Actuarial Survival Based on Gestational Age in Days at Birth for Infants Born at <26 Weeks of Gestation.

OBJECTIVE: To provide comprehensive, contemporary information on the actuarial survival of infants born at 22-25 weeks of gestation in Canada. STUDY DESIGN: In a retrospective cohort study, we included data from preterm infants of 22-25 weeks of gestation admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 2010 and 2017. Infants with major congenital anomalies were excluded. We calculated gestational age using in vitro fertilization date, antenatal ultrasound dating, last menstrual period, obstetrical estimate, or neonatal estimate (in that order). Infants were followed until either discharge or death. Each day of gestational age was considered a category except for births at 22 weeks, where the first 4 days were grouped into one category and the last 3 days were grouped into another category. For each day of life, an actuarial survival rate was obtained by calculating how many infants survived to discharge out of those who had survived up to that day. RESULTS: Of 4335 included infants, 85, 679, 1504, and 2067 were born at 22, 23, 24, and 25 weeks of gestation, respectively. Survival increased from 32% at 22 weeks to 83% at 254-6/7 weeks. Graphs of actuarial survival developed for the first 6 weeks after birth in male and female children indicated a steep increase in survival during the first 7-10 days postnatally. CONCLUSIONS: Survival increased steadily with postnatal survival and was dependent on gestational age in days and sex of the child.

Neonatal listeriosis: the importance of placenta histological examination-a case report.

Neonatal listeriosis is not a rare disease, but it is infrequently diagnosed and reported in the literature. Herein we report a case of listeria lethal sepsis, followed by increased cytokines levels in the cord blood, in which diagnosis was made possible by histological examination of the placenta.

Myasthenia gravis and pregnancy: clinical implications and neonatal outcome.

BACKGROUND: The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. METHODS: To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasthenia gravis. Retrospective chart review of pregnant patients with myasthenia gravis, followed at the National Institute of Perinatology in Mexico City over an 8-year period. Data was abstracted from the medical records on the clinical course during pregnancy, delivery and neonatal outcome. RESULTS: From January 1, 1996 to December 31, 2003 18 patients with myasthenia gravis were identified and included in the study. The mean +/- SD maternal age was 27.4 +/- 4.0 years. During pregnancy 2 women (11%) had an improvement in the clinical symptoms of myasthenia gravis, 7 women (39%) had clinical worsening of the condition of 9 other patients (50%) remained clinically unchanged. Nine patients delivered vaginally, 8 delivered by cesarean section and 1 pregnancy ended in fetal loss. Seventeen infants were born at mean +/- SD gestational age of 37.5 +/- 3.0 weeks and a mean birth weight of 2710 +/- 73 g. Only one infant presented with transient neonatal myasthenia gravis. No congenital anomalies were identified in any of the newborns. CONCLUSIONS: The clinical course of myasthenia gravis during pregnancy is variable, with a significant proportion of patients experiencing worsening of the clinical symptoms. However, neonatal transient myasthenia was uncommon in our patient population.

Risk factors for the development of bronchopulmonary dysplasia: a case-control study.

BACKGROUND: Advances in neonatal care over the past decades have meant that an increasing number of very premature infants survive today than in years past. One of the main factors contributing to the survival of these infants is development in ventilatory support. However, this has lead to lung injury and an increase in the incidence of bronchopulmonary dysplasia (BDP). METHODS: A case-control study was conducted at the National Institute of Perinatology Neonatal Intensive Care Unit in Mexico City, Mexico to evaluate the risk factors associated with the development of BPD in premature infants requiring ventilatory support within the first days of life for respiratory failure. Twenty two cases and 22 control premature infants admitted to the Neonatal Unit requiring assisted ventilation and that survived for more than 28 days were included. The neonatal and maternal risk factors that were considered for analysis were the following; mode of delivery, antenatal steroids, gestational age, birth weight, Apgar scores, sepsis, patent ductus arteriosus, and ventilation parameters. RESULTS: Factors associated with the development of BPD were late sepsis (OR 7.29, 95% CI 1.61-35.8, p=0.002), and two or more episodes of sepsis (OR 7.60, 95% CI 1.46-44.6, p=0.004). Other risk factors were low birth weight and younger gestational age at birth. CONCLUSIONS: Similar to what has been reported by other investigators in developed countries, our study showed that neonatal sepsis, low birth weight, and gestational age were associated with BPD in our patients.

[Occurrence of Aedes albopictus in the state of Pará, Brazil]. / Encontro de Aedes albopictus no Estado do Pará, Brasil.

It is first reported the detection of Aedes (Stg) albopictus mosquitoes in state of Par , Brazil, in the urban area of Medicil ndia, a municipality far 90 km from Altamira, where 42 adult mosquitoes were baited using human attraction. All mosquitoes were pooled and inoculated into C6/36 and suckling mice in attempts for virus isolation. No virus was isolated. The occurrence of Aedes albopictus in urban areas of the Amazon region is of concern since dengue and yellow fever viruses are endemic in the Amazon and thus there is a potential risk for this mosquito species to become infected with both viruses.