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Implementing the eat, sleep, console method into a tertiary care delivery center

BackgroundInfants experiencing Neonatal Opioid Withdrawal Syndrome (NOWS) after birth has been a significant public health issue since the opioid crisis began in the U.S. Traditional assessment tools for symptom management have historically resulted in prolonged hospitalization and continued exposure to opioids after birth to treat them. PurposeEat, Sleep, Console (ESC) was implemented to replace a popular NOWS assessment tool in a neonatal intensive care unit at a large urban children's hospital's maternity center. The aim was to determine whether using ESC would decrease length of hospitalization, use of morphine for treatment, as well as increase the number of direct discharges from the postpartum unit. ResultsALOS decreased from 9.2 days to 6.2 days, a 33% reduction. Morphine treatment initiation decreased from 21.7% to 3.8%, an 82.4% reduction. Neither group included infants treated with a second line medication. Finally, the discharge rate improved by 47% directly from the postpartum unit. ConclusionsUsing ESC, all identified outcomes regarding management of infants with NOWS improved. Wide-scale use of ESC could have multiple benefits for this patient population including a reduction in healthcare costs and prolonged exposure to opioids after birth, as well as preservation of the mother-infant dyad in the immediate postpartum period. Further research is needed to study the long-term impact of the ESC method.

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Global prevalence of congenital heart diseases in infants: A systematic review and meta-analysis

BackgroundCongenital heart anomalies, among the most common congenital abnormalities, are the leading cause of mortality resulting from congenital diseases. This study's objective is to investigate the prevalence of congenital heart diseases in infants through a systematic review and meta-analysis. MethodsThis study systematically searched electronic databases, including PubMed, Scopus, Science Direct, and Web of Science, for studies reporting the global prevalence of congenital heart diseases in infants up to March 2023. ResultsIn the review of 16 studies with a total sample size of 35,281,800 individuals, the heterogeneity test (I2) indicated high heterogeneity (I2 = 99.8%), and a random-effects model was used to analyze the results. Accordingly, the global prevalence of congenital heart anomalies in infancy was reported to be 0.003 (95% CI: 0.002–0.004) or more precisely with exact decimals 0.0027 (95% CI: 0.0022–0.0035), which is 0.27 percent, 2.78 per 1000 and 27.8 per 10,000 births. Additionally, the assessment of publication bias in the studies, considering the large sample size, was performed using the Begg and Mazumdar correlation test, which showed no significant publication bias (p = 0.566). ConclusionBased on the results of this study, it was reported that the global prevalence of congenital heart diseases in infants is increasing annually. Ventricular and atrial septal defects had the highest prevalence, with a higher occurrence in male infants compared to female infants. It is necessary to implement policies to reduce the prevalence of these diseases and prevent infant mortality caused by them.

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The impact of COVID-19 disease on maternal and neonatal outcomes among birthing women in Jordan

BackgroundPregnant women are considered among the vulnerable groups affected by COVID-19. In addition to the direct effect on maternal health, COVID-19 adversely affects neonatal outcomes. PurposeTo explore the impact of COVID-19 on maternal and neonatal outcomes among birthing women in Jordan. MethodA descriptive comparative retrospective design was used. A self-report questionnaire was used to collect data from 140 conveniently selected women admitted to a large governmental hospital in central Jordan. The participants' data files contained data about the birth outcomes. ResultThe results showed that rates of fetal distress incidence as a reason for emergency cesarean X2 (1, N = 140) = 9.46, p = 0.002, and the need to use electronic fetal heart rate monitoring X2 (1, N = 140) = 6.87, p = 0.009 were higher in mothers infected with COVID-19. The non-infected group reported higher use of analgesics during labor X2 (1, N = 140) = 5.42, p = 0.02, episiotomy occurrence X2 (1, N = 140) = 36.96, p = 0.001, incidence of any laceration during labor X2 (1, N = 140) = 38.60, p = 0.001 and gestational age F (1, 8.926) = 0.003, P < 0.05. ConclusionsThis study indicated that COVID-19 could lead to significant adverse outcomes for pregnant women. It also emphasized the need for more understanding of the implications for newborns born to women infected with COVID-19. Outcomes could serve as a baseline for future studies exploring the effect of COVID-19 on maternal and neonatal outcomes among birthing women.

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Neurobehavioral outcome of multi-sensory stimulation intervention in preterm neonates: Randomised controlled trial

BackgroundPreterm neonates are exposed to overwhelming and unusual sensory stimulations in the neonatal intensive care unit, which can have deleterious effects on their neurobehavioral outcomes. Therefore, neonatal nurses play a crucial role in enhancing these neonates' neurobehavioral outcomes. This study aimed to investigate the neurobehavioral outcomes of a multi-sensory stimulation intervention in preterm neonates. DesignA randomized, controlled pretest-posttest trial with two parallel groups. SubjectsSixty preterm neonates who were medically stable with a mean gestational age of 32.95 ± 1.845 weeks and a mean birth weight of 1550.83 ± 208.077 g. SettingNeonatal intensive care unit at Alexandria University Children's Hospital at Smouha, Alexandria, Egypt. MethodsAll eligible neonates were randomly assigned to the study or the control group. The control group received standard neonatal nursing care, while the study group received the multi-sensory stimulation intervention in addition to standard nursing care. The neonates received the intervention for 30 min daily for two consecutive weeks. The outcomes were evaluated within 24 h of admission and after two weeks using the Neonatal Neurobehavioral Examination Scale. ResultsThe multi-sensory stimulation intervention significantly improved the mean total score of preterm neonates’ neurobehavioral responses after two weeks (65.20 ± 7.65) compared to the control group (46.87 ± 7.55) (P = 0.000). ConclusionMulti-sensory stimulation intervention had a protective effect on preterm neonates’ neurobehavioral outcomes. Therefore, it should be integrated into standard nursing care for preterm neonates.

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