Objective:Neonatal sepsis is a critical pathology that particularly affects neonates,especially preterm and low birth weight neonates,with varying incidence according to the onset(early or late)of the disease.Although...Objective:Neonatal sepsis is a critical pathology that particularly affects neonates,especially preterm and low birth weight neonates,with varying incidence according to the onset(early or late)of the disease.Although preterm neonatal mortality related to sepsis is high in Ethiopia and in the study area,limited studies have been conducted on the time-to-death and predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,this study aimed to determine the time-to-death and predictors of mortality among preterm neonates with neonatal sepsis admitted to government hospitals in Southwest Ethiopia in 2022.Methods:A prospective cohort study was conducted at the Southwest government hospitals between March 2021 and January 30,2022.The data were entered into Epi-data version 4.4.2.1 and exported to Stata version 14 for editing,cleaning,and analysis.The Cox proportional hazards(CPH)model was used to identify the predictors of mortality.Results:In this study,out of 354 preterm neonates diagnosed with neonatal sepsis,121(34.18%)had died with an incidence rate of 59.8%(95%confidence interval[CI]:50-71.5)deaths per 1000 person-day-observations.The median survival time of preterm neonates diagnosed with neonatal sepsis was 15 days.The following factors were the predictors of mortality among preterm neonates diagnosed with neonatal sepsis:(1)the neonate’s mother did not have antenatal care(ANC)follow-up(adjusted hazard ratio[AHR]2.5[95%CI:1.3-4.84]);(2)the neonates had an APGAR score<7(5th-minute activity,pulse,grimace,appearance,and respiration)(AHR 1.5[95%CI:1.29-3.46]);(3)and they had comorbidities such as respiratory distress syndrome(RDS)(AHR 1.50[95%CI:1.13-2.31])and jaundice(AHR 1.89[95%CI:1.26-2.84]).Conclusions:In this study,preterm neonates diagnosed with neonatal sepsis showed a higher incidence of mortality compared with other national and local studies.The median survival time of neonates was 15 days.Born from mothers who did not have ANC follow-up,5th-minute APGAR score<7,and comorbidities such as RDS and jaundice were independent predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,healthcare providers and other stakeholders should consider prompt and timely diagnosis and therapeutic interventions to preterm neonates with neonatal sepsis.展开更多
BackgroundSome research suggests that vitamin E may help prevent intraventricular hemorrhage (IVH) in preterm neonates. However, consolidated evidence regarding its effects on brain vascular health in this population ...BackgroundSome research suggests that vitamin E may help prevent intraventricular hemorrhage (IVH) in preterm neonates. However, consolidated evidence regarding its effects on brain vascular health in this population is lacking. This study systematically reviews primary research on this topic. This study examines the effectiveness of vitamin E supplementation in preventing IVH in preterm neonates than a placebo, thus addressing gaps in the literature.MethodsThe Cochrane, Dimensions, Embase, and PubMed databases were searched for relevant studies based on specific inclusion criteria. Subsequently, the relevant data were extracted, and statistical analysis was conducted using R studio (version 4.3.1) by applying appropriate models to account for heterogeneity and generate a combined estimate. The results were interpreted considering potential biases and limitations.ResultsFive studies involving 554 patients were included. Among them, 274 (49.45%) received vitamin E. The results (relative ratio 0.57;95% confidence interval 0.35–0.92;p = 0.02;I2 = 56%) demonstrated a reduction in the incidence of IVH in patients who received administration of vitamin E (n = 274) compared with those who received a placebo (n = 280).ConclusionThese findings highlight the potential therapeutic benefits of vitamin E supplementation in preterm neonates, which show a significant reduction in IVH incidence than placebo. Further research and clinical trials are required to fully explore its protective effects in this population.展开更多
BACKGROUND Congenital scoliosis(CS)is a spinal deformity caused by defective segmentation and development of vertebrae during early embryogenesis.It occurs in 0.5%-1%in 1000 births and may rarely occur with congenital...BACKGROUND Congenital scoliosis(CS)is a spinal deformity caused by defective segmentation and development of vertebrae during early embryogenesis.It occurs in 0.5%-1%in 1000 births and may rarely occur with congenital defects affecting the heart or genitourinary system.Truncus arteriosus(TA)is a life-threatening cardiac defect in which a single arterial trunk supplies both systemic and pulmonary circulation,leading to complications such as pulmonary hypertension,heart failure,and severe hypoxia.Although rare individually,the co-occurrence of both conditions poses unique diagnostic and therapeutic challenges,with limited documentation in medical literature.CASE SUMMARY We present a 36-week preterm neonate with CS associated with TA type 1,pre-senting with respiratory distress,cyanosis,and altered spinal curvature.This case demonstrates the complexity of managing neonates with multiple congenital de-fects.Here,the patient was managed with oxygen supplementation,heart failure medication,nasogastric feeding,and multidisciplinary care to optimize her for surgical corrections.A coordinated,interdisciplinary approach was employed to optimize outcomes,particularly in a resource-limited setting.Immediate re-spiratory and cardiovascular stabilization and long-term orthopedic and cardiac interventions were central to improving the patient’s quality of life and survival.CONCLUSION Recognizing co-existing congenital anomalies and their embryological interre-lation is critical in holistic patient care,particularly during neonatal and infancy.展开更多
Objective: In preeclampsia, abnormal fetal hemodynamics changes can be detected by Doppler ultrasound and predicted the perinatal outcome. But seldom studies focus on these preterm neonate’s hemodynamics changes duri...Objective: In preeclampsia, abnormal fetal hemodynamics changes can be detected by Doppler ultrasound and predicted the perinatal outcome. But seldom studies focus on these preterm neonate’s hemodynamics changes during 72 hours after birth and the adverse short-term outcomes. The present study is planned to assess the parameters of middle cerebral arteries and associate the short-term outcome at 37 weeks early term age in pregnancies complicated by preeclampsia. Methods: A total of 114 preterm neonates were included. The Doppler cranial ultrasound was performed to bilateral middle cerebral arteries within 12 - 24 hours, 36 - 48 hours, 60 - 72 hours after birth for all the eligible study neonates. The parameters of resistive index (RI), resistive index (PI) and middle cerebral velocity (MBFV) were recorded by Doppler cranial ultrasound and 106 infants survived assessed by the Neonatal Behavioral Neurological Assessment (NBNA) at 37 weeks early term-equivalent age. Results: There were a total of 106 subjects that finally completed the NBNA examination at 37 weeks of early term-equivalent age. In the surviving infants, there were a total of 26 infants with abnormal NBNA scores, among them, 12 infants’ mothers were diagnosed with preeclampsia, accounting for up to 46.1%. In these preterm neonates, the lower velocity of bilateral middle cerebral arteries was observed in abnormal infants (p Conclusion: Velocity of middle cerebral artery is significantly abnormal in preeclampsia. The slower velocity in the 72 hours after birth, the higher associated with adverse perinatal short-term outcome.展开更多
Despite significant advancements in the care of premature infants and ongoing research aimed at identifying the pri-mary risk factors associated with neonatal diseases,retin-opathy of prematurity(ROP)continues to be o...Despite significant advancements in the care of premature infants and ongoing research aimed at identifying the pri-mary risk factors associated with neonatal diseases,retin-opathy of prematurity(ROP)continues to be one of the most severe and disabling conditions affecting preterm neonates[1,2].The increased survival rate of infants in lower ges-tational age(GA)ranges has contributed to the increased incidence of ROP in high-income countries.Furthermore,there is an increasing incidence of ROP in middle-and low-income countries.展开更多
Recent decades have seen transformative advancements in neonatal care,significantly improving survival rates for preterm and critically ill neonates.From the introduction of neonatal intensive care units(NICUs)to adva...Recent decades have seen transformative advancements in neonatal care,significantly improving survival rates for preterm and critically ill neonates.From the introduction of neonatal intensive care units(NICUs)to advances in ventilation techniques and surfactant therapy,the field has evolved to meet the growing needs of vulnerable newborns[1].展开更多
文摘Objective:Neonatal sepsis is a critical pathology that particularly affects neonates,especially preterm and low birth weight neonates,with varying incidence according to the onset(early or late)of the disease.Although preterm neonatal mortality related to sepsis is high in Ethiopia and in the study area,limited studies have been conducted on the time-to-death and predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,this study aimed to determine the time-to-death and predictors of mortality among preterm neonates with neonatal sepsis admitted to government hospitals in Southwest Ethiopia in 2022.Methods:A prospective cohort study was conducted at the Southwest government hospitals between March 2021 and January 30,2022.The data were entered into Epi-data version 4.4.2.1 and exported to Stata version 14 for editing,cleaning,and analysis.The Cox proportional hazards(CPH)model was used to identify the predictors of mortality.Results:In this study,out of 354 preterm neonates diagnosed with neonatal sepsis,121(34.18%)had died with an incidence rate of 59.8%(95%confidence interval[CI]:50-71.5)deaths per 1000 person-day-observations.The median survival time of preterm neonates diagnosed with neonatal sepsis was 15 days.The following factors were the predictors of mortality among preterm neonates diagnosed with neonatal sepsis:(1)the neonate’s mother did not have antenatal care(ANC)follow-up(adjusted hazard ratio[AHR]2.5[95%CI:1.3-4.84]);(2)the neonates had an APGAR score<7(5th-minute activity,pulse,grimace,appearance,and respiration)(AHR 1.5[95%CI:1.29-3.46]);(3)and they had comorbidities such as respiratory distress syndrome(RDS)(AHR 1.50[95%CI:1.13-2.31])and jaundice(AHR 1.89[95%CI:1.26-2.84]).Conclusions:In this study,preterm neonates diagnosed with neonatal sepsis showed a higher incidence of mortality compared with other national and local studies.The median survival time of neonates was 15 days.Born from mothers who did not have ANC follow-up,5th-minute APGAR score<7,and comorbidities such as RDS and jaundice were independent predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,healthcare providers and other stakeholders should consider prompt and timely diagnosis and therapeutic interventions to preterm neonates with neonatal sepsis.
文摘BackgroundSome research suggests that vitamin E may help prevent intraventricular hemorrhage (IVH) in preterm neonates. However, consolidated evidence regarding its effects on brain vascular health in this population is lacking. This study systematically reviews primary research on this topic. This study examines the effectiveness of vitamin E supplementation in preventing IVH in preterm neonates than a placebo, thus addressing gaps in the literature.MethodsThe Cochrane, Dimensions, Embase, and PubMed databases were searched for relevant studies based on specific inclusion criteria. Subsequently, the relevant data were extracted, and statistical analysis was conducted using R studio (version 4.3.1) by applying appropriate models to account for heterogeneity and generate a combined estimate. The results were interpreted considering potential biases and limitations.ResultsFive studies involving 554 patients were included. Among them, 274 (49.45%) received vitamin E. The results (relative ratio 0.57;95% confidence interval 0.35–0.92;p = 0.02;I2 = 56%) demonstrated a reduction in the incidence of IVH in patients who received administration of vitamin E (n = 274) compared with those who received a placebo (n = 280).ConclusionThese findings highlight the potential therapeutic benefits of vitamin E supplementation in preterm neonates, which show a significant reduction in IVH incidence than placebo. Further research and clinical trials are required to fully explore its protective effects in this population.
文摘BACKGROUND Congenital scoliosis(CS)is a spinal deformity caused by defective segmentation and development of vertebrae during early embryogenesis.It occurs in 0.5%-1%in 1000 births and may rarely occur with congenital defects affecting the heart or genitourinary system.Truncus arteriosus(TA)is a life-threatening cardiac defect in which a single arterial trunk supplies both systemic and pulmonary circulation,leading to complications such as pulmonary hypertension,heart failure,and severe hypoxia.Although rare individually,the co-occurrence of both conditions poses unique diagnostic and therapeutic challenges,with limited documentation in medical literature.CASE SUMMARY We present a 36-week preterm neonate with CS associated with TA type 1,pre-senting with respiratory distress,cyanosis,and altered spinal curvature.This case demonstrates the complexity of managing neonates with multiple congenital de-fects.Here,the patient was managed with oxygen supplementation,heart failure medication,nasogastric feeding,and multidisciplinary care to optimize her for surgical corrections.A coordinated,interdisciplinary approach was employed to optimize outcomes,particularly in a resource-limited setting.Immediate re-spiratory and cardiovascular stabilization and long-term orthopedic and cardiac interventions were central to improving the patient’s quality of life and survival.CONCLUSION Recognizing co-existing congenital anomalies and their embryological interre-lation is critical in holistic patient care,particularly during neonatal and infancy.
文摘Objective: In preeclampsia, abnormal fetal hemodynamics changes can be detected by Doppler ultrasound and predicted the perinatal outcome. But seldom studies focus on these preterm neonate’s hemodynamics changes during 72 hours after birth and the adverse short-term outcomes. The present study is planned to assess the parameters of middle cerebral arteries and associate the short-term outcome at 37 weeks early term age in pregnancies complicated by preeclampsia. Methods: A total of 114 preterm neonates were included. The Doppler cranial ultrasound was performed to bilateral middle cerebral arteries within 12 - 24 hours, 36 - 48 hours, 60 - 72 hours after birth for all the eligible study neonates. The parameters of resistive index (RI), resistive index (PI) and middle cerebral velocity (MBFV) were recorded by Doppler cranial ultrasound and 106 infants survived assessed by the Neonatal Behavioral Neurological Assessment (NBNA) at 37 weeks early term-equivalent age. Results: There were a total of 106 subjects that finally completed the NBNA examination at 37 weeks of early term-equivalent age. In the surviving infants, there were a total of 26 infants with abnormal NBNA scores, among them, 12 infants’ mothers were diagnosed with preeclampsia, accounting for up to 46.1%. In these preterm neonates, the lower velocity of bilateral middle cerebral arteries was observed in abnormal infants (p Conclusion: Velocity of middle cerebral artery is significantly abnormal in preeclampsia. The slower velocity in the 72 hours after birth, the higher associated with adverse perinatal short-term outcome.
基金funded by Ministero dell’Universitàe della Ricerca,PRIN 2022 D.D.104 del 02/02/2022 Finanziato dall’Unione Europea—NextGenerationEU—OBERON,2022FYB-MEX,Italy.
文摘Despite significant advancements in the care of premature infants and ongoing research aimed at identifying the pri-mary risk factors associated with neonatal diseases,retin-opathy of prematurity(ROP)continues to be one of the most severe and disabling conditions affecting preterm neonates[1,2].The increased survival rate of infants in lower ges-tational age(GA)ranges has contributed to the increased incidence of ROP in high-income countries.Furthermore,there is an increasing incidence of ROP in middle-and low-income countries.
文摘Recent decades have seen transformative advancements in neonatal care,significantly improving survival rates for preterm and critically ill neonates.From the introduction of neonatal intensive care units(NICUs)to advances in ventilation techniques and surfactant therapy,the field has evolved to meet the growing needs of vulnerable newborns[1].
