Pediatrics – Neonatal/Perinatal
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.
Consensus Paper | Management of respiratory distress syndrome
6 Mar, 2023 | 14:14h | UTC
Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland
3 Mar, 2023 | 13:51h | UTCSummary: The study aimed to determine the association between maternal diabetes and overweight/obesity and the risk of congenital heart defects (CHDs) in offspring. The study analyzed data from all children born in Finland between 2006 and 2016 and their mothers. Maternal type 1 diabetes (T1DM) was found to be associated with a significantly increased risk for any CHD, with an odds ratio of 3.71, whereas maternal overweight and obesity were associated with only a slightly increased risk for complex defects and left ventricular outflow tract obstruction. Maternal diabetes was responsible for 3.0% of offspring’s CHD, while maternal overweight and obesity were responsible for 0.7%, indicating weaker associations between maternal overweight and obesity and CHD in the offspring than previously reported.
Commentary from the author on Twitter
Proudly presenting our preprint (thread):
Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland https://t.co/rFnlNYPrgn 1/7
— Emmi Helle (@EmmiHelle) February 27, 2023
WHO Report | A woman dies every two minutes due to pregnancy or childbirth
28 Feb, 2023 | 14:04h | UTCSummary: This new report by United Nations agencies shows that a woman dies every two minutes due to pregnancy or childbirth. The report covers maternal deaths from 2000 to 2020 and reveals that maternal deaths either increased or stagnated in nearly all regions of the world, with some regions experiencing major setbacks. The poorest parts of the world and countries affected by conflict continue to have the highest rates of maternal deaths. Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions aggravated by pregnancy are the leading causes of maternal deaths, which are largely preventable and treatable with access to high-quality healthcare. The COVID-19 pandemic may have further held back progress on maternal health. The report calls for urgent action to ensure every woman and girl has access to critical health services before, during, and after childbirth, so they can fully exercise their reproductive rights.
News Release: A woman dies every two minutes due to pregnancy or childbirth: UN agencies – World Health Organization
Commentaries:
Ambitious goal to slash maternal deaths in jeopardy – Nature
U.N.: Progress on reducing global maternal mortality has stalled since 2015 – STAT
Eight Hundred Women Die Every Day During Pregnancy or Childbirth – Health Policy Watch
Brief Review | Congenital infections: priorities and possibilities for resource-limited settings
1 Mar, 2023 | 13:32h | UTCCongenital Infections: Priorities and Possibilities for Resource-limited Settings – The Pediatric Infectious Disease Journal (free for a limited period)
RCT | 2-y outcomes confirm the harms caused by high prophylactic platelet transfusion thresholds in preterm infants
28 Feb, 2023 | 13:53h | UTCSummary: The study investigated the long-term outcomes of preterm infants who participated in a randomized trial of platelet transfusions at different threshold levels. Infants with platelet counts below 50×109/L were enrolled and randomized to either a higher threshold of 50×109/L or a lower threshold of 25×109/L. The study found that infants randomized to the higher threshold had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years compared to the lower threshold group. The study further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. The mechanisms by which platelet transfusions could mediate harmful effects remain unknown, but the study identified increased rates of intraventricular hemorrhage and bronchopulmonary dysplasia in the higher threshold group, which may contribute to the adverse outcomes observed.
Original Study: Randomized Trial: Platelet-Transfusion Thresholds in Neonates
Commentary from the author on Twitter (thread – click for more)
We already knew from the @PlaNeT2_trial that a higher prophylactic platelet transfusion threshold (<50) in preterm babies is associated with significantly increased mortality or major bleeding compared with a lower one (<25)… https://t.co/pJrE44BIIx
— Carmel Moore (@carmelmoore) February 22, 2023
Cross-sectional study | Risk factors for hearing loss at birth in newborns with congenital CMV infection
28 Feb, 2023 | 13:20h | UTCRisk Factors for Hearing Loss at Birth in Newborns With Congenital Cytomegalovirus Infection – JAMA Pediatrics (link to abstract – $ for full-text)
Commentary: Factors ID’d for Hearing Loss in Newborns With Congenital Cytomegalovirus – HealthDay
Commentaries on Twitter
Findings of this cross-sectional study suggest that newborns with congenital cytomegalovirus infection and petechiae at birth, periventricular cysts on MRI, or a seroconversion in the first trimester had a higher risk of congenital hearing loss. https://t.co/csecGRFjug
— JAMA Otolaryngology – Head & Neck Surgery (@JAMAOto) January 3, 2023
A study in @JAMAOto examines the association of clinical independent risk factors and hearing loss in congenital CMV https://t.co/n0ScC6eMuB#EBNEOalerts #neoEBM #neotwitter pic.twitter.com/j1R5law7bo
— Evidence-Based Neo (@EBNEO) January 18, 2023
Health and nutrition claims for infant formula: international cross sectional survey
22 Feb, 2023 | 12:31h | UTCHealth and nutrition claims for infant formula: international cross sectional survey – The BMJ
Editorial: Poorly substantiated health claims on infant formula – The BMJ
News Release: Most health claims on infant formula products seem to have little evidence – BMJ Newsroom
Commentary: Little evidence to support health claims made on formula milk – BBC
Commentary from one of the authors on Twitter (thread – click for more)
https://twitter.com/mbrockwa/status/1626034305393893376
AHA Scientific Statement | Anesthetic care of the pregnant patient with cardiovascular disease
20 Feb, 2023 | 12:29h | UTCSummary: The AHA emphasizes the need for specialized cardio-obstetric anesthesiology care for pregnant patients with cardiovascular disease, involving a multidisciplinary team of obstetricians, cardiologists, anesthesiologists, and other specialists as needed. The approach includes preoperative evaluation, intraoperative management, and postoperative care to maintain maternal hemodynamic stability, optimize oxygen delivery to the fetus, and avoid factors that exacerbate cardiovascular disease. Vaginal delivery with effective neuraxial analgesia is the preferred mode of delivery, with cesarean delivery used for obstetrical indications or high-risk patients. Specific recommendations are also provided for the management of patients with different types of cardiovascular disease, including congenital heart disease, valvular heart disease, pulmonary hypertension, and hypertrophic cardiomyopathy.
Top Things to Know: Statement on the anesthetic care of the pregnant patient with cardiovascular disease – American Heart Association
SR | The impact of interventions to prevent neonatal healthcare-associated infections in low- and middle-income countries
16 Feb, 2023 | 14:47h | UTC
SR | The impact of antimicrobial stewardship in children in low- and middle-income countries
16 Feb, 2023 | 14:46h | UTC
The Lancet Series | Breastfeeding 2023
13 Feb, 2023 | 12:52h | UTCHomepage: Breastfeeding 2023 – The Lancet
Editorial: Unveiling the predatory tactics of the formula milk industry
Breastfeeding: crucially important, but increasingly challenged in a market-driven world
Marketing of commercial milk formula: a system to capture parents, communities, science, and policy
Commentaries:
Expert reaction to review of formula baby milk – Science Media Centre
M-A | Pacifier use and breastfeeding in term and preterm newborns
9 Feb, 2023 | 13:41h | UTC
Review | The role of MRI in the diagnosis and prognostic evaluation of fetuses with congenital diaphragmatic hernia
9 Feb, 2023 | 13:40h | UTC
RCT | Outcomes in children of women with type 2 diabetes exposed to metformin vs. placebo during pregnancy
8 Feb, 2023 | 12:32h | UTCOutcomes in children of women with type 2 diabetes exposed to metformin versus placebo during pregnancy (MiTy Kids): a 24-month follow-up of the MiTy randomised controlled trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)
Cohort Study | Perinatal predictors of clinical instability at birth in late-preterm and term infants
8 Feb, 2023 | 12:09h | UTC
SR | Sodium assessment in neonates, infants, and children
8 Feb, 2023 | 12:01h | UTC
Cohort Study | Neurodevelopmental outcomes after late-onset meningitis in children born extremely preterm
7 Feb, 2023 | 13:38h | UTCCommentary: Late-Onset Meningitis ID’d in 1 Percent of Extreme Preemies – HealthDay
Commentary on Twitter
A cohort study in @JAMANetworkOpen examines neurodevelopmental outcomes in infants born < 26 weeks with late onset meningitis https://t.co/AmnRiKaeYt #EBNEOalerts #neoEBM #neotwitter pic.twitter.com/USlLDbG2UY
— Evidence-Based Neo (@EBNEO) December 28, 2022
Update guidelines for women with HIV who are virally suppressed incorporate breastfeeding their infants as a viable option
6 Feb, 2023 | 13:40h | UTC
Commentary on Twitter
Updated guidelines now incorporate breastfeeding options for PWH with suppressed VL on ART. https://t.co/JPR1K8zzv6
— Carlos del Rio (@CarlosdelRio7) February 3, 2023
Position Paper | Enteral nutrition in preterm infants
30 Jan, 2023 | 00:54h | UTC
RCT | Monitoring of cerebral tissue oxygen saturation to guide oxygen delivery in preterm neonates did not improve outcomes
25 Jan, 2023 | 11:23h | UTC
M-A | Diagnostic value of four biomarkers in detecting neonatal sepsis in low- and middle-income countries
24 Jan, 2023 | 14:21h | UTC
Gestational age at birth and cognitive outcomes in adolescence: population based full sibling cohort study
19 Jan, 2023 | 14:27h | UTCEditorial: Gestational age at birth and school performance – The BMJ
News Release: Premature birth linked to poorer school grades in adolescence – BMJ