Category Archives: Neonatology

Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation.

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Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation.
Neonatology. 2020 Jun 09;:1-10
Authors: Richter AE, Scherjon SA, Dikkers R, Bos AF, Kooi EMW
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Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation.

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Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation.
Neonatology. 2020 Jun 09;:1-10
Authors: Richter AE, Scherjon SA, Dikkers R, Bos AF, Kooi EMW
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Postnatal Cerebral Hyperoxia Is Associated with an Increased Risk of Severe Retinopathy of Prematurity.

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Postnatal Cerebral Hyperoxia Is Associated with an Increased Risk of Severe Retinopathy of Prematurity.
Neonatology. 2019 Sep 05;:1-7
Authors: Richter AE, Bos AF, Huiskamp EA, Kooi EMW
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The Association between Multisite Near-Infrared Spectroscopy and Routine Hemodynamic Measurements in Relation to Short-Term Outcome in Preterms with Clinical Sepsis.

The Association between Multisite Near-Infrared Spectroscopy and Routine Hemodynamic Measurements in Relation to Short-Term Outcome in Preterms with Clinical Sepsis.
Neonatology. 2015 Sep 19;108(4):297-304
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The Quality of General Movements after Treatment with Low-Dose Dexamethasone in Preterm Infants at Risk of Bronchopulmonary Dysplasia.

The Quality of General Movements after Treatment with Low-Dose Dexamethasone in Preterm Infants at Risk of Bronchopulmonary Dysplasia.

Neonatology. 2014 Jul 5;106(3):222-228

Authors: Hitzert MM, Roescher AM, Bos AF

Abstract
Background: High-dose dexamethasone (DXM) treatment of preterms at risk of bronchopulmonary dysplasia leads to a deterioration in quality of their general movements (GMs). It is unknown whether low-dose DXM affects GM quality similarly. Objectives: To assess the effect of low-dose DXM treatment on the quality of GMs and fidgety GMs (FMs). Methods: A prospective study of preterms admitted to our NICU between 2010 and 2012, and treated with DXM (starting dose 0.25 mg/kg/day). We assessed GM/FM quality and calculated their motor optimality score (MOS) before, during, and after treatment up to 3 months postterm. Neurological follow-up was performed between 12 and 36 months. We related risk factors with infants’ GM trajectories and MOSs. At 3 months we compared the MOSs of low-dose DXM infants and a historical cohort of infants treated with high-dose DXM or hydrocortisone. Results: 17 infants were included. GM/FM quality improved in 9 out of 13 initially abnormal infants (p = 0.004). Shorter periods of mechanical ventilation and higher birth weights were associated with better GM trajectories (p = 0.032 and p = 0.042, respectively). Infants starting treatment later had higher MOSs on day 7 (p = 0.047). Low-dose DXM infants had higher MOSs than high-dose DXM infants (β = -0.535; 95% CI -0.594 to -0.132; p = 0.003). Out of 17 infants, 2 died, 14 developed normally, and 1 developed with mild neurodevelopmental impairments. Infants whose GMs/FMs remained normal or improved had better outcomes than infants whose GMs/FMs remained abnormal (p = 0.019). Conclusions: Out of the 17 infants treated with low-dose DXM, 2 died. Of the surviving infants, neurological functioning improved with the majority having normal neurodevelopment at the age of 12-36 months. © 2014 S. Karger AG, Basel.

PMID: 25012880 [PubMed – as supplied by publisher]

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Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis.

Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis.

Neonatology. 2014 May 7;106(1):49-54

Authors: Schurink M, Scholten IG, Kooi EM, Hulzebos CV, Kox RG, Groen H, Heineman E, Bos AF, Hulscher JB

Abstract
Background: Intestinal fatty acid-binding protein (I-FABP) is a promising marker for necrotizing enterocolitis (NEC). It can be measured in plasma (I-FABPp) and urine (I-FABPu). Data on the best way to measure I-FABP (in plasma or urine) and the necessity of simultaneous measurement of the urinary creatinine concentration to correct for physiological variations in urine concentration are not available. This holds also true for the reciprocal relation between I-FABPp, I-FABPu and other more conventional laboratory parameters. Objectives: To evaluate the above-mentioned correlations of I-FABP measurements in neonates with suspected NEC. Methods: All neonates with suspected NEC were prospectively included. I-FABPp and I-FABPu were analyzed at regular intervals during the first 24 h after onset of symptoms. Correlation and agreement were assessed between these and other parameters (i.e. IL-6, WBC, platelet count, CRP, pH and lactate). Results: Included were 24 boys, 13 girls [median (range) GA 28 weeks (24-36), median birth weight 1,190 g (570-2,400)]. I-FABPu correlated strongly with I-FABPp (r 0.80, p < 0.001) with an adequate agreement. A very strong correlation between I-FABPu and I-FABPu/urine creatinine ratio (r 0.98, p < 0.001) existed. Correlations between I-FABPp/u and conventional parameters were moderate to strong until 8 h after onset of symptoms. Conclusion: In neonates with suspected NEC, I-FABPu correlates strongly with I-FABPp, offering an opportunity to choose the most appropriate way of measuring I-FABP. Calculating urinary IFABP/creatinine ratio seems redundant. Moderately strong correlations between I-FABPu and IL-6, WBC and lactate were found. © 2014 S. Karger AG, Basel.

PMID: 24818641 [PubMed – as supplied by publisher]

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Severe neonatal hyperbilirubinemia in the Netherlands.

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Severe neonatal hyperbilirubinemia in the Netherlands.

Neonatology. 2013;104(2):137-42

Authors: Gotink MJ, Benders MJ, Lavrijsen SW, Rodrigues Pereira R,…

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Volume expansion does not alter cerebral tissue oxygen extraction in preterm infants with clinical signs of poor perfusion.

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Volume expansion does not alter cerebral tissue oxygen extraction in preterm infants with clinical signs of poor perfusion.

Neonatology. 2013;103(4):308-14

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Growth in small-for-gestational-age preterm-born children from 0 to 4 years: the role of both prematurity and SGA status.

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Growth in small-for-gestational-age preterm-born children from 0 to 4 years: the role of both prematurity and SGA status.

Neonatology. 2013;103(4):293-9

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Clinical Importance of a Fixed Bowel Loop in the Treatment of Necrotizing Enterocolitis.

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Clinical Importance of a Fixed Bowel Loop in the Treatment of Necrotizing Enterocolitis.

Neonatology. 2013 Nov 15;105(1):33-38

Authors: Muller A, Schurink M, Bos AF, Hulzebos CV, Martijn A, Hulscher JB, Kooi EM

Abstract
Background: The need for surgical treatment in neonates with necrotizing enterocolitis (NEC) is associated with high mortality. Although pneumoperitoneum and progressive disease are generally accepted indications for surgery, it is unclear whether a fixed bowel loop (FBL) should prompt surgery. Objective: To determine the relationship between an FBL, type of treatment, and death in the management of NEC. Methods: Retrospective analysis (January 2000-December 2011) of all neonates with definite NEC in a tertiary neonatal intensive care unit. FBL was defined as a persistent (i.e. >24 h) dilated intestinal segment present on serial abdominal X-rays. Results: NEC was diagnosed in 141 neonates (median gestational age 30 weeks; median birth weight 1,340 g). An FBL was reported in 38 (27%) patients, of whom 18 were treated surgically. Mortality among FBL patients was independent of the type of treatment (surgical versus conservative): 8/18 and 7/20, respectively (p = 0.55). Of the 103 patients without FBL, 37 (36%) were treated surgically, which is comparable to the FBL group. Again, mortality was not related to the type of treatment (surgical versus conservative): 5/37 and 6/66, respectively (p = 0.49). The presence of an FBL was associated with mortality: more patients with an FBL (15/38, 39%) died than without an FBL (11/103, 11%; odds ratio 5.45, 95% confidence interval 2.21-13.45; p < 0.01). Conclusions: In NEC patients, an FBL is associated with increased mortality. On its own it has moderate significance to guide treatment. Nevertheless, because it reflects disease severity, early recognition is important and prompt (surgical) treatment should be considered. © 2013 S. Karger AG, Basel.

PMID: 24247082 [PubMed – as supplied by publisher]

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Moderate unconjugated hyperbilirubinemia causes a transient but delayed suppression of amplitude-integrated electroencephalographic activity in preterm infants.

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Moderate unconjugated hyperbilirubinemia causes a transient but delayed suppression of amplitude-integrated electroencephalographic activity in preterm infants.

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