scholarly journals Unprecedented reduction in births of very low birthweight (VLBW) and extremely low birthweight (ELBW) infants during the COVID-19 lockdown in Ireland: a ‘natural experiment’ allowing analysis of data from the prior two decades

2020 ◽  
Vol 5 (9) ◽  
pp. e003075 ◽  
Author(s):  
Roy K Philip ◽  
Helen Purtill ◽  
Elizabeth Reidy ◽  
Mandy Daly ◽  
Mendinaro Imcha ◽  
...  
Keyword(s):  
Poisson Regression ◽  
Rate Ratio ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Well Being ◽  
Very Low Birthweight ◽  
Live Births ◽  
Regional Trends ◽  
Extremely Low Birthweight ◽  
Health And Well Being

BackgroundAetiology of births involving very low birthweight (VLBW) and extremely low birthweight (ELBW) infants is heterogeneous and preventive strategies remain elusive. Socioenvironmental measures implemented as Ireland’s response to the SARS-CoV-2 virus (COVID-19) pandemic represented a national lockdown, and have possibly influenced the health and well-being of pregnant women and unborn infants.MethodsRegional trends of VLBW and ELBW infants in one designated health area of Ireland over two decades were analysed. Poisson regression and rate ratio analyses with 95% CI were conducted. Regional data covering most of the lockdown period of 2020 were compared with historical regional and national data and forecasted national figures for 2020.ResultsPoisson regression analysis found that the regional historical VLBW rate per 1000 live births for January to April, 2001–2019 was 8.18 (95% CI 7.21 to 9.29). During January to April 2020, an unusually low VLBW rate of just 2.17 per 1000 live births was observed, reflecting a rate ratio of 3.77 (95% CI 1.21 to 11.75), p=0.022, representing a 73% reduction of VLBW during the first 4 months of 2020 compared with same period for the preceding two decades. There were no ELBW infants admitted to the regional neonatal intensive care unit. National Irish VLBW rate for 2020 is forecasted to be reduced to approximate 400 per 60 000 births compared with the historical 500–600 range.ConclusionAn unprecedented reduction in regional births of VLBW and ELBW infants was observed in Ireland coinciding with the COVID-19 lockdown. Potential determinants of this unique temporal trend possibly reside in the summative socioenvironmental impact of the COVID-19 lockdown. Our findings, if mirrored in other regions that have adopted a lockdown, demonstrate the potential to evaluate these implicated behavioural and socioenvironmental modifiers to positively influence VLBW and ELBW rates globally.

A review of the risk of being born too soon

2002 ◽  
Vol 13 (3) ◽  
pp. 157-168 ◽  
Author(s):  
Janet M Rennie
Keyword(s):  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Burden Of Illness ◽  
Perinatal Care ◽  
Well Being ◽  
Good Health ◽  
Increased Risk ◽  
Extremely Low Birthweight ◽  
True Measure ◽  
Health And Well Being

The true measure of success or failure of perinatal care is not merely neonatal survival, but survival with good health and well-being into childhood and beyond. Quantifying this measure is important for all babies, particularly for those born prematurely. The risks are highest for those with a birthweight less than 1 kg (extremely low birthweight) and/or at less than 26 weeks gestation. There is continuing concern about the burden of illness and disability amongst survivors in this vulnerable group. However, we must not forget that all preterm infants are at increased risk of disability later in childhood and that the same is true for babies born at term who are sick enough to require neonatal intensive care.

Thromboelastographic profiles of healthy very low birthweight infants serially during their first month

2019 ◽  
Vol 105 (4) ◽  
pp. 412-418 ◽  
Author(s):  
Genny Raffaeli ◽  
Armando Tripodi ◽  
Giacomo Cavallaro ◽  
Valeria Cortesi ◽  
Erica Scalambrino ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Maximum Amplitude ◽  
Very Low Birthweight ◽  
Term Infants ◽  
Term Neonates ◽  
Outcomes Measures ◽  
Very Low Birthweight Infants ◽  
Α Angle

ObjectiveWe determined thromboelastographic (TEG) profiles of healthy very low birthweight infants (VLBWIs) of the day of birth and at set intervals during their first month.DesignProspective observational study with blinded clinical and laboratory follow-up.SettingLevel III neonatal intensive care unit (June 2015 to June 2018).PatientsConsecutive qualifying VLBWIs were enrolled at birth and followed up for 30 days.Interventions and main outcomes measuresLaboratory (citrated-native TEG, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, blood count) and clinical variables were retrieved at birth, 3rd–5th, 10th and 30th day of life. Blood samples temporally related to events with a potential hemostatic impact (sepsis, bleeding, platelets/plasma transfusions, ibuprofen/indomethacin administration) were excluded from analysis.ResultsWe enrolled 201 VLBWIs and 72 full-term neonates. Sixty-seven of the healthy VLBWIs completed the 30-day follow-up. 541 TEG traces were analysed.On day 1, the median (minimum–maximum) TEG values were as follows: reaction time (R), 8.2 min (1–21.8); kinetics (K), 2.8 min (0.8–16); α angle, 51° (14.2–80.6); maximum amplitude (MA), 54.9 mm (23.9–76.8). PT and APTT were 15.9 s (11.7–51.2) and 59 s (37.8–97.5), respectively. The above parameters suggest minor hypocoagulability compared with term infants. On day 30, the median (minimum–maximum) R was 5 (1–16.9), K 1 (0.8–4.1), α 74.7 (41.1–86.7) and MA 70.2 (35.8–79.7). PT and APTT were 12.1 (10.4–16.6) and 38.8 (29.6–51.4), respectively. Those parameters are consistent with a relatively hypercoagulable phenotype, compared with term infants.ConclusionsHealthy VLBWIs have a prolonged PT and APTT, but their TEG profiles suggest a relatively balanced hemostatic system, with slight hypocoagulability initially (compared with term neonates), gradually evolving to a somewhat more procoagulant phenotype over the first month.

scholarly journals Perinatal quality improvement bundle to decrease hypothermia in extremely low birthweight infants with birth weight less than 1000 g: single-center experience over 6 years

2020 ◽  
Vol 68 (7) ◽  
pp. 1256-1260
Author(s):  
Dilip R Bhatt ◽  
Nirupa Reddy ◽  
Reynaldo Ruiz ◽  
Darla V Bustos ◽  
Torria Peacock ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Hospital Costs ◽  
Moderate Hypothermia ◽  
Quality Improvement Initiative ◽  
Single Center Experience ◽  
Continuous Quality ◽  
Extremely Low Birthweight

Normothermia (36.5°C–37. 5°C) at the time of admission to the neonatal intensive care unit (NICU) in extremely low birthweight (ELBW) infants (birth weight <1000 g) is associated with decreased morbidity and mortality, decreased length of stay and hospital costs. We designed a thermoregulation bundle to decrease hypothermia (<36.5°C) in ELBW infants with a multidisciplinary perinatal quality improvement initiative that included the following key interventions: dedicated delivery room (DR)/operating room (OR) for all preterm deliveries of ≤32 weeks with DR/OR temperature set 24/7 at 74°F by the hospital engineering staff, use of exothermic mattress, preheated radiant warmer set at 100% for heat prior to delivery, servo-controlled mode after the neonate is placed on the warmer, and use of plastic wrap, head cap and warm towels. A total of 200 ELBW infants were admitted to our NICU between January 1, 2014 and December 31, 2019. Hypothermia (<36.5°C) occurred in 2.5% of infants, normothermia (36.5°C–37.5°C) in 91% of infants and transitional hyperthermia (>37.5°C) in 6.5% of ELBW infants. No case of moderate hypothermia (32°C–36°C) was seen in our infants. Our target rate of less than 10% hypothermia was reached in ELBW infants over the last 2 years with no cases of moderate hypothermia in 6 years. Eliminating hypothermia among ELBW remains a challenge and requires team effort and continuous quality improvement efforts.

Predicting costs and outcomes of neonatal intensive care for very low birthweight infants

Public Health ◽  
1991 ◽  
Vol 105 (2) ◽  
pp. 121-126 ◽  
Author(s):  
R.C. Stevenson ◽  
P.O.D. Pharoah ◽  
R.W.I. Cooke ◽  
B. Sandhu
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Very Low Birthweight ◽  
Very Low Birthweight Infants

scholarly journals Parainfluenza 3 Respiratory Infection Associated with Pericardial Effusion in a Very Low Birthweight Infant

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Cristina Aranda Cazón ◽  
Luis Arruza Gómez ◽  
Gloria Herranz Carrillo ◽  
Cristina González Menchén ◽  
Zarife Daoud Pérez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pericardial Effusion ◽  
Respiratory Infection ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Respiratory Infections ◽  
Pediatric Population ◽  
Very Low Birthweight ◽  
Very Low Birthweight Infant

Parainfluenza 3 virus is a frequent cause of respiratory infections in the pediatric population although it is uncommonly diagnosed in neonates, being usually reported as neonatal intensive care unit microepidemics. We report a case of parainfluenza 3 respiratory infection associated with pericardial effusion in a very low birthweight infant.

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