Evidências para o tratamento de feridas em recém-nascidos: revisão integrativa

Introdução: Diante das particularidades e desafios no manejo e tratamento de feridas em recém-nascidos torna-se importante para o enfermeiro conhecer, indicar e avaliar a eficácia e segurança das coberturas e produtos, inclusive na análise dos produtos para o público neonatal. Objetivo: Identificar na literatura as principais coberturas e produtos utilizados no tratamento de feridas em recém-nascidos. Metodologia: Trata-se de uma revisão integrativa de literatura, com artigos publicados entre os anos de 2018 a 2022, que abordaram os temas de coberturas e produtos utilizados no tratamento de feridas em recém-nascidos. A coleta de dados foi realizada por meio de consulta na Biblioteca Virtual de Saúde e Scientific Eletronic Library Online. Foram utilizados os descritores "newborn", "wounds" e "bandage". A análise foi realizada conforme a estratégia PICO e estruturados pelo PRISMA. Resultados: Diante dos achados foi possível identificar 13 artigos que abordavam produtos e coberturas destinados ao tratamento de feridas em neonatos. Foram encontrados 14 tipos de coberturas/produtos e dispositivos que utilizam a terapia por pressão negativa. Considerações finais: A literatura indica o uso de produtos e cobertura com princípios passivos, ativos e biológicos para o tratamento de feridas em neonatos, inclusive no prematuro, valendo destacar a importância em considerar o uso seguro de coberturas adequadas a esse público.

Introducción: Dadas las particularidades y desafíos en el manejo y tratamiento de heridas en recién nacidos, es importante que los enfermeros conozcan, indiquen y evalúen la efectividad y seguridad de apósitos y productos, incluido el análisis de productos para el público neonatal. Objetivo: Identificar en la literatura los principales apósitos y productos utilizados para el tratamiento de heridas en recién nacidos. Metodología: Se trata de una revisión integrativa de la literatura, con artículos publicados entre 2018 y 2022, que abordaron los temas de apósitos y productos utilizados en el tratamiento de heridas en recién nacidos. La recolección de datos se realizó mediante consulta en la Biblioteca Virtual en Salud y Biblioteca Científica Electrónica en Línea. Se utilizaron los descriptores "newborn", "wounds" y "bandage". El análisis se realizó según la estrategia PICO y estructurado por PRISMA. Resultados: Teniendo en cuenta los hallazgos, fue posible identificar 13 artículos que abordaron productos y apósitos destinados al tratamiento de heridas en recién nacidos. Se encontraron 14 tipos de revestimientos/productos y dispositivos que utilizan terapia de presión negativa. Consideraciones finales: La literatura indica el uso de productos y coberturas con principios pasivos, activos y biológicos para el tratamiento de heridas en recién nacidos, incluidos los prematuros, y cabe resaltar la importancia de considerar el uso seguro de coberturas adecuadas para esta población.

Introduction: Given the particularities and challenges in the management and treatment of wounds in newborns, it becomes important for nurses to know, indicate and evaluate the efficacy and safety of dressings and products, even in the analysis of products for the neonatal population. Objective: To identify in the literature the main dressings and products used to treat wounds in newborns. Methodology: This is an integrative literature review, with articles published between 2018 and 2022, which addressed the topics of dressings and products used in the treatment of wounds in newborns. Data collection was carried out through consultation in Biblioteca Virtual de Saúde and in the Scientific Electronic Library Online. The "newborn", "wounds" and "bandage" descriptors were used. The analysis was carried out according to the PICO strategy and structured following PRISMA. Results: Given the findings, it was possible to identify 13 articles that addressed products and dressings intended for treating wounds in newborns. Fourteen types of dressings/products and devices that use negative pressure therapy were found. Final considerations: The literature indicates the use of products and dressings with passive, active and biological principles for the treatment of wounds in newborns, including premature neonates, and it is worth highlighting the importance of considering the safe use of dressings that are suitable for this population.

Consecuencias inmunológicas de la infección materna por VIH en el recién nacido no infectado / Immunologic consequences of maternal HIV infection in the uninfected newborn

Resumen Con la implementación de estrategias de cuidado perinatal, la tasa de transmisión vertical del virus de inmunodeficiencia humana (VIH) ha disminuido considerablemente en el mundo. A pesar de no mostrar cargas virales, los infantes expuestos al VIH no infectados (ENI) cursan en sus primeros meses de vida con mayores tasas de morbimortalidad. Esto se relaciona con enfermedades infecciosas por microorganismos oportunistas y menor respuesta a las vacunas en comparación con infantes sin exposición al virus, lo que sugiere alteraciones en su sistema inmunitario. En esta revisión abordamos diferentes evidencias de alteraciones en las respuestas inmunitarias innatas y adaptativas de infantes ENI que pudieran explicar esta disfuncionalidad inmunitaria. Adicionalmente, este conocimiento ayuda a entender cómo se desarrolla el sistema inmunitario desde los primeros momentos de gestación que servirán para encontrar alternativas de manejo y terapias para el bienestar de los infantes con esta condición.

Abstract With the implementation of perinatal care strategies, the rate of vertical transmission of human immunodeficiency virus (HIV) has decreased considerably worldwide. Despite the absence of viral loads, infants exposed to HIV not infected during gestation have higher morbidity and mortality rates. This is found to be related to infectious diseases by opportunistic microorganisms and lower response to vaccines in their first months of life compared to non-HIV exposed infants, suggesting alterations in their immune system. In this review we address different evidence of alterations in the innate and adaptive immune responses of HIV exposed infants that could explain their immune dysfunctionality. Additionally, this knowledge helps to understand how the immune system develops from the early stages of gestation and will serve to find management alternatives and therapies for the welfare of the infants with this condition.

Frecuencia de malnutrición y su relación con complicaciones en mujeres embarazadas y sus recién nacidos / Frequency of malnutrition and their relationship with complications in pregnant women and their newborns

En el embarazo el requerimiento energético y de nutrientes aumentan, el déficit o el exceso puede afectar el estado nutricional de la madre y del neonato. Con el objetivo de determinar la frecuencia de malnutrición y su relación con complicaciones en mujeres embarazadas y sus recién nacidos que acuden al Hospital Distrital de Capiatá del Ministerio de Salud Pública y Bienestar Social, en el mes de febrero a agosto de 2022, se realizó un estudio observacional descriptivo de corte transverso retrospectivo que incluyó a 140 gestantes, de las cuales 64 presentaron complicaciones por malnutrición y 76 no presentaron ninguna complicación. La edad media fue de 26,9±6,6 años con un rango de edad de 15 a 40 años. Los resultados muestran que el 45.7% (n=64) de las gestantes presentaron complicaciones por malnutrición, el 51,6% presentó diabetes gestacional, anemia en el 29,7%, el 7,8% presentó anemia y diabetes gestacional, el otro 7,8% hipertensión arterial, el 1,6% manifestó hipertensión arterial y diabetes gestacional y el otro 1,6% presentó anemia, hipertensión arterial y diabetes gestacional. En relación a la evaluación nutricional al inicio y al final de la gestación en las gestantes con complicaciones hubo una leve disminución en los porcentajes de obesidad de 43,7% a 37,5% y un aumento del bajo peso de 11% a 20,3%. En cuanto al tipo de parto en las gestantes con complicaciones el 51,6% fue por cesárea (n=33), las cuales presentaron diabetes gestacional en el 54,5%, seguido de anemia en el 21,2%. Se comprobó un mayor porcentaje de sobrepeso y obesidad (29,7%) en los recién nacidos de madres con complicaciones. Se pudo evidenciar la frecuencia de malnutrición y complicaciones en casi la mitad de las gestantes, es preciso generar mayores estrategias en salud pública para prevenir la malnutrición y complicaciones en gestantes.

In pregnancy the energy and nutrient requirement increases, the deficit or excess can affect the nutritional status of the mother and the neonate. In order to determine the frequency of malnutrition and their relationship with complications in pregnant women and their newborns who go to the Capiata District Hospital of the Ministry of Public Health and Social Welfare, in the month of February to August 2022, a Descriptive observational study of retrospective cross -section that included 140 pregnant women, of which 64 presented complications for malnutrition and 76 did not present any complication. The Middle Ages was 26.9 ± 6.6 years with an age range of 15 to 40 years. The results show that 45.7% (n = 64) of pregnant women presented complications for malnutrition, 51.6% presented gestational diabetes, anemia in 29.7%, 7.8% presented anemia and gestational diabetes, the other 7.8% arterial hypertension, 1.6% expressed arterial hypertension and gestational diabetes and the other 1.6% presented anemia, arterial hypertension and gestational diabetes. In relation to nutritional evaluation at the beginning and at the end of pregnancy in pregnant women with complications there was a slight decrease in obesity percentages of 43.7% to 37.5% and an increase in low weight of 11% to 20, 3%. As for the type of childbirth in pregnant women with complications, 51.6%was due to caesarean section (n = 33), which presented gestational diabetes in 54.5%, followed by anemia in 21.2%. A higher percentage of overweight and obesity (29.7%) was proven in mother's newborns with complications. The frequency of malnutrition and complications could be evidenced in almost half of the pregnant women, it is necessary to generate greater public health strategies to prevent malnutrition and complications in pregnant women.

Caracterización clínica del binomio madre-hijo de recién nacidos hijos de madres con VIH en el Hospital Barrio Obrero, años 2016 al 2021

Introducción : El virus de la inmunodeficiencia humana (VIH) es un miembro de la familia Retroviridae, actualmente agrupado dentro del género Lentivirus. Objetivos: Describir las características clínicas de los recién nacidos hijos de madres con diagnóstico de VIH positivos. Materiales y Métodos : Se realizó un estudio descriptivo, transversal, retrospectivo del binomio madre-hijo de recién nacidos hijos de madres con VIH, internados en el Servicio de Neonatología del Hospital General Barrio Obrero en el periodo comprendido de enero de 2016 a diciembre 2021. Se procedió a la recolección de los datos de las fichas del periodo correspondiente al estudio. Resultados : Un total de 31 individuos (binomios madre-hijo) fueron analizados, la mayoría del sexo masculino, un tercio de los niños nació con bajo o muy bajo peso, se registraron 11 madres con controles prenatales insuficientes o nulo, lo que dio lugar a 5 partos vaginales, éstos sin control prenatal. El motivo de internación fue la hiperbilirrubinemia, la profilaxis recibida por los RN fue monoterapia con Zidovudina. Conclusiones : Esta investigación ha demostrado que a pesar del esfuerzo de los programas de control de VIH y maternos, los niños aún nacen con bajo o muy bajo peso, se observan controles prenatales insuficientes y partos vaginales.

Introduction: The human immunodeficiency virus (HIV) is a member of the Retroviridae family, currently grouped within the Lentivirus genus. Objectives: To describe the clinical characteristics of newborns born to mothers diagnosed with HIV. Materials and Methods: This was a descriptive, cross-sectional and retrospective study of the mother-child pairing of newborns born to mothers with HIV, admitted to the Neonatology Service of the Barrio Obrero General Hospital from January 2016 to December 2021. We proceeded to collect the data from the records of the period corresponding to the study. Results: A total of 31 individuals (mother-child pairs) were analyzed, most of the infants were male, one third of the children were born with low or very low weight, 11 mothers had insufficient or no prenatal care, which resulted in 5 vaginal deliveries in those without prenatal care. The most frequent reason for infant hospitalization was hyperbilirubinemia, the prophylaxis received by the newborns was Zidovudine monotherapy. Conclusions: This research has shown that despite the efforts of the HIV and maternal control programs, children are still born with low or very low weight, we found insufficient prenatal care and vaginal deliveries.

Frecuencia de malnutrición y su relación con complicaciones en mujeres embarazadas y sus recién nacidos

En el embarazo el requerimiento energético y de nutrientes aumentan, el déficit o el exceso puede afectar el estado nutricional de la madre y del neonato. Con el objetivo de determinar la frecuencia de malnutrición y su relación con complicaciones en mujeres embarazadas y sus recién nacidos que acuden al Hospital Distrital de Capiatá del Ministerio de Salud Pública y Bienestar Social, en el mes de febrero a agosto de 2022, se realizó un estudio observacional descriptivo de corte transverso retrospectivo que incluyó a 140 gestantes, de las cuales 64 presentaron complicaciones por malnutrición y 76 no presentaron ninguna complicación. La edad media fue de 26,9±6,6 años con un rango de edad de 15 a 40 años. Los resultados muestran que el 45.7% (n=64) de las gestantes presentaron complicaciones por malnutrición, el 51,6% presentó diabetes gestacional, anemia en el 29,7%, el 7,8% presentó anemia y diabetes gestacional, el otro 7,8% hipertensión arterial, el 1,6% manifestó hipertensión arterial y diabetes gestacional y el otro 1,6% presentó anemia, hipertensión arterial y diabetes gestacional. En relación a la evaluación nutricional al inicio y al final de la gestación en las gestantes con complicaciones hubo una leve disminución en los porcentajes de obesidad de 43,7% a 37,5% y un aumento del bajo peso de 11% a 20,3%. En cuanto al tipo de parto en las gestantes con complicaciones el 51,6% fue por cesárea (n=33), las cuales presentaron diabetes gestacional en el 54,5%, seguido de anemia en el 21,2%. Se comprobó un mayor porcentaje de sobrepeso y obesidad (29,7%) en los recién nacidos de madres con complicaciones. Se pudo evidenciar la frecuencia de malnutrición y complicaciones en casi la mitad de las gestantes, es preciso generar mayores estrategias en salud pública para prevenir la malnutrición y complicaciones en gestantes.

In pregnancy the energy and nutrient requirement increases, the deficit or excess can affect the nutritional status of the mother and the neonate. In order to determine the frequency of malnutrition and their relationship with complications in pregnant women and their newborns who go to the Capiata District Hospital of the Ministry of Public Health and Social Welfare, in the month of February to August 2022, a Descriptive observational study of retrospective cross -section that included 140 pregnant women, of which 64 presented complications for malnutrition and 76 did not present any complication. The Middle Ages was 26.9 ± 6.6 years with an age range of 15 to 40 years. The results show that 45.7% (n = 64) of pregnant women presented complications for malnutrition, 51.6% presented gestational diabetes, anemia in 29.7%, 7.8% presented anemia and gestational diabetes, the other 7.8% arterial hypertension, 1.6% expressed arterial hypertension and gestational diabetes and the other 1.6% presented anemia, arterial hypertension and gestational diabetes. In relation to nutritional evaluation at the beginning and at the end of pregnancy in pregnant women with complications there was a slight decrease in obesity percentages of 43.7% to 37.5% and an increase in low weight of 11% to 20, 3%. As for the type of childbirth in pregnant women with complications, 51.6%was due to caesarean section (n = 33), which presented gestational diabetes in 54.5%, followed by anemia in 21.2%. A higher percentage of overweight and obesity (29.7%) was proven in mother's newborns with complications. The frequency of malnutrition and complications could be evidenced in almost half of the pregnant women, it is necessary to generate greater public health strategies to prevent malnutrition and complications in pregnant women.

New WHO Recommendations for the Care of Preterm and Low Birth Weight Infants – A Potential Strategy to Transform the Current Healthcare Needs of Neonates

Despite major advances in the field of maternal and child health, preterm and lowbirth neonates still carry a substantial burden of both mortality and morbidity, especially in low and middle-income countries. In view of accumulating new evidence, there was a felt need for updating and expanding the previous World Health Organization recommendations of 2015. The new evidence-based recommendations for care of the preterm or low birthweight infant consist of 25 recommendations and one good practice statement and were published on 15 November, 2022. We herein provide the key recommendations for the benefit of the readers.

Alterações auditivas em recém-nascidos de gestantes com diagnóstico de covid-19: uma revisão sistemática / Hearing changes in newborns whose mothers had been diagnosed with COVID-19 during pregnancy: A systematic review / Alteraciones auditivas en recién nacidos de mujeres embarazadas con diagnóstico de covid-19: una revisión sistemática

Introdução: A integridade do sistema auditivo é essencial para o desenvolvimento das habilidades auditivas e aquisição da linguagem da criança. Considerando a alta prevalência de perda auditiva em recém-nascidos, devido a infecções congênitas que ocorrem durante a gestação, há a necessidade de investigar os efeitos da Covid-19 na audição do RN. Objetivo: Verificar a associação entre perda auditiva em neonatos de gestantes diagnosticadas com COVID-19. Estratégia de Pesquisa: A busca de artigos científicos foi realizada nas bases de dados Medline (Pubmed), LILACS, SciELO, Scopus, Web of Science e Bireme sem restrição de idioma, período e localização. Para complementar e evitar viés de risco foi realizada uma busca por literatura cinzenta no Google Acadêmico. Critérios de Seleção: A revisão sistemática foi conduzida de acordo com as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e incluiu estudos que pontuaram ≥ 6 pontos de acordo com o protocolo de pontuação qualitativa proposto por Pithon et al. (2015). Análise dos dados: Os artigos elegíveis foram analisados e quantificados seguindo os critérios propostos no presente estudo com juízes cegos nas etapas de recuperação. Resultados: foram recuperados 29 artigos com potencial de inclusão, dos quais 6 responderam à questão norteadora com potencial de elegibilidade. Quatro estudos encontrados não detectaram associação entre infecção materna por COVID-19 e perda auditiva congênita. Conclusão: A infecção por COVID-19 durante a gravidez não parece ser fator de risco para perda auditiva congênita e não foram verificadas alterações auditivas impactantes que comprometessem estes neonatos por infecção vertical. (AU)

Introduction: The integrity of the auditory system is essential for children to develop auditory skills and acquire language. Considering the high prevalence of hearing loss in newborns due to congenital infections that occur during pregnancy, there is a need to investigate the effects of COVID-19 on newborns' hearing. Objective: To verify the association between hearing loss in newborns whose mothers had been diagnosed with COVID-19 during pregnancy. Research Strategy: Scientific articles were searched in the MEDLINE (PubMed), LILACS, SciELO, Scopus, Web of Science, and BIREME databases, without restrictions on the language, time, and place of study. The grey literature was also searched in Google Scholar to complement the sample and avoid risk bias. Selection Criteria: The systematic review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and included studies that scored ≥ 6 points according to the protocol for qualitative scoring proposed by Pithon et al. (2015). Data analysis: It was performed using a specific form for systematic reviews prepared by two researchers in Excel®. Results: 29 potentially eligible articles were retrieved, six of which answered the research question. Four studies did not detect an association between maternal COVID-19 infection and congenital hearing loss. Conclusion: COVID-19 infection during pregnancy does not seem to be a risk factor for congenital hearing loss and there were no impacting hearing changes due to vertical infection that might affect these newborns. (AU)

Introducción: La integridad del sistema auditivo es fundamental para el desarrollo de las habilidades auditivas y la adquisición del lenguaje de los niños. Considerando la alta prevalencia de hipoacusia (HL) en recién nacidos (RN), debido a infecciones congénitas que ocurren durante el embarazo, surge la necesidad de investigar los efectos del Covid-19 en la audición del recién nacido. Objetivo: Verificar la asociación entre hipoacusia en neonatos de gestantes diagnosticadas con COVID-19. Estrategia de investigación: La búsqueda de artículos científicos se realizó en las bases de datos Medline (Pubmed), LILACS, SciELO, Scopus, Web of Science y Bireme, sin restricción de idioma, período y ubicación. Para complementar y evitar sesgos de riesgo, se realizó una búsqueda de literatura gris en Google Scholar. Criterios de selección: La revisión sistemática se realizó de acuerdo con las recomendaciones de los Elementos de información preferidos para revisiones sistemáticas y metanálisis (PRISMA). Los estudios que obtuvieron una puntuación ≥ 6 puntos según el protocolo de puntuación cualitativa propuesto por Pithon et al. (2015). Análisis de datos: Se realizó mediante un formulario específico para revisión sistemática elaborado por dos investigadores del Programa Excel®. Resultados: se recuperaron 29 artículos con potencial de inclusión, de los cuales 6 respondieron a la pregunta orientadora Cuatro estudios encontrados no detectaron una asociación entre la infección materna por COVID-19 y la pérdida auditiva congénita. Conclusión: La infección por COVID-19 durante el embarazo no parece ser un factor de riesgo para la pérdida auditiva congénita y no hubo cambios auditivos impactantes que pudieran comprometer a estos recién nacidos debido a la infección vertical. (AU)

An update on vaccination in preterm infants

Abstract Objective: The objective of this article is to review the most current literature on vaccines, focusing on their safety, immunogenicity, and efficacy in preterm newborns, aiming to improve vaccine coverage in this population. Data source: Most recent scientific publications addressing the immunization of preterm newborns. Data synthesis: Despite its immunological immaturity, vaccination is well tolerated by preterm infants, and protective immune responses are observed, but some studies have shown that preterm infants undergo unjustified delays in their vaccination schedule. Conclusions: Despite being widely recommended, the routine immunization of preterm infants is often delayed, putting this vulnerable population at risk for several diseases, many of which are preventable by immunization. Every effort should be made to develop universal guidelines that define the immunization of preterm infants.

Frecuencia de consumo de drogas adictivas ilícitas en gestantes o puérperas y su detección en recién nacidos en un hospital materno-infantil de Asunción

Introducción: la adicción a sustancias ilícitas constituye un problema de salud pública, del cual no están exentas las embarazadas. Los efectos deletéreos sobre el feto pueden tener consecuencias catastróficas. Objetivo: Determinar la frecuencia de uso de drogas ilícitas en mujeres gestantes y caracterizar a estas mujeres y sus recién nacidos de julio de 2020 a julio de 2021. Material y método: Estudio transversal, descriptivo, observacional con madres con sospecha de uso de drogas y sus recién nacidos (RN). Se buscó asociación entre variables estudiadas. Se utilizó escala de Finnegan para síndrome de abstinencia neonatal (SAN) y se determinó presencia de drogas en orina. Resultados: Fueron incluidos 107 binomios madres -hijos. Prevalencia de madres adictas de 11,42%. Edad promedio de madres 24,5 años y 29,9% en situación calle. 70% fueron partos vaginales, 90,5% con APGAR de 7-10. 26,1% fueron RN prematuros. RCIU 34,5%, PEG 35,5%. 93,3% mujeres se autorreportó como consumidora, 57,9% tuvo control prenatal nulo. 56% de gestantes presentó signos evidentes de ser consumidora de drogas ilícitas al ingreso. La droga más consumida fue la cocaína (COC) 85%. Detección de cocaína en RN fue 81,3%. SAN en 24,2% RN. Se encontró Cocaína en la orina de 18/26 de los pacientes con SAN, y en 64/77 de los pacientes sin síndrome de abstinencia. Tuvo Lues el 25,9%. Se encontró asociación de SAN con la presencia de COC en el RN. Conclusiones: el consumo de drogas en la embarazada expone al RN a drogas deletéreas, siendo la droga más frecuentemente consumida la COC. La prevalencia de SAN fue baja, encontrándose asociación entre esta entidad y la presencia de COC en RN.

Introduction: Addiction to illicit substances constitutes a public health problem, from which pregnant women are not exempt. The deleterious effects on the fetus can have catastrophic consequences. Objective: To determine the frequency of illicit drug use in pregnant women and to characterize these women and their newborns during the time period from July 2020 to July 2021. Materials and methods: this was a cross-sectional, descriptive, observational study with mothers suspected of drug use and their newborns (NBs). An association was sought between the studied variables. The Finnegan scale for neonatal abstinence syndrome (NAS) was used and the presence of drugs in urine was determined. Results: 107 mother-child pairs were included. The prevalence of addicted mothers was 11.42%. Average age of mothers was 24.5 years and 29.9% were living on the street. 70% were vaginal deliveries, 90.5% with an APGAR score of 7-10. 26.1% were premature newborns. IUGR 34.5%, SGA 35.5%. 93.3% women self-reported as drug consumers, 57.9% had zero prenatal control. 56% of pregnant women presented obvious signs of being an illicit drug user upon admission. The most consumed drug was cocaine (COC), 85%. Detection of cocaine in newborns was 81.3%. NAS was diagnosed in 24.2% NB. Cocaine was found in the urine of 18/26 of the patients with NAS, and in 64/77 of the patients without withdrawal syndrome. 25.9% had Lues. An association of NAS with the presence of COC in the newborn was found. Conclusions: drug use in pregnant women exposes the newborn to deleterious drugs, COC being the most frequently used drug. The prevalence of NAS was low, although we found an association between NAS and the presence of COC in newborns.

Clinical value of neonatal transport team participating in the management of twin neonates before transport / 中国小儿急救医学

Objective:To investigate and analyze the necessity and clinical significance of professional neonatal transport team participating in post-natal resuscitation, management and transport of twin neonates after birth.Methods:A total of 298 cases of twin neonates admitted to the Department of Neonatology at the Fifth Medical Center of PLA General Hospital from January 2017 to December 2021 were selected.According to whether the neonatal transport team participated in birth resuscitation and management, they were divided into participation group ( n=136) and case group ( n=162). The resuscitation measures taken after birth, Apgar score, respiratory support during transport, basic information at admission, the first arterial blood gas after admission, complications during hospitalization, length of stay and outcome of the two groups of twins were retrospectively analyzed. Results:Compared with twins in case group, the proportion of tracheal intubation before transport was significantly higher in participation group(5.88% vs.0.62%, χ2=6.997, P=0.013), hospital admissions were significantly shorter[48(7, 115) min vs.87(47, 425) min, Z=-11.593, P<0.001], and significantly lower rates of hypoxia on admission(9.56% vs.17.90%, χ2=4.250, P=0.039), significantly higher percutaneous oxygen saturation[96(86, 100)% vs.95(85, 100)%, Z=-7.274, P<0.001], and higher blood-gas-oxygen partial pressure on admission[(91.02±25.77)mmHg vs.(87.82±25.23)mmHg, t=1.076, P=0.008] were found.The incidence of hypothermia on admission was significantly lower(36.03% vs.47.53%, χ2=4.008, P=0.045), and the differences between two groups were statistically significant( P<0.05). The proportion of critically ill neonates(40.44% vs.24.07%, χ2=9.172, P=0.002), length of hospital-stay[11(4, 76)d vs.9(3, 72) d, Z=-2.684, P=0.014] as well as the intravenous nutrition time[7(0, 42)d vs.5(0, 40) d, Z=-2.470, P=0.014] in participaton group were significantly higher than those in case group, and there were statistically significant differences between two groups( P<0.05). Conclusion:Professional neonatal transport teams play a positive role in neonatal resuscitation and later hospitalization during the pre-transport management of twin neonates.It can improve success rate of tracheal intubation in asphyxia resuscitation of twin neonates.Neonatal transport to the NICU for management takes less time, reducing the incidence of hypoxemia during transport, hypoxia status and hypothermia after admission.Obstetric pediatric medical staff in midwifery hospitals should strengthen the professional training of neonatal asphyxiation resuscitation, improve the skill of neonatal asphyxiation resuscitation and tracheal intubation, and strengthen the post-birth care for twin neonates.

A qualitative study of the family-centred care needs of neonatal parents in the post-pandemic era / 中国实用护理杂志

Objective:To explore the needs of parents of hospitalized neonates with the challenges of implementing family-centered care during the Covid-19 pandemic.Methods:Using a method of phenomenological interviewing and Colaizzi′s method of data analysis, the information of 18 parents of admitted infants of Children′s Hospital of Fudan University from January 1 to 20, 2022 were collected and analyzed.Results:In the post-epidemic era, 5 themes of needs for parents of hospitalized neonates during family-centered care were identified: closeness to babies; emotional support; training about feeding; accommodation services; financial support.Conclusions:In the post-epidemic era, experiencing worry, anxiety, uncertainty, helplessness, loss and other negative psychological experience, the parents of hospitalized neonates have many unsatisfied needs. Hospital administrators need to focus on the needs of parents for family-centered nursing care, and actively explore effective coping strategies.

Traqueostomía en prematuros con displasia broncopulmonar grave / Tracheostomy in premature infants with severe bronchopulmonary dysplasia

Los recién nacidos con displasia broncopulmonar dependientes de ventilación mecánica a las 36 semanas, corresponden en general a prematuros menores de 27 semanas con morbilidad grave: enterocolitis, infecciones, retinopatía, retraso en el crecimiento y secuelas del neurodesarrollo. Si la extubación no es posible entre las 40 y 50 semanas, se indica una traqueostomía, normalmente acompañada de una gastrostomía. La decisión depende del apoyo ventilatorio, de la morbilidad asociada (neurológica, hipertensión pulmonar, lesiones de la vía aérea) y del grado de desnutrición. La traqueostomía optimiza el manejo ventilatorio, disminuye la necesidad de sedación, facilita la movilidad, la neurorrehabilitación y el alta al hogar en ventilación domiciliaria. La edad óptima de ejecución no está estandarizada, pero hay evidencia que muestra beneficios en el neurodesarrollo si se realiza antes de los 120 días de vida. La mayoría de los prematuros traqueostomizados son manejados en domicilio y a los 5 años ya se encuentran decanulados.

Newborns with bronchopulmonary dysplasia (BPD) dependent on mechanical ventilation at 36 weeks, generally correspond to newborns younger than 27 weeks with severe morbidity: enterocolitis, infections, retinopathy, growth retardation and neurodevelopmental sequelae. If extubation is not possible at 40-50 weeks post menstrual age, a tracheostomy is indicated, usually accompanied by a gastrostomy. The decision depends on ventilatory support, associated morbidity (neurological, pulmonary hypertension, airway lesions) and the degree of malnutrition. Tracheostomy optimizes ventilatory management, reduces the need for sedation, facilitates mobility, neurorehabilitation, and discharge on home ventilation. The optimal age for tracheostomy is not standardized, but there is evidence showing neurodevelopmental benefits if it is performed before 120 days. Most tracheostomized newborns are managed at home and at 5 years of age they are already decannulated.

Rooming-in practices and satisfaction with care according to discharge on exclusive breastfeeding / Prácticas en el área de alojamiento conjunto y satisfacción con la atención recibida conforme al alta hospitalaria en lactancia exclusiva / Práticas no alojamento conjunto e satisfação com o atendimento segundo alta em aleitamento materno exclusivo

ABSTRACT Objective: to describe the practices that favor breastfeeding performed in the Rooming-In area and satisfaction with the care received according to discharge on exclusive breastfeeding. Method: a quantitative study conducted between July 2020 and September 2021 in a maternity teaching hospital from southern Brazil; a total of 756 puerperal women participated by means of an online questionnaire 20 days after hospital discharge. The data were analyzed in a descriptive way with absolute and relative frequencies, and the chi-square test was applied to verify any statistical difference according to the "discharge on exclusive breastfeeding" outcome. Results: the prevalence of discharge on exclusive breastfeeding was 85.0% and the practices that presented and association with the outcome were guidelines regarding the breastfeeding readiness signs (69.0% versus 57.5%), correct position and latch (94.1% versus 86.7%), free demand (79.2% versus 69.0%), exclusive breastfeeding until the sixth month of life and complemented until two years of age (77.9% versus 67.3%); and the practice of not offering other milk during hospitalization (88.5% versus 17.1%). Satisfaction with the care received was high (95.0%) and presented no association with the outcome of "discharge on exclusive breastfeeding". Conclusion: most of the women treated had access to the practices that favor breastfeeding, and education in health exerted a positive impact on exclusive breastfeeding at hospital discharge.

RESUMEN Objetivo: describir las prácticas que favorecen la lactancia materna realizadas en el área de Alojamiento Conjunto y el grado de satisfacción con la atención recibida conforme al alta hospitalaria en lactancia exclusiva. Método: estudio cuantitativo realizado entre julio de 2020 y septiembre de 2021 en una maternidad escuela del sur de Brasil; las participantes fueron 756 puérperas que respondieron un cuestionario en línea 20 días después del alta hospitalaria. Los datos se analizaron en forma descriptiva por medio de frecuencias absolutas y relativas; se aplicó la prueba de chi-cuadrado para verificar si existía alguna diferencia estadística conforme al desenlace de "alta hospitalaria en lactancia exclusiva". Resultados: la prevalencia del alta hospitalaria en lactancia exclusiva fue del 85,0% y las prácticas que presentaron una asociación con el desenlace fueron las indicaciones orientativas relacionadas con la señales de prontitud para mamar (69,0% versus 57,5%), posición y agarre correctos (94,1% versus 86,7%), libre demanda (79,2% versus 69,0%), lactancia exclusiva hasta el sexto mes de vida y complementada hasta los dos años de edad (77,9% versus 67,3%); y la práctica de no ofrecer otro tipo de leche durante la internación (88,5% versus 17,1%). El grado de satisfacción con la atención recibida fue elevado (95,0%) y no presentó ninguna asociación con el desenlace de "alta hospitalaria en lactancia exclusiva". Conclusión: la mayoría de las mujeres atendidas tuvo acceso a las prácticas que favorecen la lactancia materno, y la educación en salud ejerció un efecto positivo sobre la lactancia exclusiva al momento del alta hospitalaria.

RESUMO Objetivo: descrever as práticas que favorecem o aleitamento materno realizadas no alojamento conjunto e satisfação com o atendimento recebido segundo alta em aleitamento materno exclusivo. Método: estudo quantitativo realizado entre julho de 2020 e setembro de 2021 em uma maternidade escola no Sul do Brasil, participaram 756 puérperas por meio de questionário online 20 dias após a alta hospitalar. Os dados foram analisados de forma descritiva, frequência absoluta e relativa, foi aplicado o teste de chi-quadrado para verificar uma diferença estatística segundo o desfecho alta em aleitamento materno exclusivo. Resultados: a prevalência da alta em aleitamento materno exclusivo foi de 85,0% e as práticas que apresentaram associação com o desfecho foram as orientações quanto aos sinais de prontidão para a mamada (69,0% versus 57,5%), a posição e pega correta (94,1% versus 86,7%), a livre demanda (79,2% versus 69,0%), o aleitamento materno exclusivo até o sexto mês de vida e complementado até os dois anos (77,9% versus 67,3%); e a prática da não oferta de outro leite durante a internação (88,5% versus 17,1%). A satisfação com o atendimento recebido foi elevada (95,0%) e não apresentou associação com o desfecho de alta em aleitamento materno exclusivo. Conclusão: a maioria das mulheres atendidas teve acesso às práticas que favorecem o aleitamento materno e a educação em saúde trouxe impacto positivo para o aleitamento materno exclusivo na alta hospitalar.

Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review / Prevalencia de lactancia materna en recién nacidos de madres con COVID-19: una revisión sistemática / Prevalência de aleitamento materno em recém-nascidos de mães com COVID-19: uma revisão sistemática

ABSTRACT Objectives: to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. Methods: a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. Results: fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. Conclusions: despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.

RESUMEN Objetivos: comparar la prevalencia de lactancia materna exclusiva versus alimentación artificial en recién nacidos de madres con COVID-19. Métodos: revisión sistemática de prevalencia, según JBI. Búsquedas en las bases de datos PubMed®, Embase, CINAHL, LILACS y Web of Science™ en agosto de 2021. Se seleccionaron estudios transversales, longitudinales o de cohortes, sin limitaciones de idioma y tiempo que mostraran prevalencia de lactancia materna o que permitieran calcular. Resultados: se analizaron 15 artículos publicados en 2020 y 2021, de cohorte (60%) o transversal (40%). El promedio de lactancia materna exclusiva en madres con COVID-19 fue 56,76% (IC=39,90-72,88), y lactancia artificial, 43,23% (IC = 30,99 - 55,88), sin diferencias estadísticamente significativas. Conclusiones: a pesar de las recomendaciones de mantener la lactancia materna, hubo una reducción a nivel mundial, en comparación con períodos previos a la pandemia. Con los avances de la ciencia, estas tasas han mejorado, mostrando el impacto de la evidencia en las prácticas. Como limitaciones se citan las fuentes del estudio. Se recomienda realizar nuevos estudios. Registro PROSPERO CRD42021234486.

RESUMO Objetivos: comparar as prevalências de aleitamento materno exclusivo versus aleitamento artificial em recém-nascidos de mães com COVID-19. Métodos: revisão sistemática de prevalência, segundo JBI. Buscas nas bases PubMed®, Embase, CINAHL, LILACS e Web of Science™ em agosto de 2021. Selecionados estudos transversais, longitudinais ou coortes, sem limitação de idioma e tempo que apresentavam prevalência de aleitamento materno ou que permitissem o cálculo. Resultados: 15 artigos publicados em 2020 e 2021, coortes (60%) ou transversais (40%) foram analisados. A média de aleitamento materno exclusivo em mães com COVID-19 foi 56,76% (IC=39,90-72,88), e artificial, de 43,23% (IC = 30,99 - 55,88), sem diferenças estatisticamente significantes. Conclusões: apesar das recomendações para a manutenção do aleitamento materno, houve redução mundialmente, quando comparados à períodos anteriores à pandemia. Com avanços da ciência, esses índices têm melhorado, mostrando o impacto das evidências nas práticas. Como limitações, citam-se fontes dos estudos. Recomenda-se realização de novos estudos. Registro PROSPERO CRD42021234486.

Limite de viabilidade de prematuros extremos atendidos em um hospital universitário / Limit of viability of extremely preterm infants treated at a university hospital / Límite de viabilidad de prematuros extremos atendidos en un hospital universitario

Objetivo: descrever o perfil de recém-nascidos com prematuridade extrema e identificar fatores associados a mortalidade segundo idade gestacional e o limite de viabilidade destes. Método: estudo observacional retrospectivo, com abordagem quantitativa, realizado em um hospital universitário do estado de Minas Gerais, desenvolvido de agosto de 2021 a janeiro de 2022. A amostra foi composta por 39 prontuários de prematuros extremos nascidos vivos. Foi realizada a análise descritiva das variáveis quantitativas usando medidas como média, desvio-padrão e valores mínimo e máximo. As variáveis categóricas foram descritas a partir de suas distribuições de frequência absoluta e percentual. Resultados: a maioria das gestantes são mulheres adultos-jovens, realizaram pré-natal e parto cesárea. Dos prematuros prevalece sexo masculino, idade gestacional de 25 semanas, evoluíram para óbito a maioria destes com idade gestacional de 23 e 24 semanas. Conclusão: o limite de viabilidade nesse serviço situa-se em uma idade gestacional igual ou maior que 25 semanas.

Objective: to describe the profile of newborns with extreme prematurity and to identify factors associated with mortality according to gestational age and their limit of viability. Method: a retrospective observational study, with a quantitative approach, carried out in a university hospital in the state of Minas Gerais, developed from August 2021 to January 2022. The sample consisted of 39 records of live-born extreme preterm infants. Descriptive analysis of quantitative variables was performed using measures such as mean, standard deviation and minimum and maximum values. Categorical variables were described from their absolute and percentage frequency distributions. Results: most pregnant women are young-adult women, who underwent prenatal care and cesarean delivery. Of the preterm infants, the male sex prevails, with a gestational age of 25 weeks, most of whom died at a gestational age of 23 and 24 weeks. Conclusion: the limit of viability in this service is at a gestational age equal to or greater than 25 weeks.

Objetivo: describir el perfil de los recién nacidos con prematuridad extrema e identificar los factores asociados a la mortalidad según la edad gestacional y su límite de viabilidad. Método: estudio observacional retrospectivo, con abordaje cuantitativo, realizado en un hospital universitario del estado de Minas Gerais, desarrollado entre agosto de 2021 y enero de 2022. La muestra estuvo compuesta por 39 prontuarios de prematuros extremos nacidos vivos. El análisis descriptivo de las variables cuantitativas se realizó utilizando medidas como la media, la desviación estándar y los valores mínimo y máximo. Las variables categóricas se describieron a partir de sus distribuciones de frecuencia absoluta y porcentual. Resultados: la mayoría de las gestantes son mujeres adultas jóvenes, que realizaron control prenatal y parto por cesárea. De los prematuros prevalece el sexo masculino, con una edad gestacional de 25 semanas, la mayoría de los cuales fallecieron a las 23 y 24 semanas de edad gestacional. Conclusión: el límite de viabilidad en este servicio es a una edad gestacional igual o mayor a 25 semanas.

Cardiovascular physical examination as a screening tool for congenital heart disease in newborns at a teaching hospital in Ghana

Objectives: To determine the usefulness of cardiovascular physical examination (CPE) as a screening tool in a lowresource setting for detecting congenital heart disease (CHD) in newborns delivered at the Maternity Unit of Korle Bu Teaching Hospital (KBTH), Accra, Ghana. Design: A hospital-based cross-sectional study with a comparison group component. Setting: Maternity Unit of the KBTH, Accra, Ghana. Participants: Over eight months, newborns aged 1-14 days delivered at ≥ 34 weeks' gestation at the Maternity Unit, KBTH, were recruited into the study. Intervention: Each newborn was examined using a set of CPE parameters for the presence of congenital heart disease. Those with suggestive features of CHD had a confirmatory echocardiogram test. Main Outcome Measure: Abnormal CPE features and their corresponding echocardiogram findings. Results: A total of 1607 were screened, with 52 newborns showing signs of CHD on CPE, of which 20 newborns were proven on echocardiogram to have congenital heart disease. Abnormal CPE parameter that was associated with CHD was murmur (P=0.001), dysmorphism (p=0.01), newborns with chest recessions (p=0.01) and lethargy (p=0.02). CPE's sensitivity, specificity, and positive and negative predictive values were 95%, 60.7%, 36.5% and 98,1%, respectively. The most common acyanotic CHD found was isolated atrial septal defect (ASD), followed by patent ductus arteriosus (PDA). The only cyanotic CHD found was a case of tricuspid atresia. Conclusion: Cardiovascular physical examination at birth is an effective and inexpensive screening tool for detecting CHD in newborns, which can easily be utilised in low-resource settings.

Research Advances on Childhood and Adolescent Vaccinations and Seizures / 中山大学学报(医学科学版)

Vaccination for children and adolescents is an effective strategy for preventing and controlling infectious diseases. However， clinical reports showed that vaccination may be associated with epilepsy or seizures， potentially increasing public hesitancy about vaccination， and affecting vaccination coverage. At present， no evidence showed that vaccination could damage the nervous system and cause epilepsy or seizures. In this review， we explore the association of multiple vaccinations in children and adolescents with epilepsy or seizures， and further understand the safety of vaccination， thereby improving vaccine coverage in China.

Recommendations for the diagnosis and treatment of maternal SARS-CoV-2 infection / 中华围产医学杂志

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human's health. With the passing of time, the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumu-lates. To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China, the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission. This recommendations includes the epidemiology, diagnosis, management, maternal care, medication treatment, care of birth and newborns, and psychological support associated with maternal SARS-CoV-2 infection. It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.

Study on low birth weight and its associated factors among newborns delivered in a tertiary care hospital of Banda district, Uttar Pradesh

Background: Low birth weight is associated with higher morbidity and mortality including impaired growth and development, malnutrition etc. Worldwide, one- fifth of newborns delivered are low birth weight. Aims & objectives: To estimate frequency of low birth weight & its associated factors among newborns delivered in a tertiary care hospital. Materials & Methods: A cross sectional analysis of 290 newborns delivered in tertiary care hospital, Banda, Uttar Pradesh during period of 15th February 2021 to 31st December 2021 was done for estimating low birth weight frequency & its associated factors including child characteristics, mother characteristics & father characteristics using data from medical record section of hospital. Frequency, percentages, mean, standard deviation, chi square test & independent t- test was used. P value <0.05 was considered significant. Results: 91 out of 290 newborns delivered were low birth weight (27.9%, 95% CI- 23.1%- 33.4%). The following factors were shown to have a significant association with low birth weight: education of mother (p=0.04), education of father (p=0.03), occupation of father (p=0.02), and duration of pregnancy (p<0.001). Conclusion: This study demonstrated that education of mother, education of father, occupation of father, and duration of pregnancy had significant association with low birth weight frequency that suggests that improving literacy status can help in decreasing burden of low birth weight apart from other factors.

Perfil de morbidade no primeiro ano de vida entre recém-nascidos de alto risco / Morbidity profile in the first year of life among high-risk newborns

Os cuidados destinados aos recém-nascidos prematuros extremos têm propiciado importantes resultados na sobrevida dessas crianças. Objetivo: Caracterizar o perfil de morbidade no primeiro ano de vida entre recémnascidos de alto risco. Materiais e Métodos: Trata-se de uma pesquisa exploratória realizada no ambulatório de seguimento de recém-nascidos de alto risco do norte de Minas Gerais. A coleta de dados foi referente às admissões no período de março de 2014 a abril de 2015. O instrumento contemplava características: demográficas, sociais, condições de gestação e parto, intercorrências no pós-parto e condições de saúde das crianças acompanhadas ao longo do primeiro ano de vida. Realizou-se a análise estatística descritiva e o teste Qui-Quadrado, assumindo-se um nível de significância de 5% para comparação da distribuição das morbidades por faixas de peso. Resultados: Participaram deste estudo 282 recém-nascidos, sendo 53,9% do sexo masculino. Entre as mães, 58,2% era multípara e 35,8% hipertensas. Em relação ao peso de nascimento, 59,6% dos recém-nascidos acompanhados pesaram menos de 1500 gramas. As principais morbidades identificadas no primeiro ano de vida foram atraso do desenvolvimento neuro-psicomotor, infecções de vias aéreas superiores, as alterações neurológicas e as afecções respiratórias crônicas. Foram registradas diferenças estatisticamente significantes para o atraso do desenvolvimento neuro-psico-motor (p<0,001), intercorrências neurológicas (p=0,008) e episódios de diarreia (p=0,047), entre as faixas de peso de nascimento. Conclusão: A assistência ambulatorial para o recém-nascido prematuro de alto risco contribui para a identificação e a prevenção de doenças recorrentes nessa população(AU)

Introduction: Care for extremely premature newborns has provided important results in the survival of these children. Objective: To characterize the morbidity profile in the first year of life among high-risk newborns. Materials and Method: This is an exploratory research carried out at the follow-up clinic for high-risk newborns in the north of Minas Gerais. Data collection referred to admissions in the period from March 2014 to April 2015. The instrument included characteristics: demographic, social, pregnancy and delivery conditions, postpartum complications and health conditions of children monitored during the first year of life. Descriptive statistical analysis and the chisquare test were performed, assuming a significance level of 5% to compare the distribution of morbidities by weight range. Results: A total of 282 newborns participated in this study, 53.9% of whom were male. Among the mothers, 58.2% were multiparous and 35.8% were hypertensive. Regarding birth weight, 59.6% of newborns monitored weighed less than 1500 grams. The main morbidities identified in the first year of life were delayed neuro-psycho-motor development, upper airway infections, neurological disorders and chronic respiratory conditions. Statistically significant differences were recorded for delayed neuro-psycho-motor development (p<0.001), neurological complications (p=0.008) and episodes of diarrhea (p=0.047), between birth weight ranges. Conclusion: Outpatient care for high-risk premature newborns contributes to the identification and prevention of recurrent diseases in this population(AU)