scholarly journals Preterm Infant Outcomes Following COVID-19 Lockdowns in Melbourne, Australia

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1169
Author(s):  
Brendan Mulcahy ◽  
Daniel L. Rolnik ◽  
Alexia Matheson ◽  
Yizhen Liu ◽  
Kirsten R. Palmer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Preterm Infants ◽  
Inflammatory Markers ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Neonatal Morbidity ◽  
Exposed Group ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Infant Outcomes

Background Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear. Methods We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results Median gestational age was 35 + 4 weeks (295 infants, exposed group) vs. 35 + 0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes as well as early neonatal inflammatory markers.

scholarly journals Neonatal outcomes of preterm infants born during COVID-19 community lockdowns in Melbourne, Australia

2021 ◽  
Author(s):  
Brendan Mulcahy ◽  
Daniel Rolnik ◽  
Alexia Matheson ◽  
Yizhen Liu ◽  
Kirsten Palmer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Neonatal Morbidity ◽  
Exposed Group ◽  
White Cell ◽  
Neonatal Outcomes ◽  
Control Group

Background: Community lockdowns during the COVID-19 pandemic may influence preterm birth rates, but mechanisms are unclear. Methods: We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results: Median gestational age was 35+4 weeks (295 infants, exposed group) vs. 35+0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions: COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes, and early white cell and neutrophil counts.

NEONATAL OUTCOMES FOLLOWING LATE PRETERM BIRTH

2012 ◽  
Vol 23 (2) ◽  
pp. 97-119 ◽  
Author(s):  
ELAINE M BOYLE
Keyword(s):  
Preterm Birth ◽  
Preterm Delivery ◽  
Preterm Infants ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Late Preterm ◽  
Very Preterm ◽  
Late Preterm Birth ◽  
Extremely Preterm ◽  
Adverse Neonatal Outcomes

It is well recognised that birth before 32 weeks of gestation is associated with substantial neonatal morbidity and mortality and these risks have been extensively reported. The focus of perinatal research for many years has therefore been very preterm and extremely preterm delivery, since the likelihood and severity of adverse neonatal outcomes are highest within this group. In contrast, until recently, more mature preterm infants have been understudied and indeed, almost ignored by researchers.

scholarly journals Effect of Nursing Protocol Regarding Nasal Skin Breakdown for Preterm Infants Receiving Continuous Positive Airway Pressure

2020 ◽  
Vol 1 (3) ◽  
pp. 16
Author(s):  
Khadiga M. Said ◽  
Rawia A. Mohamed ◽  
Safaa F. Draz
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Neonatal Intensive Care ◽  
Positive Airway Pressure ◽  
Skin Condition ◽  
Control Group ◽  
Nasal Cpap ◽  
Skin Breakdown ◽  
Significant Difference

Context: Neonates, particularly those who are born premature, may require ventilation assistance immediately after birth, since their lung may not be fully developed. The use of nasal continuous positive airway pressure (CPAP) is increasing as a means of respiratory support in many premature infants. So, the presence of nasal skin breakdown may be seen as a complication. Aim: To evaluate the effect of nursing protocol regarding nasal skin breakdown for preterm infants receiving nasal continuous positive airway pressure (CPAP). Methods: A quasi-experimental research design utilized to conduct the current study. The study conducted at Neonatal Intensive Care Units (NICUs) and Surgical Neonatal Intensive Care Unit "SNICU" of Benha Specialized Pediatric Hospital at Benha city. A convenient sample of nurses (70) working in NICU sand SNICU and a purposive random sample of (77) preterm infants included from the settings mentioned above. Those premature infants were divided into two groups (study and control) (35) in the control group and (42) in the study group, who selected according to the power analysis equation based on the total number of preterm infants who admitted to the setting mentioned above during 2017. Three tools used. A structured interviewing questionnaire sheet designed to assess nurses’ sociodemographic characteristics, and nurses' knowledge regarding CPAP, care provided to preterm infants undergoing CPAP, and nasal skin breakdown. The second tool was a nursing practice observation checklist to assess nurses' practice regarding nasal CPAP. The third tool was Preterm Medical Assessment Record. It designed to assess the characteristics of preterm infants and medical data of preterm infants. The last tool was the Neonatal Skin Condition Score (NSCS) scale that is designed to assess the neonates’ skin condition. Results: Findings of the present study revealed a statistically significant difference (P<0.05) pre and post nursing protocol implementation regarding CPAP, the role of the nurse caring for preterm infants undergoing nasal CPAP, and nasal skin breakdown. The results also revealed a highly statistically significant difference in nursing practice regarding care for preterm infants undergoing nasal CPAP pre and post nursing protocol implementation at (p<0.001). Nasal Skin Breakdown in the study group was significantly less than in the control group at a different time of assessment at (p˂0.001). Conclusion: It can be concluded that the research hypothesis is accepted, nursing protocol implemented for nurses improved their knowledge and practice as well as reduced nasal skin breakdown in the preterm newborns receiving NCPAP. The study recommended applying the nursing protocol for nurses caring for preterm infants to reduce nasal skin breakdown during CPAP ventilation, which is an effective and safe non-invasive intervention in all NICUs as a standard of care for all preterm infants.

scholarly journals Metabolic-endocrine disruption due to preterm birth impacts growth, body composition, and neonatal outcome

2021 ◽  
Author(s):  
Lea Sophie Möllers ◽  
Efrah I. Yousuf ◽  
Constanze Hamatschek ◽  
Katherine M. Morrison ◽  
Michael Hermanussen ◽  
...  
Keyword(s):  
Body Composition ◽  
Preterm Birth ◽  
Postnatal Development ◽  
Endocrine Disruption ◽  
Fat Mass ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Endocrine Function ◽  
List Type ◽  
Term Infants

Abstract Despite optimized nutrition, preterm-born infants grow slowly and tend to over-accrete body fat. We hypothesize that the premature dissociation of the maternal–placental–fetal unit disrupts the maintenance of physiological endocrine function in the fetus, which has severe consequences for postnatal development. This review highlights the endocrine interactions of the maternal–placental–fetal unit and the early perinatal period in both preterm and term infants. We report on hormonal levels (including tissue, thyroid, adrenal, pancreatic, pituitary, and placental hormones) and nutritional supply and their impact on infant body composition. The data suggest that the premature dissociation of the maternal–placental–fetal unit leads to a clinical picture similar to panhypopituitarism. Further, we describe how the premature withdrawal of the maternal–placental unit, neonatal morbidities, and perinatal stress can cause differences in the levels of growth-promoting hormones, particularly insulin-like growth factors (IGF). In combination with the endocrine disruption that occurs following dissociation of the maternal–placental–fetal unit, the premature adaptation to the extrauterine environment leads to early and fast accretion of fat mass in an immature body. In addition, we report on interventional studies that have aimed to compensate for hormonal deficiencies in infants born preterm through IGF therapy, resulting in improved neonatal morbidity and growth. Impact Preterm birth prematurely dissociates the maternal–placental–fetal unit and disrupts the metabolic-endocrine maintenance of the immature fetus with serious consequences for growth, body composition, and neonatal outcomes. The preterm metabolic-endocrine disruption induces symptoms resembling anterior pituitary failure (panhypopituitarism) with low levels of IGF-1, excessive postnatal fat mass accretion, poor longitudinal growth, and failure to thrive. Appropriate gestational age-adapted nutrition alone seems insufficient for the achievement of optimal growth of preterm infants. Preliminary results from interventional studies show promising effects of early IGF-1 supplementation on postnatal development and neonatal outcomes.

scholarly journals Positive Airway Pressure Therapy Adherence with Mask Resupply: A Propensity-Matched Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 720
Author(s):  
Adam Benjafield ◽  
Liesl Oldstone ◽  
Leslee Willes ◽  
Colleen Kelly ◽  
Carlos Nunez ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Group Versus ◽  
Control Group ◽  
Billing Data ◽  
Pressure Therapy ◽  
Therapy Termination ◽  
Few Data ◽  
And Control ◽  
The Impact

There are currently few data on the impact of mask resupply on longer-term adherence to positive airway pressure (PAP) therapy. This retrospective analysis investigated the effects of mask/mask cushion resupply on the adherence to PAP versus no resupply. Deidentified patient billing data for PAP supply items were merged with telemonitoring data from Cloud-connected AirSense 10/AirCurve 10 devices via AirViewTM (ResMed). Eligible patients started PAP between 1 July 2014 and 17 June 2016, had ≥360 days of PAP device data, and achieved initial U.S. Medicare adherence criteria. Patients who received a resupply of mask systems/cushions (resupply group) were propensity-score-matched with those not receiving any mask/cushion resupply (control group). A total of 100,370 patients were included. From days 91 to 360, the mean device usage was 5.6 and 4.5 h/night in the resupply and control groups, respectively (p < 0.0001). The proportion of patients with a mean device usage ≥4 h/night was significantly higher in the resupply group versus the control group (77% vs. 59%; p < 0.0001). The therapy termination rate was significantly lower in the resupply group versus the control group (14.7% vs. 31.9%; p < 0.0001); there was a trend toward lower therapy termination rates as the number of resupplies increased. The replacement of mask interface components was associated with better longer-term adherence to PAP therapy versus no resupply.

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