Neonatal Network最新文献

A complete blood count (CBC) with differential is an essential laboratory test used to evaluate overall physiologic health and detect potential disorders in neonates. This test provides valuable insights into various blood cell types and structures and offers information on infections, immune status, anemia, and other hematologic conditions. Given the unique physiology and susceptibility of neonates to infections and other complications, interpreting the CBC with differential results in this population requires a specialized approach. The purpose of this article is to describe the components of the CBC and provide the reader with a neonatal case study to analyze and calculate values from within the CBC. The article also highlights common disorders causing abnormal neonatal CBC values and potential outcomes.

The purpose of this survey is to evaluate parental knowledge of respiratory syncytial virus (RSV) and its prevention. The study design used is an online survey. A total of 331 Canadian parents of preterm infants completed the survey. The main outcome variables used in the survey are knowledge of RSV, sources of information, and understanding strategies to decrease the risk of RSV infection. Of the participants, 99.4% understood the seriousness of RSV, but 19.6% were not confident in their knowledge. Respiratory syncytial virus education was provided to 75.6% in the hospital. 98.7% of uninformed parents wished they had been enlightened. Postdischarge, 60.5% felt unconfident in protecting their infant, and 70.8% searched for information. Health care professionals were the recommended source for RSV information (82.4-85.0%). Despite 98.6% understanding the importance of childhood immunizations, 24.1% remained anxious. Moreover, 65.4% received information about palivizumab, and 97.0% were confident about its use. Although 79.4% were unaware of nirsevimab, 75.4% would accept it. For maternal RSV vaccination, acceptability was 72.6%. Parents require accurate, reliable, and consistent information on RSV and its prevention, delivered to them in the NICU, following discharge, and via reputable online resources. Health care professionals, both in the NICU and community, should be well-informed and receive regular education throughout the year on RSV and the latest thinking on prevention.

This study investigates the impact of a prehabilitative oromotor stimulation, namely, premature infant oral motor intervention (PIOMI), on feeding performance in preterm infants during hospitalization and early infancy. In this randomized, blinded clinical trial, 130 preterm infants (26-32 weeks PMA) were randomly assigned to either the intervention group, which received PIOMI, or the control group. PIOMI was administered twice daily for 5 minutes, approximately 15-20 minutes before feeding, starting at 30 weeks' gestation. Follow-up assessments were conducted until 6 months of corrected age. The results demonstrated that infants in the intervention group showed significantly improved feeding performance scores (p < .001), achieved independent oral feeding at lower body weights (p < .001), and had a shorter hospitalization period (p < .05). Additionally, a greater proportion of infants in the intervention group were on mothers' milk at discharge and sustained breastfeeding until 6 months of corrected age (p < 0.005). The findings highlight the effectiveness of PIOMI as a prehabilitative strategy to enhance feeding performance, reduce hospital stays, and promote sustained breastfeeding in preterm neonates.

Congenital hearing loss hinders the child's social, emotional, and intellectual development. This systematic review was planned because the determination of congenital hearing loss and risk factors will guide health service planning. This systematic review was conducted based on previous studies in Turkey to determine the prevalence and the risk factors of newborn congenital hearing loss. This systematic review was conducted between November 2020 and February 2021; Google Scholar, PubMed, ScienceDirect, EBSCOhost, and Springer electronic databases were screened with the keywords "newborn hearing screening" and "congenital hearing loss." According to the results of the systematic review of 13 studies, 1 prospective and 12 retrospective, the prevalence of congenital hearing loss is 0.5% and 1.1% in those with risk factors; newborns are screened within 1 month, diagnosed within 2 months on average, and intervened with between the 3rd and 14th months; and the most common risk factors for hearing loss are admission in intensive care/mechanical ventilation for more than 5 days/history of ototoxic drug use, hyperbilirubinemia requiring an exchange transfusion/phototherapy, prematurity, consanguineous marriage, and family history of hearing loss, respectively.

Joubert syndrome (JS) is a rare neurodevelopmental and multisystem ciliopathy that affects 1 in 80,000-10,0000 infants globally per year. Classic defects include hypoplasia of the cerebellar vermis, thickened cerebellar peduncles, and deepened interpeduncular fossa, which is regarded as a "molar tooth" sign. More than 30 genes have been associated with JS. Gene mutations disrupt normal ciliary development and function during early embryogenesis and cause a vast array of symptoms and pathologies. The purpose of this article is to investigate this rare and complex medical condition. We present up-to-date information on the genetics, pathophysiology, clinical manifestations, diagnostics, and management of JS. We also include a valuable perspective from a pediatric geneticist who specializes in JS to enhance our understanding of challenges associated with making a molecular diagnosis and emphasize the importance of early recognition and diagnostics as a means to optimize the quality of care.

Hirschsprung's disease (HD) is a congenital intestinal motility disorder characterized by the absence of ganglionic cells in the distal intestine, leading to functional bowel obstruction and affecting 1 in every 5,000 neonates. A serious complication of HD is Hirschsprung-associated enterocolitis (HAEC), a life-threatening systemic illness responsible for a significant proportion of HD-related mortality. Proper management of HD, especially preventing HAEC, includes the use of rectal irrigations, which caregivers must master before their neonate's discharge. However, barriers such as short NICU stays and lack of standardized parental education hinder successful home care. This article provides an overview of HD pathophysiology, clinical manifestations, diagnostics, and management, alongside a practical parent education tool for rectal irrigation techniques to enhance at-home care and reduce morbidity.

Positive parent touch (PPT), including skin-to-skin care (STSC) and containment, is an evidence-based practice that provides short- and long-term benefits to preterm infants, while also improving parent-infant attachment and reducing parental stress. This quality improvement (QI) initiative aimed to decrease average days from birth to first STSC in infants born less than 29 weeks' gestation from 14.2 days to 7 days. A secondary aim was to decrease the average number of hours from birth to first PPT in the same population from 41.3 hours to ≤24 hours. Data were stratified by ethnicity to identify disparities. Using the Model for Improvement, a multidisciplinary team collaborated to identify barriers to early STSC implementing strategic interventions to improve STSC and PPT. Data were monitored and analyzed using statistical process control and run charts. An improvement was noted in mean days for STSC from a baseline of 14.2-3.3 days. Similarly, an improvement was noted in mean hours for PPT from a baseline of 41.3 hours to 28 hours. This NICU improved and sustained time to first STSC and PPT in preterm infants by combining QI methods with a family-centered care approach that emphasized neuroprotection and parent involvement.