Umbilical Cord Collection and Drug Testing to Estimate Prenatal Substance Exposure in Utah.

Objective: Our primary objective was to estimate statewide prenatal substance exposure based on umbilical cord sampling. Our secondary objectives were to compare prevalence of prenatal substance exposure across urban, rural, and frontier regions, and to compare contemporary findings to those previously reported.

Methods: We performed a cross-sectional prevalence study of prenatal substance exposure, as determined by umbilical cord positivity for 49 drugs and drug metabolites, through the use of qualitative liquid chromatography-tandem mass spectrometry.

Hospital Outcomes of Infants with Neonatal Opioid Withdrawal Syndrome at a Tertiary Care Hospital with High Rates of Concurrent Nonopioid (Polysubstance) Exposure.

Objective: Neonatal opioid withdrawal syndrome (NOWS) describes infants' withdrawal signs and symptoms after birth due to an interruption of prenatal opioid exposure. Many infants with NOWS are also exposed to nonopioids, however. This study was to determine hospital outcomes of infants exposed to opioids alone or coexposed with nonopioid substances (polysubstance).

Intergenerational transmission of emotion dysregulation: Part II. Developmental origins of newborn neurobehavior.

We investigated whether neurobehavioral markers of risk for emotion dysregulation were evident among newborns, as well as whether the identified markers were associated with prenatal exposure to maternal emotion dysregulation. Pregnant women (N = 162) reported on their emotion dysregulation prior to a laboratory assessment. The women were then invited to the laboratory to assess baseline respiratory sinus arrhythmia (RSA) and RSA in response to an infant cry.

Is my baby normal? A review of seemingly worrisome but normal newborn signs, symptoms and behaviors.

Infant patients are a unique challenge to emergency department (ED) physicians as the spectrum of normal infant signs, symptoms and behaviors are often difficult to differentiate from abnormal and potentially life-threatening conditions. In this article, we address some common chief complaints of neonates and young infants presenting to the ED, and contrast reassuring neonatal and young infant signs and symptoms against those that need further workup and intervention.

Management of newborns born to mothers with chorioamnionitis: is it time for a kinder, gentler approach?

Objective: Current recommendations are that newborns of mothers with chorioamnionitis have a complete blood count, blood culture, and antibiotic therapy. We hypothesized that utilizing the early-onset sepsis (EOS) risk calculator and a clinical symptom assessment could safely reduce the number of newborns subjected to laboratory testing and antibiotics.

Methods: We reviewed 698 well-appearing newborns of estimated gestational age of ≥34 weeks born to mothers with chorioamnionitis.

Neonatal medications.

Neonatal abstinence syndrome (NAS) is reaching epidemic proportions related to perinatal use of opioids. There are many approaches to assess and manage NAS, including one we have outlined. A standardized approach is likely to reduce length of stay and variability in practice.

Timing of initial well-child visit and readmissions of newborns.

Background And Objectives: Recommendations for the timing of the first well-child visit (WCV) after discharge from a well-baby nursery (WBN) suggest that the visit occur within 48 hours of discharge for those with a WBN length of stay of ≤48 hours and within 3 to 5 days for those with a WBN length of stay of >48 hours. The purpose of these early visits is to detect conditions that may cause readmission in the first weeks after birth, but the effectiveness of early visits to accomplish this has not been shown. The objectives of this study were to determine (1) the frequency of early visits and (2) to compare readmission rates for those who had an early visit compared with those who did not.

Early readmission of newborns in a large health care system.

Background: Early readmissions of apparently healthy newborns after discharge from well baby nurseries (WBN) may reflect an inadequate assessment of the newborn's readiness for discharge.

Objective: To determine the frequency, causes, costs, and variations in rates of early rehospitalization of newborns discharged from 21 WBNs in 1 health care system.

Methods: We queried the Enterprise Data Warehouse of Intermountain Healthcare (IH), a large Utah health care system, to identify newborns with gestational ages of 34 to 42 weeks discharged from an IH WBN between 2000 and 2010.

The prevalence of prenatal opioid and other drug use in Utah.

Objectives: Determine the prevalence of prenatal opioid and other drug positivity among women delivering infants in Utah and compare the findings with national data.

Study Design: Umbilical cord tissue samples and nonidentifiable demographic data were collected anonymously in 13 labor and delivery units throughout Utah. Samples were analyzed for opioids, amphetamines, cannabinoids, cocaine, phencyclidine, barbiturates, benzodiazepines, propoxyphene, and alcohol biomarkers.

Medical and mental health of children entering the utah foster care system.

Background: Investigators from several states have reported that children entering foster care are at risk for medical and mental health conditions. Additional information based on data from a larger statewide population of children in foster care would assist in the development of appropriate strategies of care for these children.

Objectives: The purpose of this work was to describe the prevalence of medical and mental health conditions, the number of referrals for specialty care, the use of medications and to compare the prevalence of these conditions across age groups of children entering foster care in Utah.

The good habit of reading (El Buen Habito de la Lectura): parental reactions to an enhanced Reach Out and Read program in a clinic for the underserved.

This report describes parental reactions to a Reach Out and Read (ROR) program enhanced with a children's library in an urban clinic serving low-income immigrant families.

Bottled, filtered, and tap water use in Latino and non-Latino children.

Objectives: To describe bottled, filtered, and tap water consumption and fluoride use among pediatric patients; to analyze differences between ethnic and socioeconomic groups; and to describe the frequency of physician-parent discussions regarding water consumption.

Design: Convenience sample survey.

Setting: An urban public health clinic.

Changing prevalence of prenatal substance abuse in Utah.

Objective: To estimate the current prevalence of prenatal exposure to methamphetamines and other drugs of abuse among infants born in Utah and compare the results with those of a maternal substance abuse prevalence study performed in 1991 in the same geographic area.

Methods: Thirteen well baby nurseries in calendar year 2000 and six neonatal intensive care units (NICUs) in 2001-2002 collected anonymous meconium samples and associated, but nonidentifiable, demographic data on consecutively born infants. Samples were screened by enzyme immunoassay and confirmed by gas chromotography/mass spectroscopy for methamphetamines, cannabinoids, and benzoylecognine.

Prevalence of fatty acid ethyl esters in meconium specimens.

Background: Fetal alcohol syndrome (FAS), alcohol-related birth defects (ARBDs), and alcohol-related neurodevelopment disorders (ARNDs) in neonates are often the result of maternal alcohol consumption during pregnancy. Facial characteristics are associated with FAS, but ARBDs and ARNDs are more difficult to diagnose. Fetal exposure to alcohol can cause central nervous system dysfunction, pre- and postnatal growth problems, cardiac defects in neonates, and attention deficit disorders and mental retardation in older children.

Metamizole use by Latino immigrants: a common and potentially harmful home remedy.

A 4-year-old boy presented with fever, septic arthritis, and persistent neutropenia. Bone marrow biopsy revealed no evidence of neoplasia. Additional history disclosed that the patient had been given metamizole for pain before onset of his illness.