Neonatal Serum Research Articles

Relationship between maternal Vitamin D levels and neonatal Vitamin D levels with delayed neonatal hypocalcemia - A hospital-based observational study

Background: Vitamin D has important role in regulating various metabolic processes in the body including calcium metabolism. Fetuses and neonates are dependent on their mothers to get adequate supply of Vitamin D. Maintaining adequate maternal Vitamin D levels may be highly beneficial for their fetuses and the babies. Aims and Objectives: The aim of the study was to find a correlation, if any, between maternal Vitamin D status and neonatal Vitamin D levels and delayed neonatal hypocalcemia. Materials and Methods: Fifty mother infant pairs with neonatal late onset hypocalcemia were included in the study. Detailed clinical history along with simultaneous maternal and neonatal blood samples were taken for estimation of calcium, phosphorus, parathormone (intact), and Vitamin D levels. Results: Mean maternal and neonatal serum Vitamin D (25-OH Vitamin D) levels were 19.5±7.5 and 15±8.5, respectively. There was a statistically significant correlation between maternal and neonatal Vitamin D levels (P=0.001). There was also a direct correlation between low maternal Vitamin D levels and delayed hypocalcemia in neonates (P=0.048). Mean maternal and neonatal serum calcium levels were 9±1.5 mg/dl and 6.2±0.4 mg/dl, respectively. There was no significant statistical correlation between the two (P>0.05). Conclusion: Maternal Vitamin D level appears to be an important determinant of neonatal Vitamin D and serum calcium levels.

Correlation between transcutaneous bilirubin levels and total serum bilirubin levels in postnatal period in a tertiary care center

Background: Neonatal jaundice is generally a benign condition seen during the postnatal period. The non-invasive methods including transcutaneous bilirubinometry have been developed for assessment of neonatal jaundice, transcutaneous bilirubin TcB) meters noninvasively estimate the bilirubin levels by measuring light transmission through the skin of neonates this value is then to be plotted against a chart in order to look for hyperbilirubinemia. Aim was to determine the efficacy of measuring the transcutaneous bilirubin as a screening tool for clinically significant hyperbilirubinemia. Methods: Study was a cross sectional study conducted under pediatric department of SMBT IMS and RC at tertiary care center after taking the approval from the ethical committee. Total of 110 neonates that appear to be clinically suffering from neonatal jaundice were considered for study after consent from respective parent/ guardian. Neonatal TCB levels and serum bilirubin levels were done. If bilirubin levels lie in phototherapy range, then baby was shifted to NICU and phototherapy treatment was given, and once levels came within normal range after the phototherapy treatment, again serum bilirubin levels were measured in order to compare pre-and post-treatment levels. Results: Present study showed male preponderance. 64 were male and 46 were female. Majority 61% were full term normal delivery and 39% were LSCS. Mean TCB level was 8.5±2.8. Statistical significance was seen for TCB and sever hyperbilirubinemia. Conclusions: Present study concluded that hyperbilirubinemia is commonly seen among males. Newborn delivered had hyperbilirubinemia. Statistical significance was seen between TCB level and severity of the disease. Thus, neonatal TCB levels can be used as a screening test for detecting hyperbilirubinemia in neonates. As TCB is a noninvasive and cost effective it can be used widely as predictor of the disease.

Physiologically-based pharmacokinetic model to investigate the effect of pregnancy on risperidone and paliperidone pharmacokinetics: Application to a pregnant woman and her neonate.

This study aimed to determine the effects of pregnancy and ontogeny on risperidone and paliperidone pharmacokinetics by assessing their serum concentrations in two subjects and constructing a customized physiologically-based pharmacokinetic (PBPK) model. Risperidone and paliperidone serum concentrations were determined in a pregnant woman and her newborn. PBPK models for risperidone and paliperidone in adults, pediatric, and pregnant populations were developed and verified using the Simcyp simulator. These models were then applied to our two subjects, generating their "virtual twins." Effects of pregnancy on both drugs were examined using models with fixed pharmacokinetic parameters. In the neonatal PBPK simulation, 10 different models for estimating the renal function of neonates were evaluated. Risperidone was not detected in the serum of both pregnant woman and her newborn. Maternal and neonatal serum paliperidone concentrations were between 2.05-3.80 and 0.82-1.03 ng/ml, respectively. Developed PBPK models accurately predicted paliperidone's pharmacokinetics, as shown by minimal bias and acceptable precision across populations. The individualized maternal model predicted all observed paliperidone concentrations within the 90% prediction interval. Fixed-parameter simulations showed that CYP2D6 activity largely affects risperidone and paliperidone pharmacokinetics during pregnancy. The Flanders metadata equation showed the lowest absolute bias (mean error: 22.3% ± 6.0%) and the greatest precision (root mean square error: 23.8%) in predicting paliperidone plasma concentration in the neonatal population. Our constructed PBPK model can predict risperidone and paliperidone pharmacokinetics in pregnant and neonatal populations, which could help with precision dosing using the PBPK model-informed approach in special populations.

Effects of alkaline mineral complex supplementation on production performance, serum variables, and liver transcriptome in calves.

Calf diarrhea causes huge economic losses to livestock due to its high incidence and mortality rates. Alkaline mineral complex water is an alkaline solution containing silicon, sodium, potassium, zinc, and germanium, and has biological benefits and therapeutic effects. This study aimed to evaluate the impact of alkaline mineral complex water supplementation on the health of calves and to investigate the effect of Alkaline mineral complex water supplementation on neonatal calf serum variables and the liver transcriptome. Sixty Holstein calves (age 1.88 ± 0.85 days, weight 36.63 ± 3.34 kg) were selected and randomly divided into two groups: the T group (treatment group with alkaline mineral complex water supplemented during the experiment) and C group (control group without alkaline mineral complex water supplementation). Alkaline mineral complex water supplementation significantly increased the body weight for calves aged 60 d and average daily gain during the experimental period (1-60 d). In addition, Alkaline mineral complex water supplementation could significantly decrease the diarrhea rate for calves aged 16-30 d, enhance the T-AOC, IgG, IGF-1, and IGFBP-2 in concentrations. The results of KEGG enrichment analysis in transcriptomics indicate that Alkaline mineral complex water supplementation inhibited the target IL-1B gene of the NF-kappa B signaling pathway of liver. Alkaline mineral complex water supplementation decreased calf diarrhea and improved partial immune function, anti-inflammatory activity, antioxidant capacity, and health of calves. Alkaline mineral complex is a candidate to replace medicated feed additives. Alkaline mineral complex waterAlkaline mineral complex waterAlkaline mineral complex waterAlkaline mineral complex waterAlkaline mineral complex waterAlkaline mineral complex waterAlkaline mineral complex water.

Association of Neonatal Serum Creatinine Concentration with Maternal Serum Creatinine Concentration and Birth Weight.

The serum creatinine (SCr) concentration in neonates is generally high for its body size, compared to those of infants. The aim of the present study was to investigate the effect of maternal SCr on neonatal SCr through measurements of prenatal maternal SCr and neonatal SCr from birth to postnatal Day 5. In addition, postnatal changes in SCr were compared between term and preterm infants, given that few studies have addressed this topic. The retrospective study subjects were 151 neonates whose Scr was measured consecutively from birth to postnatal Day 5 and 124 mothers whose SCr was measured prenatally. There were significant correlations between maternal SCr and neonatal SCr at birth (r = 0.858, p < 0.001) and on postnatal Day 1 (r = 0.235, p < 0. 001). The SCr of term infants (median 0.69 mg/dL, range 0.54 - 0.96 mg/ dL) were higher than those of preterm infants (median 0.63 mg/dL, range 0.43 - 1.23 mg/dL, p < 0.001) at birth; however, these values were reversed on postnatal Day 1 (Term: median 0.75 mg/dL, range 0.51 - 1.13 mg/dL, Pre-term: median 0.88 mg/dL, range 0.56 - 1.25 mg/dL, p < 0.001). There were differences in the timing of reaching to peak SCr between preterm and term neonates. In addition, birth weight might affect SCr concentrations after birth. The results of this study suggest that neonatal SCr is influenced by maternal SCr, although the effect disappears by postnatal Day 2. Moreover, glomerular filtration rate differs between term and preterm infants.

Evaluation of the relationship between neonatal serum asprosin levels and anthropometric measurements in newborns of mothers with and without gestational diabetes mellitus.

Asprosin is a newly identified adipokine that is expressed in the placenta. Its production is increased in women with gestational diabetes mellitus (GDM), and it is a factor related to insulin resistance. This study aimed to determine whether neonatal serum asprosin levels are associated with anthropometric characteristics of newborns born to mothers with and without GDM. This study included 51 newborns of mothers with GDM (insulin-treated or diet-treated) and 55 control newborns with their mothers. In newborns, anthropometric parameters were measured, and the concentrations of asprosin were detected by ELISA. Maternal blood glucose levels, body weight, and length were measured and body mass index (BMI) was calculated. Serum asprosin levels were significantly higher and linked to a higher risk in the newborns of mothers with GDM compared with those of the control newborns (170.3 [132.6] vs. 91.4 [68.7] ng/mL, p < 0.001). Serum asprosin levels were negatively correlated with blood glucose concentrations (r = -0.282, p = 0.045) in the newborns of mothers with GDM and significantly positively correlated with birth weight (r = 0.315, p = 0.019) in the control newborns. Newborn serum asprosin levels were positively correlated with the glucose levels (r = 0.264, p = 0.006) of all mothers. In addition, newborns born to an insulin-treated mother with GDM had significantly higher birth weight and length than newborns born to a diet-treated mother with GDM (3262.9 vs. 3137 g, p = 0.032, and 49.7 vs. 49.2 cm, p = 0.05). Although asprosin levels were higher in newborns of mothers treated with insulin, these differences were not statistically significant. Mothers with GDM had high blood glucose levels (p = 0.032). Serum levels of asprosin are increased and negatively correlated with glucose concentrations in newborns of mothers with GDM. Asprosin could be used as an early biomarker in newborns of GDM mothers.

The role of nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome in diagnosis of late onset neonatal sepsis.

Neonatal sepsis is a major cause of morbidity and mortality among neonates. Nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome is a core element for innate immune protection. The study aims to estimate the expression of NLRP3 inflammasome in full term newborn infants who suffer from late onset sepsis, in order to assess its diagnostic value. This case-control study was conducted in NICU. 40 newborns with late onset sepsis, and 40 control neonates were included. The analysis of NLRP3 inflammasome was done by ELISA. There was a significant elevation of NLRP3 inflammasome in the serum of neonates with late onset sepsis group than the control group, P values were < 0.001, and the best cut off value of NLRP3 to detect late onset septic was > 3 ng/ml with sensitivity of 92.5% and specificity of 97.5%. Receiver operating characteristic curve showed that the best cut off point of NLRP3 to predict mortality in cases group was > 7.29 with sensitivity of 75.0%, specificity of 91.67%, PPV of 50.0%, NPV of 97.1% and total accuracy of 0.84%. n-SOFA scoring system increased significantly among LOS group and there was positive correlation with NLRP 3 inflammasome, P < 0.012. NLRP3 inflammasome can be used for the diagnosis of late onset neonatal sepsis. The increase of its values was not affected by gender, birth weight, gestational age and postnatal age. It was the novel sepsis markers that were not fully studied in neonatal population. The prognostic values may need further studies.

Clinical Value of Serum Interleukin-18 in Neonatal Sepsis Diagnosis and Mortality Prediction.

Previous studies have demonstrated that interleukin-18 (IL-18) levels were elevated in adult patients with sepsis. However, its role in neonatal sepsis remains unknown. The current research was conducted to assess the clinical value of serum IL-18 level as a candidate biomarker in neonatal sepsis diagnosis and prediction of mortality. From July 2022 to September 2022, we prospectively enrolled 91 septic neonates and 31 non-sepsis neonates in the intensive care unit of neonates at Henan Children's Hospital in Zhengzhou, China. Neonatal peripheral blood serum was collected at admission and levels of serum IL-18 were assessed. Employing multivariate logistic regression analysis, the evaluation of the potential of IL-18 as an independent biomarker for sepsis was executed. Furthermore, employing the receiver operating characteristic (ROC) curve analysis, the diagnostic value of IL-18 in sepsis and the ability of IL-18 in predicting the mortality of neonatal sepsis was measured. The statistical package SPSS 24.0 was employed to conduct all statistical analyses. Serum IL-18 levels in neonates in the sepsis group were elevated compared to the control group, reaching the highest levels in the non-survival sepsis group (P < 0.001). Correlation analysis exhibited a positive relationship between IL-18 levels and age, body temperature, respiratory rate, and C-reactive protein levels. IL-18 was identified as an independent biomarker in identifying sepsis (OR = 4.747, 95% CI 1.493-15.092, P = 0.008) by multiple logistic regression. ROC curve analysis exhibited that IL-18 was good in identifying neonatal sepsis (area under curve (AUC) = 0.77, 95% CI = 0.68-0.85, P < 0.001) and predicting neonatal mortality (AUC = 0.80, 95% CI = 0.63-0.96, P = 0.003). IL-18 was a potential biomarker for identifying neonatal sepsis and neonatal mortality prediction.

Sources of variance in the results of a commercial bovine immunoglobulin G radial immunodiffusion assay.

Radial immunodiffusion (RID) is used to quantify IgG concentration in neonatal beef or dairy calf serum; variability has been noted that may affect the precision and accuracy of assay results. We determined the source, range, and homogeneity of variance in the results of a commercial bovine IgG RID assay (Triple J Farm). To estimate the variance in the precipitin ring diameter, we used 6 sera, measured 28 times across 8 plates and 4 lots, and 3 standards with known IgG concentrations, measured 75 times across 69 plates and 5 lots. The source of diameter variance was determined using variance partition coefficients for lot, plate, and repetition. We used 11 different methods to generate standard curves to convert RID precipitin ring diameters to IgG concentrations. The Levene test of homogeneity of variance (α = 0.1) was used to evaluate the equality of variance between the standards or serum precipitin ring diameters and calculated IgG concentrations. Lot and plate contributed minimally to the diameter variance. Precipitin ring diameters had equal variance. Calculated IgG concentrations for serum not requiring dilution had equal variance. A linear equation from aggregated standards, performed within the same day, had greater accuracy for the calculated IgG concentrations of the standards compared to other equation methods. Regardless of standard curve methodology or IgG concentration, variability inherent to the assay limits its clinical usefulness.

A large series of molecular and serological specimens to evaluate mother-to-child SARS-CoV-2 transmission: a prospective study from the Italian Obstetric Surveillance System

ObjectivesTo assay the presence of the SARS-CoV-2 genome in vaginal, rectal, and placental swabs among pregnant women and in newborn nasopharyngeal swabs and to investigate the immunological response and maternal antibody transfer through the umbilical cord blood and milk of unvaccinated mothers. MethodsVaginal, rectal, and placental specimens, maternal and neonatal serum, and milk were collected from a wide cohort of pregnant Italian women with confirmed SARS-CoV-2 infection admitted to the hospital between February 25, 2020 and June 30, 2021. Samples were tested in selected reference laboratories according to a shared interlaboratory protocol. ResultsAmong 1086 enrolled women, the SARS-CoV-2 positive rate detected in all specimens ranged from 0.7% to 8.4%. Respectively, 45.2% of maternal sera collected during pregnancy and 39.7% of those collected at birth tested positive for immunoglobulin G, whereas 50.5% tested positive among neonates. Nasopharyngeal swabs were positive in 0.8% of the newborns, and immunoglobulin G was detected in 3.0% of the milk samples. The highest immunological response was recorded within 30 days during pregnancy and within 60 days of birth and in the neonatal population. ConclusionVertical transmission should be considered a rare event; although, a good maternal immunological response and antibodies transfer throughout the umbilical cord blood was detected.

3 Impacts of Vitamin and Mineral Supplementation to Beef Heifers During Gestation on Performance Measures of the Neonatal Calf, Trace Mineral Status, and Organ Weights at 30 Hours After Birth

Abstract Objectives were to evaluate the effects of feeding a vitamin and mineral (VTM) supplement to beef heifers during gestation on calf performance, body measurements, trace mineral status, and organ weights at 30 h after birth. We hypothesized that VTM supplementation during gestation would improve mineral status in the neonatal calf but not impact calf performance parameters and body and organ weights at 30 hours after birth. Fourteen Angus-based heifers [initial body weight (BW)] = 273.7 ± 1.10 kg) were randomly assigned to receive either a basal diet (CON; n = 7) or a basal diet plus a VTM supplement (VTM; n = 7; 113 g•heifer-1•d-1, targeting gain of 0.45 kg/day) from 60 d pre-breeding through gestation. Immediately after parturition, blood samples were collected from dams and calves, then calves were separated from their dams. Calves were fed one feeding of colostrum replacer, followed by milk replacer every 12 h, then euthanized at 30 h. Body weight and measurements were recorded, then organs and viscera were removed, weighed, and sampled. Dam serum and neonatal serum, liver, and blood were analyzed for concentrations of minerals. Data were analyzed using the GLM Procedure of SAS with individual animal as the experimental unit. Dietary treatments did not impact calf weight (0 h or 30 h), calf body measurements, or body weight of the dam at calving (P ≥ 0.32). Further, neonatal organ weights were not influenced (P ≥ 0.21) by maternal VTM treatment. Concentrations of Se and Co in calf serum and Se in calf liver were increased (P ≤ 0.02) by VTM treatment; however, concentrations of Cu, Mn, Mo, and Zn in calf muscle, liver, and serum were not impacted (P ≥ 0.07) by VTM treatment. Concentrations of Co in serum of the dam was the only mineral affected by dietary treatments, being greater (P = 0.001) in VTM than CON dams. In the current experiment providing trace mineral supplementation throughout gestation did not impact calf weight or body measurements at birth. However, the implications of altered mineral status of the neonatal calves at birth, and presumably throughout gestation, may have additional postnatal effects that warrant further investigation.

Knockdown of circ_0038467 alleviates lipopolysaccharides-induced 16HBE cell injury by regulating the miR-545-3p/TRAF1 axis in neonatal pneumonia

BackgroundNeonatal pneumonia is a common illness in the neonatal period with a high fatality rate. Accumulating proofs have attested to the crucial role of circular RNAs (circRNAs) in pneumonia. This study was intended to expound on the function of circ_0038467 and the underlying mechanism in lipopolysaccharide (LPS)-stimulated 16HBE cell injury in neonatal pneumonia. Methods16HBE cells were exposed to LPS to establish an in vitro neonatal pneumonia cell model. Quantitative real-time polymerase chain reaction (qRT-PCR) was implemented for detecting the levels of circ_0038467, microRNA-545-3p (miR-545-3p), and tumor necrosis factor receptor-associated factor 1 (TRAF1) in neonatal pneumonia serums and LPS-treated 16HBE cells. Cell Counting Kit-8 (CCK-8), 5-ethynyl-2′-deoxyuridine (EdU) incorporation, and flow cytometry assays were used to examine cell viability, proliferation, and apoptosis, respectively. The protein abundances of proliferation/apoptosis/inflammation-correlated makers and TRAF1 were tested by Western blot. RNase R and Actinomycin D assays were implemented to determine the features of circ_0038467. The mutual effect between miR-545-3p and circ_0038467 or TRAF1 was affirmed by a dual-luciferase reporter and RNA pull-down assay assays. ResultsCirc_0038467 was upregulated in neonatal pneumonia serum specimens and LPS-triggered 16HBE cells. LPS administration restrained 16HBE cell proliferation and promoted apoptosis and inflammation, whereas circ_0038467 silence recovered these influences. Meanwhile, miR-545-3p was targeted by circ_0038467, and circ_0038467 could modulate LPS-treated 16HBE cell injury through absorbing miR-545-3p. Furthermore, circ_0038467 controlled TRAF1 level via segregating miR-545-3p. Moreover, TRAF1 overexpression relieved the suppressive impact of circ_0038467 silence in LPS-triggered 16HBE cell detriment. ConclusionCirc_0038467 knockdown mitigated LPS-exposed 16HBE cell damage through regulating miR-545-3p/PPARA axis.

Antenatal magnesium sulphate and delayed passage of meconium: A multicentre study

IntroductionThe published evidence on the association between magnesium sulphate (MgSO4) and delayed passage of meconium (DPM) is contradictory. ObjectivesTo determine whether there is an association between the administration of MgSO4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO4 administered to the mother. Population and methodsRetrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals. Delayed passage of meconium was defined as failure to pass meconium within 48 h of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 h between the first and second bowel movements. ResultsThe study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM. Delayed passage of meconium was not associated with antenatal MgSO4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels.Older gestational age (OR, 0.8; confidence interval [CI], 0.69–0.93; P = 0.003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04–4.86; P = 0.04) was a risk factor for DPM. ConclusionThe neonatal serum levels of magnesium reached with the doses of MgSO4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM.

Effects of hepatitis B vaccination on hepatitis B surface antigen in neonates and its change in vivo.

Vaccination is effective to prevent hepatitis B virus (HBV) infection. However, there is still a risk of infection after vaccination. In clinical work, we found that newborns were positive for HBV surface antigen (HBsAg) after vaccination. To determine the effect of hepatitis B vaccination on the detection of HBsAg trend in newborns. We collected data at birth, history of vaccination for hepatitis B, quantitative HBsAg results, and other information about newborns born in our hospital from July 2017 to July 2020. Serum samples from healthy neonates were randomly selected to be supplemented with recombinant hepatitis B vaccine on a concentration gradient, and HBsAg was measured quantitatively. Data from 1417 neonates were included in the study; 306 (21.6%) were HBsAg positive within 8 d after vaccination, with levels ranging from 0.104 IU/mL to 0.339 IU/mL. The proportion of neonates with HBsAg-positive serum was significantly correlated with the level of hepatitis B surface antibodies (anti-HBs) in the serum of their mothers (P < 0.01). Experiments in vitro showed that the proportion of neonates with HBsAg-positive serum was correlated with the dose of the hepatitis B vaccine, and when the concentration of the hepatitis B vaccine reached 5 ng/mL and 10 ng/mL, the serum HBsAg levels showed a significant negative correlation with the original concentration of serum anti-HBs. Hepatitis B vaccination can affect the level of HBsAg detected in neonatal serum, and the effect could be mitigated by delaying the measurement. Moreover, maternal anti-HBs offset the effects of neonatal vaccination on HBsAg serum levels.

Frequency of Neonatal Hyperbilirubinemia in Maternal Hyperglycemia

Objective: To evaluate the occurrence of newborn hyperbilirubinemia among women who were diagnosed as maternal hyperglycemia. Subject and Method: The present cross-sectional study was conducted in the OBS and Gynecology department of PNS Shifa Karachi. The study was done over the time period of six months. All pregnant women who visit antenatal clinics at PNS Shifa Hospital with a gestational age of 24 and 32 weeks undergoing a 75 gm 2 h glucose tolerance test and fulfilling criteria of IFG, IGT, or GIGT were included. After delivery, a 2 ml blood sample was drawn from each newborn and sent to the hospital diagnostic laboratory to evaluate the neonatal bilirubin level and serum bilirubin &gt;300µmol/L after 96 hrs was considered as neonatal hyperbilirubinemia. All of the data was obtained using a study proforma. For the analysis of the data, SPSS software version 20 was utilized. Results: A total of 157 hyperglycemic mothers were studied; their average age was 28.20±4.67years and gestational ag was 37.11±3.22 weeks. Out of all, most of the women 100(63.7%) were multiparous. Caesarean section was done in 98(62.4%) cases. New born Neonatal hyperbilirubinemia was noted in 10.2% of the cases. The frequency of the neonatal hyperbilirubinemia was higher in the age groups of 19–30 years and &gt;30 years, while findings were non-significant statistically according to maternal age and gestational age (p = &gt;0.05). Conclusion: The study's findings showed that 10.2% of women with diabetes were found to have newborns with hyperbilirubinemia. It was proven to be statistically insignificant based on maternal age and gestational age. Keywords: Maternal, hyperglycemia, hyperbilirubinemia

SARS-CoV-2 IgG "heritage" in newborn: A credit of maternal natural infection.

Description of transplacental passage of specific SARS‐CoV‐2 IgG from mothers who contracted natural infection to their newborns. Retrospective cohort analysis including pregnant women diagnosed with SARS‐CoV‐2 and their newborns both tested for SARS‐CoV‐2 specific IgG and IgM with antibody titration at delivery. Nasopharyngeal swab were taken from both mothers and neonates, and tested for SARS‐CoV‐2 using polymerase chain reaction (PCR). IgM and IgG were analyzed in maternal and neonatal serum of 143 mother−infant dyads. 86% of women with a positive SARS‐CoV‐2 PCR >14 days before delivery developed specific IgG and 84% of their infants showed transplacental passage of IgG. Pregnant women infected with SARS‐CoV‐2 achieve antibody seroconversion following the kinetics described in the general population, and transplacental transfer of IgG specific antibodies occurs. No conclusion can be drawn on passive immunity efficacy or duration.

Neonatal acute kidney injury and serum cystatin C as its early predictor

Aim: To assess cystatin-C as an early biomarker for identifying AKI in newborns at risk for the condition. Methodology: Prospective cohort study in neonates with preterm and term admitted to NICU. The study group comprised of 24 Neonates with risk of AKI &amp; 24 Neonates with no risk of AKI. The Biochemical investigations were done. Collected data was subjected to statistical analysis using SPSS. Results: In this study, there is no significant correlation between gestational age and Creatinine &amp; Cystatin C levels of day 1 &amp; day 5/ death.There is no significant correlation between birth weight and Creatinine day 1, Creatinine &amp; Cystatin C levels of day 5/ death. But positive correlation between birth weight and Cystatin C levels of day 1. Serum Cystatin C can predict development of AKI in at cutoff point of &gt;1.41 mg/l, AUC= 1.000 with sensitivity of 93.3 % and specificity of 97.4 %. Conclusion : The rate of rise of serum cystatin C was earlier and the absolute number was also higher than serum creatinine. Cystatin C levels can predict AKI earlier than serum creatinine value. It can predict AKI atleast 1 or 2 days earlier than serum creatinine.

Peculiarities of changes in the cardiovascular system in the course of sepsis in newborns

The issues of early diagnostics of cardiovascular disorders in neonates with sepsis using up-to-date methods of examination are relevant today and will remain so in the future. They can be used as screening methods with the purpose to verify the possible development of cardiovascular dysfunction. Aim of the study: The study aimed to investigate the peculiarities of possible changes in the cardiovascular system and physiological electrical heart activity in neonates with signs of generalised infectious-inflammatory process, and to assess possible diagnostic methods and use of electrocardiography to verify cardiovascular disorders in newborns with neonatal sepsis. Materials and methods: To achieve the study objective, we followed up a total of 69 neonates with signs of generalised infectious-inflammatory process. Group I (32 patients – 46.4%) included neonates with a term of gestation of 37–42 weeks, and group II included 37 preterm neonates (53.6%) with a term of gestation under 36 weeks inclusive. Results: Generalised infectious-inflammatory process during the neonatal period of term infants is accompanied by electrocardiographic signs of left ventricular overload associated with the female sex (r = 0.30), delivery by cesarean section (r = 0.27), and assessment of neonatal condition by a 5-minute Apgar score (r = −0.33). The study demonstrates that increased values of lactate dehydrogenase activity in the blood plasma both in the term and preterm neonates are associated with left ventricular overload among the former, and the right ventricular overload among the latter, that is, preterm neonates. Conclusions: Increased values of lactate dehydrogenase activity in the blood serum of both term and preterm neonates are associated with left ventricular overload in term neonates, while right ventricular overload in preterm infants thus can be considered as a marker of cardiovascular dysfunction caused by neonatal sepsis, especially in the subpopulation of term patients considering its diagnostic value. Changes found in electrophysiological heart activity promote the necessity of routine use of electrocardiography in neonates with signs of the septic process.

Sulfato de magnesio antenatal y eliminación tardía de meconio: Estudio multicéntrico

IntroductionThe published evidence on the association between magnesium sulphate (MgSO4) and delayed passage of meconium (DPM) is contradictory. ObjectivesTo determine whether there is an association between the administration of MgSO4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO4 administered to the mother. Population and methodsRetrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals.Delayed passage of meconium was defined as failure to pass meconium within 48 hours of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 hours between the first and second bowel movements. ResultsThe study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM.Delayed passage of meconium was not associated with antenatal MgSO4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels.Older gestational age (OR, 0.8; confidence interval [CI], 0.69–0.93; P = .003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04–4.86; P = .04) was a risk factor for DPM. ConclusionThe neonatal serum levels of magnesium reached with the doses of MgSO4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM.

Association between betamethasone levels and respiratory distress syndrome in preterm births: A prospective cohort study.

The recommended fixed dosage of betamethasone for pregnancies at risk of preterm birth was determined in the 1970s, regardless of gestational age (GA), number of fetuses, and maternal weight. We aimed to examine the association between maternal and neonatal betamethasone serum levels and neonatal respiratory distress syndrome (RDS) and to examine whether levels correlate with maternal weight, GA, or number of fetuses. A prospective study was conducted at a single academic medical center between August 2016 and February 2019. Women received betamethasone and delivered between 28+0 and 34+6 weeks were included. Maternal serum levels (MSLs), and neonatal serum levels (NSLs) of betamethasone at delivery were analyzed using Corticosteroid enzyme‐linked immunosorbent assay kit. RDS was diagnosed according to clinical and radiographic findings. We assumed that the sensitivity of NSLs to detect RDS is 95%; hence, 150 neonates were needed (power 80%, alpha 0.05). Overall, 124 women were included; including 96 (77.4%) singletons, 26 (21.0%) twins, and 2 (1.6%) triplets, corresponding to 154 neonates. RDS was diagnosed in 35 neonates (22.7%). After adjusting for GA, time elapsed from the last dose, and number of doses, NSLs were associated with RDS (relative risk: 0.97, 95% confidence interval: 0.94–0.99, p = 0.011). A level of 6.00 ng/ml predicted RDS with a sensitivity of 80.0% and specificity of 64.7%. Adjusted MSLs were not associated with RDS. Both maternal and neonatal serum levels were not associated with the number of fetuses and maternal weight. In conclusion, NSLs are associated with RDS whereas MSLs are not.