ABM Clinical Protocol #1: Guidelines for Glucose Monitoring and Treatment of Hypoglycemia in Term and Late Preterm Neonates, Revised 2021

ObjectivesAntenatal corticosteroids (ACS) decrease neonatal mortality and morbidity among preterm neonates, yet there has been concern regarding their long-term safety. We hypothesised that potential long-term adverse effects of ACS may be observed among infants born during the late preterm period (LPT, 340/7–366/7 weeks of gestation), when the benefits of ACS are subtle.DesignPopulation-based, retrospective cohort.SettingOntario, Canada, between 2006 and 2011.PatientsAll live singleton infants born during the LPT period with a minimum 5-year follow-up.InterventionsExposure to ACS prior to 340/7 weeks of gestation.Main outcome measuresSuspected neurocognitive disorder, audiometry testing or visual testing.ResultsOverall, 25 668 infants were eligible for analysis, of whom 2689 (10.5%) received ACS. Infants in the ACS group had lower mean birth weight and higher rates of birth weight <10th percentile, neonatal resuscitation and neonatal intensive care unit admission. At 5 years of age, ACS exposure was associated with an increased risk of suspected neurocognitive disorder (adjusted HR (aHR) 1.12, 95% CI 1.05 to 1.20), audiometry testing (aHR 1.20, 95% CI 1.10 to 1.31) and visual testing (aHR 1.06, 95% CI 1.01 to 1.11).ConclusionIn children born during the LPT period, exposure to ACS prior to 340/7 weeks of gestation is associated with an increased utilisation of the healthcare system related to audiometry and visual testing and suspected neurocognitive disorders by 5 years of age.

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Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0515 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Megan Rodrigues ◽

Pratibha Rana ◽

Gene Lee ◽

Chaitali Mahajan ◽

Michael Nyp ◽

...

Keyword(s):

Early Diagnosis ◽

Intrauterine Growth Restriction ◽

Clinical Characteristics ◽

Glucose Monitoring ◽

Blood Glucose Monitoring ◽

Preterm Neonates ◽

Hyperinsulinemic Hypoglycemia ◽

Glucose Levels ◽

Normal Glucose ◽

Short Time

Abstract Objectives Describe clinical characteristics, course, and risk factors for hyper-insulinemic hypoglycemia (HIH) in preterm infants and identify impediments to early diagnosis. Methods Electronic records of infant–mother dyads were used to describe clinical characteristics, lab parameters, and course of HIH. Results All eight patients (gestational ages 26w0d–29w3d) had intrauterine growth restriction (IUGR) due to placental insufficiency, (4/8) were small for gestational age. All maintained normal glucose levels with glucose infusion during the first 48 h six of eight patients had cholestasis despite being on parenteral nutrition for short time (average 17 days). Four of eight patients were treated with diazoxide (average 22 days). Four of eight patients who recovered spontaneously (average 49 days after diagnosis) responded to continuous feeds and hydrocortisone for other clinical indications. Conclusions In IUGR preterms, HIH is asymptomatic, may be prolonged, requiring diazoxide treatment. Transient cholestasis is seen in majority of patients. Euglycemia should be demonstrated on bolus gavage feeds, off glucocorticoids before discontinuing blood glucose monitoring.

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A RETROSPECTIVE ANALYSIS OF MATERNALAND FETAL OUTCOMES OF PRETERM DELIVERIES IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA.

10.36106/ijsr/0701516 ◽

2021 ◽

pp. 42-44

Author(s):

Varsha Konyala ◽

Poornima M ◽

Suma K.B

Keyword(s):

Preterm Delivery ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Preterm Births ◽

Late Preterm ◽

Preterm Neonates ◽

Care Hospital ◽

Maternal Complications ◽

Record Keeping

Aim:To study preterm delivery outcomes in a tertiary care hospital in South India. Methods: The study was conducted for a 7 month period from July 1, 2020 to January 31, 2021at JSS Hospital, Mysuru. Relevant details of every pregnant woman who underwent a preterm delivery and the subsequent neonate born were collected and followed till discharge. Results: The prevalence rate of preterm births was 11.81%. There were 44 early preterm deliveries and 88 late preterm deliveries. The most common maternal complications that lead to preterm births PPROM and preeclampsia.36 early preterm and 29 late preterm neonates required an NICU admission. This included 7 pairs of twins in the early preterm and 1 pair of twins in the late preterm. In the NICU, the most common complications noted were RDS, and sepsis.4 neonates remained by mother's side soon after delivery in the early preterm subset, whereas 54 of late preterm neonates were kept by the mother's side soon after delivery. 31 of 40 early preterm, 86 of the 88 of late preterm neonates were healthy and t for discharge. Conclusion:The prevalence of preterm birth rate in our study stands comparable to the reported global average. Preterm births have a multifactorial etiology. Timely referral to higher centers, experienced obstetricians, and a good NICU facility proved helpful to both the mother and neonate. Thorough record keeping also allows a true picture of preterm prevalence on the basis of which, policies and decisions can be made to further improve preterm care.

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Pulmonary air leak syndrome in term and late preterm neonates

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180411081m ◽

2019 ◽

Vol 147 (9-10) ◽

pp. 578-582

Author(s):

Gordana Markovic-Sovtic ◽

Tatjana Nikolic ◽

Aleksandar Sovtic ◽

Jelena Martic ◽

Zorica Rakonjac

Keyword(s):

Mechanical Ventilation ◽

Medical Center ◽

Perinatal Asphyxia ◽

Late Preterm ◽

Respiratory Support ◽

Medical Emergency ◽

Preterm Neonates ◽

Air Leak ◽

Average Birth Weight ◽

Air Leak Syndrome

Introduction/Objective. Air leak syndrome is more frequent in neonatal period than at any other period of life. Its timely recognition and treatment is a medical emergency. We present results of a tertiary medical center in treatment of air leak syndrome in term and late preterm neonates. Methods. Neonates born between 34th 0/7 and 41st 6/7 gestational weeks (g.w.) who were treated for air leak syndrome in the Neonatal Intensive Care Unit of Mother and Child Health Care Institute, from 2005 to 2015 were included in the study. Antropometric data, perinatal history, type of respiratory support prior to admission, chest radiography, type of pulmonary air leak syndrome and its management, underlying etiology, and final outcome were analyzed. Results. Eighty-seven neonates of an average gestational age 38.1 ? 1.9 g.w. were included in the study. The average birth weight was 3182.5 ? 55.5 g. Fourty-seven (54%) were born by cesarean section and 40 (46%) were born by vaginal delivery. Prior to admission, 62.1% received supplemental oxygen, 4.6% were on nasal continuous positive airway pressure, and 21.8% were on conventional mechanical ventilation. Type of delivery did not significantly affect the appearance of pneumothorax, nor did the type of respiratory support received prior to admission (p > 0.05). The majority (93.1%) had pneumothorax, which was unilateral in 79%. The length of mechanical ventilation significantly affected the appearance of pneumothorax (p = 0.015). Low Apgar score in the first minute and the presence of pneumopericardium were significant factors predisposing for an unfavorable outcome. Conclusion. Improving mechanical ventilation strategies and decreasing the rate of perinatal asphyxia in term and late preterm neonates could diminish the incidence of pulmonary air leak syndrome in this age group.

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"COMPARATIVE STUDY OF EARLY NEONATAL MORBIDITIES OF LATE PRETERM AND TERM NEONATES"

10.36106/8532772 ◽

2021 ◽

pp. 23-25

Author(s):

Jatin Manocha ◽

Kusum Mahajan ◽

Anuj Kumar

Keyword(s):

Preterm Infants ◽

Prospective Observational Study ◽

Neonatal Period ◽

Newborn Infants ◽

Late Preterm ◽

Preterm Neonates ◽

Feeding Problems ◽

Term Neonates ◽

Late Preterm Infants ◽

Study Results

Background- Newborn infants are unique in their physiology and the health problems that they experience. Neonatal period is dened from birth to under four weeks of age. Late preterm infants may physiologically and physically appear like infants born at term, but most late preterm infants may undergo complications like respiratory distress, apnea, hypothermia, feeding problems, hypoglycemia, hyperbilirubinemia, sepsis, and mortality. AIM-To compare the clinical prole of late preterm neonates with term neonates. MATERIALAND METHODS: This prospective observational study was carried out in neonatal division of department of pediatrics MMIMSR, Mullana. Eligible neonates delivered at MMIMSR, Mullana born from 34 weeks up to 42 weeks gestation were included. All infants enrolled in the study was followed daily till rst 7 days of life for any morbidity by clinical evaluation and review of hospital records.104 preterms included in the study and 226 term neonates were included in the study. Results- Preterms born via LSCS and NVD were(58%vs.42%).Morbidities in late preterms were Hypoglycemia (21.2% vs. 9.3%), Hypothermia (15.4%vs5.7%), hypocalcaemia (38.4% vs. 5.3%), neonatal hyperbilirubinemia(67.3% vs. 30.5%), feeding difculties(44.2% vs. 14.6%), sepsis(40.4% vs. 19.5%), respiratory support(53% vs. 47%)

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ABM Clinical Protocol #10: Breastfeeding the Late Preterm (34–36 6/7 Weeks of Gestation) and Early Term Infants (37–38 6/7 Weeks of Gestation), Second Revision 2016

Breastfeeding ◽

10.1016/b978-0-323-68013-4.00047-x ◽

2022 ◽

pp. 862-869

Author(s):

Eyla G. Boies ◽

Yvonne E. Vaucher

Keyword(s):

Late Preterm ◽

Clinical Protocol ◽

Term Infants ◽

Early Term

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