Pediatrics – Neonatal/Perinatal
Cluster RCT | Eat, sleep, console approach vs. usual care for neonatal opioid withdrawal
3 May, 2023 | 15:35h | UTCEat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: “Eat, Sleep, Console” reduces hospital stay and need for medication among opioid-exposed infants – NIH News Releases
Commentary on Twitter
In this randomized trial, infants who were treated with the Eat, Sleep, Console model for neonatal opioid withdrawal syndrome had a significantly shorter hospital stay than those in the usual-care group. Full results of the ESC-NOW trial: https://t.co/13j7a5DhZd#PAS2023 pic.twitter.com/so5jqIVwpi
— NEJM (@NEJM) April 30, 2023
Criteria for placental examination for obstetrical and neonatal providers
28 Apr, 2023 | 13:06h | UTC
RCT | Cerebral oximetry monitoring fails to reduce death or severe brain injury in extremely preterm infants
25 Apr, 2023 | 14:45h | UTCCerebral Oximetry Monitoring in Extremely Preterm Infants – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In extremely preterm infants, the use of cerebral oximetry monitoring to guide treatment for the first 72 hours after birth did not reduce the risk of death or severe brain injury at 36 weeks’ postmenstrual age. Full study: https://t.co/JX7Ra3OpjM pic.twitter.com/VACbUUAq3i
— NEJM (@NEJM) April 19, 2023
Sudden unexpected infant deaths in the US: 2015–2020
25 Apr, 2023 | 14:27h | UTCSudden Unexpected Infant Deaths: 2015–2020 – Pediatrics
Commentary:
Increasing Disparities in Sudden Unexpected Infant Deaths Reflect Societal Failures – Pediatrics
2020 spike in SIDS likely due to diagnostic shifting, not COVID-19 – Contemporary Pediatrics
SR | Opioids for procedural pain in neonates
19 Apr, 2023 | 13:11h | UTCOpioids for procedural pain in neonates – Cochrane Library
M-A | Retinopathy of prematurity and neurodevelopmental outcomes in preterm infants
10 Apr, 2023 | 13:36h | UTC
Podcast | Congenital hypothyroidism
6 Apr, 2023 | 13:11h | UTC#78: Congenital Hypothyroidism – The Cribsiders
RCT | Safety and efficacy of Pitolisant in children aged 6 years or older with narcolepsy with or without cataplexy
6 Apr, 2023 | 13:08h | UTCSafety and efficacy of pitolisant in children aged 6 years or older with narcolepsy with or without cataplexy: a double-blind, randomised, placebo-controlled trial – The Lancet Neurology (link to abstract – $ for full-text)
Commentary: Pitolisant Improves Pediatric Narcolepsy Symptoms Regardless of Cataplexy in Phase 3 Study – Neurology Live
SR | Induction of labor at or near term for suspected fetal macrosomia
6 Apr, 2023 | 12:55h | UTC
Review | Use of cardio-pulmonary ultrasound in the neonatal intensive care unit
5 Apr, 2023 | 12:58h | UTCUse of Cardio-Pulmonary Ultrasound in the Neonatal Intensive Care Unit – Children
Review | Evaluation of the hypotensive preterm infant: evidence-based practice at the bedside?
5 Apr, 2023 | 12:55h | UTCEvaluation of the Hypotensive Preterm Infant: Evidence-Based Practice at the Bedside? – Children
Review | Respiratory management of the preterm infant: supporting evidence-based practice at the bedside
5 Apr, 2023 | 12:53h | UTC
SR | Risk factors for length of NICU stay of newborns
3 Apr, 2023 | 13:23h | UTCRisk factors for length of NICU stay of newborns: A systematic review – Frontiers in Pediatrics
Prematurity and bronchopulmonary dysplasia: what general pediatricians should know
30 Mar, 2023 | 14:12h | UTCPrematurity and BPD: what general pediatricians should know – European Journal of Pediatrics
Cohort Study | Opioid use for pain relief after birth appears to pose no significant risk to breastfed infants
23 Mar, 2023 | 13:08h | UTCSummary: This large study from Canada found that infants born to mothers prescribed opioids after delivery, mainly following a cesarean, are at no greater risk of harm shortly after birth than infants of mothers not prescribed opioids. This suggests that breastfeeding is likely safe for babies whose mothers are taking opioids for pain relief.
The study included 865,691 mother-infant pairs discharged from Ontario hospitals within seven days of delivery between September 2012 and March 2020. Researchers matched mothers who filled an opioid prescription within seven days of discharge to those who did not.
Among the infants admitted to the hospital within 30 days, 2,962 (3.5%) were born to mothers who filled an opioid prescription compared with 3,038 (3.5%) born to mothers who did not, showing that infants of mothers prescribed opioids were no more likely to be admitted to the hospital for any reason. These children were only marginally more likely to visit the emergency department in the subsequent 30 days, and no differences were found for other serious outcomes, including breathing problems or admission to a neonatal intensive care unit, and no infant deaths occurred.
Although the study has some limitations, the high initial breastfeeding rates in Canada (90%) and the consistency of the findings with the fact that millions of new mothers are prescribed opioids after delivery each year provide confidence in the conclusions.
Editorial: Opioid analgesia for breastfeeding mothers – The BMJ
News Release: Infants of mothers given opioids after birth are at low risk of harm – BMJ Newsroom
M-A | The efficacy of Kangaroo-Mother care to the clinical outcomes of LBW and premature infants
21 Mar, 2023 | 13:35h | UTCSummary: Kangaroo-Mother Care (KMC) is a method that involves skin-to-skin contact between the mother and newborn, frequent exclusive or almost exclusive breastfeeding, and early discharge. KMC is an alternative to traditional care interventions for low birthweight (LBW) infants, and the World Health Organization has recommended its use for LBW infants for over a decade.
The authors conducted a meta-analysis including 17 randomized clinical trials involving 17,668 participants. They found that KMC can significantly reduce neonatal mortality, lower hypothermia and sepsis rates, and reduce the duration of hospital stay. The authors suggest that KMC should be promoted, popularized, and standardized in clinical practice.
Related:
Kangaroo mother care to reduce morbidity and mortality in low birthweight infants – Cochrane Library
Consensus on complementary feeding in pediatrics
21 Mar, 2023 | 13:30h | UTC
SR | Systemic corticosteroid regimens for prevention of bronchopulmonary dysplasia in preterm infants
21 Mar, 2023 | 13:14h | UTCSummary: Different timing and dosages of corticosteroids to prevent lung injury – Cochrane Library
SR | Postnatal phenobarbital for the prevention of intraventricular hemorrhage in preterm infants
21 Mar, 2023 | 13:15h | UTC
Commentary on Twitter
?What are the benefits and risks of #phenobarbital (a medicine used to control seizures) for preventing bleeding to the brain in #preterm #infants?
This @CochraneNeonate systematic review looks at the evidence from 10 studies with 792 babies.https://t.co/upqW8azhZP pic.twitter.com/wcpnjlu3t0
— The Cochrane Library (@CochraneLibrary) March 16, 2023
Review | The latent phase of labor
20 Mar, 2023 | 13:28h | UTCThe latent phase of labor – American Journal of Obstetrics & Gynecology
Commentary on Twitter
AJOG Expert Review in Labor: The latent phase of labor- Management of a prolonged latent phase of labor https://t.co/ep0rPrldAn @acog @RCObsGyn @SOGCorg @ranzcog @ISUOG pic.twitter.com/fm7cUaQsOr
— AJOG (@AJOG_thegray) March 17, 2023
Consensus Statement | Point-of-care ultrasound for systematic assessment of the crashing neonate
17 Mar, 2023 | 13:05h | UTC
SR | Planned hospital birth compared with planned home birth for pregnant women at low risk of complications
17 Mar, 2023 | 12:51h | UTCSummary: Planned hospital birth versus planned home birth – Cochrane Library
20 million pregnant women with group B streptococcus carriage: consequences, challenges, and opportunities for prevention
15 Mar, 2023 | 14:53h | UTC
SR | Intermittent phototherapy versus continuous phototherapy for neonatal jaundice
7 Mar, 2023 | 12:59h | UTCSummary:
Phototherapy is a widely accepted first-line therapy for neonatal jaundice, and while continuous phototherapy is traditionally used, intermittent phototherapy has been proposed as an equally effective alternative with practical advantages such as improved maternal feeding and bonding. This systematic review compared intermittent vs. continuous phototherapy’s effectiveness and safety in treating neonatal jaundice.
The study included 12 randomized controlled trials involving 1600 infants, and found little or no difference between intermittent and continuous phototherapy in reducing bilirubin levels. Continuous phototherapy was found to be more effective in preterm infants, but the risks and potential benefits are unknown.
The review concludes that while there are theoretical benefits to intermittent regimens, large, well-designed, prospective trials are needed to determine whether intermittent and continuous phototherapy are equally effective and safe in both preterm and term infants.
Article: Intermittent phototherapy versus continuous phototherapy for neonatal jaundice – Cochrane Library
Summary: Intermittent phototherapy versus continuous phototherapy for neonatal jaundice – Cochrane Library
Cohort Study | Early pregnancy exposure to NSAIDs is associated with slightly higher risks of neonatal and maternal adverse outcomes
7 Mar, 2023 | 12:56h | UTCSummary:
A nationwide cohort study in South Korea, including 1.8 million pregnancies, investigated the association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during early pregnancy and neonatal and maternal adverse outcomes.
The study revealed that pregnant women exposed to NSAIDs during early pregnancy were at increased risk of oligohydramnios and had a slightly higher likelihood of having an infant with major congenital malformations and low birth weight. These risks remained elevated when comparing NSAIDs against acetaminophen or past users.
The study suggests that clinicians should weigh the need to prescribe NSAIDs in early pregnancy against the modest but possible risk of neonatal and maternal outcomes and consider prescribing nonselective NSAIDs for <10 days, with continued careful monitoring for any safety signals.