Unlabelled: The purpose of this study is to compare the effects of two different ways of stopping incubator humidification on episodes of hypothermia, hyperthermia, hyponatraemia, hypernatraemia, or skin injury. The design is a single site, two-armed, parallel, randomised, clinical trial conducted between April 2019 and March 2022. The setting was a quaternary referral and teaching hospital in Queensland, Australia. There were 140 extremely preterm infants, born < 28 weeks gestational age (GA). Intervention groups were (1) cease humidity: incubator humidification turned from 80% to off at 00.01am on day 8 of life (n = 70); or (2) gradually reduce humidity: incubator humidification reduced by 5% at 00:01 of each day from day 8 until ceased on day 14 (n = 70). The primary outcome was episodes of temperature instability: defined as either hypothermia < 36.5 °C or hyperthermia > 37.5 °C. Secondary outcomes included episodes of hyponatraemia: hypernatraemia or skin injury. One hundred forty infants were enrolled, 70 in each group. No statistically significant differences for any outcomes. Hyperthermia: 77% (n = 54) in the cease group and 73% (n = 51) in the gradual reduction group (P = 0.70). Hypothermia: 53% (n = 37) in the cease group and 37% (n = 26) in the gradual reduction group (P = 0.09). The number of hyponatraemic events was similar for both groups (P = 0.73), as for hypernatraemic events (P = 0.3). Skin injury in week 2 of life: 63% in the cease group and 67% in the gradual reduction group (P = 0.72).
Conclusions: Ceasing or gradually reducing incubator humidification after day 7 of life had no effect on the number of episodes of hypothermia or hyperthermia in this cohort of extremely preterm infants (EPTI). There was also no effect on the number of episodes of hyponatraemia or hypernatraemia.
Trial Registration: ANZCTR.org.au (Australia New Zealand Clinical Trials Registry). ACTRN 1261 9000 266167 Registered 21/2/2019.
What Is Known: • Incubator humidification is a widely accepted and routine practice in the management of EPTI as it influences transepidermal water loss (TEWL) and supports thermoregulation. However, weaning practices remain varied and inconsistent across the globe. • There remains a paucity of data to inform specific evidenced-based humidification practices.
What Is New: • Ceasing or gradually reducing incubator humidification after 7 days had no effect on temperature stability, serum sodium levels, or frequency of skin injury in this cohort of EPTI between day 8 and day 14. • There is no apparent benefit in prolonging incubator humidity beyond day 7 of life in these EPTI.
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http://dx.doi.org/10.1007/s00431-024-05893-w | DOI Listing |
BMC Pregnancy Childbirth
December 2024
Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, 5612 AZ, North Brabant, The Netherlands.
This study aimed to predict preterm birth in nulliparous women using machine learning and easily accessible variables from prenatal visits. Elastic net regularized logistic regression models were developed and evaluated using 5-fold cross-validation on data from 8,830 women in the Nulliparous Pregnancy Outcomes Study: New Mothers-to-Be (nuMoM2b) dataset at three prenatal visits: - , - , and - weeks of gestational age (GA). The models' performance, assessed using Area Under the Curve (AUC), sensitivity, specificity, and accuracy, consistently improved with the incorporation of data from later prenatal visits.
View Article and Find Full Text PDFPediatr Res
December 2024
The Sahlgrenska Centre for Pediatric Ophthalmology Research, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background: Two risk factors for severe retinopathy of prematurity (ROP) in extremely preterm infants are thrombocytopenia and low levels of arachidonic acid (AA) and docosahexaenoic acid (DHA). To date, these risk factors have not been linked.
Method: Infants born < 28 weeks gestational age (GA) from 2016 to 2019 were randomized to postnatal enteral AA/DHA supplementation or standard care (controls).
Mol Med
December 2024
Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Necrotizing enterocolitis (NEC) is a severe inflammatory and necrotizing disease of the intestine that primarily affects the neonates, particularly premature infants. It has a high incidence of approximately 8.9% in extremely preterm infants, with a mortality rate ranging from 20 to 30%.
View Article and Find Full Text PDFAm J Perinatol
December 2024
Neonatology, Surya Hospitals, Mumbai, India.
Objectives: Previous studies have suggested a potential role for inhaled corticosteroids, such as budesonide, in reducing bronchopulmonary dysplasia (BPD) among preterm infants. The objective of our study was to investigate the effectiveness of intratracheal administration of corticosteroid with surfactant on the composite outcome of death or BPD at 36 weeks in extremely low birth weight (ELBW) infants.
Study Design: This before-after cohort study compared outcomes in ELBW infants with respiratory distress syndrome (RDS) who received intratracheal surfactant with budesonide to a historical cohort who received surfactant alone.
JAMA Netw Open
December 2024
Vermont Oxford Network, Burlington.
Importance: Previous research has examined outcomes among very preterm newborns by the birthing parent's race and ethnicity, but knowledge about these trends during the COVID-19 pandemic is limited.
Objective: To examine trends in outcomes among Black, Hispanic, and Asian preterm newborns compared with White preterm newborns.
Design, Setting, And Participants: This cohort study (2018-2022) took place at 774 neonatal intensive care units in the Vermont Oxford Network.
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