Delayed cord clamping in preterm twin infants: a systematic review and meta-analysis.

Objective: To compare the effects of delayed cord clamping (DCC) versus early cord clamping (EDD) on all-cause in-hospital mortality and selected morbidities among preterm twin neonates.

Data Sources: A search of PubMed, Ovid Medline, Embase, Cochrane database, Web of Science and CINAHL was conducted in December 2023 for studies comparing DCC to ICC in preterm twin neonates.

Study Eligibility Criteria: Studies were deemed eligible if they included preterm twin neonates (< 37 weeks of gestation), compared delayed (≥ 30 seconds) vs early (<30 seconds) umbilical cord clamping at delivery and described at least one outcome of interest.

Butterflies and Ribbons: Supporting Families Experiencing Perinatal Loss in Multiple Gestation.

In neonatology, multiple pregnancies are common. Unfortunately, it is not rare for one baby to die. Communication with parents in these circumstances has been demonstrated to be sub-optimal.

Survival and Long-Term Outcomes of Children Who Survived after End-of-Life Decisions in a Neonatal Intensive Care Unit.

Objective: To investigate long-term outcomes of infants who survive despite life-and-death discussions with families and a decision to withdraw or withhold life-sustaining interventions (WWLST) in one neonatal intensive care unit.

Study Design: Medical records for neonatal intensive care unit admissions from 2012 to 2017 were reviewed for presence of WWLST discussions or decisions, as well as the 2-year outcome of all children who survived. WWLST discussions were prospectively recorded in a specific book; follow-up to age 2 years was determined by retrospective chart review.

Fragility and resilience: parental and family perspectives on the impacts of extreme prematurity.

Objectives: Extremely preterm babies have a significant risk of neurodevelopmental impairment (NDI). There has been little investigation regarding the impact of prematurity on families. The objective of this study was to explore parental perspectives regarding the impact of prematurity on themselves/their family.

Gratitude, fragility and strength: Perspectives of adults born preterm about prematurity.

Aim: The aim of the study was to explore how young adults thought that being born preterm had affected their lives.

Methods: Adult participants of a research cohort were questioned about their perspectives. Answers were analysed using mixed methods.

Pulmonary important outcomes after extremely preterm birth: Parental perspectives.

Aim: To describe pulmonary important outcomes (PIO) reported by parents of children born extremely preterm.

Methods: Over 1-year, all parents of children aged 18 months-7-years born <29 weeks' GA were asked regarding their perspectives. The proportion of parents who described PIO and the themes they invoked were examined.

Guilt and Regret Experienced by Parents of Children Born Extremely Preterm.

Objectives: To explore decisional regret of parents of babies born extremely preterm and analyze neonatal, pediatric, and parental factors associated with regret.

Study Design: Parents of infants born <29 weeks of gestational age, aged between 18 months and 7 years, attending neonatal follow-up were enrolled. Hospital records were reviewed to examine morbidities and conversations with parents about levels of care.

Avoidance of routine endotracheal intubation and general anesthesia for primary closure of gastroschisis: a systematic review and meta-analysis.

Purpose: Over the last few decades, several articles have examined the feasibility of attempting primary reduction and closure of gastroschisis without general anesthesia (GA). We aimed to systematically evaluate the impact of forgoing routine intubation and GA during primary bedside reduction and closure of gastroschisis.

Methods: The primary outcome was closure success.

The most immature infants: Is evidence-based practice possible?

Introduction: At extremely low gestational ages, preterm infants are markedly physiologically immature, thus their responses to common clinical interventions may differ from more mature preterm babies. This study was performed to describe the evidence base which is available to make care decisions for such infants.

Methods: A literature search of recent large neonatal randomized controlled trials (RCTs) was performed to determine the representation of infants <25 weeks of gestation, and whether it is clear if the overall results applied to the most immature infants.

The ethics of family integrated care in the NICU: Improving care for families without causing harm.

The philosophy of care in Neonatal Intensive care Units (NICU) has changed with increasing integration of families. We examined parents' and clinicians' perspective about Family Integrated Care (FiCare) in our quaternary NICU. We found that parents and clinicians reported many benefits for families.

Hypotension in Preterm Infants (HIP) randomised trial.

Objective: To determine whether restricting the use of inotrope after diagnosis of low blood pressure (BP) in the first 72 hours of life affects survival without significant brain injury at 36 weeks of postmenstrual age (PMA) in infants born before 28 weeks of gestation.

Design: Double-blind, placebo-controlled randomised trial. Caregivers were masked to group assignment.

Techniques to Communicate Better With Parents During End-of-Life Scenarios in Neonatology.

Background And Objectives: Clinicians are urged to optimize communication with families, generally without empirical practical recommendations. The objective of this study was to identify core behaviors associated with good communication during and after an unsuccessful resuscitation, including parental perspectives.

Methods: Clinicians from different backgrounds participated in a standardized, videotaped, simulated neonatal resuscitation in the presence of parent actors.

Prostanoids and their analogues for the treatment of pulmonary hypertension in neonates.

Background: Persistent pulmonary hypertension of the newborn (PPHN) is a disease entity that describes a physiology in which there is persistence of increased pulmonary arterial pressure. PPHN is characterised by failure to adapt to a functional postnatal circulation with a fall in pulmonary vascular resistance. PPHN is responsible for impairment in oxygenation and significant neonatal mortality and morbidity.

Building trust and improving communication with parents of children with Trisomy 13 and 18: A mixed-methods study.

Background: Trisomy 13 and trisomy 18 are common life-limiting conditions associated with major disabilities. Many parents have described conflictual relationships with clinicians, but positive and adverse experiences of families with healthcare providers have not been well described.

Aim: (1) To investigate parental experiences with clinicians and (2) to provide practical recommendations and behaviors clinicians could emulate to avoid conflict.

Integrating Parents in Neonatal and Pediatric Research.

Background: Parents and their infants are the beneficiaries of neonatal and pediatric research, but in the past they have been excluded from most stages of research projects. As a result, many projects may fail to produce the most worthwhile information for parents and families. Lately, veteran resource parents and patients have been increasingly integrated in research initiatives.

Cardiac arrest with pulseless electrical activity rhythm in newborn infants: a case series.

The 2015 neonatal resuscitation guidelines added ECG to assess an infant's heart rate when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. We report four cases of pulseless electrical activity during neonatal cardiopulmonary resuscitation in levels II-III neonatal intensive care units in Canada (Edmonton [n=3] and Winnipeg [n=1]).

Pulseless electrical activity: a misdiagnosed entity during asphyxia in newborn infants?

Background: The 2015 neonatal resuscitation guidelines added ECG as a recommended method of assessment of an infant's heart rate (HR) when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room.

Objectives: To compare accuracy of ECG with auscultation to assess asystole in asphyxiated piglets.