsis
  • Neonatal nutritional supplements can boost early growth in infants who are small for their gestational age, but their impact on long-term growth remains uncertain.
  • A review of various studies found that while these supplements improved infant length and bone mineral content, they did not significantly affect childhood BMI.
  • Additionally, the benefits in height growth appeared to be present in male toddlers but were not observed in females, indicating that results may vary by sex.
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