Neonates In Group Research Articles

Hemoglobin normalization outperforms other methods for standardizing dried blood spot metabolomics: A comparative study

Dried blood spot (DBS) metabolomics has numerous applications in newborn health screening, exposomics, and biomonitoring of environmental chemicals in pregnant women and the elderly. However, accurate metabolite quantification is hindered by several challenges: notably the “hematocrit effect” and unknown blood-spotting volumes. Different techniques have been employed to overcome these issues but there is no consensus on the optimal normalization method for DBS metabolomics, and in some cases no normalization is used. We compared five normalization methods (hemoglobin (Hb), specific gravity (SG), protein, spot weight, potassium (K+)) to unnormalized data, and assessed sex-related differences in the DBS metabolome in 21 adults (group 1, n = 10 males, n = 11 females). The performance of each normalization method was evaluated using multiple criteria: (a) reduction of intragroup variation (pooled median absolute deviation, pooled estimate of variance, pooled coefficient of variation, NMDS and principal component analysis), (b) effect on differential metabolic analysis (dendrogram, heatmap, p-value distribution), and (c) influence on classification accuracy (partial least squares discriminant analysis, sparse partial least squares discriminant analysis error rates, receiver operating curve, random forest out of bag error rate). Our results revealed that Hb normalization outperformed all the other methods based on the three criteria and 13 different parameters; the performance of Hb was further demonstrated in an independent group of DBS from 18 neonates (group 2, n = 9 males, n = 9 females). Furthermore, we showed that SG and Hb are correlated in adults (rs = 0.86, p < 0.001), and validated this relationship in an independent group of 18 neonates and infants (group 3) (rs = 0.84, p < 0.001). Using the equation, SG = −0.4814Hb2 + 2.44Hb + 0.005, SG can be used as a surrogate for normalization by Hb. This is the first comparative study to concurrently evaluate multiple normalization methods for DBS metabolomics which will serve as a robust methodological platform for future environmental epidemiological studies.

ASSESSMENT OF LEVELS OF LIPID PROFILE, APOLIPOPROTEINS, AND ATHEROGENIC INDEX IN CORD BLOOD OF NEONATES ACCORDING TO GESTATIONAL AGE

Background: A considerable amount of cholesterol is needed by human body for the maintenance of tissue and various bodily metabolisms. Cardiac disorders are major cause for morbidity and mortality in recent years. Cord blood lipoprotein is influenced by factors such as placental insufficiency, mode of delivery, and conditions affecting fetal growth. The present study was planned to analyze cord blood lipid profile, apolipoproteins, and atherogenic index in different gestational age and compare them gender wise. Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Geetanjali Medical College and Hospital, Udaipur. The study group included 640 neonates, divided into two groups on the basis of gestational age into near-term neonates (34–37 weeks) and term neonates (&gt;37 weeks). The cord blood samples were taken from placental side of umbilical cord at birth. The blood was tested to determine lipid profile, apolipoproteins, and atherogenic index. Results: The results showed total cholesterol, triglyceride, HDL-C, LDL-C, ApoA-1, and Apo B level higher in near-term neonates group than term neonates. TC, TG, HDL-C, VLDL-C, and apolipoprotein A-1 were negatively correlated but LDL-C and apolipoprotein B were positively correlated with gestational age. Conclusion: The study showed that the gestational age is associated with lipid parameters. Prematurity as a factor was associated with atherogenic index.

Magnetic Resonance Imaging Evaluation of a Hearing Protector Device Designed for Neonatal Patients

BackgroundHearing protection for neonates that can be effectively used during magnetic resonance imaging (MRI) examinations is limited. Because MRI-related acoustic noise poses a serious risk to this patient population, a viable option for hearing protection is needed. A new hearing protector device was recently developed specifically for neonates. Because of safety concerns for products used in the MRI setting, the objective of this investigation was to evaluate MRI-related issues for this hearing protector device. In addition, patient tolerance and responses were observed and reported from in a small group of neonates. MethodsThe neonatal hearing protector device (DREAMIES T-M, NEATCap Medical, LLC, Bethlehem, Pennsylvania) was evaluated for magnetic field interactions (translational attraction and torque; 3-Tesla), MRI-related heating (1.5-Tesla/64-MHz and 3-Tesla/128-MHz), and in vitro testing of artifacts (T1-weighed spin echo and gradient echo pulse sequences obtained at 3-Tesla) using standardized test procedures. In addition, seven study subjects wearing the neonatal hearing protector device underwent MRI of the brain. ResultsThere was no translation attraction, no torque, no heating at 1.5-Tesla/64-MHz and 3-Tesla/128-MHz, and no artifacts were observed for the neonatal hearing protector device in the in vitro and study subject observations. The device was easy to apply, stayed in place for the duration of the MRI examination, and was tolerated well by the neonates evaluated. ConclusionsBecause of the benign findings for the MRI tests, along with the materials used to make this device (i.e., nonmetallic and nonconducting), this new neonatal hearing protector device is designated “MR Safe”, which is a medical device that poses no known hazards resulting from exposure to any MRI environment. In the limited number of subjects evaluated during the observational period, the device provided sufficient noise protection enabling neonates to remain undisturbed throughout their scans, resulting in images with little or no motion artifacts and diagnostically acceptable MRI examinations.

ROP-like retinopathy in full/near-term newborns: A etiology, risk factors, clinical and genetic characteristics, prognosis and management.

PurposeRetinopathy of prematurity (ROP) like retinopathy (ROPLR) could occur in full/near-term newborns. The causes and clinical features are still largely elusive. This study focused on the risk factors, clinical and genetic characteristics, treatment and outcome, and prognosis of ROPLR.MethodsA total of 47 consecutive full/near-term newborns during 2016–2017 with ROPLR were included. The clinical and genetic characteristics, treatment and outcome, prognosis, and potential underlying etiology of ROPLR were were analyzed.Results91 eyes of 47 infants were found to have ROPLR. The ROPLR regressed completely in 65.9% and partially in 20.9% of eyes without any interventions. Retinal changes of family exudative vitreoretinopathy (FEVR) were allocated in 12 neonates (group A), perinatal hypoxia-ischemia were categorized in 17 neonates (group B), and the other 18 neonates were categorized in group C. Compared to those in group B/C, infants in group A had significantly more severe retinopathy (stage 4/5, p < 0.001) and more treatments (p < 0.00 risk factor 1).ConclusionsPerinatal hypoxia-ischemia might be a major risk factor for ROPLR, in which spontaneous regression was common. FEVR, confirmed by positive family findings and genetic testing, might be the second risk factor of ROPLR, in which retinopathy is more severe and treatment is needed.

A Protocol to Assess Adult Outcomes at 30 Years Following Preterm Birth.

Among the most intense adversity experiences for infants is premature birth. Early birth marks the beginning of a life course that broadly affects families, healthcare, education, social systems, and the survivors themselves. For many, the transition to adulthood is challenging and often hampered by cognitive, physical and mental health, and motor and independence difficulties. The aim of this study was to share a comprehensive protocol of a 10th follow-up study of premature infants in their 30s. The protocol accounts for stress during the neonatal period, the cumulative context (risk and protection) of development, biological and epigenetic mechanisms, and individual resilience. The prospective, five-group longitudinal design includes 215 term-born and preterm-born individuals with various neonatal morbidities at ages 30-35 years. Adult outcomes include health, adaptive, executive function, work, and social competence. Novel measures are four system indicators of allostatic load (AL) and epigenetics. Contextual measures include socioeconomic risk and individual resilience. All measures were selected based on coherence with constructs of the scientific aims, strong psychometrics, continuity for repeated measures, and minimal subject burden. Objective assessments include body composition imaging, exercise testing, blood and saliva collection, and actigraphy. The two-phase protocol takes approximately 8 hours. After an 11-month COVID-19 pause, participant response has been strong. As of May 2022, 75 participants have completed the full protocol, and 99 have consented to participate. When socioeconomic risk is controlled, we hypothesize that life course trajectories in physical and psychological health, adaptive function, and executive function will differ between term and preterm neonatal morbidity groups. AL will vary across groups and contribute to outcomes. We expect proximal protection and resilience to mediate the cumulative medical and socioeconomic risk and AL. Epigenome-wide DNA methylation, with estimates of age acceleration, will be examined across groups and explored in longitudinal associations with medical risk, socioeconomic status, and protection. To our knowledge, this is the only U.S. study of premature infants aged 30-35 years. With millions of preterm-born individuals reaching adulthood, the protocol incorporates molecular and genetic biomarkers in a life course developmental examination to inform the timing and content of interventions.

Associations between provider-assigned Apgar score and neonatal race

For decades, the Apgar scoring system has been used to evaluate neonatal status and determine need for resuscitation or escalation in care, such as admission to a neonatal intensive care unit. However, the variation and accuracy of provider-assigned Apgar scores across neonatal racial groups have yet to be evaluated. This study aimed to investigate how provider-assigned Apgar scores vary by neonatal race independently of clinical factors and umbilical cord gas values. We conducted a retrospective cohort study at an urban academic medical center. All live births at ≥23 weeks and 0 days of gestation from January 1, 2019 through December 31, 2019 with complete data available were included. Data were queried from the electronic medical record and included race, ethnicity, gestational age of neonate, umbilical cord gas values (umbilical artery pH and base deficit), admission to the neonatal intensive care unit, and presence of maternal-fetal complications. Primary outcome measures were neonates' Apgar scores at 1 and 5 minutes. Color Apgar score and admission to the neonatal intensive care unit served as secondary outcome measures. We performed 3 partially proportional ordinal regression models controlling for an increasing number of covariates, with Model 1, the baseline model, adjusted for gestational age, Model 2 additionally adjusted for umbilical cord gases, and Model 3 additionally adjusted for maternal medical conditions and pregnancy complications. A total of 977 neonates met selection criteria; 553 (56.6%) were Black. Providers assigned Black neonates significantly lower Apgar scores at 1 minute (odds ratio, 0.63; 95% confidence interval, 0.49-0.80) and 5 minutes (odds ratio, 0.64; 95% confidence interval, 0.47-0.87), when controlling for umbilical artery gases, gestational age, and maternal-fetal complications. This difference seemed related to significantly lower assigned color Apgar scores at 1 minute when controlling for all the above factors (odds ratio, 0.52; 95% confidence interval, 0.39-0.68). Providers admitted full-term Black neonates to the neonatal intensive care unit at higher rates than non-Black neonates when controlling for all factors (odds ratio, 1.29; 95% confidence interval, 0.94-1.77). Black neonates did not have more abnormal cord gas values (mean umbilical artery pH of 7.259 for Black vs 7.256 for non-Black neonates), which would have supported their admission to the neonatal intensive care unit. Providers applied inaccurate Apgar scores to Black neonates given that the umbilical cord gases were not in agreement with lower Apgar scores. These inaccuracies may be a factor in unnecessary admissions to neonatal intensive care units, and suggest that colorism and racial biases exist among healthcare providers.

Donor Age and Time in Culture Affect Dermal Fibroblast Contraction in an In Vitro Hydrogel Model.

Current cellular hydrogel-based skin grafts composed of human dermal fibroblasts and a hydrogel scaffold tend to minimize contraction of full-thickness skin wounds and support skin regeneration. However, there has been no comparison between the sources of the dermal fibroblast used. Products using human adult or neonatal foreskin dermal fibroblasts are often expanded in vitro and used after multiple passages without a clear understanding of the effects of this initial production step on the quality and reproducibility of the cellular behavior. Based on the known effects of 2D tissue culture expansion on cellular proliferation and gene expression, we hypothesized that differences in donor age and time in culture may influence cellular properties and contractile behavior in a fibroblast-populated collagen matrix. Using porcine skin as a model based on its similarity to human skin in structure and wound healing properties, we isolated porcine dermal fibroblasts of three different donor ages for use in a 2D proliferation assay and in a 3D cell-populated collagen matrix contractility assay. In 2D cell culture, doubling time remained relatively consistent between all age groups from passage 1 to 6. In the contractility assays, fetal and neonatal groups contracted faster and generated more contractile force than the adult group at passage 1 in vitro. However, after five passages in culture, there was no difference in contractility between ages. These results show how cellular responses in a hydrogel scaffold differ based on donor age and time in culture in vitro, and suggest that consistency in the cellular component of bioengineered skin products could be beneficial in the biomanufacturing of consistent, reliable skin grafts and graft in vivo models. Future research and therapies using bioengineered skin grafts should consider how results may vary based on donor age and time in culture before seeding. Impact statement Little is known about the impact of donor cell age and time in culture on the contraction of cellular, hydrogel-based skin grafts. These results show how cellular phenotypes of porcine fibroblasts differ based on donor age and time in culture. This information is beneficial when addressing important inconsistencies in biomanufacturing of bioengineered skin grafts and in vitro models. These findings are relevant to research and therapies using bioengineered skin graft models and the results can be used to increase reproducibility and consistency during the production of bioengineered skin constructs. The information from this study can be extrapolated to future in vivo studies using human dermal fibroblasts in an in vivo model to help determine the best donor age and time in culture for optimal wound healing outcomes or more reproducible in vitro testing constructs.

Body composition in term neonates of mothers with hypertensive disorders of pregnancy.

Neonates of gravidas with hypertensive disorders of pregnancy (HDP) are at increased lifelong risk of cardiometabolic complications. Neonatal adiposity measured by body composition (BC) is a better surrogate of nutritional status than birth weight. Data comparing BC in term neonates of hypertensive and normotensive pregnant patients is lacking. Our objective was to compare body composition in both groups of neonates. This was a retrospective cohort study from March 2018 to June 2019 at our tertiary institution where term neonatal BC are routinely measured. Neonates of patients with HDP and matched controls were included. Skin fold thickness (SFT) and percent body fat (PBF) were calculated using a validated anthropometric formula and compared using Mann-Whitney U and chi-square tests. One hundred and forty-two neonates of patients with HDP were compared to 150 controls. Demographic characteristics were similar except for higher pre-pregnancy BMI (29.7 ± 8.4 vs 26.75 ± 7.1, p = <0.01) in the HDP group. SFT was not significantly different (4.6 vs 4.4 mm, p = 0.09) but PBF was higher in the hypertensive group (13.15 vs 11.72, p = 0.01). PBF is higher in neonates of mothers with HDP, which may contribute to an increased risk of cardiometabolic complications later in life. Birth weight percentiles do not explain the predisposition to cardiovascular complications in offspring of hypertensive mothers. Body composition estimation may provide an explanation for this increased risk. Percent body fat is higher in term neonates of mothers with hypertensive disorders of pregnancy than neonates of normotensive mothers. Body composition is different in term neonates of mothers with hypertensive disorders of pregnancy.

Comparison of vitamin D levels between mothers and infants with and without prolonged membrane rupture

Background. Premature membrane rupture is a known causes of preterm labor and accounts for approximately one-third of cases. Vitamin D deficiency may play a role in preterm labor as well. Objective. The present study aimed to compare vitamin D levels in mothers and infants with and without prolonged rupture of membranes (PROM). Materials and methods. This cross-sectional study was conducted with 241 babies, with and without a history of membrane rupture, in mothers in the neonatal ward of Ghaem Hospital, Mashhad, from 2019 to 2021 with available sampling methods. After confirmation of prolonged membrane rupture (more than 18 hours before birth) based on history and examination with a speculum, we completed a data collection tool, a checklist including laboratory evaluation and neonatal and maternal characteristics. The conditions of neonates with and without prolonged membrane rupture were compared. Data were analyzed by T-test and Chi-square. Results. We examined a total of 241 neonates including 148 (61.4%) without prolonged rupture of the membranes in mothers and 93 (38.6%) with PROM. There were statistically significant differences between the two groups regarding: maternal vitamin D level (p = 0.001); neonatal vitamin D level (p = 0.001); and fifth minute Apgar score (p = 0.003). These variables were lower in the group of neonates with PROM. Conclusion. Vitamin D deficiency in mothers was significantly associated with prolonged membrane rupture. With increasing severity of vitamin D deficiency, the probability of PROM increases and, therefore, the likelihood of preterm labor and its complications rises.

Educational Review: The Impact of Perinatal Oxidative Stress on the Developing Kidney.

Oxidative stress occurs when there is an imbalance between reactive oxygen species/reactive nitrogen species and antioxidant systems. The interplay between these complex processes is crucial for normal pregnancy and fetal development; however, when oxidative stress predominates, pregnancy related complications and adverse fetal programming such as preterm birth ensues. Understanding how oxidative stress negatively impacts outcomes for the maternal-fetal dyad has allowed for the exploration of antioxidant therapies to prevent and/or mitigate disease progression. In the developing kidney, the negative impact of oxidative stress has also been noted as it relates to the development of hypertension and kidney injury mostly in animal models. Clinical research addressing the implications of oxidative stress in the developing kidney is less developed than that of the neurodevelopmental and respiratory conditions of preterm infants and other vulnerable neonatal groups. Efforts to study the oxidative stress pathway along the continuum of the perinatal period using a team science approach can help to understand the multi-organ dysfunction that the maternal-fetal dyad sustains and guide the investigation of antioxidant therapies to ameliorate the global toxicity. This educational review will provide a comprehensive and multidisciplinary perspective on the impact of oxidative stress during the perinatal period in the development of maternal and fetal/neonatal complications, and implications on developmental programming of accelerated aging and cardiovascular and renal disease for a lifetime.

Міокардіальна дисфункція як складова поліорганної невідповідності при неонатальному сепсисі

The formation of myocardial dysfunction in neonatal sepsis remains a topical issue in current neonatal practice. Myocardial dysfunction with neonatal sepsis is found to promote a double increase of neonatal loss rate, and maintenance of an adequate cardiac output is very important predictor for survival of patients with neonatal sepsis. Purpose - to study clinico-paraclinical markers of myocardial dysfunction in case of an alternative term of neonatal sepsis debut for timely verification and rational correction of cardiovascular disorders. Materials and methods. Considering various terms of neonatal sepsis manifestation with its early and late variants, a comparative analysis of clinical-paraclinical markers of generalized infectious-inflammatory process was made in 26 neonates at the stage of obstetrical aid (retrospective analysis) and in the intensive care departments for neonates and their resuscitation (prospective follow-up). According to the results of the analysis of medical records of newborns, the diagnosis of early neonatal sepsis was established in 14 (53.8%) newborns who were included in the clinical group I of the study, and the diagnosis of late neonatal sepsis was established in 12 (46.2%) newborns who were included in the clinical group II. Results. After birth general condition of patients from the group I was assessed as of moderate severity - in 1 (7.1%) and severe - in 13 (92.9%) neonates; in the group II the 2 neonates (16.7%) were in the condition of moderate severity (р&gt;0.05) and 10 (83.3%) neonates were in severe condition (р&gt;0.05). Assessment of cardiovascular constituent in the neonatal groups of comparison according to the constellation scale nSOFA in the means values did not differ reliably, though it was indicative of a tendency to deeper disorders in case of late neonatal sepsis. Conclusions. Sepsis-induced myocardial dysfunction is manifested by increase in the content of cardio-specific markers (creatine phosphokinase, МВ fraction, troponin I). An increased content of troponin I in the blood higher than that of the norm in case of late neonatal sepsis possesses a high inclination (83.3%) to the formation of myocardial dysfunction. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: neonates, neonatal sepsis, myocardial dysfunction.

Perinatal Transmission and Outcomes of SARS-CoV-2 Infection

Maternal SARS-CoV-2 infection can adversely affect the birth and neonatal outcomes. The authors prospectively enrolled 196 neonates born to 193 SARS-CoV-2–positive mothers to determine the rate of mother-to-baby transmission of SARS-CoV-2 and its effect on short-term neonatal outcomes in Indian population. Nineteen babies turned out to be RT-PCR–positive for SARS-CoV-2, carrying a perinatal transmission rate of 9.8%. Rates of prematurity and low birth weight were 12.8% and 18.9% in the neonatal group, respectively. On comparing SARS-CoV-2–positive (n = 19) and negative (n = 177) neonatal groups, rate of prematurity, hospital admission rate, and death rate were higher in the former group. The placental positivity rate for SARS-CoV-2 was 8.1%, but no relation was found between placental and neonatal infection.

Multisystem Inflammatory Syndrome in Neonates; a Real Diagnostic Dilemma!

Neonatal multisystem inflammatory syndrome is a potentially life threatening disease entity which was described following the global crisis of SARS-CoV-2 that still demands further evidence for a conclusive diagnosis. We report a group of neonates who admitted to our neonatal intensive care unit with predominantly cardiac manifestations were treated for early onset of sepsis and subsequently for Neonatal multisystem inflammatory syndrome ended up with a good survival outcome.

Vasopressin associated hyponatremia in critically ill children: A cross-sectional study

BackgroundThe association of hyponatremia with vasopressin therapy in children is controversial. We aimed to evaluate the incidence and severity of hyponatremia associated with the administration of vasopressin in critically ill pediatric patients. MethodsThis retrospective cross-sectional study included children younger than 14 years who were admitted to the pediatric or pediatric cardiac intensive care units and received vasopressin for at least 24 h. ResultsIn total, 176 critically ill pediatric patients were enrolled, with a median age of 22 days (7.3–146). The mean sodium level was notably decreased from 143.5 mEq/L ± 7.15 at the baseline to 134.3 mEq/L ± 7.7 at the 72-hour measurement after the initiation of vasopressin and varied significantly at all intervals from the baseline measurement (P < 0.001). Twenty-four hours after the discontinuation of vasopressin, more than half of the patients had hyponatremia. The highest proportion had mild hyponatremia (32.8%), followed by moderate hyponatremia (13.1%), and profound hyponatremia (7.5%). The incidence of hyponatremia was independent of gender (P = 0.94) or age group (P = 0.087). However, more than two-thirds of the moderate-profound cases and more than one-third of mild cases were observed in the neonate group (P = 0.043). The vasopressin dose did not affect the incidence (P = 0.25) or the severity of the hyponatremia (P = 0.56). Notably, all laboratory and hemodynamic parameters varied significantly at the end of therapy, compared to the baseline. ConclusionsContinuous monitoring for hyponatremia when children are placed on vasopressin is essential to protect against more severe complications.

Differences in the Distribution of the General Movements Classification Between Neonatal Risk Groups in the Children's Hospital Zurich: An Observational Study

Neonatal infants are at increased risk for motor development disorders. To compare General Movements (GMs) classification between three neonatal risk groups, correlate the GMs Assessment (GMA) with a standardized developmental neurological examination (SDNE) and determine risk factors for abnormal GMs. Monocentric observational study with three risk groups (children with operated congenital heart disease (CHD) n=26, with operated congenital gastrointestinal malformations (CGM) n=17 and with fetal operated myelomeningocele (MMC) n=12 who underwent inpatient video-based examination. GMA was evaluated according to Hadders-Algra classification and divided into 4 categories: normal optimal (NO), normal suboptimal (NS), mildly abnormal (MA), definitely abnormal (DA). The distribution was as follows: CHD 80.8% NS, 19.2% MA, CGM 5.9% NO, 64.7% NS, 29.4% MA, MMC upper extremities 100% NS, lower extremities 33.3% NS, 33.3% MA and 33.3% DA (group comparison Kruskal-Wallis 10.729, p=0.003). GMA correlated significantly with SDNE (Spearman r s=0.869, p<0.001). Binary logistic regression analysis showed that only gestational age (Chi2=11.93, p<0.001) correlated with abnormal GMs. The majority of children showed normal GMs. Children with MMC and those with lower gestational age showed an increased risk of abnormal GMs. The GMA and SDNE represent complementary "bedside tools" to detect early motor abnormalities.

Assessment of Hippocampal Cell Death and Memory Deficits in Rats Following Neonatal Stress

Objective: Neonatal stress (NS) has harmful effects on the hippocampal neurons of rat neonates. It has been reported to enhance neuronal cell death and impair memory behaviors. The researchers conducted this study in order to assess NS’s effects on hippocampal apoptosis and memory deficits in rat neonates’ hippocampus. Methods: Three groups of male Wistar rat neonates exposed to NS; rat neonates reared with 1 hour neonatal isolation (NI) for 8 consecutive days (P2-P9), rat neonates exposed to febrile seizure (FS) at day 10 (P10) and rat neonates reared with both NI plus FS (NI-FS). Control group was reared normally. Novel object recognition test (NORT) carried out to evaluate the effects of NI, FS and NI-FS on memory deficits. At day 22 (P22), Terminal deoxynucleotidyl transferase- mediated dUTP nick end labeling (TUNEL) assay was done. Results: NORT demonstrated that rat neonates exposed to NI-FS had short-term and long-term memory deficits (P&lt;0.01 and P&lt;0.001). Rat neonates experienced NI had long-term memory deficits (P&lt;0.05). TUNEL assay results showed that NI-FS increased the count of hippocampal apoptotic neurons in Cornu Ammonis 1 (CA1), Cornu Ammonis 3 (CA3) and dentate gyrus (DG) subfields (P&lt;0.001, P&lt;0.001 and P&lt;0.001). Also, NI increased the count of hippocampal TUNEL positive cells in CA3 and DG subfields (P&lt;0.05 and P&lt;0.01). In addition, FS increased the count of hippocampal apoptotic neurons in DG subfield (P&lt;0.05). Conclusion: The present results showed that NS exerted apoptotic effect and induced memory deficits in the hippocampus of rat neonate.

Timing of Graves' Hyperthyroidism Management in Pregnant Women: Impact on the Infant Thyroid Volume.

The thyroid of the fetus of a mother with Graves’ disease (GD) is affected by the transplacental passage of both antithyroid drugs (ATDs) and thyroid-stimulating hormone receptor antibodies (TRAb). Thyroid hormone imbalances are harmful for the developing brain. This study aimed to evaluate the impact of the duration of antithyroid drug treatment in hyperthyroid pregnant women with GD on infants’ thyroid volume. Twenty-nine neonates born to mothers with GD were divided into two groups depending on the duration of ATDs treatment. The ultrasound thyroid volumes of the infants were measured within the first week of life. Thyroid-stimulating hormone, thyroxine, and TRAb values were recorded. There was no difference between groups in the thyroid hormones’ values. The median thyroid volume for the entire group of neonates with mothers with GD, for the groups of neonates of mothers with long- and short-treated GD, and for the control group were 1.539, 1.816, 1.347 and 1.014 mL, respectively. There were statistically significant differences in the thyroid volume between the GD group and the control group, as well as between the groups of neonates of mothers with long- and short-treated GD (p < 0.05). Studies have shown that the longer the duration of ATDs administration to mothers, the greater the thyroid volume of the neonate.

Patterns of infant dermatoses: An observational study from the dermatology outpatient clinic of a tertiary referral center

Objectives: To study the pattern of dermatoses among infants who attended the dermatology outpatient clinic of a tertiary referral center. Materials and Methods: We included 270 consecutive infants (children aged 1 year and below) with dermatoses who attended the outpatient clinic of the department of dermatology of our tertiary referral center. Using a preset proforma, we collected information on patient profile, evolution of dermatosis, and clinical features. The dermatoses observed were classified as transient and non-infective conditions, nevi and other developmental defects, genodermatoses, infections and infestations, inflammatory dermatoses, reactive dermatoses, and other miscellaneous conditions. Results: The study participants included 162 males (60%) and 108 females (40%). Fifty-three infants (53/270, 19.6%) were neonates. The most common dermatoses observed among the study participants were infections and infestations (86, 31.9%) followed by inflammatory dermatoses (83, 30.7%). Among the neonates, the common dermatoses observed were napkin dermatitis (14/53, 26.4%), transient neonatal pustular melanosis (6/53, 11.3%), and congenital melanocytic nevus (6/53, 11.3%). The common dermatoses observed among infants above 28 days were fungal infections (32/217, 14.7%), atopic dermatitis (23/217, 10.6%), miliaria (22/217, 10.1%) and infantile seborrheic dermatitis (21/217, 9.7%). Limitations: The study carried out in the outpatient clinic of the dermatology department of a tertiary referral center and the cross-sectional design were the major limitations. Conclusion: Fungal infection was the most frequently observed infection. Whether, this indicates an epidemiological shift in the prevalence of dermatophytosis in pediatric age group needs analysis in future multicenter studies. Napkin dermatitis and atopic dermatitis were the most common non-infective dermatoses in the neonatal and post-neonatal age groups, respectively.

Retrospective analysis of neonates born after assisted reproductive technology and admitted to the neonatal intensive care unit

Dear Editor, There are limited studies evaluating neonatal outcomes after assisted reproductive technology (ART) in Asia, especially Southeast Asia, hence this study aimed to fill this gap in literature. We conducted a retrospective study on a group of neonates conceived via ART performed at the National University Hospital (NUH), Singapore and admitted to its neonatal

Neonatal isolation provokes hippocampal apoptosis and recognition memory impairment in rats

Neonatal isolation (NI) has detrimental consequences on the hippocampal neurons of rat neonates. It has been reported to enhance neuronal cell death and impair memory behaviors. We conducted this study to assess the effects of NI on hippocampal apoptosis and recognition memory impairment in the hippocampus of rat neonates. One group of male Wistar rat neonates exposed to NI; rat neonates reared with 1-hour neonatal isolation (NI) for eight consecutive days (P2-P9). On the other hand, the control group reared normally. Novel object recognition test (NOR) test used to evaluate the effects of NI on recognition memory impairment. On day 22 (P22), a TUNEL assay was done. NOR demonstrated that rat neonates who experienced NI had long-term memory deficits (P&lt;0.01). TUNEL assay results showed that NI increased the number of TUNEL positive neurons in CA1, CA3, and DG subfields of the hippocampus (P&lt;0.05, P&lt;0.001, and P&lt;0.001). The present results indicated that NI exerted apoptotic effect and induced recognition memory impairment in the rat neonate’s hippocampus.