Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 49.668
Filtrar
1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46824

RESUMO

Uma equipe de especialistas da Faculdade de Medicina de Ribeirão Preto (FMRP) da USP desenvolveu um aditivo, batizado de Lioneo, que enriquece o leite materno, concentrando nutrientes do próprio leite humano, para o que consideram ser o “padrão ouro” na alimentação dos prematuros. Com o diferencial de ser feito somente de leite humano – os produtos em uso atualmente são baseados em leite de vaca -, o preparo do aditivo usa técnicas simples como a liofilização, que transforma líquido em pó, sem alterar as características do leite e preservando a concentração dos nutrientes essenciais que somente existem no leite materno. Esse pó é adicionado ao leite materno e oferecido aos recém-nascidos.


Assuntos
Leite Humano , Recém-Nascido de muito Baixo Peso , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Nutrição Materna
2.
Cochrane Database Syst Rev ; 9: CD003248, 2019 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-31529790

RESUMO

BACKGROUND: Infants born preterm (before 37 weeks' gestation) have poorer outcomes than infants at term, particularly if born before 32 weeks. Early cord clamping has been standard practice over many years, and enables quick transfer of the infant to neonatal care. Delayed clamping allows blood flow between the placenta, umbilical cord and baby to continue, and may aid transition. Keeping baby at the mother's side enables neonatal care with the cord intact and this, along with delayed clamping, may improve outcomes. Umbilical cord milking (UCM) is proposed for increasing placental transfusion when immediate care for the preterm baby is needed. This Cochrane Review is a further update of a review first published in 2004 and updated in 2012. OBJECTIVES: To assess the effects on infants born at less than 37 weeks' gestation, and their mothers of: 1) delayed cord clamping (DCC) compared with early cord clamping (ECC) both with immediate neonatal care after cord clamping; 2) DCC with immediate neonatal care with cord intact compared with ECC with immediate neonatal care after cord clamping; 3) DCC with immediate neonatal care after cord clamping compared with UCM; 4) UCM compared with ECC with immediate neonatal care after cord clamping. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (10 November 2017), and reference lists of retrieved studies. We updated the search in November 2018 and added nine new trial reports to the awaiting classification section to be assessed at the next update. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing delayed with early clamping of the umbilical cord (with immediate neonatal care after cord clamping or with cord intact) and UCM for births before 37 weeks' gestation. Quasi-RCTs were excluded. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Random-effects are used in all meta-analyses. Review authors assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: This update includes forty-eight studies, involving 5721 babies and their mothers, with data available from 40 studies involving 4884 babies and their mothers. Babies were between 24 and 36+6 weeks' gestation at birth and multiple births were included. The data are mostly from high-income countries. Delayed clamping ranged between 30 to 180 seconds, with most studies delaying for 30 to 60 seconds. Early clamping was less than 30 seconds and often immediate. UCM was mostly before cord clamping but some were milked after cord clamping. We undertook subgroup analysis by gestation and type of intervention, and sensitivity analyses by low risk of selection and attrition bias.All studies were high risk for performance bias and many were unclear for other aspects of risk of bias. Certainty of the evidence using GRADE was mostly low, mainly due to imprecision and unclear risk of bias.Delayed cord clamping (DCC) versus early cord clamping (ECC) both with immediate neonatal care after cord clamping (25 studies, 3100 babies and their mothers)DCC probably reduces the number of babies who die before discharge compared with ECC (average risk ratio (aRR) 0.73, 95% confidence interval (CI) 0.54 to 0.98, 20 studies, 2680 babies (moderate certainty)).No studies reported on 'Death or neurodevelopmental impairment' in the early years'.DCC may make little or no difference to the number of babies with severe intraventricular haemorrhage (IVH grades 3 and 4) (aRR 0.94, 95% CI 0.63 to 1.39, 10 studies, 2058 babies, low certainty) but slightly reduces the number of babies with any grade IVH (aRR 0.83, 95% CI 0.70 to 0.99, 15 studies, 2333 babies, high certainty).DCC has little or no effect on chronic lung disease (CLD) (aRR 1.04, 95% CI 0.94 to 1.14, 6 studies, 1644 babies, high certainty).Due to insufficient data, we were unable to form conclusions regarding periventricular leukomalacia (PVL) (aRR 0.58, 95% CI 0.26 to 1.30, 4 studies, 1544 babies, low certainty) or maternal blood loss of 500 mL or greater (aRR 1.14, 95% CI 0.07 to 17.63, 2 studies, 180 women, very low certainty).We identified no important heterogeneity in subgroup or sensitivity analyses.Delayed cord clamping (DCC) with immediate neonatal care with cord intact versus early cord clamping (ECC) (one study, 276 babies and their mothers)There are insufficient data to be confident in our findings, but DCC with immediate neonatal care with cord intact may reduce the number of babies who die before discharge, although the data are also compatible with a slight increase in mortality, compared with ECC (aRR 0.47, 95% CI 0.20 to 1.11, 1 study, 270 babies, low certainty). DCC may also reduce the number of babies who die or have neurodevelopmental impairment in early years (aRR 0.61, 95% CI 0.39 to 0.96, 1 study, 218 babies, low certainty). There may be little or no difference in: severe IVH; all grades IVH; PVL; CLD; maternal blood loss ≥ 500 mL, assessed as low certainty mainly due to serious imprecision.Delayed cord clamping (DCC) with immediate neonatal care after cord clamping versus umbilical cord milking (UCM) (three studies, 322 babies and their mothers) and UCM versus early cord clamping (ECC) (11 studies, 1183 babies and their mothers)There are insufficient data for reliable conclusions about the comparative effects of UCM compared with delayed or early clamping (mostly low or very low certainty). AUTHORS' CONCLUSIONS: Delayed, rather than early, cord clamping may reduce the risk of death before discharge for babies born preterm. There is insufficient evidence to show what duration of delay is best, one or several minutes, and therefore the optimum time to clamp the umbilical cord remains unclear. Whilst the current evidence supports not clamping the cord before 30 seconds at preterm births, future trials could compare different lengths of delay. Immediate neonatal care with the cord intact requires further study, and there are insufficient data on UCM.The nine new reports awaiting further classification may alter the conclusions of the review once assessed.


Assuntos
Recém-Nascido Prematuro , Circulação Placentária/fisiologia , Cordão Umbilical , Transfusão de Sangue/estatística & dados numéricos , Hemorragia Cerebral/prevenção & controle , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Gravidez , Resultado da Gravidez , Nascimento Prematuro , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(9): 856-860, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31506142

RESUMO

OBJECTIVE: To investigate the infection factors associated with neurodysplasia in early and moderately preterm infants at a corrected age of 18 months. METHODS: The preterm infants with a gestational age of 28 weeks to <34 weeks who were admitted to the neonatal intensive care unit and followed up at the outpatient service for high-risk preterm infants from June 2015 to December 2018 were enrolled as subjects. At a corrected age of 18 months, the revised Bayley Scales of Infant Development was used to evaluate neurodevelopment. Univariate and multivariate logistic regression analyses were used to investigate the infection factors affecting neurodevelopment. RESULTS: A total of 138 early or moderately preterm infants were enrolled, among whom 59 had neurodysplasia at a corrected age of 18 months. The univariate logistic regression analysis showed that neurodysplasia was associated with late-onset infection, positive blood culture, and other systemic infections (P<0.05). The multivariate logistic regression analysis showed that late-onset infection was an independent risk factor for neurodysplasia (OR=1.510, 95%CI: 1.133-3.600, P<0.05). CONCLUSIONS: Late-onset infection can increase the risk of neurodysplasia in early and moderately preterm infants.


Assuntos
Recém-Nascido Prematuro , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Fatores de Risco , Sepse
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(9): 886-889, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31506147

RESUMO

OBJECTIVE: To investigate the short-term prognosis of the co-twin who survives after single intrauterine fetal demise (sIUFD). METHODS: A total of 52 infants who survived after sIUFD were enrolled as the case group, and 104 twins, matched for gestational age, from a pair of live-born twins without sIUFD were enrolled as the control group. Related clinical data were compared between the two groups. RESULTS: Among the 52 infants who survived after sIUFD, 42 (80.8%) were preterm infants, 13 (25.0%) had brain injury, and 3 (5.8%) died in the neonatal period. Compared with the control group, the case group had significantly higher incidence rates of meconium stained amniotic fluid/bloody amniotic fluid/polyhydramnios/hypamnion, torsion of cord/nuchal cord, and placenta previa/placenta abruption, as well as significantly higher incidence rates of birth asphyxia, anemia or polycythemia at birth, and coagulation disorder at birth (P<0.05). The case group also had significantly higher incidence rates of nosocomial infection and brain injury than the control group during hospitalization (P<0.05). CONCLUSIONS: There is an increase in the incidence rate of complications in the co-twin who survives after sIUFD. Prenatal evaluation and long-term follow-up should be performed for the surviving co-twin.


Assuntos
Recém-Nascido Prematuro , Resultado da Gravidez , Prognóstico , Feminino , Morte Fetal , Humanos , Recém-Nascido , Gravidez , Gêmeos
5.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(9): 881-885, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31506146

RESUMO

OBJECTIVE: To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants. METHODS: A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis). RESULTS: There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05). CONCLUSIONS: Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.


Assuntos
Sepse , Enterocolite Necrosante , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Estudos Retrospectivos , Streptococcus agalactiae
6.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 503-524, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480946

RESUMO

Differences in Conflict-Based Play Behavior, Socio-Emotional and Cognitive Development of Preterm Children Compared to Full-Term Children at Preschool Age Preterm children are at increased risk for socio-emotional and cognitive developmental difficulties at preschool age. This study investigates whether preterm children (n = 50) at the age of five years show different socio-emotional competencies in conflict situations and in the corresponding conflict resolution capacity in comparison to full-term children (n = 50). For this purpose, the MacArthur Story Stem Battery was used as the central examination method. In addition, parents completed the Strengths and Difficulties Questionnaire to obtain information about the children's behavior; moreover, the Wechsler Preschool and Primary Scale of Intelligence - Third Edition was applied to examine cognitive development. The parental reports did not reveal any behavioral differences between preterm and term children. However, significant group differences regarding their play behavior were detected. In their narratives, preterm children included content themes of interpersonal conflict and dysregulation more frequently compared to term born controls. Concerning empathic and moral themes and narrative coherence, no group difference could be detected. This could indicate that preterm children show no clinically manifest behavioral disorders at preschool age, but differences concerning intrapsychic experience compared to controls. In addition, preterm children had significantly lower IQ scores than term-born controls. Gestational age was a significant predictor of IQ and hyperactivity and attention problems. The results clarify the need for long term clinical follow up of preterm children and should be used to provide more specific care and support.


Assuntos
Comportamento Infantil/psicologia , Cognição , Emoções , Recém-Nascido Prematuro/psicologia , Comportamento Social , Pré-Escolar , Idade Gestacional , Humanos , Recém-Nascido , Testes de Inteligência , Escalas de Wechsler
7.
Bratisl Lek Listy ; 120(9): 658-662, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475549

RESUMO

AIM: To analyse the dynamics of macronutrients in breast milk in Slovakian women and compare the dynamics between mothers of hospitalized newborns and donors of human breast milk relative to the gestational age of their babies. METHODS: Human milk samples were collected from 101 breastfeeding women and analysed once or repeatedly from September 2017 to August 2018. Group A consisted of 79 mothers of newborns hospitalized at the Neonatal Department of Intensive Medicine (NDIM) of whom 69 were mothers of premature newborns (subgroup A1) and 10 were mothers of term babies (subgroup A2). Group B consisted of 22 breast milk donors registered at the Human Milk Bank at National Institute of Children's Diseases (NICHD). Of these, 4 were mothers of premature newborns (subgroup B1) and 18 were mothers of term newborns (subgroup B2). From subgroup A1, we chose two mothers, one with a hypotrophic newborn and another with a eutrophic newborn. The results were obtained by using the MIRIS breast­milk analyzer. RESULTS: The overall dynamics of macronutrients correspond with other studies, however, we demonstrated that the level of macronutrients in individual cases were different. CONCLUSION: The determination of macronutrients in human milk is essential in neonatal care. It provides information about the nutritional value of breast milk and helps to optimise nutrition according to the individual needs of newborns (Fig. 10, Ref. 16).


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Leite Humano/química , Nutrientes/análise , Aleitamento Materno , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Bancos de Leite
8.
Soins Pediatr Pueric ; 40(310): 20-26, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31543230

RESUMO

The feeding of the premature infant, even when this is done by gastric tube, should be a moment of sharing. However, the way care is normally organised and at times the availability of the parents turn the process into something the baby passively endures. But an enteral nutrition by tube feeding in the arms of the parents who push the feeding syringe by hand reveals a benefit for the premature newborn and the parents.


Assuntos
Nutrição Enteral/métodos , Recém-Nascido Prematuro , Intubação Gastrointestinal , Humanos , Recém-Nascido , Pais/psicologia
9.
Soins Pediatr Pueric ; 40(310): 31-33, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31543232

RESUMO

The death of a twin hospitalised in neonatal intensive care presents several issues that the children's nurse must take into account. Identifying the elements which characterise the issues around supporting families confronted at the same time with the grieving and bonding processes enables suitable actions to be put in place.


Assuntos
Pesar , Enfermeiras Pediátricas/psicologia , Pais/psicologia , Relações Profissional-Família , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Terapia Intensiva Neonatal , Apego ao Objeto , Gêmeos
10.
Medicine (Baltimore) ; 98(33): e16838, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415406

RESUMO

RATIONALE: Hypertrophic cardiomyopathy (HCM) is a heterogeneous, usually familial disorder of heart muscle. The hypertrophic form of cardiomyopathy is frequently genetic, or as part of several neuromuscular disorders. In neonates, especially prematurity, HCM could also be secondary to corticosteroid treatment. PATIENT CONCERNS: We reported here a 34 weeks gestational age preterm infant presented with profound cardiomegaly after multiple doses of hydrocortisone used to treat blood pressure instability associated with septic shock and persistent pulmonary hypertension (PPHN). DIAGNOSIS: Patient presented auscultation of a grade III/IV harsh systolic ejection murmur from day 14, which was absent before. Profound cardiomegaly was indicated at chest film at day 30. Echocardiography showed severe thickening of the IVS (13.8 mm, z score = 8.29) and mild thickening of the posterior left ventricular wall (LVPW, 6 mm). INTERVENTIONS: Propranolol and captopril were started along with supportive care. The patient was also admitted to NICU for further treatment with 24-hour Holter electrocardiographic monitoring. OUTCOMES: A reversible course was observed without left ventricular outflow tract obstruction nor arrhythmias within 4 weeks. LESSONS: The risk/benefit ratio must be carefully considered when corticosteroids are used in prematurity. Monitors such as echocardiography and electrocardiograph should be conducted in order to guide cardiovascular management. Systematic surveys of the incidence of cardiac complications in a larger population of preterm infant treated with corticosteroid are needed in the future.


Assuntos
Cardiomiopatia Hipertrófica/induzido quimicamente , Hidrocortisona/efeitos adversos , Hipertensão/induzido quimicamente , Doenças do Prematuro/tratamento farmacológico , Síndrome da Persistência do Padrão de Circulação Fetal/tratamento farmacológico , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino
11.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(4): 711-715, 2019 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-31420627

RESUMO

OBJECTIVE: To explore the effect of breastfeeding promotion strategies on neonatal clinical outcomes of preterm infants during hospitalization in the neonatal intensive care unit (NICU). METHODS: We developed breastfeeding promotion strategies, including the establishment of a multidisciplinary breastfeeding steering team, breastfeeding support of families and society, family-integrated care, kangaroo mother care, donor human milk bank, and so on. Preterm infants meeting the inclusion standard, less than 32 weeks gestational age, who were admitted to NICU from November 2015 to February 2017 were enrolled, and the eligible infants were divided into two groups (control group and intervention group) before and after policy implementation. The data of preterm infants including breastfeeding related outcomes (time to initiation of enteral feeding, time to initiation of breastfeeding, time to achieve full breastfeeding, time to achieve full enteral feeding and rate of breastfeeding), growth (extrauterine growth restriction) and complications were compared between the two groups. RESULTS: One hundred and twenty-three preterm infants were enrolled, including 61 in the control group and 62 in the intervention group. There were no significant differences in gender, gestational age, birth weight, intrauterine growth retardation (IUGR) and admission disease status between the two groups (P>0.05). Compared with the control group, there were significantly earlier time to initiation of enteral feeding [15.37 (10.00, 22.13) h vs. 20.25 (12.88, 26.33) h, P<0.01], time to achieve full breastfeeding [91.00 (69.75, 103.00) h vs. 94.00 (80.37, 118.75) h, P=0.04], and time to achieve full enteral feeding [12 (11, 15) d vs. 14 (12, 18) d, P<0.01] in the intervention group. Otherwise, there were no significant differences in time to initiation of breastfeeding, hospital stay, extrauterine growth restriction (EUGR) occurance rate of weight, the rate of breastfeeding, motality, and the incidence of complications including feeding intolerance, neonatal necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) (P>0.05). CONCLUSION: The breastfeeding promotion strategie was a quality improvement of ordinary breastfeeding protocol. It had significantly reduced time to initiation of enteral feeding, time to achieve full breastfeeding and time to achieve full enteral feeding for preterm infants in NICU. Further research is needed to confirm whether the strategies can improve the breastfeeding rate and reduce the occurrence of the complications, such as NEC, BPD, and ROP.


Assuntos
Aleitamento Materno , Enterocolite Necrosante , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal , Método Canguru
12.
Cochrane Database Syst Rev ; 8: CD012731, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31425619

RESUMO

BACKGROUND: Hyperbilirubinaemia occurs in approximately two-thirds of all newborns during the first days of life and is frequently treated with phototherapy. Although generally seen as safe, there is rising concern regarding phototherapy and its potentially damaging effects on DNA and increased side effects particularly for preterm infants. Other methods, such as enteral feeding supplementation with prebiotics, may have an effective use in the management of hyperbilirubinaemia in neonates. OBJECTIVES: To determine whether administration of prebiotics reduces the incidence of hyperbilirubinaemia among term and preterm infants compared with enteral supplementation of milk with distilled water/placebo or no supplementation. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE via PubMed (1966 to 14 June 2018), Embase (1980 to 14 June 2018), and CINAHL (1982 to 14 June 2018). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-randomised trials. SELECTION CRITERIA: We considered all RCTs that studied neonates comparing enteral feeding supplementation with prebiotics versus distilled water/placebo or no supplementation. DATA COLLECTION AND ANALYSIS: Two reviewers screened papers and extracted data from selected papers. We used a fixed-effect method in combining the effects of studies that were sufficiently similar. We then used the GRADE approach to assess the quality of the evidence. MAIN RESULTS: Three small studies evaluating 154 infants were included in this review. One study reported a significant reduction in the risk of hyperbilirubinaemia and rate of treatment with phototherapy associated with enteral supplementation with prebiotics (risk ratio (RR) 0.75, 95% confidence interval (95% CI) 0.58 to 0.97; one study, 50 infants; low-quality evidence). Meta-analyses of two studies showed no significant difference in maximum plasma unconjugated bilirubin levels in infants with prebiotic supplementation (mean difference (MD) 0.14 mg/dL, 95% CI -0.91 to 1.20, I² = 81%, P = 0.79; two studies, 78 infants; low-quality evidence). There was no evidence of a significant difference in duration of phototherapy between the prebiotic and control groups, which was only reported by one study (MD 0.10 days, 95% CI -2.00 to 2.20; one study, 50 infants; low-quality evidence). The meta-analyses of two studies demonstrated a significant reduction in the length of hospital stay (MD -10.57 days, 95% CI -17.81 to -3.33; 2 studies, 78 infants; I² = 0%, P = 0.004; low-quality evidence). Meta-analysis of the three studies showed a significant increase in stool frequency in the prebiotic groups (MD 1.18, 95% CI 0.90 to 1.46, I² = 90%; 3 studies, 154 infants; high-quality evidence). No significant difference in mortality during hospital stay after enteral supplementation with prebiotics was reported (typical RR 0.94, 95% CI 0.14 to 6.19; I² = 6%, P = 0.95; 2 studies; 78 infants; low-quality evidence). There were no reports of the need for exchange transfusion and incidence of acute bilirubin encephalopathy, chronic bilirubin encephalopathy, and major neurodevelopmental disability in the included studies. None of the included studies reported any side effects. AUTHORS' CONCLUSIONS: Current studies are unable to provide reliable evidence about the effectiveness of prebiotics on hyperbilirubinaemia. Additional large, well-designed RCTs should be undertaken in neonates that compare effects of enteral supplementation with prebiotics on neonatal hyperbilirubinaemia with supplementation of milk with any other placebo (particularly distilled water) or no supplementation.


Assuntos
Hiperbilirrubinemia Neonatal/prevenção & controle , Prebióticos/administração & dosagem , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/prevenção & controle , Masculino , Fototerapia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Cochrane Database Syst Rev ; 8: CD002972, 2019 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-31452191

RESUMO

BACKGROUND: Artificial formula can be manipulated to contain higher amounts of macro-nutrients than maternal breast milk but breast milk confers important immuno-nutritional advantages for preterm or low birth weight (LBW) infants. OBJECTIVES: To determine the effect of feeding preterm or LBW infants with formula compared with maternal breast milk on growth and developmental outcomes. SEARCH METHODS: We used the standard strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), and Ovid MEDLINE, Ovid Embase, Ovid Maternity & Infant Care Database, and CINAHL to October 2018. We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials that compared feeding preterm or low birth weight infants with formula versus maternal breast milk. DATA COLLECTION AND ANALYSIS: Two review authors planned independently to assess trial eligibility and risk of bias, and extract data. We planned to analyse treatment effects as described in the individual trials and report risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with 95% confidence intervals. We planned to use a fixed-effect model in meta-analyses and to explore potential causes of heterogeneity in subgroup analyses. We planned to use the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We did not identify any eligible trials. AUTHORS' CONCLUSIONS: There are no trials of formula versus maternal breast milk for feeding preterm or low birth weight infants. Such trials are unlikely to be conducted because of the difficulty of allocating an alternative form of nutrition to an infant whose mother wishes to feed with her own breast milk. Maternal breast milk remains the default choice of enteral nutrition because observational studies, and meta-analyses of trials comparing feeding with formula versus donor breast milk, suggest that feeding with breast milk has major immuno-nutritional advantages for preterm or low birth weight infants.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Humanos , Lactente , Fórmulas Infantis , Recém-Nascido , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
14.
Wiad Lek ; 72(7): 1408-1412, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398177

RESUMO

Congenital thrombosis and amputation in infancy is not common. Therefore, the existing literature lacks sufficient evidence regarding this subject. Available research primarily focuses on treatment and causes of thrombosis in children. The paper describes a case of preterm infant after transtibial amputation due to common iliac artery thrombosis during the perinatal period. The girl began neurodevelopmental therapy based on normal development patterns of infants, which was provided three times a week for 45 minutes. The rehabilitation process also included prosthesis and surgical interventions. The assessment of motor development of the child was carried out at the age of 6, 9, 12, 18 and 20 months, using the motor scale of the Albert Infants Motor Scale (AIMS). Case analysis allows to state that infant rehabilitation after transtibial amputation should be individualized, and focus on supporting normal motor development, based on the correct movement sequences of infants. Additionally, the AIMS scale can be used to assess the gross motor development in infants after amputation and is useful in formulating early therapeutic intervention. A prosthetist should perform prosthesis revisions as often as needed, i.e., in infants that is usually every 4 months. What is more, successful outcomes can be achieved by implementing proper surgical procedures regarding the appositional overgrowth of the residual limb in growing children.


Assuntos
Membros Artificiais , Doenças do Prematuro , Trombose , Amputação , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Trombose/complicações
15.
Cas Lek Cesk ; 158(3-4): 118-125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31416318

RESUMO

The various health risks associated with the increasing age of mothers at childbirth include the low birth weight of new-born children. The aim of the article is to verify the relationship between the birth weight of new-born children and the age of mothers at childbirth employing data on new-born children from the General Health Insurance Company of the Czech Republic. The data also allow take into consideration other characteristics such as the gender of the child, the frequency of childbirth, complications during hospitalisation and the type of conception (spontaneous or following IVF treatment). It was found that the proportion of new-born children with birthweights of 2500+ g exceeded 93% for women aged 25-39 and that the proportion is only slightly lower for women aged 40 and over. The lowest proportion (less than 88 %) was determined for women below the age of 20, while the proportion for women aged 20-24 years stood at 92 %. No relationship was proved between a higher proportion of children born with low weights and the higher age of women with respect either to single or multiple births. However, the research did reveal the significantly higher proportion of children from single births with lower birth weights most likely born following IVF treatment. Moreover, the proportion of new-born children hospitalised due to health complications increases with the increasing age of mothers at childbirth with respect to both normal and lower birth weights.


Assuntos
Peso ao Nascer , Idade Materna , Resultado da Gravidez , Nascimento Prematuro , Adulto , Idoso , Criança , República Tcheca , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Mães , Vigilância da População , Gravidez , Técnicas de Reprodução Assistida , Adulto Jovem
16.
Medicine (Baltimore) ; 98(31): e16665, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374040

RESUMO

BACKGROUND: The aim of this study was to summarize current evidence evaluating the association between antenatal infection and intraventricular hemorrhage (IVH) in preterm infants. MATERIALS AND METHODS: We searched for published articles on antenatal infection and IVH in 3 English (PubMed, the Cochrane Library, and EBSCO) and 3 Chinese (VEIPU, CNKI, and WANFANG) databases on May 19, 2019. In addition, the references of these articles were screened. The included studies had to meet all of the following criteria: preterm infants (<37 weeks); comparing antenatal infection with no infection; the outcomes included IVH (all grades), mild IVH, or sereve IVH; the type of study was randomized controlled trial or cohort study. RESULTS: A total of 23 cohort studies involving 13,605 preterm infants met our inclusion criteria. Antenatal infection increased the risk of IVH (odds ratios ([OR] 2.18, 95% confidence intervals [CI] 1.58-2.99), mild IVH (OR 1.95, 95% CI 1.09-3.49) and severe IVH (OR 2.65, 95% CI 1.52-4.61). For type of antenatal infection, the ORs and 95% CI were as follows: 2.21 (1.60-3.05) for chorioamnionitis, 2.26 (1.55-3.28) for histologic chorioamnionitis, 1.88 (1.22-2.92) for clinical chorioamnionitis, and 1.88 (1.14-3.10) for ureaplasma. CONCLUSIONS: Antenatal infection may increase the risk of developing IVH in the preterm infant. The evidence base is however of low quality and well-designed studies are needed.


Assuntos
Hemorragia Cerebral Intraventricular/epidemiologia , Recém-Nascido Prematuro , Infecção/epidemiologia , Resultado da Gravidez/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Peso ao Nascer , Corioamnionite/epidemiologia , Feminino , Idade Gestacional , Humanos , Gravidez , Índice de Gravidade de Doença
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46652

RESUMO

Pesquisa realizada pela Faculdade de Ciências Farmacêuticas (FCF) da USP com crianças internadas em dois hospitais na cidade de São Paulo, teve como objetivo entender como o colostro age na formação da microbiota de bebês prematuros. Por meio da coleta de amostras de saliva e fezes, os cientistas analisaram quais bactérias estão presentes no organismo de crianças que consumiram leite materno logo nos primeiros dias de vida.


Assuntos
Leite Humano , Bancos de Leite , Colostro , Recém-Nascido Prematuro , Microbiota
18.
J Med Microbiol ; 68(9): 1306-1313, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31274401

RESUMO

Introduction. Umbilical catheterization offers unique vascular access that is only possible in the neonatal setting due to unobstructed umbilical vessels from foetal circulation. With the cut of the umbilical cord, two arteries and a vein are dissected, allowing quick and painless catheterization of the neonate. Unfortunately, keeping the umbilical access sterile is challenging due to its mobility and necrosis of the umbilical stump, which makes it a perfect model for vessel catheter colonization analysis.Aim. The aim of this study was to evaluate bacterial colonization of the umbilical catheter, with a focus on the difference between various sections of the catheter, the duration of catheterization, patient status and gestational age.Methodology. We performed bacterial cultures for 44 umbilical catheters, analysing the superficial and deep parts of the catheter separately, and revealed colonization in one-third of cases.Results. One hundred per cent of the colonization occurred in preterm infants, with a shift towards extreme prematurity. The catheters were mainly colonized by coagulase-negative staphylococci. The majority of catheters presented with superficial colonization dominance, and there were no cases of deep colonization. The bacterial strains and their resistance were consistent between the catheter's proximal and distal parts, as well as positive blood cultures. The patients with the most intense bacterial catheter colonization presented with sepsis around removal time or a couple of days later, especially if they were extremely premature and exhibited very low birth weight. Catheterization time did not play a major role.Conclusion. Umbilical catheters are vectors for skin microflora transmission to the bloodstream via biofilm formation, regardless of antibiotic use and the duration of catheterization, especially in preterm neonates.


Assuntos
Antibacterianos/uso terapêutico , Bactérias/isolamento & purificação , Cateterismo/métodos , Cateteres/microbiologia , Uso de Medicamentos , Contaminação de Equipamentos , Recém-Nascido Prematuro , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Bacteriemia/patologia , Bactérias/classificação , Bactérias/efeitos dos fármacos , Técnicas Bacteriológicas , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/microbiologia , Infecções Relacionadas a Cateter/patologia , Cateterismo/efeitos adversos , Farmacorresistência Bacteriana , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
19.
Rev Bras Enferm ; 72(3): 592-599, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269121

RESUMO

OBJECTIVE: to describe the influence of oxygen in retinopathy of prematurity (ROP) in premature newborns (PTNB) hospitalized in neonatal units of intensive care and undergoing ophthalmological follow-up procedures after hospital discharge. METHOD: retrospective cohort study, from January 2014 to June 2016, whose data collection totaled 181 charts. Descriptive and inferential statistical analysis. RESULTS: when using oxygen (O2) in 148 PTNB (81.7%), both mask (n=141; 77.9%; p-value <0.001) and the tracheal tube predominated (n=100; 55.25; p-value <0.001) for 15 days in average. The time of use and O2 concentration of the tracheal tube (p-value <0.001), the time of mask use (p-value <0.001) and the time and concentration of O2 of the continuous positive airway pressure (CPAP) (p-value <0.001) were significant to cause ROP in 50 PTNB (11.31%). CONCLUSION: the oxygen therapy has influenced the development and severity of ROP, indicating the need to adopt protocols for its use.


Assuntos
Recém-Nascido Prematuro/fisiologia , Oxigênio/metabolismo , Retinopatia da Prematuridade/etiologia , Brasil , Estudos de Coortes , Idade Gestacional , Humanos , Recém-Nascido Prematuro/crescimento & desenvolvimento , Oxigênio/efeitos adversos , Retinopatia da Prematuridade/fisiopatologia , Estudos Retrospectivos
20.
Egypt J Immunol ; 26(1): 91-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31332999

RESUMO

Immature immune system in neonates is considered a risk factor for neonatal infections and sepsis. Mannose-binding lectin (MBL) is one of the innate immune system components that could recognize a wide variety of pathogens and initiate an immune response against them. Objectives of this study were to assess the correlation between serum level of MBL and MBL2 gene polymorphism and incidence of neonatal sepsis. Isolation of bacteria from neonatal blood culture was carried out by conventional methods then, serum level of MBL was measured by ELISA and MBL2 gene polymorphism was determined by PCR-RFLP. Out of 50 neonates with sepsis enrolled in this study, 44 (88%) neonates had MBL deficiency and 6 (12%) had normal serum level with a very high statistically significant difference (P=0.00001). Genotype BB was more frequent in neonatal sepsis (56%) followed by genotype AB (32%) then genotype AA (12%) and it was more prevalent in preterm (63.2%) than in full term (33.3%) with a high statistically significant difference (P=0.001). Patients with BB genotype had the lowest MBL level in serum compared to other genotypes with a very high significant difference (P=0.001). In conclusion, low serum level of MBL and genotype BB might be significantly associated with development of sepsis among neonates.


Assuntos
Lectina de Ligação a Manose/sangue , Lectina de Ligação a Manose/genética , Sepse Neonatal/sangue , Polimorfismo Genético , Genótipo , Hospitais Universitários , Humanos , Recém-Nascido , Recém-Nascido Prematuro
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA