Journal of Neonatal-Perinatal Medicine - Volume 9, issue 1

Authors: Stohl, H. | Kohm, A.D. | Dossett, E.

Article Type: Review Article

Abstract: Untreated perinatal depression and anxiety increase the risk of pregnancy complications, introducing significant maternal and neonatal complications. Unfortunately, antidepressant treatment with selective serotonin reuptake inhibitors (SSRIs) is similarly associated with adverse perinatal outcomes. Providers should consider all maternal and fetal outcomes when addressing this dilemma.

DOI: 10.3233/NPM-16915057

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 1-5, 2016

Authors: Sherman, Tami I. | Moya, Fernando | Simmons, Phillip D. | Kurtz, Danielle | Shaffer, Thomas H.

Article Type: Research Article

Abstract: AIM: We examined the perceptions of parents with regard to animal-derived versus synthetic medications of comparable efficacy. We hypothesized that this issue is a concern in neonatal care and that the perceptions of parents from one geographical location would be similar to those of another. METHODS: A survey was distributed to parents of neonates admitted to a neonatal intensive care unit of a southeastern hospital. RESULTS: Of 153 parents surveyed, 150 (98%) responded. More mothers than fathers completed the surveys (113 vs. 34). Fifty-six percent of participants indicated a college or higher education; 40% had an …income of $51,000/yr or higher. Thirty-four percent of parents had concerns about animal-derived medications, 41% preferred a synthetic medication of equivalent efficacy, and 69% would like to be informed if a medication was animal-derived. CONCLUSION: Parents have concerns about exposing neonates to animal-derived medication and wish to be informed if an animal-derived medication is being considered. Show more

Keywords: Animal-derived, medication, newborn, survey, synthetic

DOI: 10.3233/NPM-16915062

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 7-14, 2016

Authors: Ramadan, M.K. | Hussein, G. | Saheb, W. | Rajab, M. | Mirza, F.G.

Article Type: Research Article

Abstract: OBJECTIVE: The study objective was to examine the effect of antenatal corticosteroids on the incidence of short-term neonatal morbidities in singletons born during the late preterm period. STUDY DESIGN: This was a prospective cohort study of singleton gestations at risk of imminent delivery between 34 0/7 and 36 6/7 weeks. Short-term neonatal morbidities were compared between the corticosteroid exposed and non-exposed groups. The rates of Neonatal Morbidity Composite and Any Adverse Neonatal Morbidity were then compared between the two groups. RESULTS: During the two-year study period, a total of 295 subjects were included. Of …those, 74 were exposed to antenatal corticosteroids, while 221 cases constituted the non-exposed group. There was no statistically significant difference in the rate of Any Adverse Neonatal Morbidity (47.3% vs. 40.7% , p  = 0.32) or the rate of Neonatal Morbidity Composite (34.4% vs. 37.8% , p  = 0.59) between the two groups. Additionally, there was no statistically significant difference in the rates of neonatal intensive care unit admission, respiratory distress syndrome, transient tachypnea of the newborn, hypothermia, and need for phototherapy. CONCLUSION: Administration of antenatal corticosteroids to parturients at risk of imminent delivery during the late preterm period does not appear to reduce short-term neonatal morbidities. Show more

Keywords: Antenatal corticosteroids, late preterm, neonatal morbidity, prematurity, respiratory morbidity

DOI: 10.3233/NPM-16915086

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 15-22, 2016

Authors: August, D. | Kandasamy, Y.

Article Type: Research Article

Abstract: AIMS: Studies have highlighted that antenatal steroids could have an effect on neonatal skin maturation. This study examined if there was a relationship between the administration of antenatal glucocorticoids for mothers and the skin injuries in their neonates. Data from skin injury audit were extracted from the neonatal database and analyzed to determine differences in the prevalence of neonates with pressure injuries [cases] whose mothers had received antenatal steroids, compared to those without pressure injuries [control]. RESULTS: Of 247 neonates audited, 77 [31%], had documented pressure injuries, 170 [69%] had no documented injury. The median birth weight and …gestation were 1400 g [IQR 893–2268 g] and 30.3 weeks [IQR 26.3–40.0 weeks] respectively. Of the neonates born less than 34 weeks, 80% were exposed to antenatal steroids and were equally distributed across patient genders. Within the 77 cases, 53 [66%] were exposed to antenatal steroids compared to controls in which 88 [53%] had not. The effect between cases and controls was not statistically significant [χ 2  = 2.81, P  = 0.09]. However a difference was noted between genders, as female neonates benefited from the exposure to steroids [OR = 0.317, 95% [CI 0.105–0.956], p value –0.041]. CONCLUSION: Antenatal glucocorticoids appear to be beneficial in reducing pressure injury prevalence in female neonates. Show more

Keywords: Pressure injury, neonate, antenatal glucocorticoid, steroid

DOI: 10.3233/NPM-16915063

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 23-29, 2016

Authors: Ayala-Ramírez, P. | Buitrago, T. | Poveda, A. | Rodríguez, J.L. | Olaya-C, M. | García-Robles, R.

Article Type: Research Article

Abstract: INTRODUCTION: Preeclampsia has a global frequency of 2–8% and a frequency of 10% in developing countries. In Colombia, preeclampsia causes 42% of maternal mortality. Alterations in placental homeostasis have been proposed to be involved in its pathophysiology. The aim of this study was to compare mRNA and protein levels of tissue factor (F3) and thrombomodulin (THBD) and the histopathological findings of placentas. MATERIALS AND METHODS: We studied 16 placentas from patients with preeclampsia and 19 term placentas with uncomplicated pregnancy. An expert pathologist, who was masked to the group assignment, conducted an evaluation to determine specific histological changes. …Assessments of mRNA and protein levels of F3 and THBD were performed using real-time PCR and ELISA, respectively. RESULTS: Cases and controls differed in the frequency of decidual arteriopathy (p  = 0.027), acute infarction (p  = 0.001) and hyperplasia of the syncytiotrophoblast (p  = 0.0017). Cases had increased levels of F3 mRNA (p  = 0.0124) and protein (p  <  0.0001) and THBD mRNA (p  <  0.0001) and protein (p  <  0.0001). CONCLUSION: In placenta of patients with preeclampsia, we detected abnormal expression of F3 and THBD with increased protein and mRNA levels. The role of these molecules in the pathogenesis of this disease and in alterations of hemostatic and histopathological aspects of placentas need further studying. Show more

Keywords: Hypertension of pregnancy, THBD, histopathology, mRNA

DOI: 10.3233/NPM-16915034

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 31-39, 2016

Authors: Nicolás, C. | Benítez, P. Rodríguez | Riaño, M.O. Arroyo | Canencia, L. Matesanz | Mercurio, C. | Fernández, M. Silva | Luna, M. Sánchez | Jorge, A. Tejedor

Article Type: Research Article

Abstract: BACKGROUND: Preeclampsia affects up to 10% of pregnancies worldwide and is one of the main causes of fetal morbidity and mortality. Although it has been linked to developmental delay, its long-term effects on neurologic development in children have yet to be sufficiently quantified. OBJECTIVES: To evaluate whether preeclampsia’s severity and its obstetric management correlate to the degree of disability in these infants. MATERIALS AND METHOD: This is an observational and descriptive study performed on a population of 96 women who were diagnosed with preeclampsia at Hospital General Universitario Gregorio Marañón between 2007 and 2014, and their …111 children. To evaluate the mother, we gathered data pertaining to her medical history, renal function markers, and medical management of the preeclampsia. To assess the children, we collected fetal growth measurements, acute fetal distress markers and main diagnoses at birth. We used the Pediatric Evaluation of Disability Inventory in its computerized adaptive test version (PEDI-CAT) to study performance in the relevant areas, and the TNO-AZL Preschool children Quality of Life (TAPQOL) to estimate health-related quality of life. RESULTS: PEDI-CAT percentiles were consistently lower in the social/cognitive domain than in other areas. Lower social/cognitive percentiles were associated to both lower maternal IgG levels and presence of necrotizing enterocolitis during the neonatal period. CONCLUSIONS: A connection between preeclampsia and poor social/cognitive outcomes exists that warrants further research. Show more

Keywords: Quality of life, cognitive delay, social functioning, autism spectrum disorders, immunoglobulin G, necrotizing enterocolitis, gut microbiome, PEDI-CAT, TAPQOL

DOI: 10.3233/NPM-16915065

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 41-48, 2016

Authors: Olaya-C, M. | Salcedo-Betancourt, J. | Galvis, S.H. | Ortiz, A.M. | Gutierrez, S. | Bernal, J.E.

Article Type: Research Article

Abstract: INTRODUCTION: Preeclampsia is associated with abnormalities in the umbilical cord in several ways: morphological, biochemical and functional. Alteration in blood vessels of the placenta, decidua and circulatory system of the fetus might be related to factors that cause preeclampsia and may be associated with alterations of the umbilical cord. OBJECTIVES: This study aimed to analyze the relationship between each type of umbilical cord abnormality and the different subtypes of hypertensive gestational disorders. METHODS: We conducted a prospective study on consecutive autopsies and its placentas, looking for abnormalities in the umbilical cord’s features and their clinical associations. …RESULTS: Umbilical cord abnormalities including length, diameter, insertion, entanglements, knots and coils were associated with maternal gestational hypertension. CONCLUSION: In women with gestational hypertension, umbilical cord abnormalities are associated with fetal and neonatal consequences. Show more

Keywords: Placenta, gestational hypertension, pregnancy, eclampsia, HELLP syndrome

DOI: 10.3233/NPM-16814108

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 49-57, 2016

Authors: Prodromidou, A. | Frountzas, M. | Perrea, D. | Vlachos, G.D. | Pergialiotis, V.

Article Type: Research Article

Abstract: BACKGROUND: Cervical cerclage is a commonly applied procedure which is used as a preventive measure against preterm births among women with a short cervix (<25mm) or with previous painless mid-trimester pregnancy losses. The purpose of the present study is to evaluate whether the presence of maternal obesity reduces the efficacy of cervical cerclage. MATERIALS AND METHODS: We searched Medline (1966–2015), Scopus (2004–2015), Popline (1974–2015) and ClinicalTrials.gov (2008–2015) along with reference lists of electronically retrieved studies. RESULTS: Three studies were included in our review which involved 606 women. Among them 210 were obese (BMI>30 kg/m2 ) and 47 …morbidly obese (BMI >40 kg/m2 ). The presence of obesity among women who had a cervical cerclage due to ultrasound or history indications did not seem to affect the gestational age at delivery or the neonatal birthweight. Furthermore, according to the findings of a single study it did not seem to reduce the gestational latency period in days (normal weight group 24.3±3.2, overweight group 21.1±5.1, obese group 21.4±4.9 p  = 0.171). CONCLUSION: According to the findings of our systematic review obesity does not influence the efficacy of cervical cerclage. However, firm results are precluded due to the small number and the methodological heterogeneity of existing studies. Further, studies are needed to corroborate our findings. Show more

Keywords: BMI, obesity, weight, cerclage, preterm

DOI: 10.3233/NPM-16915058

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 59-65, 2016

Authors: Kurtom, Waleed | Quast, Deborah | Worley, Leslie | Oelberg, David G.

Article Type: Research Article

Abstract: OBJECTIVE: To investigate the relationship between umbilical vein catheter (UVC) placement and death in extremely premature newborns (<29 weeks gestation). STUDY DESIGN: Utilizing a retrospective, case-control study design, results for newborns that received UVC placements and died were compared with those who received UVC placements and survived (n  = 719) by univariate and multiple logistic regression analyses. RESULT: Death rate was 30% in infants with low lines versus 16% in those without (p  = 0.012). High UVC tip placement significantly and independently increased severe periventricular hemorrhages (p  = 0.014). Severe periventricular hemorrhage increased death rates by 3-fold independent of …gestational age (p  <  0.001). Proper line placement significantly reduced severe periventricular hemorrhage by 2.5-fold independent of gestational age (p  = 0.019). CONCLUSION: In extremely premature newborns, incorrect UVC placement is significantly associated with death through its relation to severe periventricular hemorrhage. Show more

Keywords: Umbilical catheters, high-risk newborns, intraventricular hemorrhages

DOI: 10.3233/NPM-16915060

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 67-72, 2016

Authors: El Shemi, M.S. | Mohamed, M.H. | AbdelRahman, A.O. | Abdel Al, H. | Ramadan, N.M.

Article Type: Research Article

Abstract: OBJECTIVE: Visfatin is a hormone discovered in fat cells and is directly related to diabetes. We aimed to investigate the relationship between intrauterine growth pattern and serum visfatin concentrations in full-term infants at birth and at 6 months of life. METHODS: Cord blood visfatin concentrations were assessed in 90 full-term neonates enrolled into; Group I: 30 appropriate for gestational age (AGA) neonates to healthy mothers, Group II: 30 intra-uterine growth restricted (IUGR) neonates, 19 were born to mothers with pre-eclampsia, Group III: 30 large for gestational age (LGA) neonates, 16 were infants of diabetic mothers (IDMs). Neonates were …followed up at six months of age for visfatin concentrations. RESULTS: Cord blood visfatin concentrations were increased in IUGR compared to AGA group (p  = 0.002). Cord blood visfatin concentrations were increased in LGA compared to AGA and IUGR groups (P  <  0.001, P  <  0.001). Cord blood visfatin concentrations were positively correlated to birth weight in AGA, LGA groups (r  = 0.39, p  = 0.045, r  = 0.449, p  = 0.013 respectively). Visfatin concentrations in neonates born to mothers with pre-eclampsia and IDMs were higher than in those born to mothers without pre-eclampsia and to non-diabetic mothers (p  = 0.040, p  = 0.002 respectively). At six months, serum visfatin concentrations decreased compared to cord blood visfatin concentrations in IUGR and LGA groups (p  <  0.001). Levels in LGA were still higher than IUGR (p  = 0.004). Serum visfatin concentrations were positively correlated to cord visfatin in IUGR neonates (r = 0.497, p  = 0.005). CONCLUSION: Cord blood visfatin concentrations were increased in LGA and IUGR neonates. At six months, serum visfatin concentrations decreased compared to cord blood visfatin concentrations in LGA and IUGR groups, still higher in the former than the latter. Show more

Keywords: Adipokine, visfatin, LGA, IUGR, AGA, IDMs, infants of pre-eclamptic mothers, fetal growth

DOI: 10.3233/NPM-16915029

Citation: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 1, pp. 73-82, 2016