Publications by authors named "Wyckoff M"
Background: Preterm prelabor rupture of membranes (PPROM) before or around the limit of fetal viability is associated with serious maternal and neonatal complications including chorioamnionitis, extremely preterm birth, and pulmonary hypoplasia.
Objectives: To describe contemporary outcomes of extremely preterm infants born after prolonged periviable PPROM, and to identify perinatal factors associated with survival and survival without severe neurodevelopmental impairment (NDI).
Study Design: Among actively treated infants born alive at <27 weeks' gestational age (GA) in centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network from 2012 to 2018, the outcomes of survival and survival without severe NDI at 22-26 months' corrected age were compared between infants exposed to prolonged (≥120 hours) periviable (<24 weeks' GA) PPROM and unexposed infants born after rupture of membranes ≤18 hours before delivery or at delivery, adjusting for birth GA, sex, multiple gestation, antenatal steroids, small for gestational age (SGA), insurance, and center.
Article Synopsis
- The study aimed to see if neonatal complications were linked to death or severe neurodevelopmental impairment in extremely preterm infants who lived to 36 weeks.
- It analyzed data from nearly 3,800 infants born between 22 and 26 weeks gestation at 15 research centers, finding that serious brain injury, bronchopulmonary dysplasia, and severe retinopathy were the most significant risks.
- A higher count of these morbidities correlated with increased rates of death or severe neurodevelopmental impairment, with rates jumping from 12.6% for no morbidities to 69.9% for all three.
Mode of delivery and outcomes among inborn extremely preterm singletons: A cohort study.
Acta Obstet Gynecol Scand
December 2024
Article Synopsis
- Cesarean delivery is the most common method for extremely preterm infants, but there's limited research comparing outcomes between cesarean and vaginal births for these babies.
- A study involving data from 25 US medical centers focused on extremely preterm singletons (401-1000 g birth weight) to assess rates of death or severe neurodevelopmental impairment based on the mode of delivery.
- The results showed no significant difference in outcomes between cesarean and vaginal deliveries, but cesarean and vertex vaginal deliveries had lower mortality rates compared to breech vaginal deliveries.
Article Synopsis
- The eighth annual summary from the International Liaison Committee on Resuscitation (ILCOR) focuses on the latest findings in cardiopulmonary resuscitation (CPR) and emergency cardiovascular care, building on a comprehensive review from 2020.
- This summary is based on the evaluation of recent resuscitation evidence by experts from six different ILCOR task forces, who utilized specific criteria to assess the quality of evidence and reached consensus treatment recommendations.
- The document also identifies key areas where more research is needed, sharing insights into the task forces’ discussions through sections like Justification and Evidence-to-Decision Framework Highlights.
This is the eighth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recent published resuscitation evidence reviewed by the International Liaison Committee on Resuscitation task force science experts. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations.
View Article and Find Full Text PDFAim: Compare heart rate assessment methods in the delivery room on newborn clinical outcomes.
Methods: A search of Medline, SCOPUS, CINAHL and Cochrane was conducted between January 1, 1946, to until August 16, 2023. (CRD 42021283438) Study Selection was based on predetermined criteria.
Article Synopsis
- - The study evaluated various methods for measuring newborn heart rates at birth, focusing on their speed and accuracy.
- - Findings indicated that pulse oximetry is slower and less accurate than ECG, while auscultation and palpation are also imprecise; however, digital stethoscopes and certain types of ultrasound and ECG are promising alternatives.
- - The study concluded that ECG is the best option for reliable heart rate assessment at birth, though alternatives like pulse oximetry and digital tools still have potential but require more research.
Objective: To assess whether initial epinephrine administration by endotracheal tube (ET) in newly born infants receiving chest compressions and epinephrine in the delivery room (DR) is associated with lower rates of return of spontaneous circulation (ROSC) than newborns receiving initial intravenous (IV) epinephrine.
Study Design: We conducted a retrospective review of neonates receiving chest compressions and epinephrine in the DR from the AHA Get With The Guidelines-Resuscitation registry from October 2013 through July 2020. Neonates were classified according to initial route of epinephrine (ET vs IV).
Importance: Maternal milk feeding of extremely preterm infants during the birth hospitalization has been associated with better neurodevelopmental outcomes compared with preterm formula. For infants receiving no or minimal maternal milk, it is unknown whether donor human milk conveys similar neurodevelopmental advantages vs preterm formula.
Objective: To determine if nutrient-fortified, pasteurized donor human milk improves neurodevelopmental outcomes at 22 to 26 months' corrected age compared with preterm infant formula among extremely preterm infants who received minimal maternal milk.
Objective: To compare the rates of death or survival with severe neurodevelopmental impairment (sNDI) at 2 years among extremely preterm infants in relation to pre-pregnancy or first-trimester maternal body mass index (BMI).
Methods: This retrospective cohort study included extremely preterm infants (gestational age 22-26 weeks). The study was conducted at National Institute of Child Health and Human Development Neonatal Research Network sites.
Hypothesis: Increased social distancing was associated with a lower incidence of extremely preterm live births (EPLB) during the initial COVID-19 pandemic period.
Study Design: Prospective study at the NICHD Neonatal Research Network sites comparing EPLB (22-28 weeks) and extremely preterm intrapartum stillbirths (EPIS) rates during the pandemic period (March-July, weeks 9-30 of 2020) with the reference period (same weeks in 2018 and 2019), correlating with state-specific social distancing index (SDI).
Results: EPLB and EPIS percentages did not significantly decrease (1.
Objective: No available scale, at the time of initial evaluation for necrotizing enterocolitis (NEC), accurately predicts, that is, with an area under the curve (AUC) ≥0.9, which preterm infants will undergo surgery for NEC stage III or die within a week.
Study Design: This is a retrospective cohort study ( = 261) of preterm infants with <33 weeks' gestation or <1,500 g birth weight with either suspected or with definite NEC born at Parkland Hospital between 2009 and 2021.
Background: Respiratory care protocol including less invasive śsurfactant administration (LISA) in ≤29 weeks' gestational age (GA) infants introduced in October 2018.
Methods: Retrospective study of infants admitted on continuous positive airway pressure (CPAP) October 2018 to December 2021. Maternal and neonatal variables were compared between infants managed on CPAP with and without LISA.
Objective: Neonates born with fetal inflammatory response (FIR) are at increased risk for adverse neonatal outcomes. Our objective was to determine whether FIR and its severity is associated with severity of necrotizing enterocolitis (NEC) in preterm infants.
Methods: A case-control retrospective study of infants <33 weeks gestational age or <1500 g birthweight, including 260 with stage I-III NEC and 520 controls matched for gestational age.
Maternal, placental, and neonatal factors were compared between infants born at ≤29 weeks of gestational age with admission hyperthermia (>37.5C) and euthermia (36.5-37.
View Article and Find Full Text PDFArticle Synopsis
- The 2023 update on neonatal resuscitation guidelines is informed by four extensive systematic reviews managed by the International Liaison Committee on Resuscitation Neonatal Life Support Task Force.
- The reviews focused on key topics such as umbilical cord management for different types of newborns and the best devices for providing ventilation during resuscitation.
- New recommendations include practices like umbilical cord milking and guidelines on selecting appropriate devices for effective positive-pressure ventilation.
Article Synopsis
- - This 2023 update to neonatal resuscitation guidelines is based on recent systematic reviews conducted by a specialized task force focused on newborn care.
- - The task force reviewed scientific literature regarding umbilical cord management for different types of newborns, as well as devices for providing positive-pressure ventilation during resuscitation.
- - New recommendations include guidance on milking intact umbilical cords, choosing the right devices for ventilation, and introducing an additional primary interface for resuscitation.
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training.
View Article and Find Full Text PDFThe International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training.
View Article and Find Full Text PDFObjective: Necrotizing enterocolitis (NEC) primarily affects preterm, especially small for gestational age (SGA), infants. This study was designed to (1) describe frequency and timing of NEC in SGA versus non-SGA infants and (2) assess whether NEC is independently associated with the severity of intrauterine growth failure.
Study Design: Retrospective cohort study of infants without severe congenital malformations born <33 weeks' gestational age (GA) carried out from 2009 to 2021.
Importance: Preterm infants with varying degrees of anemia have different tissue oxygen saturation responses to red blood cell (RBC) transfusion, and low cerebral saturation may be associated with adverse outcomes.
Objective: To determine whether RBC transfusion in preterm infants is associated with increases in cerebral and mesenteric tissue saturation (Csat and Msat, respectively) or decreases in cerebral and mesenteric fractional tissue oxygen extraction (cFTOE and mFTOE, respectively) and whether associations vary based on degree of anemia, and to investigate the association of Csat with death or neurodevelopmental impairment (NDI) at 22 to 26 months corrected age.
Design, Setting, And Participants: This was a prospective observational secondary study conducted among a subset of infants between August 2015 and April 2017 in the Transfusion of Prematures (TOP) multicenter randomized clinical trial at 16 neonatal intensive care units of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.
Aim: To evaluate delivery room (DR) interventions to prevent hypothermia and improve outcomes in preterm newborn infants <34 weeks' gestation.
Methods: Medline, Embase, CINAHL and CENTRAL were searched till 22nd July 2022. Randomized controlled trials (RCTs), non-RCTs and quality improvement studies were considered.
Exhaled CO monitoring to guide non-invasive ventilation at birth: a systematic review.
Arch Dis Child Fetal Neonatal Ed
December 2023
Objective: Measuring exhaled carbon dioxide (ECO) during non-invasive ventilation at birth may provide information about lung aeration. However, the International Liaison Committee on Resuscitation (ILCOR) only recommends ECO detection for confirming endotracheal tube placement. ILCOR has therefore prioritised a research question that needs to be urgently evaluated: 'In newborn infants receiving intermittent positive pressure ventilation by any non-invasive interface at birth, does the use of an ECO monitor in addition to clinical assessment, pulse oximetry and/or ECG, compared with clinical assessment, pulse oximetry and/or ECG only, decrease endotracheal intubation in the delivery room, improve response to resuscitation, improve survival or reduce morbidity?'.
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