Healthy Term Newborns Research Articles

Findings of ocular examinations in healthy full-term newborns.

To assess the anterior and posterior segments of full-term neonates over a 1.5-year period. The findings of full-term neonates who underwent ophthalmological examinations between June 2019 and December 2020 were analyzed, and the results were retrospectively recorded. The study comprised 2972 neonates with a mean birth week of 38.7 ± 1.2 weeks and a mean birth weight of 3235 ± 464 g. The neonates were examined on an average of 49.3 ± 18.9 postnatal days. Of the examined neonates, 185 (6.2%) showed abnormal ophthalmological findings, the most prevalent of which were retinal hemorrhage in 2.3% (n=68) and white changes in the peripheral retina in 1.9% (n=55) of the neonates. Cases of optic disc pathologies (n=20), choroidal nevus (n=10), iris-choroidal coloboma (n=5), subconjunctival hemorrhage (n=6), non-specific retinal pigmentary change (n=4), congenital cataract (n=3), posterior synechia (n=3), iris nevus (n=3), corneal opacity (n=1), choroidal coloboma (n=1), iris coloboma (n=1), buphthalmos (n=1), anophthalmos (n=1), microphthalmia (n=1), lid hemangioma (n=1), and vitreous hemorrhage (n=1) collectively accounted for approximately 2% of all neonates. Pathologies that could potentially impair vision, which were detected by ophthalmological examination, accounted for 1.2% of all neonates (n=37). The most prevalent finding of the ophthalmological examinations of neonates in the present study was retinal hemorrhage. Ophthalmological examinations of neonates can help in identifying diseases that may affect their vision and are curable or may lead to amblyopia in the long term.

Нейросонографические данные у условно здоровых детей и исходы нейроразвития в возрасте двух лет

The morbidity and mortality of premature newborns, as well as their subsequent physical and psychomotor development were analyzed in many studies. Significantly fewer studies focused on neurosonographic examination of healthy full-term babies and their neurological characteristics later in life. Objective. To assess the effectiveness of screening neurosonography performed immediately after birth in healthy, full-term newborns by subsequent evaluation of their neurological and psychomotor development at the age of two years. Patients and methods. This study included 121 healthy full-term newborns (body weight at birth ≥ 2500 g; gestational age 39–41 weeks) born in 2018 in Yerevan, Republic of Armenia. All study participants underwent neurosonography; their neurological development at the age of 2 years was evaluated by a pediatrician using the Bayley scale. Results. No cases of serious brain lesions and hemorrhages were registered in out cohort of healthy full-term newborns. The majority of them (79%) had normal neurosonography results. The most common findings included lenticulostriate vasculopathy (7.4%), hyperechogenicity in the trigone region (6.6%), subependymal pseudocysts (1.6%), vascular plexus cysts (3.0%), and asymmetry of the lateral ventricles (3.3%). Conclusion. By the age of 2 years, problems with motor development were detected in 2% of participants, intellectual disability in 2% of participants, and speech disorders in 11% participants. None of the children had severe disability. Key words: preterm newborns, brain lesions, neurosonography, neurological development

Functional brain maturation and sleep organisation in neonates with congenital heart disease.

Neonates with Congenital Heart Disease (CHD) have structural delays in brain development. To evaluate whether functional brain maturation and sleep-wake physiology is also disturbed, the Functional Brain Age (FBA) and sleep organisation on EEG during the neonatal period is investigated. We compared 15 neonates with CHD who underwent multichannel EEG with healthy term newborns of the same postmenstrual age, including subgroup analysis for d-Transposition of the Great Arteries (d-TGA) (n=8). To estimate FBA, a prediction tool using quantitative EEG features as input, was applied. Second, the EEG was automatically classified into the 4 neonatal sleep stages. Neonates with CHD underwent neurodevelopmental testing using the Bayley Scale of Infant Development-III at 24 months. Preoperatively, the FBA was delayed in CHD infants and more so in d-TGA infants. The FBA was positively correlated with motor scores. Sleep organisation was significantly altered in neonates with CHD. The duration of the sleep cycle and the proportion of Active Sleep Stage 1 was decreased, again more marked in the d-TGA infants. Neonates with d-TGA spent less time in High Voltage Slow Wave Sleep and more in Tracé Alternant compared to healthy terms. Both FBA and sleep organisation normalised postoperatively. The duration of High Voltage Slow Wave Sleep remained positively correlated with motor scores in d-TGA infants. Altered early brain function and sleep is present in neonates with CHD. These results are intruiging, as inefficient neonatal sleep has been linked with adverse long-term outcome. Identifying how these rapid alterations in brain function are mitigated through improvements in cerebral oxygenation, surgery, drugs and nutrition may have relevance for clinical practice and outcome.

Sonographic Measurement of Brainstem Through the Foramen Magnum in Premature Neonates Can Predict Neurodevelopment Outcome?

Background: To investigate whether serial morphometric measurements of the brainstem using high resolution trans-foramen-magnum ultrasound (US) in premature neonates correlate with neurological outcomes.Methods: Serial brain ultrasound scans were performed in 36 consecutive preterm infants born at <34 weeks of gestation from birth until term-equivalent age. Two-dimensional brainstem measurements of the pons and medulla oblongata were compared with those in a cohort of 67 healthy full-term newborns. Neurologic assessment of the premature infants was assessed at 5 years of age.Results: Of the 36 preterm infants born between 25 and 34 weeks of gestation, eight had significantly delayed growth profiles in both the pons and medulla and developed neurological sequelae by 5 years of age.Conclusions: Morphometric measurements of the developing brainstem using high resolution trans-foramen-magnum ultrasound (US) may help predict neurological outcome in high-risk neonates, particularly in those who are born extremely premature.

Metabolomic Profile at Birth, Bronchiolitis and Recurrent Wheezing: A 3-Year Prospective Study

There is growing interest for studying how early-life influences the development of respiratory diseases. Our aim was to apply metabolomic analysis to urine collected at birth, to evaluate whether there is any early metabolic signatures capable to distinguish children who will develop acute bronchiolitis and/or recurrent wheezing. Urine was collected at birth in healthy term newborns. Children were followed up to the age of 3 years and evaluated for the development of acute bronchiolitis and recurrent wheezing (≥3 episodes). Urine were analyzed through a liquid-chromatography mass-spectrometry based untargeted approach. Metabolomic data were investigated applying univariate and multivariate techniques. 205 children were included: 35 had bronchiolitis, 11 of whom had recurrent wheezing. Moreover, 13 children had recurrent wheezing not preceded by bronchiolitis. Multivariate data analysis didn’t lead to reliable classification models capable to distinguish children with and without bronchiolitis or with recurrent wheezing preceded by bronchiolitis neither by PLS for classification (PLS2C) nor by Random Forest (RF). However, a reliable signature was discovered to distinguish children who later develop recurrent wheezing not preceded by bronchiolitis, from those who do not (MCCoob = 0.45 for PLS2C and MCCoob = 0.48 for RF). In this unselected birth cohort, a well-established untargeted metabolomic approach found no biochemical-metabolic dysregulation at birth associated with the subsequent development of acute bronchiolitis or recurrent wheezing post-bronchiolitis, not supporting the hypothesis of an underlying predisposing background. On the other hand, a metabolic signature was discovered that characterizes children who develop wheezing not preceded by bronchiolitis.

Reference Range of Complete Blood Count in Healthy Term Newborns 1 Week after Birth

BACKGROUND: Determination of the complete blood count (CBC) and reticulocyte reference range helps diagnose a disease related to changes in erythrocyte indices, white blood count, platelets, and reticulocytes, especially in newborns. AIM: The aim study is to establish a reference range for CBC and reticulocyte in healthy term newborns 1 week after birth. MATERIAL AND METHODS: The study method is prospective analyses of CBC and reticulocyte in term newborns within 1 week after birth. Inclusion criteria are term newborn (gestational age 37–42 weeks) with good tone, breathing, or crying immediately, do not have resuscitation, and the birth weight is ≥2500 g. RESULTS: Two hundred and seventy-seven term newborns met the inclusion criteria. There were 145 (52.35%) male infants and 132 (47.65%) female infants. The reference range of newborns for hemoglobin (Hb) at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 standard deviation (SD) was 11.70–19.60 g/dL, 11.90–19.57 g/dL, 12.20–19.20 g/dL, and 11.35–19.63 g/dL, respectively. In addition, reference range of male newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2SD was 12.20–20.14 g/dL, 12.28–19.91 g/dL, 12.63–19.38 g/dL, and 11.47–20.15 g/dL, respectively. The reference range of female newborns for Hb at P2.5–P97.5, P3–P97, P5–P95, and mean ± 2 SD was 11.37–19.20 g/dL, 11.50–19.20 g/dL, 11.80–19.20 g/dL, and 11.37–18.93 g/dL, respectively. CONCLUSION: The reference range of CBC and reticulocyte for healthy term newborns, male newborns, and female newborns in this study can be used as a benchmark.

Role of Cord Blood Albumin and Bilirubin for Prediction of Significant Neonatal Jaundice

Introduction: Nearly 60-80% of the term and preterm neonates are affected due to rise in bilirubin levels during early postnatal days, and causes readmission of the neonate sometimes with severe jaundice, which can be reduced if neonatal hyperbilirubinemia can be predicted early. The study was conducted to evaluate the predictive values of cord blood albumin and bilirubin for neonatal hyperbilirubinemia and to evaluate the better predictor between them. Method: In this hospital based observational study, 152 healthy term newborns with birth weight more than 2.5 kg were included. Assessment of cord blood haemoglobin, blood group, albumin and bilirubin levels was done. Follow-up for first consecutive five days after birth was done and assessed daily to look for evidence of jaundice, sepsis or any other illness. Serum bilirubin was evaluated at 72-96 hours of life in all neonates and was done early, if clinically indicated. Receiver’s Operating Characteristics curves were used for calculating the cut-off values of cord blood albumin and bilirubin in relation to hyperbilirubinemia. Result: The cut-off values obtained for albumin and bilirubin of cord blood was &lt; 2.56 mg/dL and &gt;2.33 mg/dL respectively at optimum sensitivity and specificity. Cord blood bilirubin was found to be highly sensitive for early recognition of significant neonatal hyperbilirubinemia as compared to cord blood albumin and can be used for screening purpose. Conclusion: Cord blood albumin and bilirubin can be used for negating the development of NNHB, but for screening purpose, cord blood bilirubin is more predictive of neonatal hyperbilirubinemia.

Right ventricular anatomical and functional parameters in healthy Mexican term newborns

Right ventricular anatomical and functional parameters in healthy Mexican term newborns

The Assessment of the Relationship among Bilirubin in Cord Blood and Venous Blood during the Intensive Care Unit Stay of Infants with Jaundice

Aim: Newborn babies who are released from the hospital at a younger postnatal age are more likely to be hospitalized to the nursery due to neonatal jaundice. This readmission is undoubtedly a significant source of strain in the nurseries, but it may be addressed by adequate assessment prior dismissing the newborn. The purpose of this study was to see if there was a link among cord blood bilirubin and vein bilirubin on the third day of life.&#x0D; Methods: On 120 healthy term newborns, a cross-sectional description research was conducted. Blood was drawn from the child's cord right after birth, whether vaginally or through caesarean surgery, for total serum bilirubin, unconjugated serum bilirubin levels, and conjugated serum bilirubin levels. On the third day (72 hours), a second serum blood sample is obtained from peripheral venous blood, and total serum bilirubin, unconjugated serum bilirubin, and conjugated serum bilirubin levels are measured again. The research was carried out over a one-year period, from March 2020 to February 2021.&#x0D; Results: The babies were divided into two groups: those with hyperbilirubinemia and those without. The findings acquired from aggregate and stratified samples demonstrate a significant association 0.542 and P-value 0.001 among serum cord blood bilirubin and peripheral venous blood bilirubin.&#x0D; Conclusion: There is a link among elevated bilirubin levels in normal infants born and serum cord blood bilirubin levels. The increase in serum cord blood bilirubin levels correlates with both the increase in peripheral venous blood bilirubin on the third day of life.

Mother’s Bed Incline and Desaturation Episodes in Healthy Term Newborns during Early Skin-to-Skin Contact: A Multicenter Randomized Controlled Trial

Introduction: Early skin-to-skin contact (ESSC) is associated with rare, sudden, unexpected postnatal collapse episodes. Placing the newborn in ESSC closer to an upright position may reduce the risk of airway obstruction and improve respiratory mechanics. This study assessed whether a greater inclination of the mother’s bed during ESSC would reduce the proportion of healthy term newborns (HTNs) who experienced episodes of pulse oximeter saturation (SpO₂) <91%. Methods: We conducted a multicenter randomized controlled trial comparing the effect of the mother’s bed incline, 45° versus 15°, on desaturation in HTNs during ESSC. Before delivery on 1,271 dyads, randomization was conducted, and stringent criteria to select healthy mothers and term newborns were monitored until after birth. Preductal SpO₂ was continuously monitored between 10 min and 2 h after birth. The primary outcome was the occurrence of at least one episode of SpO₂ <91%. Results: 254 (20%) mother-infant dyads were eligible for analysis (45°, n = 126; 15°, n = 128). Overall, 57% (95% confidence interval [CI]: 51%–63%) of newborns showed episodes of SpO₂ <91%. The proportion of infants with SpO₂ <91% episodes was 52% in 45° and 62% in 15° (relative risk: 0.80; 95% CI: 0.6–1.07). Conclusions: We did not show that a high mother bed inclination during ESSC led to significantly fewer HTNs who experienced episodes of SpO₂ <91%. Desaturation episodes from 10 min to 2 h after birth occurred in more than half of HTNs.

About the absence of the need to prescribe antibacterial therapy to newborns from mothers with clinical chorioamnionitis

Background. The diagnosis of a woman in labor chorioamnionitis (CA) implies a high risk of infectious complications for the mother and fetus, which determines the need for additional examination of infants and the decision on the appointment of antibacterial therapy. The purpouse of this study was determine the need to administration antibiotic therapy to full-term newborns from mothers diagnosed with chorioamnionitis. Materials and methods. 113 full-term newborns were examined, of which the main group consisted of children whose mothers were diagnosed with chorioamnionitis (n = 77), the comparison group children born to healthy mothers (n = 36). All children performed clinical and laboratory monitoring, including a clinical analysis of capillary blood in the first 24 hours of life; determination of the level of C-reactive protein (CRP) in venous blood on the 3rd day of life. Bacteriological examination of newborns included sampling of material from the ear fold, buccal mucosa, umbilical cord blood, as well as the contents of the tracheobronchial tree (TBD) during respiratory therapy with mechanical ventilation. Special research methods included studies of the proinflammatory cytokines (IL-1, IL-6) in umbilical cord blood. Histological CA was diagnosed in the presence of morphological and functional signs of inflammation in the placenta. Results. Newborns of the main group more often developed respiratory disorders requiring respiratory and oxygen therapy (p = 0,045). The production of IL-1, IL-6 in umbilical cord blood in the examined newborns of the main group was higher than in the comparison group [Odds Ratio (OR) 8.4; 95% Confidence Interval (CI): 1.067.9; OR 7.4; 95% CI: 2.521.7 respectively]. The study of blood samples revealed leukocytosis (34109) 6.5% vs 0%, p 0.05) and a shift in the leukocyte count to young forms of neutrophils (45.4% vs 16.7%, p 0.05) in the peripheral blood of infants of the main group. Infants exposed to maternal clinical chorioamnionitis had increased level of CRP 10.3 times more frequent (95% CI: 2.837.1) than in newborns in the comparison group. With dynamic clinical and laboratory monitoring, 72 children of the main group (93.5%) had no data for the course of the infection, as a result of which they did not receive antibiotic therapy. Conclusion: Administration antibiotic therapy to clinically healthy full-term newborns from mothers diagnosed with chorioamnionitis is unjustified. Infants of this group require clinical laboratory, dynamic observation with laboratory control, including a clinical blood test and determination of the CRP level, which is a preferred alternative to the appointment of antibiotic therapy.

Increased circulating cytokeratin 19 fragment levels in preterm neonates receiving mechanical ventilation are associated with poor outcome.

Invasive mechanical ventilation and oxygen toxicity are postnatal contributors to chronic lung disease of prematurity, also known as bronchopulmonary dysplasia (BPD). Cyfra 21-1 is a soluble fragment of cytokeratin 19, which belongs to the cytoskeleton stabilizing epithelial intermediate filaments. As a biomarker of structural integrity, Cyfra 21-1 might be associated with airway injury and lung hypoplasia in neonates. Serum Cyfra 21-1 concentrations for 80 preterm and 80 healthy term newborns were measured within 48 h after birth. Preterm infants with the combined endpoint BPD/mortality had significantly higher Cyfra 21-1 levels compared with those without fulfilling BPD/mortality criteria (P = 0.01). Also, severe RDS (>grade III) was associated with higher Cyfra levels (P = 0.01). Total duration of oxygen therapy was more than five times longer in neonates with high Cyfra 21-1 levels (P = 0.01). Infants with higher Cyfra 21-1 values were more likely to receive mechanical ventilation (50% vs. 17.5%). However, the duration of mechanical ventilation was similar between groups. The median Cyfra value was 1.93 ng/mL (IQR: 1.68-2.53 ng/mL) in healthy term neonates and 8.5 ng/mL (IQR: 3.6-16.0 ng/mL) in preterm infants. Using ROC analysis, we calculated a Cyfra cutoff > 8.5 ng/mL to predict BPD/death with an AUC of 0.795 (P = 0.004), a sensitivity of 88.9%, and a specificity of 55%. Mortality was predicted with a cutoff > 17.4 ng/mL (AUC: 0.94; P = 0.001), a sensitivity of 100%, and a specificity of 84%. These findings suggest that Cyfra 21-1 concentration might be useful to predict poor outcome in premature infants.

Ontogeny of plasma cytokine and chemokine concentrations across the first week of human life.

Introduction/background & aims:Early life is marked by distinct and rapidly evolving immunity and increased susceptibility to infection. The vulnerability of the newborn reflects development of a complex immune system in the face of rapidly changing demands during the transition to extra-uterine life. Cytokines and chemokines contribute to this dynamic immune signaling network and can be altered by many factors, such as infection. Newborns undergo dynamic changes important to health and disease, yet there is limited information regarding human neonatal plasma cytokine and chemokine concentrations over the first week of life. The few available studies are limited by small sample size, cross-sectional study design, or focus on perturbed host states like severe infection or prematurity. To characterize immune ontogeny among healthy full-term newborns, we assessed plasma cytokine and chemokine concentrations across the first week of life in a robust longitudinal cohort of healthy, full-term African newborns.Methods:We analyzed a subgroup of a cohort of healthy newborns at the Medical Research Council Unit in The Gambia (West Africa; N = 608). Peripheral blood plasma was collected from all study participants at birth (day of life (DOL) 0) and at one follow-up time point at DOL 1, 3, or 7. Plasma cytokine and chemokine concentrations were measured by bead-based cytokine multiplex assay. Unsupervised clustering was used to identify patterns in plasma cytokine and chemokine ontogeny during early life.Results:We observed an increase across the first week of life in plasma Th1 cytokines such as IFNγ and CXCL10 and a decrease in Th2 and anti-inflammatory cytokines such as IL-6 and IL-10, and chemokines such as CXCL8. In contrast, other cytokines and chemokines (e.g. IL-4 and CCL5, respectively) remained unchanged during the first week of life. This robust ontogenetic pattern did not appear to be affected by gestational age or sex.Conclusions:Ontogeny is a strong driver of newborn plasma-based levels of cytokines and chemokines throughout the first week of life with a rising IFNγ axis suggesting post-natal upregulation of host defense pathways. Our study will prove useful to the design and interpretation of future studies aimed at understanding the neonatal immune system during health and disease.

The effectiveness of swaddling and maternal holding applied during heel blood collection on pain level of healthy term newborns; randomized controlled trial

ABSTRACT This study was a prospective, randomized controlled trial. The study sample consisted of 105 healthy neonates who conformed to the case selection criteria. Neonates were randomly assigned to the following groups: swaddling (S), maternal holding (MH), and controls (C). The study data were obtained using an information form and the Neonatal Infant Pain Scale (NIPS). There were no statistically significant differences between total crying times (C: 81.14 ± 44.93; S:79.28 ± 40.74; MH: 69.42 ± 31.10 sec.) and the time to first calming (C: 71.28 ± 50.87; S: 59.74 ± 42.40; MH: 54.85 ± 35.61) of heel stick procedures between all groups (p>.05). It was observed that procedural pain levels were the lowest in the maternal holding group (5.57 ± 1.24), followed by swaddling (5.82 ± 0.92), and the control group (6.40 ± 0.91). As a result, both swaddling and maternal holding are effective at reducing pain felt during heel stick procedures, but mother holding may be preferred as a priority rather than swaddling. Trial registration: ClinicalTrials.gov identifier: NCT04625010.

Red cell distribution width as a prognostic marker in septic neonates versus healthy term newborns

Background: We evaluated the usefulness of RDW (red cell distribution width) as a diagnostic tool in newborn sepsis. Several biomarkers for sepsis have been studied including CRP (C-reactive protein), procalcitonin, interleukins, total WBC count (TC) absolute neutrophil count (ANC), ratio of immature neutrophils to total neutrophils (I/T ratio). An ideal biomarker for sepsis is still elusive. Hence we evaluated RDW as a sepsis marker as it was cheap and available. The objective of the study was to evaluate the role of RDW as a prognostic marker in newborn sepsis compared to healthy newborns.Methods: The study sample comprised of two groups (cases and control group) each with 40 neonates. Group 1 (cases group) comprised 40 newborns with suspected/probable sepsis based on clinical or laboratory parameters. In group 1 (suspected/probable sepsis) RDW was done at the time of suspicion of sepsis along with other relevant investigations. According to the clinical course these parameters were repeated 24-48 hrs after first value. Group 2 (control group) comprised 40 normal newborns in the postnatal ward. For the control group blood sampling for CBC and RDW was done simultaneously along with blood sampling for newborn screening.Results: On comparing the baseline variables there is no significant difference among cases and control group with respect to gender distribution, age in days, gestational age in weeks and birth weight. The mean RDW among the cases group was significantly higher than among the control group. In ROC analysis we obtained a cut off value of RDW of 17.25 is helpful to diagnose sepsis with reasonable sensitivity (70%) and specificity (60%).Conclusions: This study revealed that RDW may also be included in the diagnosis of sepsis in newborns as it is a simple, inexpensive, available and easily repeated test as it is routinely done with a complete blood count.

Glucose Profiles in Healthy Term Infants in the First 5 Days: The Glucose in Well Babies (GLOW) Study.

In this study, the plasma and interstitial (GCMS) glucose levels were measured in term healthy newborns for a period of 5 days to understand the changes in the glucose levels after birth. The findings suggest that in normal term healthy newborns if hypoglycaemia persists after the 4th day of life, then further investigations are needed to rule out other causes of persistent hypoglycaemia.

Prognostic model for determining the probability of congenital pneumonia in full-term newborns

According to the data of the World Health Organization, pneumonia is one of the leading causes of death in children under five years of age. Objective: to develop a prognostic model to determine the factors associated with the development of congenital pneumonia in full-term newborns. A comprehensive survey of 116 full-term newborns who were in the pediatric Department for newborn children and the Maternity Physiological Department of the State Institution “Republican Scientific and Practical Center “Mother and Child” in the period from 2017 to 2019 was conducted. The study group consisted of 53 healthy full-term newborns with congenital pneumonia, born at the gestational age of 39.50 ± 0.69 weeks, body weight 3337.50 ± 354.42 g and a body length of 52.20 ± 2.13 cm. The control group consisted of 63 healthy full-term babies born at gestational age of 39.30 ± 0.63 weeks, body weight 3417.30 ± 253.82 g and a body length of 52.50 ± 1.57 cm. The survey revealed the most significant factors associated with the development of congenital pneumonia in full-term newborns: from the obstetric-gynecological and somatic history of the mother’s life — spontaneous miscarriage; from the complications of pregnancy — chronic intrauterine fetal hypoxia; the placenta study determined the presence of inflammatory changes in the placenta; clinical manifestations within the first 72 hours of life included respiratory failure. Based on the data obtained, a model with sensitivity equal to 92.5 %, specifi­city 92.1 % and an area under ROC-curve (AUC) 0.94 ± 0.054, p &lt; 0.001 (95% CI 0.90–0.99). Using a prognostic model, thre­shold values were calculated: for spontaneous miscarriage — 0.810; chronic intrauterine fetal hypoxia — 0.289; inflammatory changes in the placenta — 0.565; the presence of respiratory failure — 0.928, which at threshold values ≥ 0.56 ROC-curve allows identify a high risk group for the development of congenital pneumonia among full-term newborns.

MP51-08 VOIDING PATTERN IN HEALTHY TERM NEWBORNS: A 24 HOURS VOLUME/FREQUENCY CHART USING ALARM BELLS

You have accessJournal of UrologyPediatric Urology IV (MP51)1 Sep 2021MP51-08 VOIDING PATTERN IN HEALTHY TERM NEWBORNS: A 24 HOURS VOLUME/FREQUENCY CHART USING ALARM BELLS Dmitry Khunovich, Alexander Tsivian, Ami Sidi, and David Ben Meir Dmitry KhunovichDmitry Khunovich More articles by this author , Alexander TsivianAlexander Tsivian More articles by this author , Ami SidiAmi Sidi More articles by this author , and David Ben MeirDavid Ben Meir More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002077.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The frequency/volume chart is an excellent screening method for the evaluation of voiding disorders in children. It is simple and practical and provides relevant information on daily voiding patterns. For the evaluation of suspected pediatric bladder dysfunction, a 4-hour observation period has been used in Sweden for more than a decade. Voiding patterns in healthy neonates are characterized by small, frequent voids of varying volumes. Their voiding frequency is 10 to 15 times per day until almost 12 months of age; some have suggested that normalization of urinary flow begins after the first year of life with decrease of urinary frequency to 8–10 times per day at the age of 2–3 years. It is often necessary to evaluate the bladder function in neonates with overt or suspected neuropathic bladder. However, there are no reference values for a 24-hour observation for this age group. To our knowledge, this study is the first evaluating the voiding pattern in newborns during a consecutive 24-hour period. Aim 1st- To obtain a more comprehensive data on the voiding patterns in newborns using 24-hour observations. The secondary end point of the study was the observation on defecation patterns. METHODS: Healthy newborns. 24-hour long observation period of voiding parameters. The diaper was equipped with an alarm bell (Malem™ Audio Alarm (MO3). The residual volume was not measured. RESULTS: 24 newborns completed the study, 11 girls and 13 boys, aged 7 to 49 hours (median, 19.5). The median birth age was 39.1 weeks (range 38.2-41.2), median weight was 3.284 kg (range 2.7-3.998). There was no correlation between age, height, or body weight and any micturition parameter. Neither were there any differences between girls and boys. The newborns voided 2 to 10 times during the 24-hour observation period with a median frequency of 6. The voided volume (VV) range was 10-39 ml (median 16 ml). The maximal VV in each infant was 12 to 53 ml (median, 26 ml). All but 1 infant voided within 24 hours of birth, the range was 1-36 hours (median 8.5). One infant voided for the 1st time 36 hours after birth without any obvious reason. Defecations were recorded in 23 infants during the 24-hour observation period with frequency of 0 to 7 (median, 3). CONCLUSIONS: This pilot study found that healthy newborns voids with a median frequency of 6 during a 24-hour observation period and not once an hour as previously suggested. 4-hour observation, evaluating infants and pre-toiled trained children, is insufficient. 24-hour observation should be used and may be effectively done using alarm bell. Source of Funding: No © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e899-e899 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dmitry Khunovich More articles by this author Alexander Tsivian More articles by this author Ami Sidi More articles by this author David Ben Meir More articles by this author Expand All Advertisement Loading ...

FIRST LIVE BIRTHS AFTER APPLICATION OF A READY-TO-USE IONOMYCIN IN CASES OF FAILED ARTIFICIAL OOCYTE ACTIVATION (AOA) USING CALCIMYCIN

This case series was set up to rescue cycles of previous non-responders to conventional AOA. Within a 2-year period eight couples showing total fertilization failure after single and double calcimycin treatment, respectively, were identified. These patients with no fertilization in two treatment cycles had all their mature oocytes treated with a ready-to-use ionomycin solution in the subsequent study cycle. Fertilization rate was found to be 31.3% (15/48). Three patients experienced recurrent fertilization failure again. Out of 5 transfers three biochemical pregnancies occurred and two of them resulted in the birth of a healthy male full-term newborn. Thus, the associated live-birth rate in this bad prognosis patient cohort was 25%. Ready-to-use ionomycin is a potential treatment option for AOA once other techniques have failed, and as such would allow for the usage of homologous instead of donor gametes.

Right ventricular anatomical and functional parameters in healthy Mexican term newborns.

Objective:Right ventricle (RV) function plays an important role during fetal and neonatal transitional circulation. Despite the published echocardiography guidelines in children including neonates, there is scare evidence on RV assessment using echocardiography in Mexican neonates. This study was aimed at assessing RV function and anatomical measures in healthy term newborns and defines normal values in this cohort of patients.Methods:A prospective study involving healthy term newborns in a single center were enrolled in the study to assess RV, all patients were recruited within 24-72 h after birth. The right ventricular assessment was performed as per American Society of Echocardiography’s guidelines.Results:Seventy healthy term newborns with a median gestational age of 38 (38.5 ± 2.7) weeks had RV function assessment and anatomical structures measures with a predefined ten echocardiographic parameters protocol. The mean values for: tricuspid valve diameter was 13 mm ± 1.8, basal diameter of the RV 16.7 mm ± 2, RV length 27.8 mm ± 2.2, mid cavity diameter 14.3 mm ± 1.7, RV-anteroinferior basal diameter 21.5 mm ± 2.5, tricuspid regurgitation gradient 13.3 mmHg ± 5.9, tricuspid annular plane systolic excursion 8.7 mm, right ventricular fractional area change (RVFAC) 4 chamber (%) 40.6 ± 7.5, tricuspid E/A 0.7 ± 0.5, myocardial velocities (cm/s) E´ 8 ± 2.7, A´ 9.6 ± 2.4, S´ 6.9 ± 1.2, myocardial performance index 0.5 ± 0.1, RVFAC 3 chamber (%) 37.8 ± 15.8, and pulmonary acceleration time mean value 58.8 ± 14.9. Flattening of interventricular septum was seen in 13% infants.Conclusions:This study describes echocardiographic parameters for anatomical structures and assessment of RV function in healthy term newborns during transitional circulation. We reported novel anatomical measures of the RV; this information can provide normal reference range values and be referenced while assessing RV function in normal and sick newborns during transitional circulation.