The Neuroprotective Efficacy of Postnatal Magnesium Sulfate in Term or Near-Term Infants With Moderate-to-Severe Birth Asphyxia

Abstract Objective We examined whether erythropoietin monotherapy improves neurodevelopmental outcomes in near-term and term infants with neonatal encephalopathy (NE) in low-middle income countries (LMICs). Methods We searched Pubmed, Embase, and Web of Science databases to identify studies that used erythropoietin (1500–12,500 units/kg/dose) or a derivative to treat NE. Results Five studies, with a total of 348 infants in LMICs, were retrieved. However, only three of the five studies met the primary outcome of death or neuro-disability at 18 months of age or later. Erythropoietin reduced the risk of death (during the neonatal period and at follow-up) or neuro-disability at 18 months or later (p < 0.05). Death or neuro-disability occurred in 27.6% of the erythropoietin group and 49.7% of the comparison group (risk ratio 0.56 (95% CI: 0.42–0.75)). Conclusion The pooled data suggest that erythropoietin monotherapy may improve outcomes after NE in LMICs where therapeutic hypothermia is not available.

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Intermodal Enhancement of Stimulus Localisation in Infants Born Prematurely

Perceptual and Motor Skills ◽

10.2466/pms.1989.69.1.43 ◽

1989 ◽

Vol 69 (1) ◽

pp. 43-50 ◽

Cited By ~ 2

Author(s):

Nigel Foreman ◽

Alistair Fielder

Keyword(s):

Visual Fields ◽

Visual Stimuli ◽

Peripheral Stimulus ◽

Term Infants ◽

Visual Enhancement ◽

Sensory Space ◽

Near Term ◽

Gestational Age At Birth ◽

Age At Birth ◽

Prematurely Born Infants

The interaction of auditory and visual modalities in the enhancement of orientation was examined in premature and near-term infants by presenting them auditory or visual stimuli or auditory-visual stimulus combinations at various positions in sensory space. In 4.5–15-mo.-olds, brisk orienting responses could be elicited to very peripheral stimulus positions but only when the stimulus consisted of a spatially coherent auditory-visual combination (i.e., where a sound and a light occurred at the same point in space). This occurred for all infants, irrespective of age or gestational age at birth. First, the result shows that infants can respond to visual stimuli at eccentric positions, beyond the supposed limits of their effective visual fields as measured by standard perimetry. Second, the result extends earlier studies showing that intersensory integration and stimulus localisation develop relatively normally in prematurely born infants. The auditory-visual enhancement test as used here may have a number of further uses and applications in the clinic and laboratory.

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Delivery Room Management of Asphyxiated Term and Near-Term Infants

Neonatology ◽

10.1159/000516429 ◽

2021 ◽

pp. 1-13

Author(s):

Marlies Bruckner ◽

Gianluca Lista ◽

Ola D. Saugstad ◽

Georg M. Schmölzer

Keyword(s):

Preterm Infants ◽

Newborn Infants ◽

Neonatal Resuscitation ◽

Birth Asphyxia ◽

Delivery Room ◽

Temperature Management ◽

Term Infants ◽

Term Newborn ◽

Resuscitation Guidelines ◽

Delivery Room Management

Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants.

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Delivery room resuscitation of near-term infants: Role of the laryngeal mask airway

Resuscitation ◽

10.1016/j.resuscitation.2009.11.005 ◽

2010 ◽

Vol 81 (3) ◽

pp. 327-330 ◽

Cited By ~ 22

Author(s):

Vincenzo Zanardo ◽

Gary Weiner ◽

Massimo Micaglio ◽

Nicoletta Doglioni ◽

Ramona Buzzacchero ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

Laryngeal Mask ◽

Delivery Room ◽

Term Infants ◽

Near Term

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Magnesium sulfate for term infants following perinatal asphyxia

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd004494.pub2 ◽

2021 ◽

Author(s):

Alison Kent ◽

Zsuzsoka Kecskes ◽

Tim Cochrane

Keyword(s):

Magnesium Sulfate ◽

Perinatal Asphyxia ◽

Term Infants

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Bovine Milk Oligosaccharides with Sialyllactose for Preterm Piglets

Nutrients ◽

10.3390/nu10101489 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1489 ◽

Cited By ~ 4

Author(s):

Karina Obelitz-Ryom ◽

Amalie Rendboe ◽

Duc Nguyen ◽

Silvia Rudloff ◽

Anne Brandt ◽

...

Keyword(s):

Bacterial Colonization ◽

Bovine Milk ◽

Protective Effects ◽

Gut Development ◽

Artificial Rearing ◽

Milk Oligosaccharides ◽

Term Infants ◽

Brain Functions ◽

Near Term ◽

Dietary Treatments

Oligosaccharides support gut development and bacterial colonization in term infants, but it is unknown if they benefit preterm infants. Using preterm pigs, we investigated effects of bovine milk supplements enriched with oligosaccharides to improve gut development and colonization. Caesarean-delivered preterm pigs (n = 57) were reared for 19 days. The pigs were fed bovine milk supplemented with an oligosaccharide-enriched whey containing sialyllactose, or a heterogeneous oligosaccharide ingredient. To evaluate the influence of artificial rearing, near-term, vaginally born pigs raised by their sow (n = 12) were compared with artificially reared, caesarean-delivered near-term pigs (n = 14). In preterm pigs, the clinical outcome, gut function, gut microbiota, and systemic immunity were similar among dietary treatments. Natural rearing increased growth rates, gut functions, colon short chain fatty acid concentrations and bacterial diversity, relative to artificial rearing. In conclusion, supplements with bovine milk oligosaccharides were well tolerated, but did not improve gut maturation or clinical outcomes in artificially reared preterm piglets. Immaturity at birth, coupled with artificial rearing, may render the neonate unresponsive to the gut-protective effects of milk oligosaccharides. Whether bovine milk oligosaccharides may affect other endpoints (e.g., brain functions) in conditions of immaturity remains to be investigated.

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1323 Impact of the Near Term Infants on NICU Bed Utilization

Archives of Disease in Childhood ◽

10.1136/archdischild-2012-302724.1323 ◽

2012 ◽

Vol 97 (Suppl 2) ◽

pp. A377-A377

Author(s):

E. Abdulrahman ◽

M. A. Al-Seoud

Keyword(s):

Term Infants ◽

Near Term

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The predictive accuracy of hypoxic scoring for prediction of adverse outcome in neonates born with asphyxia

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20200104 ◽

2020 ◽

Vol 7 (2) ◽

pp. 333

Author(s):

Muhammad Saqib ◽

Safeer A. Jamil ◽

Usman Arif ◽

Zubda Anwar ◽

Sarosh Waheed ◽

...

Keyword(s):

Predictive Accuracy ◽

Adverse Outcome ◽

Birth Asphyxia ◽

Major Contributor ◽

Fetal Hypoxia ◽

Negative Data ◽

Term Infants ◽

Study Objective ◽

The Mean ◽

Sensitivity Specificity

Background: Birth asphyxia is a major contributor to neonatal mortality. Fetal hypoxia followed by asphyxia is common cause of brain injury in term infants. Hypoxia score has shown to be accurate enough to predict adverse outcome in asphyxiated neonates. But controversies exist regarding predictive accuracy of hypoxia score. So we conducted this study. Objective to assess the predictive accuracy of hypoxic scoring for prediction of adverse outcome in neonates born with asphyxia.Methods: 170 neonates were screed for hypoxia score. Neonates were labelled as positive or negative. Then all neonates were followed-up for 7 days. If neonate died within 7days, then case was confirmed as positive or negative. Data was analysed by using SPSS 20. 2x2 table was developed to calculate sensitivity, specificity, PPV, NPV and predictive accuracy of hypoxia score.Results: The mean Apgar score at birth was 5.01±0.83. The sensitivity of hypoxia score was 87.8%, specificity was 90.9%, PPV was 90%, NPV was 88.9% while predictive accuracy was 89.4% taking actual adverse outcome as gold standard.Conclusions: The predictive accuracy of hypoxia score was high for prediction of adverse outcome in asphyxiated neonates.

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