Comparison of Three Different Cord Clamping Techniques Regarding Oxidative-antioxidative Capacity in Term Newborns

Objective As newborns are exposed to oxidative stress during delivery, cord clamping techniques play significant role on antioxidant status. In this study, we aimed to show the relationship between early cord clamping (ECC), delayed cord clamping (DCC) and cut umblical cord milking (C-UCM) techniques with total oxidant capacity (TOC), total antioxidant capacity (TAC) and peroxynitrite levels. Study Design Sixty-nine term infants were selected with APGAR score of 7 and above in the first and fifth minutes. The mothers of all infants had uncomplicated pregnancy, had no congenital anomaly, and delivered by cesarean section. Newborns were randomised to one of three groups: ECC (n: 23), DCC (n: 23) or C-UCM (n: 23). After all newborn babies were taken under radiant heater, blood samples were collected from the umbilical cord. The plasma samples were then frozen and stored at -80 °C until analysis and TOC, TAC and peroxynitrite levels were studied. Results The ages of the mothers participating in the study were between 17 and 42, with an average of 29.14 ± 6.28. 30 (43.5%) of the babies were girls and 39 (56.5%) were boys. The 5th minute APGAR score of the babies in early cord clamping group was significantly lower than the babies in delayed cord clamping and cut cord milking group (p = 0.034; p = 0.034; p <0.05). The TOC, OSI and Peroxynitrite measurements of three groups did not differ statistically. The TAC value of the C-UCM group was significantly higher than the patients with the ECC and DCC group (p = 0.002; p = 0.019; p <0.05). Conclusion C-UCM and DCC would be feasible methods by increasing antioxidant status and providing protective effect on the future health of the term newborns,

Predictive significance of pro-inflammatory interleukins at newborns with hypoxic-ischemic encephalopathy

Relevance. Hypoxic-ischemic damage to the central nervous system is accompanied by overproduction of pro-inflammatory interleukins in newborns. Perinatal inflammatory responses contribute to unfavorable outcomes. Methods of investigation. The analysis of the cytokine profile in the blood serum was performed in 45 full-term newborns by the method of enzyme-linked immunosorbent assay within 4–96 hours after birth. 32 children had the signs of HIE stage 2, 13 children — HIE stage 3. Unfavorable neurological consequences were formed in 47,4% of children. Research results. Revealed an increase in the levels of IL1β — 17,7 [13,6; 25,4] and IL6 35,2 [24,9; 45,0] in newborns with HIE. A significant increase in pro-inflammatory cytokines was found in patients with unfavorable outcomes compared with favorable ones. When predicting the disabling consequences of DIE, a high predictive value was established for IL1β and IL6. Conclusion. In newborns with hypoxic-ischemic encephalopathy, an increase in serum IL1β and IL6 is observed. It is advisable to use an increase in IL1β >19,4 pg/ml (OR=12,80; 95% CI: 2,90–56,58) and IL6 >40,1 pg/ml (OR=11,33; 95% CI: 2,46–52,15).

Sonographic Measurement of Brainstem Through the Foramen Magnum in Premature Neonates Can Predict Neurodevelopment Outcome?

Background: To investigate whether serial morphometric measurements of the brainstem using high resolution trans-foramen-magnum ultrasound (US) in premature neonates correlate with neurological outcomes.Methods: Serial brain ultrasound scans were performed in 36 consecutive preterm infants born at &lt;34 weeks of gestation from birth until term-equivalent age. Two-dimensional brainstem measurements of the pons and medulla oblongata were compared with those in a cohort of 67 healthy full-term newborns. Neurologic assessment of the premature infants was assessed at 5 years of age.Results: Of the 36 preterm infants born between 25 and 34 weeks of gestation, eight had significantly delayed growth profiles in both the pons and medulla and developed neurological sequelae by 5 years of age.Conclusions: Morphometric measurements of the developing brainstem using high resolution trans-foramen-magnum ultrasound (US) may help predict neurological outcome in high-risk neonates, particularly in those who are born extremely premature.

Through-plane super-resolution with autoencoders in diffusion magnetic resonance imaging of the developing human brain

ABSTRACTFetal brain diffusion magnetic resonance images are often acquired with a lower through-plane than in-plane resolution. This anisotropy is often overcome by classical upsampling methods such as linear or cubic interpolation. In this work, we employ an unsupervised learning algorithm using an autoencoder neural network to enhance the through-plane resolution by leveraging a large amount of data. Our framework, which can also be used for slice outliers replacement, overperformed conventional interpolations quantitatively and qualitatively on pre-term newborns of the developing Human Connectome Project. The evaluation was performed on both the original diffusion-weighted signal and on the estimated diffusion tensor maps. A byproduct of our autoencoder was its ability to act as a denoiser. The network was able to generalize to fetal data with different levels of motion and we qualitatively showed its consistency, hence supporting the relevance of pre-term datasets to improve the processing of fetal brain images.

Ensemble learning for the early prediction of neonatal jaundice with genetic features

Background Neonatal jaundice may cause severe neurological damage if poorly evaluated and diagnosed when high bilirubin occurs. The study explored how to effectively integrate high-dimensional genetic features into predicting neonatal jaundice. Methods This study recruited 984 neonates from the Suzhou Municipal Central Hospital in China, and applied an ensemble learning approach to enhance the prediction of high-dimensional genetic features and clinical risk factors (CRF) for physiological neonatal jaundice of full-term newborns within 1-week after birth. Further, sigmoid recalibration was applied for validating the reliability of our methods. Results The maximum accuracy of prediction reached 79.5% Area Under Curve (AUC) by CRF and could be marginally improved by 3.5% by including genetic variant (GV). Feature importance illustrated that 36 GVs contributed 55.5% in predicting neonatal jaundice in terms of gain from splits. Further analysis revealed that the main contribution of GV was to reduce the false-positive rate, i.e., to increase the specificity in the prediction. Conclusions Our study shed light on the theoretical and practical value of GV in the prediction of neonatal jaundice.

Overview on Fluid, Electrolyte and Nutrition Management of the Newborn and Pre-term Newborns

Often in extremely preterm newborns in the early postnatal daysproblems in fluid and electrolyte balance occur Due to excessive insensible water loss and renal immaturity. The dietary care of newborn newborns is challenged by the demands of growth and organ development. The stress of a serious disease makes it much more difficult to get enough nourishment. Newborns andespecially premature newborns must be assessed thoroughly for fluid and electrolytes balance. Calculating the fluid and electrolyte demand for sustaining metabolic activities, replacing losses (evaporative, third space, external), and considering pre-existing fluid imbalance are all part of effective fluid and electrolyte management. When a neonate's size or condition prevents them from receiving enteral nutrition, parenteral nutrition can help them grow and thrive. Although eating through the gastrointestinal tract is the recommended method of nutritional management, some situations necessitate the use of PN as an adjuvant or sole treatment. In this article we discuss fluid electrolytes and Nutritional management using parenteral nutrition.