Homocysteine levels in preterm infants: is there an association with intraventricular hemorrhage? A prospective cohort study.

Background: The purpose of this study was to characterize total homocysteine (tHcy) levels at birth in preterm and term infants and identify associations with intraventricular hemorrhage (IVH) and other neonatal outcomes such as mortality, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and thrombocytopenia.

Methods: 123 infants < 32 weeks gestation admitted to our Level III nursery were enrolled. A group of 25 term infants were enrolled for comparison.

Evidence-based review of oral sucrose administration to decrease the pain response in newborn infants.

Pain assessment and management are important issues for the neonatal nurse today. Clinicians have gradually come to acknowledge that newborn infants (term and preterm) are capable of responding to painful stimuli. This article reviews the evidence regarding the safety and efficacy of oral sucrose administration, to help answer the clinical question of how to manage an infant's pain response to minor invasive procedures that are everyday occurrences in the NICU.

Increasing illness severity in very low birth weight infants over a 9-year period.

Background: Recent reports have documented a leveling-off of survival rates in preterm infants through the 1990's. The objective of this study was to determine temporal changes in illness severity in very low birth weight (VLBW) infants in relationship to the outcomes of death and/or severe IVH.

Methods: Cohort study of 1414 VLBW infants cared for in a single level III neonatal intensive care unit in Delaware from 1993-2002.

Hypothyroxinemia in mechanically ventilated term infants is associated with increased use of rescue therapies.

Objective: Although common in preterm infants, transient hypothyroxinemia (TH) has not been investigated extensively in ill term infants. The objectives of this study were to investigate serum thyroxine (T4) and thyroid-stimulating hormone (TSH) in sick term infants and to determine whether there is any association between measures of thyroid function and short-term outcome in term infants who receive mechanical ventilation.

Methods: The investigation consisted of both a prospective observational study and a retrospective cohort study.

Factors that affect satisfaction with neonatal-perinatal fellowship training.

This study was designed to assess neonatal fellows' satisfaction with their training and the role of mentorship. A 31-question survey was sent to all second- and third-year fellows in the United States and Canada (n = 304). Responses were received from 201 fellows (66% response rate).

Effect of inhaled corticosteroids on markers of pulmonary inflammation and lung maturation in preterm infants with evolving chronic lung disease.

Background: Chronic lung disease (CLD) is one of the most severely disabling conditions of extremely low-birth-weight infants. Systemic corticosteroids are effective but cause many adverse effects. Targeted therapy with inhaled corticosteroids may be an effective and less toxic alternative.

Short-term use of umbilical artery catheters may not be associated with increased risk for thrombosis.

Objective: Umbilical arterial catheters (UACs) have rare but serious complications related to thrombus formation. Two specific serum markers of thrombogenesis--prothrombin fragment (F1.2) and thrombin-antithrombin (TAT)--can be assayed and correlated with abdominal ultrasound visualization of UAC thrombosis.

Factors influencing levels of 17-hydroxyprogesterone in very low birth weight infants and the relationship to death and IVH.

Objectives: 17-Hydroxyprogesterone, an intermediary hormone in cortisol synthesis, has been shown to be elevated in premature infants. However, the relationship between levels of 17-hydroxyprogesterone with death and intraventricular hemorrhage has not been extensively explored. The objective of this study was to determine the factors influencing 17-hydroxyprogesterone and determine if there is an association between intraventricular hemorrhage, mortality, and levels of 17-hydroxyprogesterone in a population of very low birth weight infants.

Admission thyroid evaluation in very-low-birth-weight infants: association with death and severe intraventricular hemorrhage.

Objectives: To determine if thyroxine (T(4)) and thyrotropin (TSH) levels, measured at the time of admission to the neonatal intensive care unit, are associated with the outcomes of death and/or severe intraventricular hemorrhage (IVH).

Study Design: Blood for total T(4) and TSH was obtained upon admission to the neonatal intensive care unit in infants with birthweights less than 1500 g. Infants were followed until hospital discharge.

Are perinatal risk factors helpful in predicting and optimizing treatment strategies for transient hypothyroxinemia in very-low-birth-weight infants?

Transient hypothyroxinemia is common in premature infants and has been associated with intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), poor neurodevelopmental outcomes, and mortality. Recent trials have failed to show that supplemental thyroid hormone improves overall neurodevelopmental outcome. The objective of this article is too determine perinatal risk factors for transient hypothyroxinemia (TH).

Platelet count and sepsis in very low birth weight neonates: is there an organism-specific response?

Objective: Thrombocytopenia is commonly observed in very low birth weight (VLBW) neonates with sepsis. Specific platelet responses to different infectious agents have not been extensively characterized. The objectives of this study were to examine platelet counts and platelet indices in preterm neonates with culture-proven sepsis to determine if there are organism-specific platelet responses.

Maternal antibiotics and decreased periventricular leukomalacia in very low-birth-weight infants.

Objective: To investigate the effect of maternal antibiotics, given in the predelivery period, on neonatal outcomes.

Design: Retrospective cohort study.

Setting: A single level 3 neonatal intensive care unit.

Family reactions during infants' hospitalization in the neonatal intensive care unit.

The purpose of this investigation is to assess family stress, coping, perceptions of their infant, and alterations in mood that may result from the hospitalization of their critically ill newborn infant. Eligible patients were those infants hospitalized in the Special Care Nursery (SCN) at Christiana Care Health Services, who were born up to 31 weeks' gestational age. Twenty-seven families (mothers and/or fathers) completed four questionnaires at 2-week intervals during the course of their premature infants' hospitalization.

Thrombopoietin in preterm infants: gestational age-dependent response.

Purpose: To investigate the factors affecting thrombopoietin (TPO) levels in preterm infants and to determine if TPO levels differ in infants born to mothers with preeclampsia and those infants with culture-proven sepsis.

Methods: Serial serum samples (N = 95) were obtained from 27 infants less than 33 weeks' gestation. Samples were analyzed for TPO using enzyme-linked immunosorbent assay.

Caesarean delivery and outcome in very low birthweight infants.

Objective: To determine the relationship between mode of delivery, intraventricular haemorrhage (IVH), and mortality in very low birthweight (VLBW) infants.

Study Design: A historical cohort study of infants admitted to a single level III neonatal intensive care unit during a five-year period. Infants < 1500 g born by caesarean delivery (n = 400) were compared to those born by vaginal delivery (n = 305).

Transfusion volume in infants with very low birth weight: a randomized trial of 10 versus 20 ml/kg.

Background: Although preterm infants often require transfusions of red blood cells for anemia of prematurity, the optimal volume of blood to be transfused has not been established.

Observations: Infants with birth weights between 500 and 1,500 g were randomly assigned to receive 10 or 20 mL/kg red blood cells. Infants with transfusions of 20 mL/kg had a greater hemoglobin (14.

Home delivery of palivizumab: outcomes and compliance in regional preterm infants.

Palivizumab, a monoclonal antibody against respiratory syncytial virus (RSV), has been shown to be effective in preventing RSV-related hospitalization in preterm infants; however, ensuring infants receive the desired monthly injections remains a challenge. We studied two cohorts of preterm infants and the rate of documented RSV illness in infants receiving palivizumab at home between 1998 and 2000. Medical records were reviewed for the number of doses received, hospitalization for RSV illness, and other demographic data.