Introduction: Germinal Matrix-Intraventricular Haemorrhage (GM-IVH) is one of the most common neurological complications in preterm infants, which can lead to accumulation of cerebrospinal fluid (CSF) and is a major cause of severe neurodevelopmental impairment in preterm infants. However, the pathophysiological mechanisms triggered by GM-IVH are poorly understood. Analyzing the CSF that accumulates following IVH may allow the molecular signaling and intracellular communication that contributes to pathogenesis to be elucidated. Growing evidence suggests that miRs, due to their key role in gene expression, have a significant utility as new therapeutics and biomarkers.
Methods: The levels of 2,083 microRNAs (miRs) in 15 CSF samples from 10 infants with IVH were measured using miRNA whole transcriptome sequencing. Gene ontology (GO) and miR family analysis were used to uncover dysregulated signalling which were then validated in vitro in human foetal neural progenitor cells treated with IVH-CSF.
Results: Five hundred eighty-seven miRs were differentially expressed in the CSF extracted at least 2 months after injury, compared to CSF extracted within the first month of injury. GO uncovered key pathways targeted by differentially expressed miRs including the MAPK cascade and the JAK/STAT pathway. Astrogliosis is known to occur in preterm infants, and we hypothesized that this could be due to abnormal CSF-miR signaling resulting in dysregulation of the JAK/STAT pathway - a key controller of astrocyte differentiation. We then confirmed that treatment with IVH-CSF promotes astrocyte differentiation from human fetal NPCs and that this effect could be prevented by JAK/STAT inhibition. Taken together, our results provide novel insights into the CSF/NPCs crosstalk following perinatal brain injury and reveal novel targets to improve neurodevelopmental outcomes in preterm infants.
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http://dx.doi.org/10.3389/fnmol.2023.1211373 | DOI Listing |
There is ample research discussing the benefits of a pacifier-activated music system with preterm and high-risk infants. Benefits include improving the quality of nonnutritive sucking (NNS) and increased feeding volume/attempts/endurance, which lead to decreased time to full oral feedings and shortened hospital stays. The use of pacifier-activated music systems supports a faster transition to oral feeding in preterm infants while learning to breastfeed or bottle feed in the NICU.
View Article and Find Full Text PDFEarly Hum Dev
December 2024
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, the Netherlands.
Introduction: Non-invasive respiratory support strategies have evolved to avoid bronchopulmonary dysplasia (BPD) in preterm infants. However, consensus on the best treatment strategy remains lacking. This study aims to investigate current practices and variations in primary respiratory support for extremely preterm neonates across neonatal intensive care units (NICUs) in the Netherlands.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark.
Importance: Current evidence of the association between prenatal exposure to glucocorticoids and long-term mental disorders is scarce and has limitations.
Objective: To investigate the association between prenatal exposure to systemic glucocorticoids and mental disorders in offspring at the age of 15 years, comparing exposed vs unexposed offspring born to mothers with the same underlying disease (risk of preterm delivery and autoimmune or inflammatory disorders).
Design, Setting, And Participants: This nationwide population-based cohort study used data from registries in Denmark with follow-up until December 31, 2018.
Paediatr Drugs
January 2025
Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
Necrotizing enterocolitis (NEC) is a relatively rare but very severe gastrointestinal disease primarily affecting very preterm infants. NEC is characterized by excessive inflammation and ischemia in the intestines, and is associated with prolonged, severe visceral pain. Despite its recognition as a highly painful disease, current pain management for NEC is often inadequate, and research on optimal analgesic therapy for these patients is lacking.
View Article and Find Full Text PDFPediatr Surg Int
January 2025
Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Purpose: To compare postoperative outcomes of bedside surgery (BS) with those of surgery performed in the operating room (ORS) in preterm and full-term neonates.
Methods: Data from neonates undergoing major surgical interventions were retrospectively evaluated. Primary outcome was the incidence of postoperative hypothermia.
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