Sensitivity and reliability of screening measures for paternal postpartum depression: an integrative review

The American Academy of Pediatrics (AAP) recommends screening mothers for Postpartum Depression (PPD) during the postpartum period. Research shows depression in parents is associated with impaired growth and development in their children. The National Perinatal Association (NPA) encourages screening fathers for depression at least twice during the first postpartum year, however a preferred screening tool has yet to be determined. To promote optimal outcomes for children, providers must assess the mental health of all new parents, regardless of gender. Therefore, the purpose of this integrative review is to examine previous scientific evidence regarding the sensitivity of screening measures for postpartum depression in fathers. Future research should be directed towards describing the psychometric properties of a tool to assess postpartum mood disorders in American fathers while analyzing appropriate screening intervals during the postpartum period.

Comparative Analysis of American Academy of Pediatrics and European Society of Hypertension Guidelines for the Diagnosis and Treatment of Pediatric Hypertension

Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.

Association Between Blood Pressure And Lung Function In Chinese Children: The Seven Northeastern Cities Study

Background: A global increase in asthma and COPD incidence has occurred, the cause is unknown. One potential relationship that has yet to be explored is the interaction between blood pressure (BP) and lung function in children 5-17 years old. Our purpose is to assess the relationship between hypotension, hypertension, and lung function in children 5 to 17 years old. Methods: Participants were recruited from elementary and middle schools from 7 cities in northeastern China (N=6,797). BP was categorized into 3 groups: hypotensive (<5th percentile or <90mmHg if children >10 years), normotensive and hypertensive (>95th percentile) based on American Academy of Pediatrics standards. Spirometry measured lung function in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and maximum mid expiratory flow (MMEF). Associations were assessed using logistic regression analysis. Results: Decreases in FVC , FEV1, PEF, and MMEF were noted in hypotensive children. Higher FVC, FEV1, PEF, and MMEF were noted among children ³ 10 with hypertension, while children <10 years, only had increased FVC compared to normotensive children. Statistically significant interactions between hypotension and PEF < 75% (OR:2.31; 95% CI: 1.17-4.23), were seen for children < 10 years. Conclusions: Our findings suggest that, in this study population, hypotension may be associated with decreased lung function, and the increased lung function may be associated with hypertension in children. Future studies are needed to confirm temporality as this is the first study to explore these relationships in children which requires in depth investigation.

Hypoglycemia screening of asymptomatic newborns on the 2nd day of life

BACKGROUND: Neonatal hypoglycemia management in the first 48 hours is guided by the American Academy of Pediatrics (AAP) and Pediatric Endocrine Society (PES) recommendations. Our aim was to determine the incidence of hypoglycemia via point of care test (POCT) on the 2nd day of life (DOL) among healthy, asymptomatic neonates regardless of risk factors. METHODS: In this prospective observational study, preprandial point of care glucose concentration was measured on the 2nd DOL in 150 healthy, asymptomatic neonates in the newborn nursery. We used 50 mg/dl (2.8 mmol/L) as the hypoglycemia threshold based on PES recommendations. RESULTS: The incidence of hypoglycemia on the second DOL was 10% among asymptomatic neonates (no risk factors = 8% ; late preterm birth (LPT) + small for gestational age (SGA) = 16% ; large for gestational age (LGA) + infant of diabetic mother (IDM) = 6%). SGA + LPT neonates accounted for the majority of the hypoglycemic cases (53.3%) and exhibited a trend towards the lowest glucose concentration (p = 0.09). CONCLUSION: The incidence of hypoglycemia on DOL 2 among asymptomatic neonates is high and of unclear significance in the absence of dedicated neurodevelopmental follow-up.

Effectiveness of short duration phototherapy in government hospital setup

Background: Neonatal hyperbilirubinemia is most common presentation of neonates. Phototherapy remains standard treatment for neonatal hyperbilirubinemia. Overcrowding in government hospital makes it difficult to give phototherapy for more than 1-2 days. The objectives of the study were to determine the effectiveness of short duration of phototherapy in treating hyperbilirubinemia and to determine the risk of rebound hyperbilirubinemia.Methods: Study was hospital based retrospective study. The study place was GIMS kalaburagi. The study was conducted from September 2019 to December 2019. All healthy full-term neonates with serum bilirubin above cut off range according to (American academy of pediatrics) nomogram were included in the study. Requirement of phototherapy was decided on serum bilirubin levels as per AAP (American academy of pediatrics) nomogram. Phototherapy was used as treatment modality.Results: Total 110 neonates were included in the study. Total of 56 neonates (50.9%) required 1 day of phototherapy to fall within normal limits for discharge and 46 neonates (41.8%) required 2 days of phototherapy to fall within normal limits for discharge with a significant p<0.05. Rebound hyperbilirubinemia requiring repeat phototherapy was seen in 6(10%) neonates who were discharged after 1 day of phototherapy and in 5 neonates (10%) who were discharged after 1 day of phototherapy with a p value of 0.05.Conclusions: Short duration phototherapy is the effective means of treatment for most neonates in government hospital set up. Serum bilirubin has to be reviewed during follow up to assess rebound hyperbilirunemia.

Karakteristik Granul Ekstrak Rebung Apus (Gigantochloa apus) Dengan Metode Granulasi Basah

Apus shoots (Gigantochloa apus) is a plant that can be used as an appetite enhancer, because it contains curcumin compounds in it. According to the American Academy of Pediatrics, dietary fiber has a very important function in the body, which can make children full and facilitate the digestive system. Children's diet with sufficient fiber, can prevent constipation (difficult bowel movements). The purpose of this study was to determine the characteristics of the granules of apus shoots (Gigantochloa apus) extract that met the physical requirements of good granules. The research method for making granules of apus shoots (Gigantochloa apus) extract was wet granulation. The data obtained from this study is that the 1st granule formula is the optimal formula among the three formulas tested because the flow is faster, namely 23.47 gr/second so that the angle of repose is getting smaller, namely 30.02⁰ and the compressibility of 7% obtained is small so that the granules are smaller got good.Key words : Bamboo shoots Extract, Granules, Wet Granulation. AbstrakTanaman rebung apus (Gigantochloa apus) merupakan tanaman yang dapat digunakan sebagai penambah nafsu makan, karena mengandung senyawa kurkumin didalamnya. Menurut American Academy Ofpediatrics, Serat pangan memiliki fungsi yang sangat penting dalam tubuh yaitu dapat membuat anak kenyang dan memperlancar sistem pencernaan. Pola makan anak dengan serat yang cukup, bisa mencegah sembelit (susah buang air besar). Tujuan dari penelitian ini adalah untuk mengetahui karakteristik granul ekstrak rebung apus (Gigantochloa apus) yang memenuhi persyaratan fisik granul yang baik. Metode penelitian pada pembuatan granul ekstrak rebung apus (Gigantochloa apus) adalah granulasi basah. Data yang diperoleh dari penelitian ini adalah formula granul ke 1 merupakan formula yang optimal diantara tiga formula yang diuji karena sifat aliran lebih cepat yaitu 23,47 gr/detik sehingga sudut diam semakin kecil yaitu 30,02⁰ dan kompresibilitas 7% yang didapatkan kecil sehingga granul yang didapat baik.Kata kunci : Ekstrak Rebung apus, Granul, Granulasi Basah.

AAP Publications Reaffirmed or Retired

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

Parenthood, Parental Benefits, and Career Goals Among Pediatric Residents: 2008 and 2019

OBJECTIVES Examine reported availability of parental benefits for pediatric residents and impact of parenthood on reported importance of characteristics of post-training positions and career goals in 2008 and 2019. METHODS We analyzed data from American Academy of Pediatrics surveys of graduating residents in 2008 and 2019 querying (1) parenthood, (2) benefits during residency, (3) importance of parental benefits and job characteristics in post-training position, and (4) subspecialty career goal. Logistic regression was used to estimate independent effects of gender, partner status, and parenthood via derived predicted values (PVs). RESULTS Of 1021 respondents, three-fourths were women. Respondents in 2019 were less likely than in 2008 to have children (24.5% vs 33.8%, P &lt; .01). In 2019, respondents were less likely to report availability of maternity (PV = 78.5% vs 89.5%, P &lt; .001) or parental leave (PV = 42.5% vs 59.2%, P &lt; .001) and more likely to report availability of lactation space (PV = 77.8% vs 56.1%, P &lt; .001.). Most residents reported control over work hours, family considerations, and number of overnight calls per month as essential or very important characteristics in post-training positions. Controlling for resident characteristics, parenthood was associated with importance of family considerations and overnight calls in post-training position. Parenthood did not associate with subspecialty career goals, but gender did. CONCLUSIONS Residents are less likely to report availability of parental benefits during residency training in 2019. Most residents, both those with children and those without, consider parent friendly characteristics important in post-training positions. Parenthood does not correlate with subspecialty career goals independent from gender.

1166. Reverse Syphilis Screening and Adherence to The Congenital Syphilis Guidelines: Institutional Experience

Background This study is analysis the consequences of the reverse syphilis screening on the management of newborns exposed to maternal syphilis, and pediatric physicians’ adherence to the existing guidelines. Methods We conducted a 5-year retrospective review of the maternal population and their newborns diagnosed with syphilis. Women with positive results (TT+/NTT+) and discordant (TT+/NTT-/TT+) and their newborns were included in the analysis. Results Per American Academy of Pediatrics (AAP), the 202 newborns were divided in two groups: proved or highly probable and possible congenital syphilis (Group A, n=102) and less likely and unlikely congenital syphilis (Group B, n=100). Except for the RPR, none of the other laboratory tests showed higher odds for predicting congenital syphilis. The RPR titers above 1:16 were only identified among newborns belonging to the Group A (5%); 32 patients (31%) in the Group A and 19 (9%) in the Group B had an RPR titer equal to or below 1:8. An RPR titer equal to or above 1:4 was almost three times more likely to be identified in patients from Group A (OR 2.91; CI 1.51- 5.59, p&lt; 0.05). The newborns with non-reactive RPRs represented 64% of the patients in the Group A and 47% of them were born to mother with non-reactive RPR also (mothers with discordant results). Among the Group B, 82% of the neonates had a non-reactive RPR and 54% were delivered to mother with non-reactive RPRs. Babies in Group B had additional work-up performed 69% (n=37) of the time; 15% of these babies were treated with intramuscular penicillin which does not follow established AAP guidelines. Statistical analysis of the laboratory tests used for the congenital syphilis work-up Result table comparing the two groups of newborns Conclusion The reverse syphilis screening and non-adherence to the guidelines led to additional screening to half of the newborns in both groups. This study highlights the need for a comprehensive maternal history at the time of delivery that is effectively communicated between the providers. This might lead to greater congruence with the established AAP guidelines. Disclosures All Authors: No reported disclosures