Healthy Term Newborns Research Articles

Comparison of facial features in fetuses and newborns following natural delivery with cephalic presentation: a pilot study

Malocclusions are usually diagnosed around 3-4 years of age according to specific criteria. The purpose of this protocol is to validate a method to understand how the type of delivery can influence the development of malocclusions. This pilot study, conducted at the Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico of Milan, evaluated the relationship between the type of delivery, fetal presentation, and the presence of malocclusions in children. The sample included 5 healthy term newborns, all born to healthy mothers with uncomplicated pregnancies by vaginal delivery. Measurements were taken, via ultrasound, at the 37th week of gestation (T0) and on the second day of life (T1), using a craniometer, caliper and goniometer, including head circumference, lower facial angle, frontonasal angle, labial fissure length, and interpupillary distance. The results suggest that further research is necessary to better understand the influence of delivery mode and fetal presentation on the development of malocclusions. This study represents an important first step, highlighting the need for larger samples and more in-depth investigation methods to obtain more conclusive results.

Cardiac Troponin-I Level at 24 hours of Age in Stable Newborn Infants Born at ≥35 Weeks of Gestation.

Cardiac troponin-I is a known biomarker of myocardial injury in adults and children but its diagnostic utility is unclear in newborns.This study aimed to establish normative data for troponin-I in stable newborns and assess any variation due to maternal diabetes status, mode of delivery, and Apgar scores. Prospective, observational study of stable newborn ≥35 weeks gestation admitted to a well-baby nursery at a single institution. Infants with respiratory distress, congenital infections, malformations, or syndromes were excluded. Troponin-I values were obtained by a validated point-of-care capillary blood sample at 24 hours of age. A total of 132 patients were included for analysis. Thirteen infants were born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy and analyzed as a subgroup, with the remaining 119 infants comprising the base cohort to establish baseline normative troponin-I levels in stable newborn infants. The mean (standard deviation) troponin-I level of infants in the base cohort group was 0.019 ± 0.018 ng/mL and in infants born with maternal SARS-CoV-2 infection during pregnancy troponin-I level was 0.081 ± 0.1 ng/mL (p < 0.001). In infants of the base cohort, there was no significant difference in troponin-I levels between diabetic versus nondiabetic mothers, vaginal birth versus cesarean section, and 5-minute Apgar score of <7 versus ≥7. Cardiac troponin-I level in healthy term newborns was 0.019 ± 0.018 ng/mL, which conforms to healthy children and adult lab values. There was no statistically significant difference in troponin-I levels in infants of maternal diabetes or normal glucose status, mode of delivery, cesarean versus vaginal, or 5-minute Apgar score of <7 or ≥7. Troponin-I levels in asymptomatic neonates born to mothers with a history of SARS-CoV-2 during pregnancy demonstrated an elevation when compared to the baseline group of infants. · Troponin-I level, biomarker of myocardial injury, in newborns not requiring delivery-room.. · Resuscitation is comparable to normal pediatric & adult population independent of mode of delivery or maternal diabetes status..

Normative Values for Thyroid Volume and Tracheal Index in Healthy Turkish Newborns in an Iodine Sufficient Region.

The study aims to determine the normal values of thyroid volume and tracheal index in healthy term newborns born in an iodine-sufficient population. Additionally, we investigated the usability of a handheld device for assessing the tracheal index. Thyroid imaging was performed at 0-2 days and 15-30 days using handheld and portable ultrasound devices. Thyroid volume and tracheal index were calculated using standard formulas. A total of 144 healthy term newborns with a mean birth weight 3230 g were enrolled. The normal thyroid volume for the entire population was 0.66 ± 0.25 ml at 0-2 days, which significantly increased to 1.12 ± 0.33 ml at 15-30 days (p<0.01). There were no significant differences in thyroid volume between genders in either age group (p=0.246 and p=0.879). Thyroid volume correlated with birth weight, length, and head circumference, with the strongest correlation being with birth weight (r=0.404, p<0.001; r=0.252, p=0.002; r=0.223, p=0.007, respectively). The tracheal index at 0-2 days was 1.84±0.30 in girls, 1.82±0.27 in boys, and 1.83±0.29 overall. At 15-30 days, it was 1.99±0.23 in girls, 2.00±0.28 in boys, and 1.99±0.25 overall. Similar to thyroid volume, the tracheal index increased with age (p<0.01), with no significant gender differences in either age group (p=0.593 and p=0.886). Thyroid volume and tracheal index were moderately correlated in both measurements (rho=0.538, p<0.01). Measurements of the trachea, and thyroid lobe widths using portable and handheld ultrasound devices were correlated (r=0.449, p<0.01; r=0.638, p<0.01; r=0.497, p<0.01). There was also a correlation between tracheal index measurements using both devices in both the first and second measurements. This study provides normative data on thyroid volumes and tracheal index in newborns from an iodine-sufficient population. The tracheal index can estimate thyroid size when volume calculation is not feasible and handheld ultrasound devices are effective for this assessment.

Factors Affecting Successful Completion of the Neonatal Hearing Screening Test (Otoacoustic Emission Test) in the First Attempt in Healthy Term Newborns Prior to Discharge from the Hospital

Introduction: Hearing loss is one of the most prevalent congenital disorders in neonates. Infants with untreated hearing loss usually struggle greatly in terms of emotional, social, and verbal development. Early identification via neonatal hearing tests and preventive strategies have been advised in order to lessen the negative impacts of congenital hearing loss on the infant's life.Objectives: To assess the factors affecting the success of performing an otoacoustic emissions(OAE) test in stable term neonates.Methodology: A descriptive type of cross sectional study was carried out at Sri Jayewardenepura Hospital from 01/06/20222 to 01/09/2022. All healthy term neonates were included, and preterm and neonates associated with other medical conditions were excluded. Results: Out of 455 neonates, 422 (92.7%) were able to successfully complete the OAE test. 85.1% (n = 365) had a bedside sound level of 60dB-65 with a mean value of 61.62 dB at the time of OAE testing (p = 0.030). 134 (29.5%) neonates were breastfed (p = 0.281) and the majority of the newborns (n=367, 80.7%) were sleeping (p = 0.460) during the OAE test. Considering the factors affecting the successful outcome of the OAE testing, there is a statistically significant association with crying (p&lt;0.001,OR(95% CI) = 0.026 (0.010- 0.068)), struggling (p = 0.003), OR (95% CI) = 0.194 (0.58 - 0.647), debris in the external ear (p&lt;0.001) with OR (95% CI) = 0.019 (0.005 - 0.75), throat secretions (p &lt;0.001), and OR (95% CI) of 0. 122 (0.034 - 0.442), external ear abnormalities (p = 0.005), and OR (95% CI) = 0.169(0.041 - 0.686).Conclusion: Crying, struggling, debris in the external ear, throat secretions, external ear abnormalities, and the sound level (dB) at the time of the test are the factors that are statistically significantly associated with the success of the OAE test. Thus, to achieve a successful OAE test, it is pivotal to keep the baby in a calm state with an optimal bedside sound level.

Promotion of breastfeeding in Italian Maternity Hospitals: a pre-intervention study

BackgroundIn Italy, exclusive breastfeeding (EBF) rates at hospital discharge range unsatisfactorily between 20–97%.MethodsIn 2023, the Project for Hospital Policy on Breastfeeding (HPB) has been launched to promote breastfeeding in Italian Maternity Hospitals (MHs) as a joint initiative of the Italian Scientific Societies involved in perinatal care together with the National Midwife (FNOPO) and Nurse (FNOPI) Boards and with Vivere Onlus, a family association. The HBP Project has been designed as an uncontrolled before-after study to increase EBF rate at hospital discharge in the population of healthy, term infant with a normal weight at birth following an intervention bundle comprising: 1) Establishment of a local hospital Working Group; 2) Adoption of a hospital policy; 3) Implementation of breastfeeding monitoring; 4) Training for perinatal care professionals; 5) Enhanced implementation of the practices of skin-to-skin contact (SSC) and mother-baby rooming-in; 6) Development/Improvement of perinatal care protocols.ResultsWe report the pre-intervention assessment of 89 out of the 111 enrolled MHs (80.2%) at the beginning of the Project (Time 1 or T1). Almost all MHs (96.6%) have a multi-professional Breastfeeding Working Group, while a hospital policy on breastfeeding is available only in 48.2%. Moreover, only 56.2% of the 9,777 perinatal health workers have been trained in breastfeeding. Over a 1-month period, SSC has been practiced in the delivery room by 76.9% of 6,304 term healthy newborn infants and rooming-in by 83.4% of 6,735 healthy term newborns of normal weight at birth. Over a 4-month period, 69.1% of 33,367 healthy term newborns of normal birth weight were exclusively breastfed at hospital discharge. Noticeably, EBF rate of MHs ranges from 4% up to 100%, the second quartile being 73%.ConclusionAt T1 of the HPB Project, breastfeeding rates at hospital discharge for healthy, term infants with a normal weight at birth appear to be suboptimal among Italians MHs. Particularly, the range of EBF rates among participating centers is wide, with 50% of the MHs having EBF rate lower than 73%. Therefore, the ongoing HPB Project might represent not only an opportunity to increase the initiation of breastfeeding and to improve quality of health care in the whole study group of MHs, but possibly also to level differences between centers.

Factors associated with breastfeeding rates at 1 month of age: Focusing on newborn feeding behaviours in a Japanese maternity hospital.

This study investigated the relationship between newborn feeding behaviour and feeding type among month-old babies and explored maternal and neonatal factors associated with breastfeeding rates at 1 month of age. This observational study was conducted in Japan with healthy mothers and full-term newborns. Newborn feeding behaviours were assessed using the Japanese Infant Breastfeeding Assessment Tool (IBFAT) within approximately 1 day of birth. Obstetric and newborn characteristics, including newborn feeding behaviours, were investigated in relation feeding type (breast milk or mixed milk) at 1 month of age. This study included 176 mother-newborn pairs. IBFAT scores were significantly higher in the breast-milk group (Median (M) = 10.5, Interquartile Ranges (IQR): 9.0-11.0) than in the mixed-milk group (M = 10.0, IQR: 7.5-11.0) (P = 0.046). Additionally, the sucking pattern of breastfeeding was showing a greater distribution of higher scores in the breast-milk group (M = 2.0, IQR: 2.0-2.5) than in the mixed-milk group (M = 2.0, IQR: 1.5-2.5) (P = 0.015). Compared to mothers who received epidural analgesia or synthetic oxytocin, primiparas who did not receive them were more likely to breastfeed (epidural analgesia: (33.3% vs. 65.8%, P = 0.004); synthetic oxytocin: (42.0% vs. 78.6%, P = 0.018)). For multiparas, Apgar and IBFAT scores were associated with feeding type at 1 month of age. This study found that newborns' effective and sustained sucking within 1 day of birth is an important factor for breastfeeding at 1 month of age. When assessing feeding type, maternal factors such as epidural analgesia should be the focus for primiparas, while neonatal factors such as feeding behaviour should be prioritised for multiparas.

Effect of β-lactam antibiotics on the gut microbiota of term neonates

β-Lactam antibiotics are a class of antibiotics commonly used to treat bacterial infections. However, the effects of β-lactam antibiotics on term neonatal intestinal flora have not been fully elucidated. Hospitalized full-term newborns receiving β-lactam antibiotics formed the antibiotic group (n = 67), while those without antibiotic treatment comprised the non-antibiotic group (n = 47). A healthy group included healthy full-term newborns (n = 16). Stool samples were collected for 16 S rDNA sequencing to analyze gut microbiota variations. Further investigation was carried out within the β-lactam antibiotic group, exploring the effects of antibiotic use on the newborns’ gut microbiota in relation to the duration and type of antibiotic administration, delivery method, and feeding practices. The antibiotic group exhibited significant difference of microbial community composition compared to the other groups. Genera like Klebsiella, Enterococcus, Streptococcus, Alistipes, and Aeromonas were enriched, while Escherichia-Shigella, Clostridium sensu stricto 1, Bifidobacterium, and Parabacteroides were reduced. Klebsiella negatively correlated with Escherichia-Shigella, positively with Enterobacter, while Escherichia-Shigella negatively correlated with Enterococcus and Streptococcus. Regardless of neonatal age, β-lactam antibiotics induced an elevated abundance of Klebsiella and Enterococcus. The impact on gut microbiota varied with the duration and type of antibiotic (cefotaxime or ampicillin/sulbactam). Compared to vaginal delivery, cesarean delivery after β-lactam treatment heightened the abundance of Klebsiella, Enterobacteriaceae_Unclassified, Lactobacillales_Unclassified, and Pectobacterium. Feeding patterns minimally influenced β-lactam-induced alterations. In conclusion, β-lactam antibiotic treatment for neonatal pneumonia and sepsis markedly disrupted intestinal microbiota, favoring Klebsiella, Enterococcus, Streptococcus, Alistipes, and Aeromonas. The impact of β-lactam varied by duration, type, and delivery method, emphasizing heightened disruptions post-cesarean delivery.

Determination of Anterior Fontanelle Size among Apparently Healthy Term Newborns in North Central Nigeria.

Anterior fontanelles (AFs) of healthy newborn infants vary widely in size, this being a function of race, geographical location, gender, birth weight, mode of delivery and gestation. Abnormal variations in AF size portend a serious pathology of the cranium or intracranial structures. The established reference value for normal AF size is, therefore, an essential diagnostic tool. This study was conducted to determine the mean AF size and factors that are associated with its variability among apparently healthy term neonates in Lokoja, North Central Nigeria. AF size was measured in 200 healthy inborn term neonates between 24 and 48 h post-delivery using a modified version of Mattur's method. Other parameters measured were head circumference, birth weight and length. Relevant statistical methods were used for data analysis, and P < 0.05 at a confidence interval of 95% was considered statistically significant. Eighty-six (43%) of the babies were males, and the mean birth weight and gestation were 3.09 (0.37) kg and 38.8 (1.2) weeks, respectively. Majority (72%) were delivered spontaneously per vagina. The mean (± SD) AF size of the study neonates was 2.62 (0.72) cm (2.53 [0.61] cm in males and 2.69 [0.79] cm in females). Neither gender nor mode of delivery affected AF size significantly. There was no significant correlation between AF size and occipitofrontal circumference. AF size for term babies in our hospital differs from AF sizes reported from other parts of the world, further reiterating the utility of local/regional neonatal AF reference values.

Factors associated with feeding behavior in the early neonatal period focusing on early skin-to-skin contact and epidural analgesia: A prospective observational study at a single hospital in Japan

BackgroundThe feeding behavior of newborns is influenced by the conditions of both the mother and newborn before and after birth. AimsThis study aimed to investigate the factors associated with newborn feeding behavior, focusing on skin-to-skin contact (SSC) as a promoting factor and epidural analgesia as an inhibiting factor, using the Japanese version of the Infant Breastfeeding Assessment Tool (IBFAT). Study DesignProspective observational study conducted in Japan. ParticipantsA total of 176 pairs of healthy mothers and their healthy full-term newborns. Outcome MeasuresThe primary outcome was newborn feeding behaviors measured using the Japanese version of IBFAT within about one day of birth. Stepwise multiple regression analysis was performed to explore the relationship between IBFAT scores and variables that might influence newborn feeding behavior. ResultsMultiple regression analysis revealed that lower IBFAT scores were associated with a higher dose of epidural fentanyl (β = −0.40), and higher IBFAT scores were associated with a longer duration of SSC (β = 0.26), even after adjusting for gestational weeks and Apgar scores. The dose and duration of synthetic oxytocin administration were not associated with IBFAT scores in the multivariate analysis. ConclusionsOur study showed a dose-dependent relationship between fentanyl and SSC, suggesting that consistently implementing SSC for the maximum duration possible may enhance newborn feeding behaviors, which are reduced by fentanyl administration.

Optimizing Newborn Outcomes in Cesarean Sections: A Comparative Analysis of Stress Indicators under General and Spinal Anesthesia.

The moment of birth represents a complex physiological process that is followed by adaptive changes in the vital systems of the newborn. Such reactions have their positive but also negative effects. The aim of this research was to determine the difference in laboratory values of stress indicators in newborn children delivered by cesarean section (CS) with general and spinal anesthesia. We attempted to make a recommendation about the optimal type of anesthesia based on our results. The study was performed on 150 healthy term newborns delivered by urgent or planned CS. Samples for adrenocorticotropic hormone (ACTH), cortisol, triglycerides, and interleukin-6 (IL-6) were analyzed. Leukocyte numbers, triglycerides, and blood sugar values were normal for the newborns' age, with statistically significantly lower values of blood sugar and triglycerides in newborns delivered by CS in spinal anesthesia (p < 0.005) compared to general anesthesia. There were no significant differences in ACTH, cortisol, and IL-6 levels between those newborns delivered via CS after spinal or general anesthesia. In cases where vaginal delivery is not possible, when CS is indicated, the use of well-controlled spinal anesthesia is followed by lower degrees of metabolic, inflammatory, and stress responses and better vitality of the baby upon birth.

Full-Term and Preterm Newborns Differ More Significantly in Photoplethysmographic Waveform Variability than Heart Rate Variability.

Features of cardiovascular autonomic regulation in infants are poorly studied compared with adults. However, the clinical significance of autonomic dysfunction in infants is very high. The goal of our research was to study the temporal and frequency-dependent features, as well as low-frequency synchronization in cardiovascular autonomic regulation in full-term vs. preterm newborns, based on the analysis of their heart rate variability (HRV) and photoplethysmographic waveform variability (PPGV). The study included three groups of newborns: 64 full-term newborns (with a gestational age at birth of 37-40 weeks) with a physiological course of the neonatal adaptation; 23 full-term newborns (with a gestational age at birth of 37-40 weeks) with a pathological course of the neonatal adaptation; and 17 preterm newborns (with a postconceptional age of 34 weeks or more). We conducted spectral analysis of HRV and PPGV, along with an assessment of the synchronization strength between low-frequency oscillations in HRV and in PPGV (synchronization index). We employed several options for the boundaries of the high-frequency (HF) band: 0.15-0.40 Hz, 0.2-2 Hz, 0.15-0.8 Hz, and 0.24-1.04 Hz. Preterm newborns had higher heart rate, RMSSD, and PNN50 values relative to both groups of full-term newborns. Values of SDNN index and synchronization index (S index) were similar in all groups of newborns. Differences in frequency domain indices of HRV between groups of newborns depended on the considered options of HF band boundaries. Values of frequency domain indices of PPGV demonstrated similar differences between groups, regardless of the boundaries of considered options of HF bands and the location of PPG signal recording (forehead or leg). An increase in sympathetic influences on peripheral blood flow and a decrease in respiratory influences were observed along the following gradient: healthy full-term newborns → preterm newborns → full-term newborns with pathology. Differences in frequency domain indices of autonomic regulation between the studied groups of newborns depended on the boundaries of the considered options of the HF band. Frequency domain indices of PPGV revealed significantly more pronounced differences between groups of newborns than analogous HRV indicators. An increase in sympathetic influences on peripheral blood flow and a decrease in respiratory influences were observed along the following gradient: healthy full-term newborns → preterm newborns → full-term newborns with pathology.

Pregnancy outcomes in women with imported malaria in mainland France: A retrospective study from 2004 to 2014

ObjectivesThere is little data on pregnant women with imported malaria in high-income countries, especially regarding offspring outcomes. We wanted to determine pregnancy outcomes of imported malaria in pregnant women in mainland France. Patients and methodsWe conducted a retrospective, descriptive study of outcomes in pregnant women hospitalized with malaria from 2004 to 2014 in two regions of mainland France. An adverse outcome was defined as a miscarriage, stillbirth, preterm birth (<35 weeks of gestation), low birth weight (LBW) defined as less than 2500 g, or congenital malaria. ResultsOf 60 pregnancies, 5 were excluded because of elective abortions; 55 were investigated, of which 11 were primigravidae and 44 multigravidae. Pregnancies were singleton (n = 51) or twin (n = 4). Mean age was 30.4 years (range:19–45 y). Among the 55 cases, 9 ended in a miscarriage (8 singletons and 1 twin pregnancy) and 1 had a stillbirth at 21 weeks of gestation, all immediately after the malarial episode. 45 gave birth (29 vaginal deliveries and 16 caesarean sections) to 48 (42 singletons and 6 twins) newborns. Amongst these, 30 were healthy full-term newborns, 10 had LBW, and 8 were preterm. Overall, 26 of 55 (47.3%) pregnancies, and 29 of 59 (49.2%) offsprings had adverse outcomes. Compared to singleton pregnancies, twin pregnancies were associated with adverse outcomes (p = 0.0438). ConclusionsImported malaria has a severe impact on pregnancy outcomes. Prevention and management of imported malaria in pregnancy should be optimized.

Associations between heat wave during pregnancy and term birth weight outcomes: The PARIS birth cohort

BackgroundClimate change will make extreme weather events more frequent in the 21st century. Extreme ambient temperatures during the prenatal period have been associated with adverse pregnancy outcomes such as preterm birth. It is unclear, however, whether heat waves during pregnancy impact fetal growth in apparently healthy term newborns. ObjectivesWe aimed to investigate associations between heat wave during pregnancy and birth weight outcomes in term newborns from the PARIS birth cohort, and to explore meteorological conditions and air pollution as possible intermediate factors. MethodsWe examined data on 3,359 newborns born between 37 and 42 weeks in Paris, France, between 2003 and 2006. Associations of maternal exposure to heat wave (during whole pregnancy and each trimester) with birth weight and small for gestational age (SGA) at term were studied using linear and logistic regression models adjusted for potential confounders. Maternal characteristics were investigated as possible modifiers. We explored the mediating role of ambient temperature, relative humidity, and air pollution levels in the relationship between heat wave during the first trimester and term SGA. ResultsMothers who were pregnant during the 2003 French heat wave (n = 506, 15 %) were more likely to have a term SGA baby (aOR = 2.70; 95 %CI: 1.38, 5.28) compared to mothers who did not experience heat wave during pregnancy. The association was stronger when heat wave occurred during the first trimester (aOR = 4.18; 95 %CI: 1.69, 10.35). Primiparous women were identified as more vulnerable than multiparous women. Average ambient temperature and air quality index explained about 36 % and 56 % of the association between heat wave during the first trimester and term SGA, respectively. ConclusionsThis study suggests prenatal exposure to heat wave, especially during the first trimester, may adversely affect fetal growth of term newborns, which could be explained by both increasing ambient temperatures and worsening air quality.

Direct breastfeeding frequency of late preterm and term infants in the neonatal intensive care unit and availability of mother’s own milk at six months of age. a retrospective cohort study

BackgroundMother’s Own Milk (MOM) reduces the risk of complications in premature infants. Breastfeeding rates for late preterm and term infants in the neonatal intensive care unit (NICU) are significantly lower than that of breastfed healthy term newborns at 6 months of age.DesignThis was a retrospective cohort study of neonates born at 34 weeks 0 days or later. Infants who were directly breastfed in the NICU and were discharged on breast milk were included. Logistic regression modeling was used to determine the significance of association.Results171 mother-infant dyads were included. After adjusting for confounders, the number of breastfeeding attempts during the NICU stay was significantly associated with the availability of MOM at six months of age (p = 0.003, 95% CI 1.02 to 1.14).ConclusionThis study is the first to show an association between the number of direct breastfeeding attempts in the NICU and availability of MOM at six months of age.

Blood pressure in healthy term and late preterm newborns in Mexico City

Blood pressure in healthy term and late preterm newborns in Mexico City

Analysis of Serum Free Thyroxine Concentrations in Healthy Term Neonates Underlines Need for Local and Laboratory-Specific Reference Interval: A Systematic Review and Meta-Analysis of Individual Participant Data.

Background: Initial evaluation of the hypothalamus-pituitary-thyroid axis is done by measuring serum free thyroxine (fT4) and thyrotropin concentrations. For correct interpretation of these measurements, reliable age-specific reference intervals (RIs) are fundamental. Since neonatal fT4 RIs conforming to the Clinical and Laboratory Standards Institute guidelines are not available for all assays, we set out to create literature-based uniform age-specific neonatal fT4 RIs that may be used for every assay. Methods: For meta-analysis of individual participant fT4 concentrations, we systematically searched MEDLINE and Embase (search date December 6, 2023; PROSPERO registration CRD42016041871). We searched for studies reporting fT4 concentrations in healthy term newborns aged 2-27 days, born to mothers without thyroid disease in iodine-sufficient regions. Authors were invited to supply data. Due to standardization differences between assays, data could not be combined for meta-analysis directly, and we attempted to normalize the data using two distinct methods. Results: We obtained 4206 fT4 concentrations from 20 studies that used 13 different assays from 6 manufacturers. First, we set out to normalize fT4 data using the mean and standard deviation of (assay-specific) adult RIs. fT4 concentrations were transformed into Z-scores, assuming a normal distribution. Using a linear mixed-effects model (LMM), we still found a significant difference between fT4 concentration across studies (p < 0.001), after this normalization. As a second approach, we normalized the fT4 concentrations using data from a method/assay comparison study. We used the relationship between the Cobas assay and the other assays as a reference point to convert all values to Cobas values. However, this method also failed to produce consistent results, with significant differences between the normalized data (LMM p < 0.001). Conclusions: We conclude that our attempts at normalizing fT4 assay results were unsuccessful. Confounders related to our unsuccessful analysis may be assay related and/or biological. These findings have significant implications for patient care, since relying on RIs from literature may result in erroneous interpretation of results. Therefore, we strongly recommend to establish local RIs for accurate interpretation of serum fT4 concentrations in neonates.

Evaluation of serotonin levels in full-term newborns of diabetic mothers

BACKGROUND: The growth of neurological and mental diseases in the offspring of patients with pre- and gestational diabetes mellitus determines the need to study the regulatory function of the serotoninergic system of the brain in newborns. This plays a key role in its morphofunctional development in early ontogenesis, which is necessary for timely diagnosis of disorders and prevention of long-term consequences.&#x0D; AIM: The aim of this study was to evaluate serotonin levels in full-term newborns with diabetic fetopathy from mothers with pre- and gestational diabetes mellitus.&#x0D; MATERIALS AND METHODS: The main group consisted of 45 newborns with diabetic fetopathy, of whom 30 individuals were from mothers with type 1 diabetes mellitus and 15 ones from mothers with gestational diabetes mellitus. The control group comprised 20 healthy full-term newborns from healthy mothers without pregnancy complications. Serotonin concentrations were determined in platelet-rich plasma of blood from the umbilical cord vein, and in a platelet suspension prepared from venous blood taken on the first day of life, using high-performance liquid chromatography with electrochemical detection.&#x0D; RESULTS: Platelet-rich plasma serotonin level in umbilical cord blood taken from newborns of the main group was more than two times lower compared to children of healthy mothers. This parameter in venous blood taken from mothers with type 1 diabetes (0.744 ± 0.117 µmol/l) corresponded to that in healthy patients, while in mothers with gestational diabetes mellitus, it was significantly lower and amounted to 0.331 ± 0.071 µmol/l (p 0.05). Moreover, platelet-rich plasma serotonin level in all newborns correlated with that in their mothers (R = 0.505; p 0.05). Serotonin levels in venous blood platelets of newborns of the main group was almost 2.5 times lower than in healthy ones.&#x0D; CONCLUSIONS: The data obtained indicate the need to use platelet serotonin values as a biochemical marker of disorders of functional brain development in children with diabetic fetopathy.

Skin-to-skin transfer from the delivery room to the neonatal unit for neonates of 1,500g or above: a feasibility and safety study.

Immediate skin-to-skin contact (SSC) is already standard care for healthy term newborns, but its use for term or preterm newborns requiring admission to neonatal intensive care unit (NICU) with or without respiratory support is challenging. This study aimed to assess the safety and feasibility of SSC during the transfer of newborn infants, using a new purpose-built mobile shuttle care-station, called "Tandem". A monocentric prospective observational study was conducted at the tertiary referral center of the Université libre de Bruxelles in Brussels, Belgium after ethical approval by Hopital Erasme's Ethics Committee (ClinicalTrials.gov ID: NCT06198478). Infants born with a birth weight above 1,500 g were included. Following initial stabilization, infants were placed in SSC with one of their parents and transferred to the NICU using the Tandem. Out of 65 infants initially included, 64 (98.5%) were successfully transported via SSC using the Tandem. One transfer was not successful due to last minute parental consent withdrawal. The median (range) duration of continuous skin-to-skin contact after birth was 120 min (10-360). SSC transfers were associated with gradually decreasing heart rate (HR) values, stable oxygen saturation levels (SpO2), and no increase in median fraction of inspired oxygen (FiO2). Heatloss was predominantly observed during initial setup of SSC. There was no significant difference in the occurrence of tachycardia, desaturation or hypothermia between preterm and term neonates. No equipment failures compromising the transfer were recorded. Skin-to-skin transfer of infants with a birthweight of equal or above 1,500 g using the Tandem shuttle is feasible and associated with stable physiological parameters. This method facilitates early bonding and satisfies parents. ClinicalTrials.gov (NCT06198478).

Comparison of oxygen saturation values between term and pre-term neonates.

Objective: To determine mean oxygen saturation (SpO2) values in normal newborns and compare mean Spo2 values between term and preterm infants. Study Design: Descriptive Case Series. Setting: Hameed Latif Teaching Hospital Lahore. Period: March 2023 to November 2023. Material &amp; Methods: The study involved 100 neonates from operation theatre and labor room. Informed consent was obtained from parents. Immediately after birth, pulse oximeter was applied and serial monitoring of oxygen saturation was carried out starting at 1 minute and recording values after every 1 minute till 10 minutes of life. Results: There were 50% male and 50% female neonates. The average SpO2 values were 76.13±10.41 at first minute, 89.68±6.62 at 5 minutes &amp; 95.84±3.65 at 10 minutes of life. Mean SpO2 was significantly high in term babies as compared to preterm babies at one minute and 5 minutes. However there was no significant difference in mean SpO2 at 10 minutes in term and preterm babies. Conclusion: The process of transition to normal postnatal oxygen saturation requires more than 5 minutes in healthy newborns. In healthy term newborn, oxygen saturation rises slowly. SpO2 monitoring may help identifying the infants requiring resuscitation to avoid overexposure to high supplemental oxygen after birth. Many newborns have SpO2 &lt;90% during the first 5 minutes of life. This should be considered when choosing SpO2 targets for infants treated with supplemental oxygen in the delivery room.

Reference Ranges for Regional Cerebral Oxygen Saturation with Masimo O3 after Birth and Differences with Other Devices.

Cerebral oximetry using near-infrared spectroscopy (NIRS) is a noninvasive optical technology widely used in neonatology. The present study aimed to define reference ranges for cerebral tissue oxygen saturation (crSO2) with a new four-wavelength NIRS device, Masimo O3 oximeter, during immediate transition after birth and compare values with those obtained previously with NIRO 200NX®. This was a prospective observational study using Masimo O3 device to measure crSO2 and regional cerebral fractional tissue oxygen extraction (cFTOE) in healthy term newborns delivered by primary cesarean section, during the 15 minutes after cord clamping. The neonates who required any medical support were excluded. The NIRS sensor was placed on the right forehead. Peripheral oxygen saturation and heart rate were continuously measured by pulse oximetry. Previous studies which established centiles for crSO2 with NIRO 200NX were used for comparison. A total of 44 newborns were included. The median crSO2 and cFTOE (interquartile range) at 2, 5, and 7 minutes was 54% (49-54), 71% (64-86), and 79% (73-84) and 0,25 (0,18-0,33), 0,19 (0,15-0,23), and 0,16 (0,12-0,21), respectively, with no further changes afterwards. The crSO2 measurements were significantly higher with Masimo O3 compared with NIRO-200NX. The present observational study presented reference ranges for crSO2 and cFTOE measured with Masimo O3 oximeter during the immediate neonatal transition. Values obtained with O3 were higher than those obtained with other oximeters. For this reason, crSO2 is device-specific so there must be known reference values for each oximeter to define therapeutic interventions based on crSO2 and assess cerebral oxygenation in clinical studies. · Masimo O3 uses four wavelengths to measure regional oxygen saturation value.. · O3 values of crSO2 and cFTOE differ with other neonatal oximeters at birth.. · Knowledge of reference range of O3 at birth is essential to guide resuscitation..