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1.
Arch. pediatr. Urug ; 92(2): e306, dic. 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1278306

ABSTRACT

Los estafilococos coagulasa negativos son microorganismos frecuentemente aislados cuya significancia clínica puede ser difícil de establecer por su carácter de comensales habituales de la piel. En la población neonatal estos patógenos han ido adquiriendo mayor protagonismo debido a la sobrevida de pacientes mas prematuros que en el pasado, así como sus necesidades de tratamiento, que determinan mayores tiempos de estadía hospitalaria. Estos elementos representan factores de riesgo también para el desarrollo de endocarditis en estos pacientes, particularmente debido a la utilización de catéteres intravasculares centrales por tiempo prolongado. En este caso clínico se presenta un paciente pretérmino severo que presentó una endocarditis a estafilococo coagulasa negativo a partir del cual discutiremos las características de las infecciones por estos microorganismos, las características de la endocarditis infecciosa en el recién nacido pretérmino y la utilización de antibióticos en estos pacientes, así como algunos elementos asociados a la vigilancia activa en el uso de antibióticos.


Coagulase negative staphylococcus (CoNS) are commonly isolated microorganisms whose clinical importance may be difficult to establish due to their role as part of our usual skin microbiota. These pathogens have gained relevance in neonatal population due to an improvement in neonatal care that determine longer survival rates and hospitals stays. Neonatal endocarditis is also affected by these microorganisms and particularly by the use of central intra vascular lines for long periods of time. In this clinical case we introduce a severe preterm patient who developed a CoNS endocarditis and discuss the characteristics of CoNS infections and endocarditis in preterm newborns as well as some antibiotic vigilance principles.


Os estafilococos coagulase negativos são microrganismos frequentemente isolados, cujo significado clínico pode ser difícil de estabelecer devido ao seu caráter de comensais cutâneos comuns. Na população neonatal, esses patógenos vêm adquirindo maior destaque devido à sobrevida de pacientes mais prematuros do que no passado, bem como suas necessidades de tratamento, as quais determinam tempos de internação mais longos. Esses elementos também representam fatores de risco para o desenvolvimento de endocardite nesses pacientes, principalmente pelo uso prolongado de cateter intravascular central. Neste caso clínico apresentaremos um paciente pré-termo grave que apresentou endocardite estafilocócica coagulase-negativa a partir do qual discutiremos as características das infecções por esses microrganismos, as características da endocardite infecciosa no recém-nascido pré-termo e o uso de antibióticos nesses pacientes bem como alguns elementos associados à vigilância ativa no uso de antibióticos.


Subject(s)
Humans , Female , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/virology , Vancomycin/therapeutic use , Endocarditis/diagnosis , Anti-Bacterial Agents/therapeutic use , Staphylococcal Infections/complications , Coagulase , Infant, Very Low Birth Weight , Endocarditis/etiology , Infant, Extremely Premature
2.
Arch. argent. pediatr ; 119(3): 162-169, Junio 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1222431

ABSTRACT

Introducción. Existe poca evidencia de la influencia de variables emocionales en la lactancia de madres de recién nacidos de muy bajo peso al nacer (RNMBPN). El objetivo de este estudio fue medir la producción de leche materna (PLM) en dos momentos de la internación neonatal y su asociación con los niveles de ansiedad, depresión y autoeficacia en lactancia en madres de RNMBPN.Población y métodos. Estudio prospectivo, observacional, multicéntrico en madres de RNMBPN (500-1500 g), en 9 centros de la Red NEOCOSUR. La PLM se obtuvo midiendo lo extraído por cada madre. Se utilizaron las escalas STAI para ansiedad, BDI para depresión, y, la escala piloto ALMA para autoeficacia. Estas fueron aplicadas a los 14 días de vida y a las 36 semanas posmenstruales. Se registraron, además, las características biosociales de madres y neonatos. Resultados. Participaron 118 madres. La PLM media a los 14 días fue de 169 ml (desvío estándar ­DE­ ± 132,4) y de 285 ml (DE ± 266,9) a las 36 semanas, y se asoció significativamente con percepción de autoeficacia en lactancia (p < 0,001), que se mantuvo durante la hospitalización. Existió una tendencia a menor producción en madres con mayores índices de depresión a los 14 días de vida de su hijo, pero no a las 36 semanas. No se encontró asociación entre PLM y ansiedad. No se encontraron asociaciones consistentemente significativas con variables biosociales. Conclusión. La PLM se asoció positivamente con autoeficacia en lactancia; no se encontró asociación con ansiedad y depresión en madres de RNMBPN


Introduction. There is little evidence regarding the influence of emotional variables on breastfeeding among mothers of very low birth weight infants (VLBWIs). The objective of this study was to measure breast milk production (BMP) at two points in time during neonatal hospitalization and its association with anxiety, depression, and breastfeeding self-efficacy levels among mothers of VLBWIs.Population and methods. Prospective, observational, and multicenter study in mothers of VLBWIs (500-1500 g) from 9 NEOCOSUR Network centers. BMP was obtained by measuring the amount extracted by each mother. The STAI scale was used for anxiety, the BDI scale for depression, and the ALMA pilot scale for self-efficacy. They were administered at 14 days of life and at 36 weeks of postmenstrual age. The biosocial characteristics of mothers and neonates were also recorded.Results. A total of 118 mothers participated. Mean BMP was 169 mL (standard deviation [SD]: ± 132.4) at 14 days and 285 mL (SD: ± 266.9) at 36 weeks, and it was significantly associated with the perception of breastfeeding self-efficacy (p < 0.001), which was maintained during hospitalization. There was a lower production trend among mothers with higher depression indices at 14 days of life, but not at 36 weeks. No association was observed between BMP and anxiety. No consistently significant associations were observed with biosocial variables.Conclusion. BMP was positively associated with breastfeeding self-efficacy; no association was observed with anxiety and depression among mothers of VLBWIs


Subject(s)
Humans , Female , Infant, Newborn , Adult , Breast Feeding , Anxiety , Prospective Studies , Infant, Very Low Birth Weight , Self Efficacy , Depression , Mothers
3.
Rev. colomb. cardiol ; 28(1): 53-59, ene.-feb. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1341260

ABSTRACT

Resumen Objetivo: Describir la prevalencia de las cardiopatías congénitas en dos hospitales de Cali entre 2011-2017. Método: Se realizó un estudio retrospectivo de una cohorte de 54.193 nacimientos en dos hospitales de Cali, que incluyó recién nacidos desde el 1.º de enero 2011 hasta el 31 de diciembre de 2017 captados en el programa de vigilancia y seguimiento de defectos congénitos. Inicialmente se hizo un análisis descriptivo de los pacientes con cardiopatías y luego se analizó la relación de algunas variables con un chi-cuadrado (C2) con una significancia de p-valor < 0,05. Resultados: La prevalencia en esta cohorte fue de 2,42 por 1.000 nacimientos. De los 131 pacientes con cardiopatías congénitas, 73 (55,73%) eran de sexo masculino; 91 (69,47%) nacieron con peso adecuado para la edad gestacional y 31 (23,66%) fueron pretérmino. De las madres, 30,53% se encontraban entre 25 y 29 años y 42% eran primigrávidas. Respecto a las cardiopatías congénitas, la más frecuente fue la comunicación interventricular con 52 (32,30%) casos; 105 (80,15%) tenían una sola cardiopatía congénita y 62 (47,33%) tenían cardiopatías aisladas. Las variables de peso para edad gestacional, edad materna y edad gestacional mostraron una relación estadísticamente significativa. Conclusiones: Las cardiopatías congénitas son de gran interés en salud pública dada su morbi-mortalidad y por ser causa de muerte en menores de un año en Colombia. Por lo tanto, se debe continuar trabajando en estrategias que mejoren su vigilancia, así como el diagnóstico prenatal, el tratamiento y el nivel de complejidad adecuado para cada paciente.


Abstract Objective: To describe the prevalence of congenital heart disease in two hospitals of Cali in between 2011 and 2017. Method: A retrospective study of a cohort of 54,193 births was carried out in two hospitals of Cali, which included newborns from January 1, 2011 to December 31, 2017, captured through the surveillance program and monitoring of birth defects. Initially, a descriptive analysis of patients with congenital heart disease was performed, and the association of some variables with a chi-square (C2) with a p-value significance <0.05. Results: The prevalence in this cohort was 2.42 x 1,000 births. Of the 131 patients with congenital heart disease, 73 (55.73%) were male; 91 (69.47%) were born with adequate weight for gestational age and 31 (23.66%) were preterm. Of the mothers, 30.53% were between 25 and 29 years old and 42% were primigravid. Regarding CC, the most frequent was interventricular communication with 52 (32.30%) cases; 105 (80.15%) had only one congenital heart disease and 62 (47.33%) had isolated heart disease. The variables of weight for gestational age, maternal age and gestational age, showed a statistically significant association. Conclusions: Congenital cardiopathy is of great interest in public health, given their morbi-mortality and as a cause of death in children under 1 year old in Colombia. Therefore, we must continue to work on strategies that improve surveillance, as well as prenatal diagnosis, treatment and the level of complexity appropriate to each patient.


Subject(s)
Humans , Male , Female , Infant, Newborn , Congenital Abnormalities , Heart Defects, Congenital , Infant, Premature , Infant, Very Low Birth Weight
4.
Article in English | WPRIM | ID: wpr-922384

ABSTRACT

OBJECTIVES@#To study the changing trend of abdominal regional oxygen saturation (A-rSO@*METHODS@#The VLBW/ELBW infants who were admitted to the neonatal intensive care unit from September 2019 to May 2021 were enrolled as subjects. Near-infrared spectroscopy was used to monitor A-rSO@*RESULTS@#A total of 63 VLBW/ELBW infants were enrolled, with 30 infants in the <29 weeks group and 33 in the ≥29 weeks group. A-rSO@*CONCLUSIONS@#In infants with VLBW/ELBW, A-rSO


Subject(s)
Birth Weight , Gestational Age , Humans , Infant , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Very Low Birth Weight , Oxygen , Prospective Studies , Spectroscopy, Near-Infrared
5.
Article in English | WPRIM | ID: wpr-922383

ABSTRACT

OBJECTIVES@#To study the effect of the course of treatment with broad-spectrum antibiotics on intestinal flora and short-chain fatty acids (SCFAs) in feces of very low birth weight (VLBW) infants.@*METHODS@#A total of 29 VLBW infants who were admitted to the Neonatal Diagnosis and Treatment Center of Children's Hospital Affiliated to Chongqing Medical University from June to December 2020 were enrolled as subjects for this prospective study. According to the course of treatment with broad-spectrum antibiotics, they were divided into two groups: ≤7 days (@*RESULTS@#There was a significant reduction in Chao index of the intestinal flora in the ≤7 days group and the >7 days group from week 2 to week 4 (@*CONCLUSIONS@#The course of treatment with broad-spectrum antibiotics can affect the abundance, colonization, and evolution of intestinal flora and the content of their metabolites SCFAs in VLBW infants. The indication and treatment course for broad-spectrum antibiotics should be strictly controlled in clinical practice.


Subject(s)
Anti-Bacterial Agents , Child , Fatty Acids, Volatile , Feces , Gastrointestinal Microbiome , Humans , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Prospective Studies
6.
Article in English | WPRIM | ID: wpr-888487

ABSTRACT

OBJECTIVES@#To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications.@*METHODS@#The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants.@*RESULTS@#A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25@*CONCLUSIONS@#The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.


Subject(s)
Female , Gestational Age , Humans , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Pregnancy , Retrospective Studies , Survival Rate
7.
Article in English | WPRIM | ID: wpr-888486

ABSTRACT

OBJECTIVES@#To evaluate the accuracy and safety of measurements of transcutaneous carbon dioxide partial pressure (TcPCO@*METHODS@#A total of 45 very low birth weight infants were enrolled. TcPCO@*RESULTS@#There was no significant difference in TcPCO@*CONCLUSIONS@#Lower electrode temperatures (38-41℃) can accurately measure blood carbon dioxide partial pressure in very low birth weight infants, and thus can be used to replace the electrode temperature of 42°C. Transcutaneous measurements at the lower electrode temperatures may be helpful for understanding the changing trend of blood oxygen partial pressure.


Subject(s)
Blood Gas Monitoring, Transcutaneous , Carbon Dioxide , Electrodes , Humans , Infant , Infant, Newborn , Infant, Very Low Birth Weight , Oxygen , Partial Pressure , Temperature
8.
Article in Chinese | WPRIM | ID: wpr-879900

ABSTRACT

OBJECTIVE@#To study the efficacy of probiotics in preventing late-onset sepsis (LOS) in very low birth weight (VLBW) infants.@*METHODS@#Databases including PubMed, Web of Science, Cochrane Library, Wanfang Data, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database were searched for randomized controlled trials (RCTs) of probiotics in preventing LOS in VLBW infants. LOS was classified as clinical LOS and confirmed LOS. RevMan 5.4 was used to perform the Meta analysis.@*RESULTS@#A total of 31 RCTs were included, with 3 490 VLBW infants in the probiotics group and 3 376 VLBW infants in the control group. The Meta analysis showed that compared with the control group, the probiotics group had significantly lower risks of clinical LOS (@*CONCLUSIONS@#Current evidence indicates that probiotics may reduce the risk of clinical LOS and clinical/confirmed LOS in VLBW infants, and the risk of confirmed LOS in VLBW infants who are exclusively breastfed.


Subject(s)
China , Female , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Probiotics/therapeutic use , Sepsis/prevention & control
9.
Article in Chinese | WPRIM | ID: wpr-879896

ABSTRACT

OBJECTIVE@#To study the clinical features of very preterm infants with prelabor rupture of membranes (PROM) and predictive factors for early-onset sepsis (EOS) and death.@*METHODS@#A retrospective analysis was performed for the clinical data of the very preterm infants with PROM (with a gestational age of < 32 weeks) who were admitted to the neonatal intensive care unit from January 2018 to May 2020. According to the time from membrane rupture to delivery, the infants were divided into four groups: < 18 hours (@*RESULTS@#There was no significant difference in the incidence rates of major neonatal complications and mortality rate among the very preterm infants with different times of PROM (@*CONCLUSIONS@#Prolonged PROM does not increase the incidence of neonatal complications and mortality in very preterm infants. Adverse outcomes of very preterm infants with PROM are mainly associated with lower birth weights, lung immaturity, and systemic infection.


Subject(s)
Female , Fetal Membranes, Premature Rupture , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Pregnancy , Retrospective Studies
10.
Article in Chinese | WPRIM | ID: wpr-879893

ABSTRACT

OBJECTIVE@#To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants.@*METHODS@#The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP.@*RESULTS@#The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation (@*CONCLUSIONS@#A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.


Subject(s)
Birth Weight , Bone Diseases, Metabolic/etiology , China/epidemiology , Female , Humans , Infant , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Pregnancy , Retrospective Studies , Risk Factors
11.
Article in Chinese | WPRIM | ID: wpr-879842

ABSTRACT

OBJECTIVE@#To study the clinical features of very preterm small-for-gestational-age infants born by cesarean section due to severe preeclampsia.@*METHODS@#Forty-two small-for-gestational-age infants who were admitted from August 2017 to July 2018 and were born due to severe preeclampsia were enrolled as the observation group. Forty very preterm infants who were born to healthy mothers since uterine contractions could not be suppressed were enrolled as the control group. Perinatal features, clinical manifestations of infection, complications, and clinical outcomes were analyzed for the two groups.@*RESULTS@#Within 6 hours and 2-3 days after birth, the observation group had significantly lower white blood cell count (WBC), absolute neutrophil count (ANC), and platelet count (PLT) than the control group (@*CONCLUSIONS@#Very preterm small-for-gestational-age infants born due to severe preeclampsia have a high incidence rate of infection and severe conditions. Early manifestations include reductions in the infection indicators WBC, ANC, and PLT, and CRP does not increase significantly in the early stage and gradually increases at 2-3 days after birth. Most of these infants require invasive ventilation after birth, with bronchopulmonary dysplasia as the main complication. Clinical changes should be closely observed and inflammatory indicators should be monitored for early identification of infection, timely diagnosis, and timely adjustment of antibiotic treatment, so as to improve the outcome.


Subject(s)
Bronchopulmonary Dysplasia , Cesarean Section , Female , Gestational Age , Humans , Infant , Infant, Extremely Premature , Infant, Newborn , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Pre-Eclampsia , Pregnancy
12.
Rev. bras. ginecol. obstet ; 42(10): 607-613, Oct. 2020. tab
Article in English | LILACS | ID: biblio-1144152

ABSTRACT

Abstract Objective The present study aims to analyze adverse fetal or neonatal outcomes in women with gestational diabetes, including fetal death, preterm deliveries, birthweight, neonatal morbidity and mortality, as well as the synergic effect of concomitant pregnancy risk factors and poor obstetric outcomes, as advanced maternal age, maternal obesity and pre-eclampsia in their worsening. Methods The present cohort retrospective study included all pregnant women with gestational diabetes, with surveillance and childbirth at the Hospital da Senhora da Oliveira during the years of 2017 and 2018. The data were collected from the medical electronic records registered in health informatic programs Sclinico and Obscare, and statistical simple and multivariate analysis was done using IBM SPSS Statistics. Results The study participants included 301 pregnant women that contributed to 7.36% of the total institution childbirths of the same years, in a total of 300 live births. It was analyzed the influence of pre-eclampsia coexistence in neonatal morbidity (p = 0.004), in the occurrence of newborns of low and very low birthweight (p < 0.01) and in preterm deliveries (p < 0.01). The influence of maternal obesity (p = 0.270; p = 0.992; p = 0.684) and of advanced maternal age in these 3 outcomes was also analyzed (p = 0,806; p = 0.879; p = 0.985).Using a multivariate analysis, the only models with statistic significance to predict the three neonatal outcomes included only pre-eclampsia (p = 0.04; p < 0.01; p < 0.01). Conclusion Only coexistence of pre-eclampsia showed an association with adverse neonatal outcomes (neonatal morbidity, newborns of low and very low birthweight and preterm deliveries) and can be used as a predictor of them in women with gestational diabetes.


Resumo Objetivo O presente estudo tem como objetivo analisar desfechos fetais ou neonatais adversos em mulheres com diabetes gestacional, incluindo morte fetal, partos prematuros, peso ao nascimento, morbilidade neonatal e mortalidade, bem como o efeito sinérgico de fatores de risco e maus desfechos concomitantes da gravidez, como idade materna avançada, obesidade materna e pré-eclâmpsia no seu agravamento. Métodos O presente estudo retrospetivo de coorte incluiu todas as gestantes com diabetes gestacional, com vigilância e parto no Hospital da Senhora da Oliveira durante 2017 e 2018. Os dados foram obtidos dos registos clínicos eletrônicos dos programas informáticos de saúde Sclinico e Obscare, e a análise estatística simples e multivariada foi feita utilizando o IBM SPSS Statistics. Resultados Os participantes do estudo incluíram 301 gestantes que contribuíram para 7,36% do total de partos da instituição, num total de 300 nados vivos. Foi analisada a influência da coexistência de pré-eclâmpsia na morbilidade neonatal (p = 0,004), na ocorrência de recém-nascidos de baixo e muito baixo peso ao nascimento (p < 0,01) e em partos prematuros (p < 0,01). Também foi analisada a influência da obesidade materna (p = 0,270; p = 0,992; p = 0,684) e da idade materna avançada nesses 3 desfechos (p = 0,806; p = 0,879; p = 0.985).Usando uma análise multivariada, os únicos modelos com significância estatística para predizer os três desfechos neonatais incluíram apenas a pré-eclâmpsia (p = 0,04; p < 0,01; p < 0,01). Conclusão Apenas a coexistência de pré-eclâmpsia mostrou associação com desfechos neonatais adversos (morbilidade neonatal, recém-nascidos de baixo e muito baixo peso e partos prematuros) e pode ser utilizada como preditor destes em mulheres com diabetes gestacional.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Adult , Young Adult , Pre-Eclampsia/epidemiology , Diabetes, Gestational , Brazil/epidemiology , Pregnancy Outcome , Retrospective Studies , Cohort Studies , Maternal Age , Infant, Very Low Birth Weight , Electronic Health Records , Fetal Death , Obesity, Maternal , Middle Aged
13.
Arch. argent. pediatr ; 118(5): 306-312, oct 2020. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1122006

ABSTRACT

Antecedentes. Los prematuros de muy bajo peso al nacer suelen generar estrés en sus madres, que puede persistir más de seis meses luego del nacimiento. Este trastorno se denomina estrés postraumático crónico (EPTC).Objetivo. Detectar frecuencia y síntomas del EPTC en madres de prematuros de muy bajo peso al nacer menores de 32 semanas de gestación.Métodos. Estudio transversal, mediante una encuesta voluntaria autoadministrada a madres con embarazo único. Se empleó la Escala de trauma de Davidson.Resultados. Se realizaron 172 encuestas; se eliminaron 26 incompletas. De 146 madres incorporadas, 64 (el 44 %) presentaron estrés. Las madres con EPTC tuvieron un 46,8 % de prematuros nacidos < 28 semanas vs. un 31,7 % en madres sin EPTC (p: 0,032). Los prematuros con peso < 1000 g fueron más frecuentes en madres con EPTC, el 53 % vs. el 34 %en madres sin estrés(p: 0,011). No hubo diferencias entre grupos de madres en morbilidad neonatal (p: 0,072). La morbilidad grave fue más frecuente en madres con EPTC, el 44 %. vs. el 28 % (p: < 0,004). Las madres con menor escolaridad tuvieron EPTC significativamente mayor (p: 0,013). No hubo diferencias en la edad materna (p: 0,313), edad de los niños (p: 0,405) y días de hospitalización en la Unidad (p: 0,316).Conclusión. El 44 % de las madres de prematuros de muy bajo peso al nacer tuvieron EPTC, significativamente más frecuente en prematuros ≤ 28 semanas, con peso < 1000 g, morbilidad grave y menor escolaridad materna


Background. The birth of very low birth weight (VLBW) preterm infants causes stress in mothers, which may continue for over 6 months. This is called chronic post-traumatic stress disorder (CPTSD).Objective. To detect CPTSD frequency and symptoms among mothers of VLBW preterm infants born before 32 weeks of gestation.Methods. Cross-sectional cohort study in mothers using a survey based on the Davidson Trauma Scale.Results. A total of 172 surveys were administered but 146 were included; 82 (56 %) did not have stress symptoms, while 64 (44 %) had CPTSD. Mothers with CPTSD accounted for 46.8 % of preterm infants born at ≤ 28 weeks versus 31.7 % in those without CPTSD (p = 0.032). Preterm infants with a birth weight < 1000 g were significantly more frequent among mothers with CPTSD, 53 % versus 34 % among those without stress (p = 0.011). No differences were observed in neonatal morbidity (p = 0.072). Severe morbidity in preterm infants was significantly more common among those with CPTSD, 43.8 % versus 28 % (p ≤ 0.004).Mothers who had a lower education accounted significantly for more cases of CPTSD (p = 0.013). No significant differences were seen in maternal age (p = 0.313), children's age (p = 0.405), and length of stay (p = 0.316).Conclusion. Among the mothers of VLBW preterm infants, 44 % had CPTSD, and this was significantly more common among those who had preterm infants born at ≤28 weeks, a birth weight <1000 g, severe morbidity, and a lower level of education.


Subject(s)
Humans , Female , Stress Disorders, Post-Traumatic , Stress, Psychological , Cross-Sectional Studies , Surveys and Questionnaires , Maternal Age , Infant, Very Low Birth Weight , Mothers/psychology
14.
Enferm. foco (Brasília) ; 11(2): 127-132, jul. 2020. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1104392

ABSTRACT

Objetivo: identificar os critérios clínicos e insumos utilizados para a administração do primeiro banho em recém-nascido prematuro de muito baixo peso internado em unidades de terapia intensiva neonatal.Métodos: estudo descritivo, com abordagem quantitativa. Com base no Método Canguru/Ministério da saúde, realizado em cinco unidades de terapia intensiva neonatal; população composta por 82 profissionais da equipe de enfermagem. Resultados: os critérios clínicos não apontados na avaliação foram 19,5% para a saturação de oxigênio, 23,2% frequência cardíaca e 29,3% frequência respiratória. Os insumos utilizados na realização do primeiro banho: água de torneira aquecida 56,1%, com controle bacteriológico 52,4%, sabão líquido 89,0%, com pH neutro em 76,8%. Conclusão: a não observância dos sinais clínicos e os insumos inadequados para a realização do banho do recém-nascido prematuro de muito baixo peso pode colocar em risco a segurança do paciente; emergindo adequações para fortalecimento da prática clínica da enfermagem. (AU)


Objective: To identify the clinical criteria and inputs used for the administration of the first bath in a very low birth weight premature newborns in neonatal intensive care units. Methods: descriptive study, with a quantitative approach based on the Kangaroo/Ministry of Health Method, carried out in five neonatal intensive care units; population composed of 82 professionals from the nursing team. Results: The clinical criteria not mentioned in the evaluation were 19.5% for oxygen saturation, 23.2% heart rate and 29.3% respiratory rate. The inputs used in the first bath: heated tap water (56.1%), with bacteriological control (52.4%), liquid soap (89.0%), with neutral pH (76.8%). Conclusion: Failure to observe clinical signs and inadequate supplies for bathing the very low birth weight premature newborn can put patient safety at risk; emerging adaptations to strengthen clinical nursing practice. (AU)


Objetivo: Identificar los criterios clínicos y los insumos utilizados para la administración del primer baño en recién nacidos prematuros de muy bajo peso al nacer en unidades de cuidados intensivos neonatales. Métodos: Estudio descriptivo, con enfoque cuantitativo, basado en el Método Canguro/Ministerio de Salud, realizado en cinco unidades de cuidados intensivos neonatales; población compuesta por 82 profesionales del equipo de enfermería. Resultados: Los criterios clínicos no mencionados en la evaluación fueron 19.5% para la saturación de oxígeno, 23.2% de frecuencia cardíaca y 29.3% de frecuencia respiratoria. Los insumos utilizados en el primer baño: agua caliente del grifo (56.1%), con control bacteriológico (52.4%), jabón líquido (89.0%), con pH neutro (76.8%). Conclusión: El incumplimiento de los signos clínicos y los suministros inadecuados para bañar al recién nacido prematuro de muy bajo peso pueden poner en riesgo la seguridad del paciente; adaptaciones emergentes para fortalecer la práctica clínica de enfermería. (AU)


Subject(s)
Infant, Very Low Birth Weight , Baths , Intensive Care Units, Neonatal , Neonatal Nursing
15.
Arch. argent. pediatr ; 118(2): 109-116, abr. 2020. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1099860

ABSTRACT

Introducción. La anemia es una complicación para los recién nacidos de muy bajo peso al nacer, y los exámenes de laboratorio son un factor de riesgo preponderante. Más del 50 % recibe, al menos, una transfusión de glóbulos rojos. Estas se han asociado a mayor riesgo de infecciones, hemorragia intracraneal, enterocolitis necrotizante y displasia broncopulmonar. En 2012, se implementó, en el Hospital Italiano de Buenos Aires, una estrategia de menor volumen de extracción de sangre por flebotomía. El objetivo del presente estudio fue evaluar su asociación con el número detransfusiones.Métodos. Estudio cuasiexperimental del tipo antes/después. Se comparó el número de transfusiones entre dos grupos de prematuros de muy bajo peso con diferente volumen de extracción. Se evaluó la correlación entre el volumen extraído y el número de transfusiones estimando el coeficiente de Spearman. Para ajustar por confundidores, se realizó un modelo de regresión logística.Resultados. Se incluyeron en el estudio 178 pacientes con edad gestacional media de 29,4 semanas (desvío estándar: 2,7) y peso al nacer de 1145 gramos (875-1345). El perfil de la serie roja inicial fue similar entre ambos grupos. El número de transfusiones (p = 0,017) y el volumen transfundido (p = 0,048) disminuyeron significativamente. El coeficiente de correlación resultó de 0,83. En el análisis multivariado, volumen de extracción y peso al nacer se asociaron a un requerimiento mayor de 3 transfusiones.Conclusión. Un menor volumen de extracción de sangre en prematuros de muy bajo peso está asociado de manera independiente a menor requerimiento transfusional.


Introduction. Anemia is a complication in very low birth weight (VLBW) infants, and lab tests are a predominant risk factor. At least one red blood cell transfusion is given in more than 50 % of cases. Transfusions are associated with a higher risk for infections, intracranial hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia. In 2012, Hospital Italiano de Buenos Aires implemented a strategy to collect a lower blood volume by phlebotomy. The objective of this study was to assess its association with the number of transfusions.Methods. Before-and-after, quasi-experimental study. The number of transfusions was compared between two groups of VLBW preterm infants with different blood collection volumes. The correlation between the collection volume and the number of transfusions was assessed estimating Spearman's coefficient. A logistic regression model was used to adjust for confounders.Results. The study included 178 patients with a mean gestational age of 29.4 weeks (standard deviation: 2.7) and a birth weight of 1145 g (875-1345). The baseline red series profile was similar between both groups. The number of transfusions (p = 0.017) and the transfusion volume (p = 0.048) decreased significantly. The correlation coefficient was 0.83. In the multivariate analysis, collection volume and birth weight were associated with a requirement of more than three transfusions.Conclusion. A lower blood collection volume in VLBW preterm infants is independently associated with fewer transfusion requirements.


Subject(s)
Humans , Male , Female , Infant, Newborn , Blood Volume , Erythrocyte Transfusion , Phlebotomy/adverse effects , Infant, Premature , Infant, Very Low Birth Weight , Erythrocyte Indices , Non-Randomized Controlled Trials as Topic , Anemia, Neonatal/prevention & control , Anemia, Neonatal/therapy
16.
Arch. argent. pediatr ; 118(2): e135-e142, abr. 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1100205

ABSTRACT

Objetivos. Se ha demostrado, en diversos estudios llevados a cabo en adultos, que los grupos sanguíneos desempeñan un papel importante en muchas enfermedades. El objetivo fue investigar si hay una relación entre las morbilidades y el sistema de grupos sanguíneos ABO en lactantes prematuros.Metodología. En este estudio de cohorte retrospectivo, se incluyó a recién nacidos prematuros que habían nacido con menos de 32 semanas de gestación y con un peso al nacer inferior a 1500 g. Se los agrupó por grupo sanguíneo (0, A, B, AB) y por morbilidades de la prematurez y se los comparó.Resultados. Se analizaron los datos de 1785 recién nacidos prematuros de muy bajo peso al nacer. La comparación entre los grupos sanguíneos A y no A reveló que los lactantes de grupo sanguíneo A tenían una incidencia más alta de conducto arterial persistente (CAP) (48,7 % frente a 39,7 %, p = 0,005) y displasia broncopulmonar (DBP) (27 % frente a 20,8 %, p = 0,04), mientras que la incidencia de la hemorragia intraventricular de grado ≥3 era más baja (5,1 % frente a 10,1 %, p = 0,006).Conclusión. Este estudio es la primera y más grande investigación sobre la relación entre los grupos sanguíneos y las morbilidades en los prematuros. Con estos resultados se demuestra que el grupo sanguíneo A podría ser un factor de riesgo de CAP y DBP


Objectives. Blood groups have been shown to play an important role in a lot of diseases in various studies conducted in adults. The objective was to investigate whether there is a relationship between morbidities and ABO blood groups system in preterm infants.Methodology. This retrospective cohort study included preterm neonates born at < 32 weeks of gestation with a birth weight < 1500 g. Neonates were grouped by blood type (O, A, B, AB) and morbidities of prematurity were compared among these groups. Results. Data pertaining to 1785 very low birth weight preterm neonates were analyzed. Comparison of the A and non-A blood groups revealed that infants with blood group A had significantly higher incidence of patent ductus arteriosus (PDA) (48.7 % vs. 39.7 %, p = 0.005) and bronchopulmonary dysplasia (BPD) (27 % vs. 20.8 %, p = 0.04), while the incidence of grade ≥ 3 intraventricular hemorrhage was lower (5.1 % vs. 10.1 %, p = 0.006).Conclusion. This study represents the first and biggest series examination of the relationship between blood groups and preterm morbidities. Our results show that blood group A may be a risk factor for PDA and BPD.


Subject(s)
Humans , Male , Female , Infant, Newborn , ABO Blood-Group System , Infant, Premature , Blood Group Antigens , Bronchopulmonary Dysplasia , Retrospective Studies , Risk Factors , Morbidity , Infant, Very Low Birth Weight , Ductus Arteriosus , Cerebral Intraventricular Hemorrhage
17.
Rev. chil. pediatr ; 91(1): 122-130, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092797

ABSTRACT

Resumen: La Retinopatía del Prematuro (RDP) es una alteración proliferativa de los vasos sanguíneos de la retina inmadura, que afecta principalmente a los recién nacidos de muy bajo peso (RNMBP) y de menor edad gestacional. El objetivo de esta revisión es describir a qué niño se debe efectuar la detección de esta enfermedad y analizar los recientes avances en su tratamiento. La detección de RDP está dirigida principalmente a los RNMBP y a < de 32 semanas de edad gestacional, pero también se ha propuesto un criterio según edad postmenstrual. Además de la fotocoagulación con láser, tratamiento estándar en la actualidad, se han desarrollado nuevas terapias, como los agentes anti factor de crecimiento vas cular endotelial (VEGF), que se han utilizado exitosamente en la retinopatía umbral, especialmente localizada en zona I, con menos efectos adversos y mejores resultados oculares a futuro. que la fo tocoagulación con láser. En los últimos años, se han realizado ensayos clínicos con propranolol oral como tratamiento de la RDP, principalmente en la etapa pre-umbral (etapa 2 o 3 en zona II ó III). Este bloqueador beta-adrenérgico puede prevenir la progresión de la retinopatía en RNMBP de etapa pre- umbral a umbral y/o evitar la necesidad de terapias invasivas, como la fotocoagulación con láser o la administración intravítrea de agentes anti-VEGF. La fotocoagulación con láser continúa siendo el tra tamiento de elección en la RDP. Los agentes anti-VEGF y el propranolol oral, evitarían la progresión de esta patología de etapa pre-umbral a umbral, y podrían complementar el tratamiento de la RDP.


Abstract: Retinopathy of Prematurity (ROP) is a proliferative disorder of the blood vessels of the immature retina, which affects mainly very-low-birth-weight infants (VLBW). The objective of this review is to describe to which infant the screening examination of this disease should be performed and to analy ze the recent advances in the treatment of this disease, which have emerged in the last decade. The detection of this disease is mainly focused on VLBW infants and newborns < 32 weeks of gestational age. In addition to laser photocoagulation, standard treatment today, new therapies have appeared, such as the anti-VEGF agents, which have been successfully used in the threshold ROP, especially located in zone I. This therapy is less harmful than laser photocoagulation and with better ocular results in the future. In recent years, oral propranolol has been used as a treatment for ROP in clinical trials, mainly in the pre-threshold stage (stage 2 or 3 in zone II or III). This drug is a beta-adrenergic blocker that can prevent the progression of retinopathy in pre-threshold to threshold stage and/or avoid the need for invasive therapies, such as laser photocoagulation or intravitreal administration of anti-VEGF agents. Laser photocoagulation continues to be the standard treatment for ROP. New treatments have emerged for ROP, such as anti-VEGF agents and oral propranolol, which could pre vent the progression of this disease from the pre-threshold to the threshold stage.


Subject(s)
Humans , Infant, Newborn , Retinopathy of Prematurity/diagnosis , Retinopathy of Prematurity/therapy , Propranolol/therapeutic use , Infant, Premature , Treatment Outcome , Combined Modality Therapy , Adrenergic beta-Agonists/therapeutic use , Infant, Very Low Birth Weight , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Light Coagulation
18.
Arch. argent. pediatr ; 118(1): e8-e15, 2020-02-00. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1095409

ABSTRACT

Introducción. Los probióticos y prebióticos presentan beneficios potenciales en la inflamacióncrónica de las mucosas, incluida la prevención de la enterocolitis necrosante. No obstante, los mecanismos y resultados de estos efectos inmunomoduladores son confusos. El objetivo fue investigar la respuesta de las citocinas a Lactobacillus y Bifidobacterium asociados con fructo- y galactooligosacáridos (simbióticos) y lactoferrina en recién nacidos de muy bajo peso al nacer.Población y métodos. Se asignó aleatoriamente a lactantes con ≤32 semanas de gestación y ≤1500 g de peso para recibir simbióticos o 1 ml de agua destilada como placebo desde la primera alimentación hasta el alta. Se obtuvieron muestras de sangre los días posnatales 0 ± 2, 14 ± 2 y 28 ± 2, y se midieron interferón-γ, interleucina (IL)-5, IL-10 e IL-17A.Resultados. En el grupo del estudio (n = 25), la concentración de IL-10 disminuyó a lo largo del estudio (p = 0,011), pero no cambió en el grupo de referencia. La concentración de IL-5 se mantuvo constante los primeros 14 días y luego disminuyó significativamente (p= 0,042) en el grupo del estudio, mientras que aumentó en los primeros 14 días (p = 0,019) y luego disminuyó en 28 días (p = 0,011) en el grupo de referencia (n = 25).La concentración de otras citocinas no cambió a lo largo del estudio.Conclusión. El uso combinado de probióticos con oligosacáridos y lactoferrina estuvo asociado con una disminución en la concentración de IL-10, pero no se observó un cambio en las otras citocinas.


Introduction. Probiotics and prebiotics, which are multifunctional agents, have potential benefits in chronic mucosal inflammation, including the prevention of necrotizing enterocolitis. However, the mechanisms and the results of these immunomodulatory effects are not clear. This study aimed to investigate the cytokine response to the combination of Lactobacillus and Bifidobacterium together with fructo- and galacto-oligosaccharides (symbiotic) and lactoferrin in very low birth weight neonates.Population and Methods. Infants ≤ 32 GWs and ≤ 1,500 g were randomly assigned to receive a symbiotic combination or 1 ml distilled water as placebo starting with the first feed until discharge. Blood samples were obtained at postnatal 0 ± 2, 14 ± 2, and 28 ± 2 days, and the serum levels of interferon-γ, interleukin (IL)-5, IL-10, and IL-17A were measured.Results. In the study group (n = 25), the IL-10 levels decreased throughout the study period (p = 0.011) but did not change in the control group. The IL-5 levels remained steady in the first 14 days and decreased significantly thereafter (p = 0.042) in the study group, whereas they increased in the first 14 days (p = 0.019), and then decreased in 28 days (p = 0.011) in the control group (n = 25). The levels of the other cytokines did not change throughout the study period.Conclusion.The combined use of probiotics with oligosaccharides and lactoferrin was associated with a decrease in IL-10 levels, but no change was observed in the other cytokines.


Subject(s)
Humans , Male , Female , Infant, Newborn , Cytokines/analysis , Probiotics/therapeutic use , Prebiotics , Synbiotics/administration & dosage , Lactoferrin/administration & dosage , Oligosaccharides/therapeutic use , Turkey , Prospective Studies , Cytokines/blood , Infant, Very Low Birth Weight , Enterocolitis, Necrotizing/prevention & control , Milk, Human
20.
Chinese Journal of Pediatrics ; (12): 653-660, 2020.
Article in Chinese | WPRIM | ID: wpr-826575

ABSTRACT

To investigate the incidence and risk factors of extrauterine growth retardation (EUGR) in very low birth weight infants (VLBWI). This prospective, multicenter observational cohort study was conducted based on Shandong Neonatal Network (SNN). The clinical data of the VLBWI (=1 051), who were admitted to 27 neonatal intensive care units from January 1, 2018 to December 31, 2018, were collected and analyzed. According to the weight at discharge or 36 weeks of postmenstrual age, all the enrolled VLBWI were assigned into EUGR group and non-EUGR group. Univariate and multivariate logistic regression analyses were used to detect the risk factors for EUGR in preterm small for gestational age (SGA) and non-SGA infants. A total of 1 051 VLBWI were enrolled, with 51.7% (543/1 051) male. The incidence of EUGR in the whole group was 60.7% (638/1 051), and were 78.3% (90/115) and 46.9% (53/113) in extremely low birth weight infant (ELBWI) and extremely preterm infants (EPI), respectively. The incidence of EUGR in SGA and non-SGA infants were 87.6% (190/217) and 53.7% (448/834), respectively. Logistic regression analysis showed that, withholding feeds (1.531, 1.237, 95: 1.180-1.987, 1.132-1.353, both <0.01) and time to achieve full enteral feeding (1.090, 1.023, 95: 1.017-1.167, 1.002-1.045, 0.014, 0.034) were independent risk factors of EUGR in both SGA and non-SGA infants. For SGA infants, cesarean delivery was an independent risk factor for EUGR (8.147, 95: 2.127-31.212, 0.002); while for non-SGA infants, hypertensive disorders during pregnancy (2.572, 95: 1.496-4.421, 0.001) and the duration of invasive ventilation (1.050, 95: 1.009 - 1.092, 0.016) were independent risk factors of EUGR. Besides, moderate and severe bronchopulmonary dysplasia (2.241, 95: 1.173-4.281, 0.015), necrotizing enterocolitis (5.633, 95: 1.333-23.796, 0.019) and retinopathy of prematurity (2.219, 95: 1.268-3.885, 0.005) were associated with EUGR. The incidence of weight-defined EUGR is high in VLBWI, especially in preterm SGA infants. Avoiding delaying feeds after birth and achieving full enteral feeding early may reduce the incidence of EUGR.


Subject(s)
Birth Weight , China , Epidemiology , Cohort Studies , Female , Fetal Growth Retardation , Epidemiology , Gestational Age , Growth Disorders , Humans , Infant , Infant, Extremely Low Birth Weight , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Male , Pregnancy , Prospective Studies , Risk Factors
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