Machine-learning-based evaluation of the usefulness of lactate for predicting neonatal mortality in preterm infants.

Background: Unlike in adult and pediatric patients, the usefulness of lactate in preterm infants has not been thoroughly discussed. This study aimed to evaluate whether the lactate level in the first hours of life is an important factor associated with neonatal death in very-low-birth-weight (VLBW) preterm infants.

Methods: Electronic medical records from a level 4 neonatal intensive care unit in South Korea were reviewed to obtain perinatal and neonatal outcomes.

Patent ductus arteriosus management in very-low-birth-weight prematurity: a place for an early operation?

Objectives: The goal was to evaluate neonatal outcomes based on treatment strategies and time points for haemodynamically significant patent ductus arteriosus (hsPDA) in very-low-birth-weight preterm infants, with a particular focus on surgical closure.

Methods: This retrospective study included very-low-birth-weight infants born between 2014 and 2021 who received active treatment for hsPDA. Neonatal outcomes were compared between (i) primary surgical closure versus primary ibuprofen; (ii) early (<14th post-natal day) versus late primary surgical closure (≥14th post-natal day); and (iii) primary versus secondary surgical closure after ibuprofen failure.

Mimicking Hypoxic-Ischemic Encephalopathy in a Newborn with 21q Deletion Originating from Ring Chromosome 21.

Partial deletion of the long arm (q) in chromosome 21 is an extremely rare condition with various phenotypes, including microcephaly, neurodevelopmental delay, dysmorphic features, and epileptic seizures. Neonatal hypoxic-ischemic encephalopathy (HIE) is an encephalopathy associated with a hypoxic-ischemic event in the brain where seizures usually occur in the earliest days of life. Neonatal encephalopathy is a distinct entity resulting from metabolic disorders, congenital infections or genetic abnormalities that could often mimic HIE features, leading to a misdiagnosis of HIE.

Impact of increased paternal age on neonatal outcomes in very-low-birth-weight infants.

Objective: Despite the trend of increasing paternal age, its impact on neonatal outcomes, particularly in preterm infants, has not been thoroughly investigated. We aimed to evaluate the perinatal characteristics and neonatal outcomes associated with paternal age.

Methods: Electronic medical records of very low-birthweight infants admitted to our unit from July 2013 to March 2022 were reviewed.

Using adenosine triphosphate bioluminescence level monitoring to identify bacterial reservoirs during two consecutive Enterococcus faecium and Staphylococcus capitis nosocomial infection outbreaks at a neonatal intensive care unit.

Introduction: This study aimed to assess the role of adenosine triphosphate (ATP) bioluminescence level monitoring for identifying reservoirs of the outbreak pathogen during two consecutive outbreaks caused by Enterococcus faecium and Staphylococcus capitis at a neonatal intensive care unit (NICU). The secondary aim was to evaluate the long-term sustainability of the infection control measures employed one year after the final intervention measures.

Methods: Two outbreaks occurred during a 53-day period in two disconnected subunits, A and B, that share the same attending physicians.

Echocardiographic assessment of brain sparing in small-for-gestational age infants and association with neonatal outcomes.

Brain sparing is an adaptive phenomenon (redistribution of blood flow to the brain) observed in fetuses exposed to chronic hypoxia, who are at risk of intrauterine growth restriction. Here, we assessed the blood flow distribution during the early neonatal period (< 7 days of life) using echocardiography, and evaluated the impact of brain-sparing on postnatal course and neurodevelopmental outcomes. This retrospective study included 42 small-for-gestational age (SGA) infants [further classified into asymmetric SGA (a-SGA, n = 21) and symmetric SGA (s-SGA, n = 21) groups according to their birth head circumference percentiles], and 1: 2 matched appropriate-for-gestational age (AGA) infants (n = 84) admitted to the neonatal intensive care unit.

Impact of preterm premature rupture of membranes and oligohydramnios on in-hospital outcomes of very-low-birthweight infants.

Objective: To analyze neonatal outcomes in very-low-birthweight (VLBW) infants depending on the presence of preterm premature rupture of membranes (PPROM), oligohydramnios, or both.

Methods: The electronic medical records of VLBW infants admitted during the study period, January 2013 to September 2018, were reviewed. Neonatal outcomes (primary outcome: neonatal death; secondary outcome: neonatal morbidity) were compared depending on whether the infant was affected by PPROM or oligohydramnios.

Role of birthweight discordance in preterm twins' outcomes in the Korean neonatal network.

Background: Twin pregnancies can be complicated by birthweight (BW) discordance. We analyzed the impact of BW discordance on clinical outcomes of very-low-birthweight (VLBW) twins.

Methods: The study population was preterm infants in the Korean Neonatal Network registry.

Non-reassuring fetal status and anesthetic impact on cesarean section-delivered very-low-birthweight infants.

Background: There is limited evidence concerning the impact on neonatal outcomes of different types of anesthesia used for cesarean delivery due to non-reassuring fetal status (NRFS). We aimed to assess the impact of NRFS and general anesthesia (GA) on neonatal outcomes in very-low-birthweight (VLBW) infants delivered by cesarean section.

Methods: Data were collected relating to VLBW infants admitted to our institution.

Short-term outcomes of very-low-birth-weight infants born to mothers of advanced and very advanced maternal age.

Objective: To evaluate whether advanced maternal age (35-39 years, AMA)/very advanced maternal age (≥40 years, VAMA) impacts neonatal outcomes of very-low-birth-weight (VLBW) infants.

Methods: Data of VLBW infants admitted to our unit were reviewed. Demographic findings and neonatal outcomes were compared among maternal age [(<35 years, not advanced maternal age,  = 329), AMA ( = 209), and VAMA ( = 43)] groups.

Dose completion of antenatal corticosteroids and neonatal outcomes in non-small-for-gestational age or small-for-gestational age very-low-birthweight infants: A Korean population-based cohort study.

Background: The protective effect of antenatal corticosteroids (ACS) in preterm infants has been well established but it remains unclear in growth-restricted fetuses. Furthermore, a substantial number of pregnant women receive only incomplete ACS treatment because of late presentation or imminent delivery at arrival to the delivery site. How this affects neonatal outcomes in small for gestational age (SGA) infants is not rigorously described.

Risk factors associated with prolonged mechanical ventilation after surgical patent ductus arteriosus ligation in preterm infants.

Background: One of the main pathophysiologies of a hemodynamically significant patent ductus arteriosus (hsPDA) involves pulmonary over-circulation. However, PDA treatment does not present with uniform effects on pulmonary outcomes. We aimed to evaluate the clinical characteristics - in particular, respiratory parameters - associated with prolonged mechanical ventilation after PDA ligation.

Respiratory Severity Score with Regard to Birthweight during the Early Days of Life for Predicting Pulmonary Hypertension in Preterm Infants.

Objective: The respiratory severity score (RSS) has been demonstrated to be associated with the oxygenation index in intubated newborn infants. We aimed to evaluate the usefulness of RSS with regard to birthweight (BW) in preterm infants for predicting an association with future pulmonary hypertension (PH).

Methods: Preterm infants with <30 weeks' gestation and <1250 g BW were reviewed and grouped into two (PH vs.

Enlarged subarachnoid space on cranial ultrasound in preterm infants: Neurodevelopmental implication.

The role of enlarged subarachnoid space (ESS) in preterm infants has not been described in concrete. We aimed to evaluate whether ESS should be considered a risk factor potentially associated with adverse neurodevelopmental outcomes in prematurity. Electronic medical records of 197 preterm infants (median 32.

Patent ductus arteriosus ligation on neurodevelopmental outcomes at corrected 2 years.

Background: Our aim in this study was to evaluate whether very low birth weight infants (VLBWI) ligated for patent ductus arteriosus (PDA) were associated with worse neurodevelopmental outcomes at corrected 2 years. The ligated group was subdivided into ≤2 weeks of life (early) and ligated > 2 weeks of life (late) groups and compared the in-hospital morbidities and long term outcomes.

Methods: Between Dec 2013 and Dec 2015, VLBWI diagnosed with hs PDA were evaluated.

Preoperative metabolic acidosis and acute kidney injury after open laparotomy in the neonatal intensive care unit.

Background: This study evaluated potential risk factors associated with acute kidney injury (AKI) in infants undergoing bedside open laparotomy in the neonatal intensive care unit (NICU), and analyzed the association between postoperative AKI and outcomes.

Methods: Retrospective data, including neonatal characteristics, perioperative findings (i.e.

Perinatal prediction model for severe intraventricular hemorrhage and the effect of early postnatal acidosis.

Purpose: Severe acidosis is one of the strongest predictors of neurologic outcomes in full-term infants with suspected hypoxic-ischemic encephalopathy. However, the relative importance of acidosis as a predictor of outcomes in preterm infants is much less clear. The goals of the present study were to examine the association between postnatal acidosis and severe intraventricular hemorrhage (IVH) and to establish a new score model including acid-base status after birth for predicting the risk of this morbidity.

Impact of histologic chorioamnionitis on pulmonary hypertension and respiratory outcomes in preterm infants.

We aimed to evaluate the association between the presence of histologic chorioamnionitis (HC) and development of pulmonary hypertension (PH) during neonatal intensive care unit (NICU) stay. Data of preterm infants born at 32 weeks of gestation or less were reviewed. The development of PH and other respiratory outcomes were compared according to the presence of HC.

Impacts of therapeutic hypothermia on cardiovascular hemodynamics in newborns with hypoxic-ischemic encephalopathy: a case control study using echocardiography.

Purpose: The effects of therapeutic hypothermia (TH) on hemodynamics in newborns with hypoxic-ischemic encephalopathy (HIE) were evaluated.

Materials And Methods: Thirty-two neonates (gestational age, 39.4 ± 1.

Clinical characteristics predicting abnormal brain magnetic resonance image findings in hypoxic-ischemic encephalopathy infants.

Background: The aim of this study was to elucidate the specific clinical characteristics associated with abnormal brain magnetic resonance image (MRI) findings in hypoxic ischemic encephalopathy (HIE) infants in order to discern how to predict poorer outcomes more accurately.

Methods: A retrospective data analysis of HIE infants admitted to the neonatal intensive care unit of a tertiary hospital was performed. Baseline perinatal information and physical and neurological findings were compared in HIE infants according to the presence of abnormal brain MRI findings.

Echocardiographic assessment of patent ductus arteriosus in very low birthweight infants over time: prospective observational study.

Background: We aimed to determine the echocardiographic parameters that can predict the presence of patent ductus arteriosus (PDA) and haemodynamically significant ductus arteriosus (HSDA) at different time points.

Methods: Echocardiogram was performed on postnatal days 3 and 7(D3-Echo and D7-Echo, respectively) in 71 very low birthweight infants with a median gestational age of 28.0 weeks.

Changes in lactate dehydrogenase are associated with central gray matter lesions in newborns with hypoxic-ischemic encephalopathy.

Purpose: Biomarkers may predict neurological prognosis in infants with hypoxic-ischemic encephalopathy (HIE). We evaluated the relationship between serum lactate dehydrogenase (LDH) and brain magnetic resonance imaging (MRI), which predicts neurodevelopmental outcomes, in order to assess whether LDH levels are similarly predictive.

Materials And Methods: Medical records were reviewed for infants with HIE and LDH levels were assessed on the first (LDH) and third (LDH) days following birth.

Expanded criteria for retinopathy of prematurity screening in moderately preterm infants: Single-center pilot study.

Background: While developed countries seek to lower the gestational age and birthweight parameters in retinopathy of prematurity (ROP) screening, older, larger infants still develop ROP in other parts of the world. The aim of this study was therefore to define criteria to identify potential ROP developers who are outliers of the common screening range.

Methods: A retrospective medical record review was performed in 147 inborn moderately preterm infants admitted to the neonatal intensive care unit during the study period.

The hospital outcomes compared between the early and late hypothermia-treated groups in neonates.

Background And Objective: The incidence of hypoxic ischemic encephalopathy (HIE) in developed countries is estimated to be 1.5 per 1000 live births. The primary aim of this study was to analyze whether earlier hypothermia (≤1 h) improves hospital outcomes in survivors who underwent therapeutic hypothermia (TH) when compared with late TH (>1 h).