Multifactorial Colonization of the Pregnant Woman's Reproductive Tract: Implications for Early Postnatal Adaptation in Full-Term Newborns.

This retrospective study aimed to investigate the impact of microorganisms identified in the reproductive tract on disorders during the early adaptation period in newborns. A cohort of 823 patients and cervical canal cultures were analyzed to identify the presence of microorganisms. Newborns included in the study were divided into two groups due to the number of pathogens identified in the swab from the cervical canal of the mother. The first group consisted of newborns whose mothers had one pathogen identified (N = 637), while the second group consisted of newborns whose mothers had two or more pathogens identified (N = 186). The analysis of disorders of the early adaptation period included the incidence of respiratory distress syndrome, the number of procedures performed with the use of CPAP, oxygen therapy, antibiotic therapy and parenteral nutrition. Respiratory distress syndrome was more common in group II than in group I (85 vs. 31, p = 0.001). In group II, CPAP (63 vs. 21, p = 0.001), oxygen therapy (15 vs. 8, p = 0.02) and antibiotics were used more frequently (13 vs. 8, p = 0.01). The findings of this study revealed that the number of pathogens colonizing the reproductive tract had a significant influence on the early adaptation period in newborns. Multifactorial colonization of the reproductive tract was associated with an increased incidence of infections in newborns and a higher prevalence of acid-base balance disorders. This study highlights the importance of monitoring and addressing the microbial composition of the reproductive tract during pregnancy.

Copeptin Concentrations in Plasma of Healthy Neonates in Relation to Water-Electrolyte Homeostasis in the Early Adaptation Period.

Copeptin (CTproAVP) is a stable by-product of arginine-vasopressin synthesis and reflects its secretion by the pituitary gland, considered as a potential new marker of dehydration. The objective of the study was to investigate CTproAVP measured after the first 48 h of postnatal life in relation to serum effective osmolality, urine osmolality, and vessels filling according to the following variables: delivery mode, postnatal weight loss, fluids administered intravenously to the mother, and fluids given orally to the neonate. A prospective observational study was conducted with 200 healthy term infants (53% male) enrolled. Serum CTproAVP concentrations were measured using the ELISA kit; haematocrit, urine osmolality, serum effective osmolality were assessed after 48 h of life. Sonographic measurements of inferior vena cava (IVC) and aorta (Ao) were performed and IVC/Ao ratios were calculated. No correlations were found between CTproAVP concentrations and both serum effective osmolality and urine osmolality. There was also no association between CTproAVP concentrations and vessel filling represented by IVC/Ao index at 48 h of life.

Baseline Diameters of Inferior Vena Cava and Abdominal Aorta Measured by Ultrasonography in Healthy Term Neonates During Early Neonatal Adaptation Period.

OBJECTIVES: To evaluate normative sonographic measurements of the inferior vena cava (IVC), aorta (Ao), and IVC/Ao ratio in the first 2 days of life in term neonates. METHODS: We prospectively observed 200 term (more than 36 and 6/7 weeks of gestation), single, healthy neonates born in a city hospital. The exclusion criteria were congenital abnormalities, an Apgar score of less than 8, and hyperbilirubinemia requiring phototherapy. Maximum IVC (distal to the hepatic-IVC junction) and Ao (above the superior mesenteric artery) diameters were measured in the first 2 days of life in the longitudinal plane. Neonatal weight loss was calculated as a percentage lost from birth weight (BW). RESULTS: A total of 200 (50% born vaginally, 53% male) neonates were enrolled. Correlations between IVC and aortic diameters as a function of gestational age, method of birth, weight loss, and body surface area (BSA) were calculated using the Spearman's rank correlation coefficient. The correlation coefficients were statistically significant for the IVC (P = .017) and Ao (P = .006) abdominal diameters versus gestational age. The Ao diameter correlated with BSA (P = .0001). In neonates with weight loss less than 8% of BW, the IVC/Ao ratio remained constant at 0.62 (95% confidence interval, 0.60-0.63). CONCLUSIONS: Sonographic measurements of IVC and Ao maximum diameters in term neonates suggests a significant positive correlation among gestational age, BSA, and IVC and Ao diameters. The IVC/Ao ratios remain constant over 48 hours after birth in neonates with weight loss up to 8% of BW, and appear to be lower than previously reported ratios for healthy children.

[Copeptin - stable C-terminal fragment of pre-provasopressin as a new stress marker in newborns]. / Kopeptyna ­ stabilny peptyd C-koncowy preprowazopresyny jako nowy marker stresu u noworodka.

Stress stimuli, including diseases, disturb homeostasis of the body and enhance secretion of various hypothalamus, pituitary and adrenal gland hormones. One of the main hypothalamic hormones secreted in stress conditions is arginine vasopressin (AVP). Vasopressin concentration in the blood reflects the severity of disease and disorders of blood volume. Measurement of vasopressin is difficult and subjected to considerable laboratory error because of the short half-life in serum and its instability in withdrawn blood samples. This hormone and copeptin are peptides produced during the cleavage of a larger precursor polypeptide: pre-provasopressin. Both peptides are formed in equimolar amounts. Copeptin is a more stable peptide, measurement of which can be performed with higher accuracy. This paper presents the importance of copeptin as a marker of stress, with particular emphasis on the neonatal period, analyzing the impact of gestational age and the route of delivery. Its potential application for assessing the degree of hydration in the adaptation period is also discussed.