Neonatal Data Research Articles

Epinephrine Versus Dopamine in Children, What Is the Current Evidence and What Do We Need? A Systematic Review and Meta-analysis

INTRODUCTION Pediatric patients often receive vasoactive agents following cardiothoracic surgery or when in shock. The use of vasoactive agents varies between different settings and has largely changed because of anecdotal observations or small observational studies. Although vasoactive agents are frequently used, there are limited studies in pediatric populations comparing them to one another. The purpose of this systematic review is to quantify the comparative effects of epinephrine and dopamine while identifying gaps in knowledge. METHODS A systematic review of published manuscripts was completed to identify full-text manuscripts in English using PubMed, Embase, and Cochrane databases. Studies were included if they included clinical data using dopamine and epinephrine in different patients and included data for the same end points for patients receiving epinephrine or dopamine. RESULTS A total of 5 studies with 397 patients were included. Of the included patients, 187 received epinephrine and 210 received dopamine. The mean age for all the patients was 45 months. When all patient data were pooled, a significantly lower mortality was associated with epinephrine compared with dopamine (risk ratio, 0.74; 95% CI, 0.55–0.99). When only neonatal data were pooled, epinephrine was associated with a significantly higher average heart rate (10 bpm; 95% CI, 2.0–18.7) and a significantly lower average mean arterial blood pressure (−2.5 mm Hg; 95% CI, −4.6 to −0.4). CONCLUSION Limited data are available comparing dopamine to epinephrine in pediatric patients. The ­available data demonstrate an apparent mortality benefit associated with the use of epinephrine.

Comprehensive Targeted and Quantitative Profiling of the Human Milk Metabolome: Impact of Delivery Mode, Breastfeeding Practices, and Maternal Diet

ScopeHuman milk (HM) is rich in bioactive compounds and essential nutrients. While research has focused on lipids, minerals, immune markers, microbiota, and oligosaccharides, specific metabolites are less studied. This study uses targeted metabolomics to identify and quantify metabolites in HM and explores the impact of perinatal and dietary factors on the metabolomic profile.Methods and resultsIn a cross‐sectional study of 123 healthy lactating women, HM samples were collected up to 1 month postpartum and analyzed using the Biocrates MxP Quant 500 kit. Maternal and neonatal clinical, anthropometric, and nutritional data were collected. A total of 432 metabolites were quantified and categorized into 20 groups. The metabolomic profiles formed three distinct clusters, primarily driven by triglyceride concentration differences. Docosahexaenoic acid (DHA) levels were higher in HM from mothers with vaginal delivery compared to C‐section births and differences in hexoses were found between exclusive and mixed‐feeding practices. Maternal diets rich in lipids and animal proteins were associated with elevated amino acids, sphingolipids, and glycosyl‐ceramides.ConclusionThe HM metabolome was grouped into three clusters influenced by delivery mode, lactation practices, and maternal diet. This comprehensive analysis opens new avenues to explore HM composition and offers valuable insights for future dietary interventions aimed at modulating HM.

NeoVault: empowering neonatal research through a neonate data hub

BackgroundStability during early postnatal life in preterm infants is related to better outcomes. Although vital signs are monitored continuously in Neonatal Intensive Care Unites, this monitoring does not include all physiological parameters nor data such as movement patterns. Although there are scattered sources of data, there is no centralized data hub for neonates information.ResultsWe have created the first neonate data hub for easy and interactive access to upload or download postural, physiological, and medical data of neonates: NeoVault. NeoVault is a platform that provides access to information through two interfaces: 1) via a Web interface (designed for medical personnel, data scientists, researchers); and 2) via a RESTful API (Application Programming Interfaces) -designed for developers-, aiming to integrate access to information into third-party applications. The web access allows searching and filtering according to specific parameters, visualization of data through graphs and images, and generation of datasets in CSV format. Access through the RESTful API is described in OpenAPI, enabling access to information from any device, facilitating it in an interoperable format. Currently, it contains nearly 800,000 postural records and 3.000 physiological data entries. The physiological and postural data stored for each neonate in NeoVault are collected through the NRP (Neonates Recording Platform) tool, which allows for the automatic and reliable collection of data.ConclusionNeoVault is an open platform for simple access to postural, physiological, and medical data of neonates that can be utilized by researchers, data scientists, medical personnel, and programmers. It enables integration into third-party applications and the generation of customized datasets.

Severe neonatal hyperbilirubinaemia in European and Indian subcontinent descendent newborns: a retrospective cohort study

Neonatal hyperbilirubinaemia is more common in Asian-descendent populations, but differences in disease severity are poorly reported. Our study aimed to compare neonatal hyperbilirubinaemia severity between European and Indian subcontinent descendent newborns. We conducted a single-centre retrospective cohort study including newborns admitted with unconjugated hyperbilirubinaemia (January 2016 to December 2021). Patients were followed during admission, comparing those with European ancestry (control group) and Indian subcontinent ancestry (India, Pakistan, Bangladesh and Nepal) (study group). The primary outcome was severe hyperbilirubinemia (TSB > 25 mg/dL, phototherapy > 6 h or need for exchange transfusion [ET]), and the secondary was TSB levels. Adjusted analysis for potential confounding factors was performed using binary logistic regression models. Of 110 newborns included, 27 (24.5%) had Indian subcontinent ancestry. Occurrence of TSB > 25 mg/dL was significantly higher in the study group (22.2% vs. 4.8%, p = 0.006), while no differences were noted in exposure to phototherapy > 6 h and ET therapy. Logistic regression models for confounding factors adjustment showed Indian subcontinent ancestry as an independent risk factor for TSB > 25 mg/dL (OR 7.49, CI 95% [1.23–45.50]). The study group revealed also higher absolute values of TSB both at admission (22.0 mg/dL vs. 19.6 mg/dL, p = 0.013) and at discharge (13.6 mg/dL vs. 11.4 mg/dL, p = 0.005). Conclusion: Our findings suggest that newborns with Indian subcontinent ancestry might show a higher risk for the development of severe hyperbilirubinemia compared to European ancestry newborns. Implementing earlier treatment thresholds in this subset of patients may help prevent severe hyperbilirubinemia. What is Known:• Indian subcontinent descendent populations have high incidence of neonatal hyperbilirubinaemia but data regarding its severity are scarce.What is New:• This article shows that, compared to European descendent newborns, Indian subcontinent descendent newborns might be at higher risk for severe hyperbilirubinaemia.

Advancing the management of neonatal hemorrhages: clinical evaluation of external ventricular drainage efficacy.

To evaluate the clinical efficacy of external ventricular drainage (EVD) in the treatment of neonatal intraventricular hemorrhage (IVH). A retrospective analysis was conducted on the clinical data of neonates with IVH admitted to the Department of Neurosurgery at Qingdao Women and Children's Hospital from January 2018 to February 2024. All patients received a definitive diagnosis followed by EVD treatment. Regular follow-ups were conducted, and patients who developed posthemorrhagic hydrocephalus (PHH) underwent ventriculoperitoneal shunt (VPS) procedures. Among the 44 neonates with IVH, 28 were male and 16 were female. The median gestational age at birth was 36weeks (range: 24-40weeks), and the median birth weight was 2.9kg (range: 0.78-4.33kg). There were 3 cases of grade II IVH, 34 cases of grade III IVH, and 7 cases of grade IV IVH. The average duration of EVD was 12.2 ± 5.6days. All patients were followed up for at least 1year. Twelve patients (27%) developed hydrocephalus, of which 8 cases (18%) with progressive ventricular enlargement underwent VPS, and 4 cases (9%) had arrested hydrocephalus and remained stable without VPS. During the follow-up period, 39 patients exhibited normal development, 3 patients (6.8%) developed epilepsy, and 2 patients (4.5%) developed cerebral palsy. EVD is an effective treatment for intraventricular hemorrhage. It improves survival rates and outcomes for patients while effectively reducing the incidence of hydrocephalus.

Low Apgar Score and Risk of Neonatal Mortality among Infants with Birth Defects.

The Apgar score is a clinical tool to assess newborn health at delivery and has shown utility in predicting neonatal mortality in the general population, but its predictive ability in neonates with birth defects remains unexplored. As such, we aimed to investigate the performance of the 5-minute Apgar score in predicting neonatal mortality among neonates with a spectrum of major birth defects. Data for neonates with birth defects born between 1999 and 2017 were obtained from the Texas Birth Defect Registry. We generated receiver operating characteristic curves and corresponding area under the curve (AUC) values for neonatal mortality (death within the first 28 days of life) by 5-minute Apgar score (<7 vs. ≥7) to measure discrimination capacity. We performed secondary analyses to determine the predictive ability of the Apgar score: (1) among infants with an isolated birth defect and (2) separately in preterm and term neonates. Low Apgar score yielded substantial predictive ability for neonatal mortality, with 25 out of 26 AUC values > 0.70 across a spectrum of defect categories. High predictive ability was consistent among neonates with isolated defects, and preterm and term neonates. The Apgar score is likely useful for predicting neonatal mortality among most neonates with birth defects. Despite small sample sizes limiting some secondary analyses, the findings emphasize the potential continued use of the Apgar score as a rapid clinical assessment tool for newborns with birth defects. Continued research may refine the Apgar score's application in this important population, both in clinical practice and population health research. · Predictive models suggest the 5-minute Apgar score (<7) is predictive of neonatal mortality.. · Consistent results were observed across spectrum of birth defect categories.. · Secondary analyses (e.g., preterm infants) yielded similarly consistent results..

Single-Cell RNA Sequencing to Guide Autologous Preterm Cord Mesenchymal Stromal Cell-Therapy.

The chronic lung disease bronchopulmonary dysplasia (BPD) remains the most common complication of extreme prematurity (<28 weeks of gestation). Umbilical cord-derived mesenchymal stromal cells (UC-MSCs) represent an opportunity for autologous cell-therapy, as UC-MSCs have been shown to improve lung function and structure in experimental BPD. However, characterization and repair capacity of UC-MSCs derived from donors with pregnancy-related complications associated with prematurity remain unexplored. To characterize UC-MSCs' transcriptome and determine if pregnancy-related complications (preeclampsia and chorioamnionitis) alter their therapeutic potential. Single-cell RNA sequencing (scRNA-seq) was used to compare the transcriptome of UC-MSCs derived from five term donors, 16 preterm donors, and human neonatal dermal fibroblasts (HNDFs, control cells of mesenchymal origin), and correlated with their therapeutic potential in experimental BPD. Using publicly available neonatal lung single-nuclei RNA sequencing data, we also determined putative communication networks between UC-MSCs and resident lung cell populations. Most UC-MSCs displayed a similar transcriptome despite of their pregnancy-related conditions and mitigated hyperoxia-induced lung injury in newborn rats. Conversely, HNDFs, one term and two preeclampsia preterm UC-MSC donors exhibited a distinct transcriptome enriched in genes related to fibroblast function and senescence and were devoid of therapeutic benefit in hyperoxia-induced BPD. Conversely, therapeutic UC-MSCs displayed a unique transcriptome active in cell proliferation and distinct cell-cell interactions with neonatal lung cell populations, including NEGR and NRNX pathways. Term and preterm UC-MSCs are lung protective in experimental BPD. scRNA-seq allows to identify donors with a distinct UC-MSC transcriptome characteristic of reduced therapeutic potential.

Sickle Cell Disease and Sickle Cell Trait on Curaçao: Pregnancy‐Related Outcomes and Complications: A Retrospective Cohort Study From a Single Centre

ABSTRACTObjectivesTo describe the pregnancy‐related outcomes and complications as well as neonatal outcomes among patients with sickle cell disease (SCD) and sickle cell trat (SCT) on Curaçao over the past half decade.MethodsA retrospective cohort study was conducted. Patients with SCD and SCT were included who gave birth from 1 December 2016 to 9 November 2019 in St. Elisabeth Hospital and from 10 November 2019 to 1 November 2023 in Curaçao Medical Center, Curaçao. Various data regarding participant characteristics, pregnancy‐related outcomes and complications and neonatal data were gathered and analysed. Descriptive statistics were utilized and p values calculated.ResultsThe most common pregnancy‐related complications in patients with SCD were pre‐eclampsia (4; 23.5%), vaso‐occlusive crisis (10; 58.8%), anaemia (15; 88.2%) and urinary tract infection (6; 35.3%). Intrauterine growth restriction was recorded in four (22.2%) pregnancies, five (29.4%) patients delivered preterm and eight (44.4%) neonates had a birth weight below 2500 g. The need for blood transfusion was significantly higher in patients with HbSS compared to patients with HbSC (88.9% HbSS vs. 12.5% HbSC, p = 0.002) and significantly more neonates from patients with HbSS were admitted to the neonatal intensive care unit (66.7% HbSS vs. 11.1% HbSC, p = 0.016). Regarding SCT, anaemia occurred in 78 (25.2%) patients and 73 (23.5%) times the amniotic fluid was stained with meconium.ConclusionThe data of this study support the results of previous studies, displaying a high rate of maternal and neonatal complications and adverse outcomes during pregnancy in patients with SCD. Close observation and a multidisciplinary approach are essential. SCT does not appear to be associated with adverse effects on maternal or foetal outcomes and complications, except for a high rate of meconium‐stained amniotic fluid.

Long-term prognosis and related factors of neonatal and small infants meningitis caused by streptococcus agalactiae

Objective: To explore the long-term prognosis and related factors of neonates and infants meningitis caused by Streptococcus agalactiae. Methods: The Clinical data of neonates and small infants with Streptococcus agalactiae meningitis admitted to the Children's Hospital of Zhengzhou University from January 2015 to May 2022 were retrospectively collected, and long-term follow-up of neurological development was conducted for the patients, with a follow-up period of ≥18 months. According to long-term neurological prognosis indicators, the patients were divided into good prognosis group and poor prognosis group, and the multivariate logistic regression model was used to analyze the factors affecting the long-term prognosis of the patients. Results: A total of 86 children were included, with 50 males and 36 females, and their age ranged from 3 to 85 (29.7±18.5) days. The follow-up duration was 20 to 78(47.2±17.0) months, and the age at the end of follow-up was 1.8 to 6.6(4.2±1.3) years. Among them, there were 54 cases in good long-term prognosis group and 32 cases in poor prognosis guoup. Infectious shock [56.3%(18/32) vs 13.0%(7/54), P<0.001], hypoproteinemia [46.9%(15/32) vs 22.2%(12/54), P=0.017], surgical intervention for neurological complications [31.0%(13/32) vs 7.4%(4/54), P=0.003], abnormal neurological examination at discharge [37.5%(12/32) vs 7.4%(4/54), P<0.001], and abnormal cranial imaging at discharge [53.1%(13/32) vs 7.4%(4/54), P<0.001] were higher in the poor prognosis group than those in the good prognosis group. The peripheral blood WBC count [M(Q1, Q3)] [4.7(3.4, 7.6)]×109/L at the onset of the disease was lower in the poor prognosis group than that in the good prognosis group [10.1(3.8, 14.1)]×109/L, and the cerebrospinal fluid protein concentration [3.0(2.1, 3.8)] g/L was higher in the poor prognosis group than that in the good prognosis group [2.5(1.9, 2.8)] g/L (both P<0.05). The multivariate logistic regression model found that peripheral blood WBC<4.0×109/L (OR=5.501,95%CI:1.430-21.170,P=0.013), infectious shock (OR=4.600,95%CI:1.008-21.004,P=0.047), neurological complications undergoing surgical intervention (OR=8.961,95%CI:1.792-44.812,P=0.008), and abnormal head imaging at discharge (OR=12.636,95%CI:2.502-63.829,P=0.002) were related factors for poor long-term prognosis in neonatal and infants meningitis caused by Streptococcus agalactiae. Conclusions: Neonates and infants meningitis caused by Streptococcus agalactiae have a high incidence of long-term adverse prognosis. Peripheral blood WBC<4.0×109/L, infectious shock, neurological complications undergoing surgical intervention, and abnormal cranial imaging at discharge are related factors for poor long-term prognosis.

Evaluation of gestational weight gain in women with twin pregnancies and its relationship to neonatal birth weight. A pilot study

BackgroundTo date, there have been no studies in Poland on weight gain in women with twin pregnancies in relation to recommendations.ObjectiveThe aim of this study was to analyze the gestational weight gain of women with twin pregnancies depending on their body weight before pregnancy, and to assess the relationship between the observed weight gain and the neonatal birth weight.Material and MethodsThe study was conducted among 50 women in twin pregnancies and their 100 newborns delivered after 36 weeks of gestation. Gestational weight gain was assessed based on the American Institute of Medicine guidelines for women in twin pregnancies. Data on the pre-pregnancy body weight and gestational weight gain were collected by interviewing the patients. Neonatal data were obtained from the hospital medical records.ResultsNormal gestational weight gain was observed only in 38% of the women. In women with monochorionic pregnancy, too low body weight gain occurred almost 3 times more often than in women with dichorionic pregnancy (74% vs. 26%), (p&lt;0.001). Women with monochorionic pregnancies also gave birth to statistically significantly more newborns with low birth weight (&lt;2500 g), compared to women with dichorionic pregnancies (62.5% vs. 37.5%) (p=0.007). The mean birth weight of newborns born to mothers with excessive weight gain was 151 g higher than children born to mothers with normal weight gain (2727 g vs. 2576 g) (p=0.035).ConclusionsIn the majority of studied women in twin pregnancies, gestational weight gain was not compliant with the current recommendations. The risk of insufficient weight gain is higher in women with monochorionic pregnancies compared to women with dichorionic pregnancies.

Severe alcohol withdrawal during pregnancy or early postpartum: maternal and fetal outcomes.

Alcohol withdrawal syndrome (AWS) during pregnancy is under-researched despite growing concerns about increased alcohol use among pregnant women. This study aims to explore the severity of AWS and its impact on maternal and fetal outcomes. This retrospective study reviewed the medical records of patients admitted to the Mayo Clinic who underwent the CIWA-Ar protocol for AWS from June 2019 through June 2022. Pregnant women identified in this cohort had their pregnancy, labor, and neonatal data analyzed for alcohol-related complications and outcomes. Out of the medical records reviewed, 8 cases involved pregnant women experiencing AWS. These cases showed a high severity of withdrawal symptoms, with a median peak CIWA-Ar score of 17 (IQR = 14). Maternal complications included a high rate of ICU admissions (37.5%; n = 3) and significant rates of miscarriage and stillbirth (37.5%; n = 3). Fetal outcomes were concerning, with 1 out of 5 (20%) neonates requiring NICU admission and experiencing conditions such as respiratory failure and neonatal abstinence syndrome. Developmental problems were noted in 2 out of 5 (40%) newborns. The findings highlight the severe implications of AWS during pregnancy, impacting both maternal and fetal health. The severity of AWS requires attentive clinical management and preventative interventions. Future research should focus on larger, prospective studies to better understand and address the risks associated with AWS in pregnant women and to improve health outcomes for mothers and their children. • Severe AWS during pregnancy leads to high ICU admissions and adverse neonatal outcomes. • 37.5% of pregnant women with AWS experienced miscarriage or stillbirth. • 20% of newborns from mothers with AWS required NICU admission for serious conditions; 40% of newborns had developmental problems. • Findings underscore the need for specialized treatment protocols to improve outcomes for pregnant women and their newborns.

Methylation Patterns of Diabetes and Obesity Susceptibility Genes in Gestational Diabetes Mellitus: A Cross-Sectional Analysis from Karachi, Pakistan.

Background: Women with gestational diabetes mellitus (GDM) and their offspring have an increased risk of adverse perinatal and long-term health outcomes, which may be attributable to epigenetic modification of diabetes and obesity susceptibility genes. We aimed to investigate the methylation patterns of eight genes in GDM and normoglycemic (NG) mothers, and their respective offspring. Methods: This cross-sectional study, conducted at Aga Khan University from August 2019 to December 2022, recruited pregnant women in the first trimester of gestation from the outpatient obstetrics clinic. Participants were classified as NG or GDM based on the Society of Obstetricians and Gynecologists Pakistan. Venous blood samples were collected from mothers and cord blood from neonates. Peripheral blood mononuclear cells were used for DNA extraction and methylation analysis using methylation-specific PCR. Maternal and neonatal clinical data were recorded. Statistical analysis was performed using R, including binary logistic regression to assess the association between various gene methylation levels and GDM. Results: The study found that GDM mothers had significantly higher fasting blood glucose, 2-hr OGTT, and serum carboxymethyl lysine (CML) levels compared to NG mothers, but no significant differences in neonatal birth weight or serum CML levels. Chemerin methylation was significantly lower in GDM mothers and their babies, while NAMPT, MTNR1B, FNDC5, FAT4, and FTO methylation levels were higher in GDM offspring compared to NG offspring. GDM mothers also had higher methylation levels of brain-derived neurotrophic factor gene (BDNF). Multivariable binary logistic regression identified methylation levels of maternal BDNF and neonatal MTNR1B to be independently associated with GDM. Conclusions: Our study shows a trend of epigenetic modifications in both GDM mothers and their offspring in various genes related to metabolism and inflammation, suggesting an intergenerational transmission of increased risk of developing metabolic disorders. These findings emphasize the need for high throughput studies, early screening, tight glucose control during pregnancy, and postnatal follow-up to mitigate long-term health risks.

Complications among assisted reproductive technique (ART) twin gestations versus spontaneously conceived twin gestations (SC): A retrospective outcome analysis among an Afro-Caribbean population at a university-based hospital in Jamaica

Aim: The aim of the study is to compare the frequency of maternal and neonatal complications among pregnant women with twin pregnancies conceived spontaneously versus conceived by assisted reproductive technique (ART). Methods: Univariate and bivariate analyses of maternal characteristics and neonatal outcomes were performed in this retrospective cohort study at a university-based hospital between 2006 and 2016 in Jamaica, a middle-income Caribbean country. Neonatal data were the primary outcomes: APGAR scores, gestational age, birth weight, admission to the neonatal intensive care unit (NICU), and the level of ventilatory support required. Maternal characteristics, comorbidities, and pregnancy complications were other outcomes studied. Results: There were 157 SC and 27 ART twin gestations. Women conceiving via ART were more likely to be advanced maternal age (p greater 0.001), have uterine fibroids (p greater 0.001), previous myomectomy (p=0.001), and incompetent cervix (p=0.003), delivery by cesarean section (p=0.007), and experience hemorrhage (p=0.017) than SC. There were no statistically significant differences in rates of preterm births, birth weight, APGAR scores, or NICU admissions. Assisted reproductive technique twins were more likely to require continuous positive airway pressure (CPAP) (p=0.025), with no differences observed between the two groups for neonatal respiratory distress. Conclusion: In our predominantly Afro-Caribbean population, ART mothers were observed to have more poor maternal outcomes than mothers who conceived spontaneously. Assisted reproductive technique and SC twins had similar neonatal outcomes; however, ART twins were more likely to require CPAP.

A validated NICU database: recounting 50 years of clinical growth, quality improvement and research.

The importance of a Neonatal Intensive Care Unit (NICU) database lies in its critical role in improving the quality of care for very preterm neonates and other high-risk newborns. These databases contain extensive information regarding maternal exposures, pregnancy complications, and neonatal care. They support quality improvement (QI) initiatives, facilitate clinical research, and track health outcomes in order to identify best practices and improve clinical guidelines. The Parkland Memorial Hospital NICU database was originally part of the Maternal and Neonatal Data Acquisition, Transmission and Evaluation project funded by the Robert Wood Johnson Foundation to assess perinatal-neonatal care in Dallas County Texas, 1977-1982. Clinical data points were defined, transcribed and validated in 1977; revalidation has occurred multiple times. Data are prospectively extracted from health records of high-risk neonates among >11,000 births annually. The database contains clinical information on >50,000 neonates, including all initially admitted to the NICU regardless of gestational age or birthweight and since 10/03/2011, all neonates admitted for observation and transferred to the term newborn nursery. The database has provided the basis for QI studies and research designed to assess and improve neonatal care. We discuss the history, evolution, administration, impact on neonatal outcomes, and future directions of our database. IMPACT: A single neonatal intensive care unit (NICU) database was designed for prospective data collection, validated and maintained for 46yrs. This database has supported quality improvement assessment, original clinical research, education and administrative requirements and impacted clinical neonatal care.

Predicting Neonatal Hypoglycemia Using AI Neural Networks in Infants from Mothers with Gestational Diabetes Mellitus.

BACKGROUND This study aimed to develop a predictive model for the association between maternal and neonatal anthropometric data and neonatal hypoglycemia based on data from mothers with gestational diabetes mellitus (GDM) and their neonates. MATERIAL AND METHODS We included 106 pregnant women with GDM (based on the World Health Organization International Association of Diabetes and Pregnancy Study Groups) and their neonates. Neonatal hypoglycemia was defined as a threshold of 2.5 mmol/L. Neonatal blood glucose levels were performed at 0, 0.5, 1, 3, and 24 h after birth. An artificial neural network (ANN) and recurrent neural network (RNN) were developed to predict the neonate blood concentrations and investigate the relative contribution of maternal and neonate clinical variables to neonatal hypoglycemia. RESULTS Of 106 mothers with GDM, 85% had obesity, and 78% had vaginal deliveries, with neonates averaging a birth weight of 3335.83 g. The ANN model, based on the clinical data from mothers and neonates, predicted blood glucose levels with a high degree of accuracy, achieving a coefficient of determination of 0.869 and a root mean square error (RMSE) of 0.274. Neonatal birth weight and maternal body mass index were the 2 most significant factors in predicting neonatal hypoglycemia, contributing 18.6% and 15.9%, respectively. The RNN model similarly forecasted glucose levels effectively, addressing the dynamic changes in blood glucose with 0.63 mmol/L RMSE and 0.53 mmol/L mean absolute error. CONCLUSIONS ANN and RNN models effectively predict neonatal hypoglycemia in infants of mothers with GDM, highlighting the critical role of maternal and neonatal factors.

TREC and KREC values in patients with congenital heart defects — neonatal screening data

Relevance. Children with congenital heart disease (CHD) are at high risk of infectious complications with unfavorable outcomes, which is associated with inadequate immune responses. TREC and KREC are recognized biomarkers of T- and B-cell lymphopoiesis.Objective of the study: to evaluate the number of circular DNA segments — TREC and KREC in children with congenital heart defects.Materials and methods. The study used data from neonatal screening for primary immunodeficiencies in the Stavropol region from January 1, 2023, to June 30, 2024. An analysis of TREC and KREC was conducted in 43 newborns with CHD compared to healthy infants.Results. The levels of TREC and KREC in children with CHD were lower than in healthy children. A correlation was established between TREC levels and absolute lymphopenia, as well as the development of infectious complications. A decrease in KREC was identified in infants with CHD and genetic syndromes. It was shown that a TREC level of less than 650 copies per 105 cells may be a predictor of the development of infectious complications in newborns with CHD.Conclusions. The reduction in the number of TREC and KREC copies in neonatal screening allows for the identification of children with CHD at high risk of infection, opening potential opportunities for preventive therapy.

Association of SARS-CoV-2 infection during late pregnancy with maternal and neonatal outcomes

BackgroundLimited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy.MethodThis was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed.ResultsAmong 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P < 0.01) and longer duration of hospital stay (6.39 ± 2.2 vs. 4.92 ± 1.6, P < 0.01). However, comparing neonatal complications, including Apgar score, preterm birth, low birth weight, cesarean section rate, newborn hearing, neonatal congenital heart defects, and height and weight compliance rate of 6-month-old children, between non-infected and infected participants did not reach statistical significance.ConclusionSARS-CoV-2 infection in late pregnancy has no significant impact on neonatal outcomes. After six months of follow-up of the neonates, we observed that SARS-CoV-2 infection in the third trimester of pregnancy did not affect their growth and development. Hopefully, these findings will guide management strategies and clinical practice.

Editorial Comment: Additional Neonatal Anthropometric Data Support the Safety Profile of Fetal MRI at Both 1.5-T and 3-T Magnet Strengths.

Editorial Comment: Additional Neonatal Anthropometric Data Support the Safety Profile of Fetal MRI at Both 1.5-T and 3-T Magnet Strengths.

Association of Prenatal Maternal Fever and Neonatal Umbilical Artery Blood-Gas Analysis: Evidence from a Tertiary Center at China

Background: Neonatal umbilical artery blood-gas analysis is a diagnostic procedure performed shortly after birth to assess the acid-base balance, oxygenation, and metabolic status of a newborn infant. This retrospective study aimed to investigate the association of prenatal maternal fever with neonatal umbilical artery blood-gas analysis. Methods: A retrospective analysis was conducted on data from 333 parturients and their newborns. Demographic characteristics, clinical information, and neonatal umbilical artery blood gas analysis data were analyzed to evaluate the association between prenatal maternal fever and neonatal blood-gas analysis. Pregnant women with fever (≥38.0 °C) during labor were compared with those without fever. Neonatal umbilical artery blood gas parameters were assessed in relation to the degree and duration of maternal fever. Results: The incidence of the adverse delivery outcome of parturients with high prenatal fever and long duration of fever was significantly higher than that of the low fever, short-term fever, and normal parturients (p &lt; 0.05). The pH of neonatal umbilical veins in the high fever groups was reduced compared with the control group (p &lt; 0.05). Lactic acid (Lac) of neonatal umbilical vein in the low fever and high fever groups was enhanced compared with the control group (p &lt; 0.05). The pH of neonatal umbilical veins in the short-term fever and long-term fever groups was elevated compared with the control group (p &lt; 0.05). The umbilical artery pH and base excess (BE) were positively correlated with maternal peak fever temperature (r = 0.20, r = 0.22, p &lt; 0.05). The umbilical Lac was negatively correlated with maternal peak fever temperature (r = –0.22, p &lt; 0.05). Moreover, the umbilical artery pH and BE were positively correlated with maternal duration of fever (r = 0.29, r = 0.21, p &lt; 0.05). The umbilical artery Lac was negatively correlated with maternal duration of fever (r = –0.25, p &lt; 0.05). Conclusions: The findings suggested that maternal fever during labor was associated with alterations in neonatal umbilical artery blood gas analysis. Understanding the influence of prenatal fever on delivery outcomes is crucial for optimizing maternal and neonatal health.

Association between Congenital Anomalies and Late-Onset Bacterial Infections in Neonates Admitted to Neonatal Intensive Care Units in Australia and New Zealand: A Population-Based Cohort Study

Introduction: Compromised neonatal intensive care unit neonates are at risk of acquiring late-onset infections (late-onset sepsis [LOS]). Neonates born with congenital anomalies (CAs) could have an additional LOS risk. Methods: Utilising the population-based Australian and New Zealand Neonatal Network data from 2007 to 2017, bacterial LOS rates were determined in very preterm (VPT, <32 week), moderately preterm (MPT, 32–36 weeks), and term (FT, 37–41 weeks) neonates with or without CA. Stratified by major surgery, the association between CA and bacterial LOS was evaluated. Results: Of 102,808 neonates, 37.7%, 32.8%, and 29.6% were born VPT, MPT, and FT, respectively. Among these, 3.4% VPT, 7.5% MPT, and 16.2% FT neonates had CA. VPT neonates had the highest LOS rate (11.1%), compared to MPT (1.8%) and FT (1.8%) neonates. LOS rates were higher in CA neonates than those without (8.2% versus 5.1% adjusted relative risk [aRR] 1.67, 95% confidence interval [CI]: 1.45–1.92). Neonates with surgery had a higher LOS rate (14.2%) than neonates without surgery (4.4%, p < 0.001). Among the neonates without surgery, CA neonates had consistently higher LOS rates than those without CA (VPT 14.3% vs. 9.6% [aRR 1.32, 95% CI: 1.11–1.57]; MPT 4% vs. 0.9% [aRR 4.45, 95% CI: 3.23–6.14]; and FT 2% vs. 0.7% [aRR 2.87, 95% CI: 1.97–4.18]). For the neonates with surgery, CAs were not associated with additional LOS risks. Conclusion: Overall, we reported higher rates of LOS in neonates with CA compared to those without CA. Regardless of gestation, CA was associated with an increased LOS risk among non-surgical neonates. Optimisation of infection prevention strategies for CA neonates should be explored. Future studies are needed to evaluate if the infection risk is caused by CA or associated complications.