Non-pharmacological pain relief interventions in preterm neonates undergoing screening for retinopathy of prematurity: a systematic review.

OBJECTIVE: The objective of this review was to determine the efficacy of non-pharmacological interventions for pain management during retinopathy of prematurity (ROP) screening. METHODS AND ANALYSIS: Electronic search of Ovid MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Google Scholar and ClinicalTrials.gov (USA) was conducted. Search terms from the research question and inclusion criteria were used to select randomised control trials (RCT) published from January 2000 to May 2023. Relevant data were extracted, and risk of bias was assessed using the Cochrane Risk of Bias tool V.2. Critical appraisal and grading of the quality of evidence were done using the Critical Appraisal Skills Programme tool for RCTs and the Grading of Recommendations Assessment, Development and Evaluation, respectively. RESULTS: Twenty-one RCTs were included; 14 used sweet taste, while 7 used modified developmental care, touch or positioning, multisensory stimulation, non-nutritive sucking or music. Six studies on sweet taste and all seven latter studies showed a difference in the pain scores in favour of the interventions. The quality of evidence was however judged low and moderate due to some concerns in the randomisation process, measurement of outcome assessment and selection of reported results domains. CONCLUSION: The use of gentle touch, nesting, positioning, music, multisensory stimulation and developmental care in reducing pain during ROP screening is promising, however, larger studies designed to eliminate the identified concerns are needed. More evidence is also needed before sweet taste interventions can be recommended in routine practice.

Human milk banking acceptability among pregnant and nursing mothers in Southwest Nigeria.

Background: Human milk bank is a sustainable source of donor human milk (DHM) which is an acceptable alternative to the mother's milk and it is not routinely available in Nigeria, a multi-ethnically diverse country.The study aimed to assess the willingness to donate or accept human milk among pregnant women and mothers attending the antenatal, immunization, outpatient, under-five, and neonatal follow-up clinics in selected health facilities in Ekiti State, Southwest Nigeria. Study Design and Methods: A descriptive cross-sectional, mixed methods study design was used to collect data in selected health facilities in Ekiti State. Questionnaires and focus group discussions were used to collect quantitative and qualitative data respectively while data analysis was done using the IBM® Statistical Package for Social Science SPSS version 26® and thematic analysis respectively. Results: Of the 798 respondents, 529 (66.3%) and 626 (78.4%) did not know about wet nursing or human milk banking (HMB) respectively and 139 (17.4%) were willing to donate their breastmilk for a stipend. In the focus group discussion, 50% had heard about wet nursing but none heard about HMB. Maternal educational level had a significant impact on their willingness to donate or accept DHM (p < 0.00). Wholesomeness, cultural, and religious biases were major reasons affecting HMB acceptability. Conclusions: Awareness and perception of HMB are poor. Appropriate information, education, and counselling on HMB are needed to drive the adoption and establishment of HMB in Nigeria.

Prevalence of Group B Streptococcus Colonisation and Antimicrobial Susceptibility Pattern among Pregnant Women Attending a Tertiary Health Facility in Ogun State, Southwest Nigeria.

Background: Genital colonisation by group B Streptococcus (GBS) in pregnant women in their third trimester has been shown to be a known risk factor for morbidity and mortality among newborns. Aim: The aim of the study was to determine the prevalence of GBS colonisation among pregnant women in Abeokuta, its associated sociodemographic factors, and the neonatal outcome among exposed babies. Design: Longitudinal cohort study. Setting: Department of Obstetrics and Gynaecology, Federal Medical Centre, Abeokuta, Ogun State. Methodology: One hundred sixty pregnant women presenting for routine antenatal care between 35 and 41 weeks were recruited consecutively. Swabs were taken from the vagina and then the rectum using a single swab. The samples were processed at the hospital's Medical Microbiology Laboratory using standard microbiological methods. Babies whose mothers were positive had their bodies swabbed and the samples sent for GBS isolates. They were also screened for early-onset neonatal sepsis with C-reactive protein. Results: Prevalence of GBS vaginal colonisation was 4.3%. There was no significant association between GBS colonisation status and age, level of education, or occupation; however, women of parity ≤1 had significantly higher prevalence of GBS colonisation than those of parity ≥2. There was no incidence of GBS infection observed in the babies. The GBS isolates were 100% sensitive to cefuroxime and 83.3% resistant to ampicillin. Conclusion: The prevalence of GBS is low in our environment. The organisms were highly sensitive to cefuroxime, erythromycin, and ceftriaxone. Routine screening of all pregnant women may be unnecessary. However, women at risk of GBS who present in labour without a recent GBS screening should be offered intrapartum prophylactic cefuroxime.

Contexte: La colonisation génitale par le streptocoque du groupe B (SGB) chez les femmes enceintes au cours de leur troisième trimestre s'est avérée être un facteur de risque connu de morbidité et de mortalité chez les nouveau-nés. Objectif: Déterminer la prévalence de la colonisation par le SGB chez les femmes enceintes à Abeokuta, ses facteurs sociodémographiques associés et l'issue néonatale chez les bébés exposés. Conception: Étude de cohorte longitudinale. Cadre: Département d'obstétrique et de gynécologie, Centre médical fédéral, Abeokuta, État d'Ogun. Méthodologie: Cent soixante femmes enceintes se présentant pour des soins prénatals de routine entre 35 et 41 semaines ont été recrutées consécutivement. Des écouvillons ont été prélevés du vagin puis du rectum à l'aide d'un seul écouvillon. Les échantillons ont été traités au laboratoire de microbiologie médicale de l'hôpital à l'aide de méthodes microbiologiques standard. Les bébés dont les mères étaient positives ont eu leur corps écouvillonné et les échantillons envoyés pour les isolats de SGB. Ils ont également été dépistés pour une septicémie néonatale d'apparition précoce avec la protéine C-réactive. Résultats: La prévalence de la colonisation vaginale par SGB était de 4,3%. Il n'y avait pas d'association significative entre le statut de colonisation par SGB et l'âge, le niveau d'éducation ou la profession; cependant, les femmes de parité ≤1 avaient une prévalence significativement plus élevée de colonisation par le SGB que celles de parité ≥2. Aucune incidence d'infection à SGB n'a été observée chez les bébés. Les isolats de SGB étaient 100% sensibles au céfuroxime et 83,3% résistants à l'ampicilline. Conclusion: La prévalence du SGB est faible dans notre environnement. Les organismes étaient très sensibles à la céfuroxime, à l'érythromycine et à la ceftriaxone. Le dépistage systématique de toutes les femmes enceintes peut être inutile. Cependant, les femmes à risque de SGB qui se présentent pendant le travail sans dépistage récent du SGB devraient se voir proposer du céfuroxime prophylactique intrapartum.