Age Infants Research Articles

Approach to Complementary Feeding and Infant Language Use: An Observational Study

ABSTRACTEmerging research suggests that a more infant‐led approach to complementary feeding may confer benefits for child language, but these findings are based on parent report studies. Using an observational approach this study examines whether different complementary feeding experiences relate to infant language exposure and language use. Fifty‐eight parents recorded a typical infant mealtime in the home (mean infant age = 14 months, SD = 4.15). Observations were coded to measure the prevalence of infant‐led and parent‐led feeding using the Family Mealtime Coding Scheme. Caregiver language use (word types and token directed at the child, mean length of utterances in child‐directed speech, responsiveness and initiations) and the number of infant vocalisations were coded in ELAN using CHAT conventions and parents completed the MacArthur Communicative Development Inventory short form as a measure of child language. Greater observed infant self‐feeding was significantly associated with greater observed exposure to language from caregivers (r = 0.312 percentage of infant self‐feeding correlated with caregiver word types directed at the child) and a greater number of infant vocalisations (r = 0.320 percentage of infant self‐feeding correlated with number of child vocalisations produced). Structural Equation Modelling showed the relationship between infant self‐feeding and infant vocalisations to be significantly mediated by enhanced quality and quantity of caregiver child‐directed speech (model fit: χ2 [5] = 5.01, p = 0.415, CFI = 1.00 [NF = 0.98], RMSEA = 0.006). Differences in the approach to complementary feeding may shape infant's experiences in ways that support language exposure and use. Autonomy associated with infant self‐feeding may enhance opportunities for social interaction.

Prenatal iodine intake and infant temperament in a multiethnic US cohort.

Maternal iodine plays a central role in fetal neurodevelopment. It is recommended that pregnant women consume sufficient levels of iodine to accommodate increased need for mother and fetus. We examined associations among prenatal dietary and supplemental iodine intake and infant temperament. The PRogramming of Intergenerational Stress Mechanisms (PRISM) study is an ongoing longitudinal pregnancy cohort. Data from 2011 to 2020 were used for this study. Women completed the Block98 FFQ ascertaining prenatal dietary and supplemental iodine intake and the Infant Behavior Questionnaire-Revised at infant age 6 months to ascertain infant temperament (Surgency/Extraversion, Negative Affectivity and Orienting/Regulation). USA. Mother-child dyads (n 892). Women were primarily Black/Hispanic Black (44 %) and non-Black Hispanic (35 %) with 46 % reporting household income < $25 000/year. Nearly half had an estimated average requirement (EAR) < 160 µg/d (49 % based on dietary intake; 43 % based on diet and supplements). Girls born to women with an EAR ≥ 160 µg/d compared to girls born to women below this level had higher unadjusted extraversion scores for dietary plus supplemental intake (β = 0·23 (0·13, 0·33)); decreased to β = 0·05 (-0·08, 0·19) after adjusting for covariates. Boys born to women with an EAR ≥ 160 µg/d (based on diet and supplements) as compared to boys born to women below this level had statistically non-significant higher unadjusted negative affective score (β = 0·06 (-0·08, 0·20)) that became significantly lower upon covariate adjustment (β = -1·66 (-1·97, -1·35)). A significant proportion of these women reported suboptimal prenatal iodine intake. Suboptimal prenatal iodine intake may have implications for child neurodevelopment evident as early as infancy.

Untargeted Lipidomic Profiling of Amniotic Fluid Reveals Dysregulated Lipid Metabolism in Healthy Normal-Weight Mothers with Fetal Macrosomia

Background: Alterations in maternal lipid metabolism have been elucidated by several studies in relation to macrosomia. However, the lipidome of the intrauterine compartment associated with macrosomia, particularly in early pregnancy, remains largely unknown. Objectives: (1) To compare the lipidomic profile of early 2nd trimester amniotic fluid (AF) of healthy mothers with normal body mass index who gave birth to large-for-gestational age (LGA) versus appropriate-for-gestational age (AGA) infants; and (2) to examine if insulin and glucose concentrations in AF were associated with the AF lipidomic profile. Methods: In this nested case–control study, bio-banked AF samples were collected from pregnant women undergoing routine amniocentesis at 12–22 weeks of gestation. A subsample of 15 LGA infants (cases) were contrasted with 15 AGA infants (controls). An untargeted lipidomics analysis using liquid chromatography quadrupole time-of-flight mass spectrometry was conducted. Univariate and multivariate statistical analyses (principal component analysis and partial least-squares discriminant analysis) were used to extract differentially abundant (DA) features with high variable importance in projection (VIP) scores. Results: LGA AF was characterized by elevations of 30 phosphatidic acid species. Among other DA features, sphingomyelin (SM 14:0;O2/20:1) had the highest VIP score and was markedly elevated in LGA AF. Neither insulin nor glucose was associated with 2nd trimester AF lipidomic profiles in these healthy, normal-weight mothers. Conclusion: These findings provide evidence of early dysregulated lipid metabolism in healthy, normal-weight mothers with LGA infants.

Quantification of persistent organic pollutants in breastmilk and estimated infant intake, Norway.

Persistent organic pollutants (POPs) are environmental contaminants that can accumulate in human tissues and pose potential health risks. Despite global efforts to reduce their prevalence, follow-up studies are needed to see if the measures are successful. Since most infants in Norway are breastfed for the first 6 months of life, monitoring POP contamination in breastmilk is important for children's health and development. This study aims to evaluate the current levels of various POPs in women's breastmilk in Innlandet County, Norway. A cross-sectional study was conducted measuring concentrations of 35 different POPs, including polychlorinated biphenyls (PCBs), chlordanes (ChlDs), hexachlorocyclohexanes (HCHs), dichlorodiphenyltrichloroethanes (DDTs), Mirex, and brominated flame retardants in 120 breastmilk samples. The study analysed the impact of maternal age, parity, pre-pregnancy BMI, and infant age on POPs levels and compared the estimated daily intake per body weight of infants to existing health guidelines. The detected percentages for PCBs were 100%, for DDTs 98.3%, and for ChlDs 98.3%. The highest median concentration was found for ΣPCBs (26.9 ng/g lw). Maternal age, parity, and infant age were significant determinants of POP concentrations. Most infants exceeded the health-based guidance values for ΣPCB, and 6.4% percent did so for ΣHCHs. Despite lower POPs concentrations in breastmilk than in earlier studies, many breastfed infants are still exposed to levels exceeding health-based guidance values. Although the study's design had limitations, the study provides updated population-based data on POPs in breastmilk. Continued monitoring and research are necessary to understand and mitigate potential health risks associated with POPs.

Maternal exploitation: impact of maternal food snatching behaviour on the growth of their offspring in Japanese macaques.

There is little information on maternal behaviour that deprives offspring of food, but some Japanese macaque, Macaca fuscata, mothers have been observed to snatch food from their offspring and eat it. This study investigated maternal food snatching behaviour (MFSB) and its impact on the growth of their offspring in provisioned, free-ranging Japanese macaques. The amount of food a mother snatched from her offspring was estimated to be 51.2% by dry weight compared to the amount of solid food an infant of the same age took in. Body mass growth of affected infants indicated a below-average mass gain. The study suggests that MFSB might be a pathological behaviour and provides the first detailed account of parental exploitation in animals.

Impact of Postpartum Hospital Length-of-Stay on Infant Gut Microbiota: A Comprehensive Analysis of Vaginal and Caesarean birth

BackgroundThe primary concern with prolonged hospitalization following birth is the risk of acquiring hospital-acquired infections (HAIs) caused by opportunistic bacteria, which can alter the early establishment of gut microbiota. ObjectiveThis study aimed to assess the association between postpartum hospital length-of-stay (LOS) and the composition of gut microbiota at 3 and 12 months of age according to birth mode. MethodsA total of 1313 Canadian infants from the CHILD Cohort Study were involved in this study. Prolonged hospital LOS was defined as > 2 days following vaginal and > 3 days after caesarean section (CS) birth. Infants' gut microbiota was characterized by Illumina 16S rRNA sequencing of faecal samples at 3-4 months and 12 months. FindingsFollowing a prolonged hospital LOS, vaginally-delivered (VD) infants with no maternal intrapartum antibiotic (IAP) exposure had a higher abundance of bacteria in their gut known to cause HAIs, including Enterococcus at 3 and 12 months, Citrobacter at 3 months and C. difficile at 12 months. Enterococcus or Citrobacter abundance at 3 months significantly mediated the association between LOS, and low abundance of Bacteroidaceae, or higher Enterococcaeae/Bacteriodaceae or Enterobacteriaceae/Bacteroidaceae abundance ratios at 12 months of age in VD infants without IAP exposure. HAI-causing Enterobacteriaceae were also more abundant in later infancy with a longer hospital LOS following CS. In the absence of exclusive breastfeeding for 3 months or any breastfeeding at 12 months, the Porphyromonadaceae (of Bacteroidota) become depleted in CS infants with a prolonged LOS. ConclusionsProlonged hospital stay after birth is associated with infant gut dysbiosis.

Risk factors for and short-term prognosis of intrauterine infection in preterm infants

Objective To identify the risk factors for and short-term prognosis of intrauterine infection (IUI) in preterm infants. Methods We retrospectively collected clinical data regarding preterm infants (28+0–36+6 weeks of gestational age) with IUI from the neonatal intensive care unit of our hospital between June 2017 and June 2022. The pathologic characteristics of the infants were classified using the Redline criteria, and the resulting groups were compared with respect to their clinical characteristics, indicators of infection, complications, and mortality rates. Results Three hundred thirty (78.1%) of the 422 enrolled neonates showed signs of histologic IUI; 51.8% showed histologic chorioamnionitis alone, and 48.2% showed both histologic chorioamnionitis and funisitis. The independent risk factors identified for IUI were maternal prenatal invasive manipulation, premature rupture of membranes (&gt;18 hours before labor), and prenatal C-reactive protein concentration. The infants with IUI showed higher incidences of respiratory distress syndrome, bronchopulmonary dysplasia, retinopathy of prematurity, and prolonged mechanical ventilation. Low gestational age and low birth weight of preterm infants were significantly associated with a higher incidence of histologic IUI, more severe inflammation, and a higher incidence of complications. Conclusions Histologic IUI is associated with high complication and mortality rates in preterm infants, as is an increasing severity of inflammation.

Disorders of gut-brain interaction are common diagnoses among infants and toddlers in gastroenterology practices in Latin America.

To assess the relative frequency and associated factors of disorders of gut-brain interaction (DGBIs) in outpatient gastrointestinal (GI) clinics in young children of Latin America. Cross-sectional study in 10 pediatric GI outpatient clinics (private and public) in five countries of Latin America (El Salvador, México, Colombia, Panamá, and Nicaragua). Parents of patients 1 month 4 years of age from outpatient clinics complete/d a diagnostic questionnaire for DGBIs per Rome IV criteria (QPGS-IV, Spanish version). We conducted descriptive analysis, two-sample t-tests and chi-square tests, univariate analyses, and logistic regression to evaluate risk factors. We collected data from 783 children. In total, 34.5% had a DGBI. Overall, functional constipation (FC) was the most common diagnosis (23.4%) in children of all ages (infants, 16.1%, 1-4-years-old, 32.7%). In infants, the second most common DGBI was regurgitation (6.6%) and in 1-4-years-old and cyclic vomiting syndrome (4.1%). The diagnosis of a DGBI was significantly associated with a family history of DGBIs (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.61-5.57, p = 0.0001). Patients who identified as black (OR 2.25, 95% CI 1.28-3.92, p = 0.0021) or mixed race (OR 1.76, 95% CI 1.25-2.48, p = 0.0006) were also significantly associated with a higher likelihood of DGBIs. DGBIs are a common diagnosis in pediatric GI clinics of Latin America. Overall, FC was the most common DGBI.

Mothers Falling Asleep During Infant Feeding.

Falling asleep while feeding (FAF) infants is common. Our primary objectives were to examine (1) maternally reported prevalence of FAF and if planned; (2) association between FAF and sociodemographic factors, feeding method, and sleep location; and (3) if receipt of education about safe sleep and bedsharing risks was associated with FAF. In the Social Media and Risk-reduction Training study, US mothers of newborns were randomized to educational messaging promoting infant safe sleep or breastfeeding. We analyzed data from 1259 mothers who responded to the postpartum survey (mean infant age, 11.2 weeks). We used generalized estimating equation logistic regression models to examine the extent that sociodemographic characteristics, feeding type, usual nighttime feeding location, and intervention group were associated with FAF. A total of 28.2% of mothers reported FAF usually or sometimes in the last 2 weeks, 83.4% of whom reported that FAF was unplanned. There were no differences in the odds of FAF by sociodemographic factors. Compared with mothers whose nighttime feeding location was their bed, mothers who reported feeding in a chair were less likely to FAF (33.6% versus 16.8%; adjusted odds ratio, 0.41; 95% confidence interval, 0.31-0.56). FAF was reported less frequently by mothers who received safe sleep interventions (15.6%), compared with mothers who received breastfeeding interventions (33.0%; adjusted odds ratio, 0.40; 95% confidence interval, 0.25-0.65). FAF is reported commonly among US mothers and is predominantly unplanned. Mothers who received safe sleep messaging were less likely to report FAF. New parents need guidance on planning for optimal safety during infant feeding.

Echocardiographic findings in newborns with inadequate intrauterine growth during pregnancy

Abstract Background Infants born small for gestational age (SGA) or diagnosed with fetal growth restriction (FGR) are at increased risk of neonatal mortality as well as cardiovascular disease later in life. Previous studies based on smaller cohorts (n&amp;lt;200) of newborns with SGA and FGR (n&amp;lt;200) have demonstrated structural and morphological alterations in the heart compared to infants born appropriate for gestational age (AGA). However, to our knowledge no previous study has systematically investigated the effect of SGA and FGR on echocardiographic parameters in the infant heart. Purpose To investigate whether echocardiographic parameters differ among infants born SGA or with FGR, in comparison to infants born AGA. Methods This study is a population-based cohort study of infants (n&amp;gt;25,000) offering postnatal cardiac examination including transthoracic echocardiography (TTE) between 2016-2018. We compared left ventricular (LV) TTE parameters in infants born SGA (birthweight ≥3rd and &amp;lt;10th percentile, n=2,106) and with FGR (birthweight &amp;lt;3rd percentile, n=972) with infants born AGA (birthweight ≥10th and &amp;lt;90th percentile, n=20,468) using a multiple linear regression analysis. We have investigated LV volumes, systolic function, diastolic function, and LV structure. All analyses were adjusted for sex, gestational age at birth, weight, length, and age at cardiac examination. Results Infants born SGA had higher heart rates compared with infants born AGA. Both infants born SGA and infants with FGR had significantly smaller LV dimensions including septal and posterior wall thicknesses (IVSd and LVPWd), and LV internal diameters (LVIDd and LVIDs). Infants born SGA had smaller end-diastolic and end-systolic volumes compared with infants born AGA (Table 1). Infants born SGA or with FGR had significantly higher mitral valve early peak velocities, compared with infants born AGA, and infants born SGA showed increased mitral valve atrial peak velocities indicating altered diastolic function (Table 1). Conclusion Infants born with inadequate intrauterine growth had smaller LV dimensions compared with infants born AGA, even when adjusting for infant size and age. Infants born SGA and with FGR both exhibited altered diastolic function. Longitudinal studies of children with inadequate intrauterine growth are needed to determine the impact on adult cardiac health.

Electrocardiographic findings in newborns with inadequate intrauterine growth during pregnancy

Abstract Background Infants born small for gestational age (SGA) or following fetal growth restriction (FGR) have an increased risk of neonatal mortality as well as cardiovascular disease later in life. Prenatal electrocardiograms (ECGs) in fetuses with FGR exhibit QT prolongation. However, neonatal alterations in the conduction system in infants born SGA or with FGR has not previously been assessed in a large cohort of infants. Purpose To investigate potential variations in electrocardiographic parameters between infants born SGA or diagnosed with FGR, in comparison to infants born appropriate for gestational age (AGA). Methods This study was based on data from a population-based cohort study of infants (n&amp;gt;25,000) with prenatal inclusion and postnatal cardiac examination including eight-lead ECG between 2016-2018. We conducted a multiple linear regression analysis to compare ECG parameters among infants with FGR (birthweight &amp;lt;3rd percentile, n=544) and SGA (birthweight ≥3rd and &amp;lt;10th percentile, n=1,384) to infants born AGA (birthweight ≥10th percentile and &amp;lt;90th percentile, n=14,076). Parameters of interest included: heart rate (HR), uncorrected and corrected (Bazzet and Fridericia) QT intervals, QRS duration, PR interval, QRS axis, maximum amplitudes of the R- and S-waves in V1 and V6. All analyses were adjusted for infant sex, gestational age at birth, and weight, length, and age at ECG examination. Results Infants born SGA or with FGR had higher HR and consequently shorter uncorrected QT intervals compared with infants born AGA (Table 1). Infants with FGR had significantly shorter corrected (Fridericias) QT intervals. Infants born SGA had smaller amplitudes of both the R- and S-wave in V6, and significantly larger amplitude of the S-wave in V1, compared with infants born AGA (Table 1). Conclusion ECGs from infants born SGA and infants with FGR differed from infants born AGA, including higher HRs and shorter uncorrected QT-intervals even after adjustments for infant size and age at the examination. Furthermore, we saw infants born SGA had reduced amplitudes of the S and R wave in the lateral lead (V6), and an increased amplitude of the S-wave in V1, compared with infants born AGA. Follow-up examinations of these infants could determine whether these alterations persist beyond the neonatal period, and to fully understand their implications of the cardiac function later in life.

Improvement in patient selection, management and outcomes in infant heart transplant from 2000 to 2020.

The study's primary outcome was to evaluate if post-transplant survival has improved over the last 2 decades. Secondary outcomes were the infant's waitlist mortality, waitlist time and identifying factors that affected the infant's survival. United Network for Organ Sharing (UNOS) database was queried for infants (age ≤ 1) who were listed for heart transplantation between 2000 and 2020. The years were divided into 3 eras (Era 1 2000-2006, Era 2 2007-2013 and Era 3 2014-2020). Non-parametric tests, Chi-Squared, Log-Rank test and Cox-Proportional hazard ratio were used for analysis (α = 0.05). 4234 infants were listed for heart transplants between 2000 and 2020. At the time of listing, Infants in era 3 were more likely to be heavier [in kg (P < 0.001)] and had better renal function (P < 0.001). Additionally, they were less likely to be on dialysis (P < 0.001), on a ventilator (P < 0.001) and on extracorporeal membrane oxygenation (P < 0.001). There has been a significant increase in left ventricular assist device use (P < 0.001), though there was no difference in waitlist (0.154) or post-transplant survival (0.51). In all 3 eras, waitlist survival (P < 0.001) and post-transplant survival (P < 0.001) have improved significantly. Congenital heart disease and extracorporeal membrane oxygenation were associated with worse waitlist survival in all 3 eras (P < 0.05). Infants are now waiting longer on the waitlist (in days) (33 Era 1 vs 46 Era 2 vs 67 Era 3, P < 0.001). Infant heart transplant outcomes have improved, but they are now waiting longer on the waitlist. Further improvement in increasing the donor pool, expert consensus on listing strategies and donor utilization is needed to improve outcomes.

Maternal pre-pregnancy body mass index and gestational weight gain on adverse birth outcomes in Chinese newborns: a retrospective study

BackgroundMaternal and child health is an important measure of national well-being. This study further explored the individual and combined effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on adverse birth weight-related outcomes.MethodsA retrospective study was carried out at a maternal and child health hospital from 2018 to 2021, and a total of 17,506 eligible women were invited to participate. The associations of pre-pregnancy BMI and GWG with adverse birth outcomes were examined by using restricted cubic spline regression and binary logistic regression.ResultsPre-pregnancy BMI and GWG had non-linear associations with low birth weight and macrosomia. They were associated with an increased risk of macrosomia (Pre-pregnancy BMI for OR = 1.170, 95%CI:1.144 to 1.197, P < 0.001, and GWG for OR = 1.071, 95%CI:1.054 to 1.089, P < 0.001) and large for gestational age infant (LGA) (Pre-pregnancy BMI for OR = 1.125, 95%CI:1.111 to 1.141, P < 0.001, and GWG for OR = 1.045, 95%CI:1.036 to 1.054, P < 0.001). The high risk of low birth weight and preterm birth was observed among the group of women with inadequate GWG. The risks of macrosomia and LGA increased with pre-pregnancy BMI from low weight to overweight and obesity, and GWG from inadequate to overabundance, while small for gestational age infant was more prevalent in the low pre-pregnancy BMI group.ConclusionsPre-pregnancy BMI and GWG exhibited non-linear associations with low birth weight and macrosomia. The various combinations of pre-pregnancy BMI and GWG had different effects on adverse birth weight-related outcomes.

Value of Maternal Renal Function Indicators in Predicting Small for Gestational Age Infants in Patient with Severe Preeclampsia

Background: Severe preeclampsia poses significant health risks to both pregnant patients and their newborns. Our goal was to explore the association between serum renal function related indicators in pregnant patients with severe preeclampsia and the occurrence of small for gestational age (SGA) infants, as well as to further identify independent risk factors for SGA based on these indicators. Methods: This was a retrospective case-control study. We evaluated the renal function indicators of 127 severe preeclampsia pregnant patients and 127 normal pregnant patients antenatally who delivered in Shijiazhuang Fourth Hospital from January 2022 to December 2022. Mann-Whitney U test and Chi-square test were used to compare the differences in clinical data between two groups. Spearman correlation analysis was used to determine the correlation between renal function indicators and newborn weight in severe preeclampsia pregnant patients. Receiver operating characteristic (ROC) curve was used to determine the optimal critical values of the above indicators, and multivariate logistic regression analysis was used to determine the independent risk factors for severe preeclampsia combined with SGA. Results: Blood urea nitrogen (BUN), serum creatinine (SCr) and serum uric acid (SUA) in severe preeclampsia patients with SGA were higher than severe preeclampsia without SGA (p &lt; 0.05 vs. all groups). In the severe preeclampsia group, these indicators were significantly negatively correlated with birth weight (p &lt; 0.001 vs. all groups), whereas no correlation was observed in the control group. In the severe preeclampsia group, a ROC analysis was performed based on whether the infants were small for gestational age, and the indicators were divided into two groups according to the optimal cut-off value. After adjusting for confounding factors, elevated BUN (≥4.9 mmol/L) served as an independent risk factor for severe preeclampsia patients with SGA (odds ratio (OR) = 4.336, 95% confidence interval (95% CI): 1.781–10.552, p = 0.001), and the corresponding area under the curve was 0.661 (0.572, 0.743). Conclusions: Serum renal function indicators in pregnant patients with severe preeclampsia were significantly associated with the occurrence of small for gestational age (SGA) infants. Moreover, elevated maternal BUN levels (≥4.9 mmol/L) prior to delivery may indicate the occurrence of SGA. However, we also acknowledge that the predictive power of this single marker is limited.

Effects of mechanical ventilation on neurodevelopment at 12 months in preterm low birth weight pediatric patients: a systematic review.

The objective of this review is to know the existing scientific evidence about the effects of mechanical ventilation (MV) on neurological development in low-birth-weight premature pediatric patients after 12 months of life, taking as background the direct impact that ventilation has on the central nervous system in the newborn during the first days of life. A systematic search was carried out between 2003 and 2024 in the data bases of: PUBMED, Cochrane Library Plus, PEDro, CINAHL, and SciELO, and two investigators scored the articles according to the Newcastle-Ottawa Assessment scale. Were found 129 non-replicated articles, and 10 cohort and cross-sectional studies were selected that performed an assessment of neurodevelopment in the three spheres after 12 months of life in corrected age of premature infants exposed to ventilator support and related the two variables independently. Mechanical ventilation is an independent neurodevelopmental risk factor in low-birth-weight preterm infants. The time of exposure and the type of ventilation were the variables with the most scientific evidence. https://www.crd.york.ac.uk/, Identifier CRD42023446797.

Do preterm infants’ retinas like bovine colostrum? A randomized controlled trial

BackgroundBovine colostrum (BC) with liposomal delivery system (LDS) is a promising supplement to premature infant formula in absence of mother own milk. We propose that BC with LDS can target multiple etiological factors that threaten the developing retina, making premature infant less liable for retinopathy of prematurity (ROP). The aim of this study was to evaluate the effect of BC with LDS in the prevention of ROP.MethodsThis was a single center, randomized, controlled trial. Two hundred and eleven preterm infants of gestational age ≤ 32weeks were admitted to the NICU of Alexandria University Children Hospital, Egypt, and randomly allocated into either non-BC group (n = 105) or BC group (n = 106). Patients in BC group received 3.5 ml /kg/day of BC for 14 days. All patients were monitored for development of ROP, anemia, late onset sepsis (LOS), bronchopulmonary dysplasia (BPD), periventricular leukomalacia (PVL) and necrotizing enterocolitis (NEC), in addition to growth assessment. Multivariate binary logistic regression analysis was performed to determine factors predicting ROP development.ResultsCompared with the non-BC group, BC group was associated with a significantly lower incidence of ROP (5/100 vs. 16/100, respectively) with a p-value of 0.033. The administration of BC significantly decreased serum C- reactive protein (CRP) level and increased weight on day-14 of the study in comparison with the CRP level and birthweight at the beginning of study, with Cohen’s D= -0.184, D = -2.246, respectively. Patients with suspected sepsis were significantly less in BC than non-BC group, p = 0.004. Patients with BC had significantly higher hemoglobin level on day-14 than non-BC-group, with median (IQR) 12.2 (11.0–13.9) and 11.7 (10.5–12.9), respectively. BC intake is one of factors that decreased development of ROP in univariate analysis. Nevertheless, weight gain and birth weight were the most significant factors affecting ROP development in multivariate-regression model.ConclusionBC may reduce the incidence of ROP in preterm neonates aged ≤ 32 weeks. This might be due to keeping better Hb level and growth rate, as well as anti-inflammatory properties through its ability to decrease CRP level.Trial registrationThis work was registered on 06/13/2022 in clinicaltrial.gov with ID no.: NCT05438680 and URL:https://classic.clinicaltrials.gov/ct2/show/NCT05438680?term=NCT05438680&draw=2&rank=1.

The role of multisensory intervention combined with aEEG in the maturation and evaluation of brain and neural development in premature infants of different gestational ages

Objective: To explore the combined effects of multisensory intervention and amplitude integrated electroencephalogram monitoring on the maturation and evaluation of brain and neural development in premature infants of different gestational ages.Methods: The controlled trial was carried out in 62 premature infants from January to February of 2023 in Genertec AMHT – Baogang Hospital. The premature infants were divided into two groups according to the gestational age: 32-33+6W (Group A) and 34-33+6W (Group B). By use of random number table method, each group was subdivided into the control group and the experimental group. The control group was monitored with aEEG within 1 day and the following 7 days after birth. The experimental group was monitored with aEEG within 1 day and the following 7 days after multisensory intervention (MS) to observe the change of aEEG parameters, in order to explore the effect of MS intervention on brain development maturity. The Neonatal Behavioral Neurological Assessment (NBNA) score was performed at 40 weeks of corrected gestational age in both groups.Results: The amplitude voltage, the total aEEG score and the sleep-wake cycle score in the experimental group were higher than those in the control group (p &lt; .05). The total NBNA score in the experimental group was higher than that in the control group.Conclusion: The multi-sensory intervention is a simple and feasible method of development support nursing, it can improve the total NBNA score of premature infants, which can promote the brain development in premature infants and improve their neurodevelopmental behavior.

Different Catch-Up Growth Patterns in Very Preterm and Small for Gestational Age Infants.

This study aimed to describe the growth pattern in preterm infants and identify factors influencing catch-up growth. A total of 288 preterm infants were divided into groups based on the degree of prematurity, sex, and size for gestational age. Growth in head circumference, length, weight-for-length, and weight was compared between groups at corrected age of 0, 3, 6, 9, 12, 18, and 24 months. Logistic regression analysis was conducted to determine risk factors for catch-up growth. At a corrected age of 24 months, the proportions of preterm infants with z-scores less than -2 for head circumference, length, weight-for-length, and weight were less than the expected 2.3% at 0.9%, 1.7%, 2.1%, and 1.7%, respectively. The head circumference, length, weight-for-length, and weight z-scores at corrected ages of 24 months were lower in the small for gestational age (SGA) group than in the non-SGA group (P < .05). The weight-for-length z-scores were higher in the late preterm birth infants than in the very preterm birth infants at a corrected age of 24 months (P < .05). At a corrected age 24 months, the proportion of male with weight z-scores <-2 was lower than that of female (P < .05). The differences in proportion of the z-scores (head circumference, length, weight-for-length, and weight) <-2 at a corrected age of 24 months among different gestational age groups and intrauterine growth status groups were not statistically significant (P > .05). We found that the factors influencing catch-up growth in preterm infants varied at different corrected age stages, and the impact of factors during hospitalization gradually diminished as the infants grew.

Assessing the efficacy of electrocardiogram for heart rate evaluation during newborn resuscitation at birth: a prospective observational study.

This study aimed to assess the efficacy of electrocardiogram (ECG) compared to pulse oximetry (PO) in detecting heart rate (HR) during high-risk newborn resuscitation. A prospective observational study was performed with high-risk delivery cases to measure the time required for HR detection. A conventional PO and a standard ECG monitor were used for HR assessment. Forty-one infants were analyzed in the study, and 11 among them needed resuscitation. Nine were <32 gestational weeks (GA), 28 were 33-35 GA, and 4 were >36 GA at birth. ECG time for placement to HR detection was significantly faster than PO detection [30 (20-43.5) vs. 125 (100-175) seconds, P<0.001]. ECG time for placement to HR detection was the fastest in the infants below 32 GA at birth [19 (11.5-30) vs. 34.5 (25-44.25) vs. 39.5 (30-64.75) seconds, P=0.039). ECG effectively evaluated HR during neonatal resuscitation compared to PO. Low gestational age infants who need resuscitation often may benefit in HR evaluation with nearby standard ECG.

Prevalence of iron deficiency anemia in exclusively breastfed infants after a 5-month iron supplementation

Iron deficiency anemia (IDA) is prevalent in exclusively breastfed (EBF) Thai infants. However, in Thailand, iron supplementation guidelines for EBF infants are not available. This prospective open-label study aimed to estimate the prevalence of IDA in 9-month-old EBF infants after receiving iron supplementation from 4 months of age until they consumed adequate iron-rich food. Forty-seven healthy, 4-month-old EBF infants were prescribed 1 mg/kg/day ferrous sulfate. Their complementary food records from 6 to 9 months were calculated for daily iron intake. Complete blood count and iron study were performed at 9 months of age. The results showed that the prevalence of IDA at 9 months was 6.4%. An employed caregiver and the male sex of the baby were significantly associated with iron deficiency. The food record revealed that the median daily iron intake was less than the Thai dietary reference intake recommendation. In summary, the prevalence of IDA in infants with 9 months of exclusive breastfeeding who received iron supplementation was lower than the background rate (25.7%) when iron was not prescribed. Most infants did not have adequate iron in complementary foods. Iron supplementation should be prescribed routinely during 4–9 months of age in healthy Thai EBF infants.