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Children
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Current Advances in Neonatal Care
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Current Advances in Neonatal Care

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: closed (15 September 2022) | Viewed by 12612

Special Issue Editor

Dr. Thomas Austin

E-Mail Website
Guest Editor
Anesthesiology and Pediatrics, Department of Anesthesiology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
Interests: pediatric perioperative outcomes; study reproducibility; predictive modelling

Special Issue Information

Dear Colleagues,

The management of newborns is a continually evolving process, given the vulnerable nature of this population.  Despite decades of medical and surgical advancements, neonates remain a high-risk group, especially if born prematurely and/or with birth defects.  In fact, children continue to face their highest rates of death during their first month of life.  Although the neonatal mortality rate has declined globally over the past thirty years, marked disparities in neonatal death still exist across countries.  Furthermore, within the United States, there are vast differences in mortality rates during the first month of life related to race, ethnicity, and socioeconomic status. 

Over the years, public health agencies and healthcare providers have worked tirelessly to improve neonatal outcomes.  Although these communities have made great strides in combating newborn morbidity and mortality, substantial room for continued improvement remains.  The identification of modifiable social, behavioral, and health risk factors that affect birth outcomes and contribute to neonatal mortality is indeed paramount.  Resource allocation to assist with these changes is also of great importance, particularly in underserved populations.  In addition, neonatal medical and surgical breakthroughs are key to both diminishing death rates and improving quality of life.  

This Special Issue of Children will feature recent advancements in neonatal care.  We invite manuscripts focused on all aspects of newborn management, including reviews and original manuscripts.

Dr. Thomas Austin
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • newborn
  • neonate
  • pre-term
  • congenital anomalies
  • neonatal surgery
  • neonatal medicine
  • healthcare policy
  • global health

Published Papers (6 papers)

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Research

Jump to: Review

10 pages, 3951 KiB  
Article
Sudden Unexpected Postnatal Collapse and Therapeutic Hypothermia: What’s Going On?
by Luca Bedetti, Licia Lugli, Elisabetta Garetti, Isotta Guidotti, Maria Federica Roversi, Elisa Della Casa, Francesca Miselli, Maria Carolina Bariola, Antonella Di Caprio, Marisa Pugliese, Fabrizio Ferrari and Alberto Berardi
Children 2022, 9(12), 1925; https://doi.org/10.3390/children9121925 - 8 Dec 2022
Cited by 1 | Viewed by 1255
Abstract
Sudden unexpected postnatal collapse (SUPC) is a rare event, potentially associated with catastrophic consequences. Since the beginning of the 2000s, therapeutic hypothermia (TH) has been proposed as a treatment for asphyxiated neonates after SUPC. However, only a few studies have reported the outcome [...] Read more.
Sudden unexpected postnatal collapse (SUPC) is a rare event, potentially associated with catastrophic consequences. Since the beginning of the 2000s, therapeutic hypothermia (TH) has been proposed as a treatment for asphyxiated neonates after SUPC. However, only a few studies have reported the outcome of SUPC after TH. The current study presents the long-term neurodevelopmental outcome of four cases of SUPC treated with TH in a single Italian center. Furthermore, we reviewed the previous literature concerning 49 cases of SUPC treated with TH. Among 53 total cases (of whom four occurred in our center), 15 (28.3%) died before discharge from the NICU. A neurodevelopmental follow-up was available only for 21 (55.3%) out of the 38 surviving cases, and seven infants developed neurodevelopmental sequelae. TH should be considered in neonates with asphyxia after SUPC. However, SUPC is a rare event, and there is a lack of comparative clinical data to establish the risk/benefit of TH after SUPC with different degrees of asphyxia. Analysis of large cohorts of newborns with SUPC, whether treated with TH or untreated, are needed in order to better identify infants who should undergo TH. Full article
(This article belongs to the Special Issue Current Advances in Neonatal Care)
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10 pages, 391 KiB  
Article
Increased Total Serum Bilirubin Level Post-Ibuprofen Use Is Inversely Correlated with Neonates’ Body Weight
by Zon-Min Lee, Yao-Hsu Yang, Ling-Sai Chang, Chih-Cheng Chen, Hong-Ren Yu and Kuang-Che Kuo
Children 2022, 9(8), 1184; https://doi.org/10.3390/children9081184 - 7 Aug 2022
Cited by 1 | Viewed by 2014
Abstract
Backgrounds: Drugs with the ability to displace bilirubin from albumin-binding sites subsequently leading to an increased bilirubin level may cause hyperbilirubinemia in neonates. Ibuprofen is commonly used to treat patent ductus arteriosus (PDA) in neonates, yet the use of ibuprofen has drawn mixed [...] Read more.
Backgrounds: Drugs with the ability to displace bilirubin from albumin-binding sites subsequently leading to an increased bilirubin level may cause hyperbilirubinemia in neonates. Ibuprofen is commonly used to treat patent ductus arteriosus (PDA) in neonates, yet the use of ibuprofen has drawn mixed conclusions. We performed a retrospective study to determine how ibuprofen use influences the total serum bilirubin (TSB) level in neonates of differing birth weight (BW). Materials and methods: Neonates (including premature infants) born at Chang Gung Memorial Hospital, Taiwan during January 2004 to July 2020 were entered into this study. We recorded the phototherapy duration, including the initial day and end day, and determined the average influence of one-day phototherapy on TSB level. The highest monitored TSB level post-ibuprofen use minus the one measured prior to ibuprofen use was considered the TSB change following ibuprofen administration in this study, and the above-mentioned influence of daily phototherapy on the TSB level was used to correlate the results. Neonates with any of the following conditions were excluded: those who received ceftriaxone, those with intraventricular hemorrhage, and those infected with TORCH. Results: The average daily influence of phototherapy on the TSB level of neonates was −0.20 (−0.57~0.05) mg/dL, −0.28 (−0.84~0.13) mg/dL, −0.75 (−1.77~0.10) mg/dL, and −1.60 (−2.70~−0.50) mg/dL in neonates with BWs of <1 kg, 1–1.49 kg, 1.5–2.49 kg, and ≥2.5 kg, respectively, indicating that neonates with a BW ≥ 1.5 kg experienced a greater reduction in TSB level following phototherapy as compared with those with a BW < 1.5 kg. The average TSB increase following ibuprofen use in neonates was 3.38 ± 2.77 mg/dL, 2.04 ± 2.53 mg/dL, and 1.34 ± 2.24 mg/dL in neonates with BWs of <1 kg, 1–1.49 kg, and ≥1.5 kg, respectively, i.e., an elevated TSB change with a decreased neonate BW was noted post-ibuprofen use (p = 0.026, one-way analysis of variance (ANOVA)). Conclusions: As ibuprofen use is correlated with an apparent increase in TSB level in neonates with a lower BW, especially in those with a BW < 1 kg, iv acetaminophen can be an appropriate alternative to ibuprofen for ELBW neonates for the treatment of PDA if they are experiencing severe unconjugated hyperbilirubinemia. Full article
(This article belongs to the Special Issue Current Advances in Neonatal Care)
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10 pages, 669 KiB  
Article
Interventions for Promoting Meconium Passage in Very Preterm Infants—A Survey of Current Practice at Tertiary Neonatal Centers in Germany
by Maximilian Gross, Helmut Hummler, Bianca Haase, Mirja Quante, Cornelia Wiechers and Christian F. Poets
Children 2022, 9(8), 1122; https://doi.org/10.3390/children9081122 - 27 Jul 2022
Cited by 2 | Viewed by 2019
Abstract
Meconium passage is often delayed in preterm infants. Faster meconium passage appears to shorten the time to full enteral feeds, while severely delayed meconium passage may indicate meconium obstruction. Neonatologists often intervene to promote meconium passage, assuming that benefits outweigh potential risks such [...] Read more.
Meconium passage is often delayed in preterm infants. Faster meconium passage appears to shorten the time to full enteral feeds, while severely delayed meconium passage may indicate meconium obstruction. Neonatologists often intervene to promote meconium passage, assuming that benefits outweigh potential risks such as necrotizing enterocolitis (NEC). We performed an anonymous online survey on different approaches to facilitate meconium passage among tertiary neonatal intensive care units (NICUs) in Germany between February 2022 and April 2022. We collected information on enteral nutrition, gastrointestinal complications, and interventions to promote meconium passage. We received 102 completed questionnaires (response rate 64.6%). All responders used interventions to promote meconium passage, including enemas (92.0%), orally applied contrast agents (61.8%), polyethylene glycol (PEG) (46.1%), acetylcysteine (19.6%), glycerin suppositories (11.0%), and maltodextrin (8.8%). There was substantial heterogeneity among NICUs regarding frequency, composition, and mode of administration. We found no differences in NEC incidence between users and nonusers of glycerin enemas, high or low osmolar contrast agents, or PEG. There is wide variability in interventions used to promote meconium passage in German NICUs, with little or no evidence for their efficacy and safety. Within this study design, we could not identify an increased risk of NEC with any intervention reported. Full article
(This article belongs to the Special Issue Current Advances in Neonatal Care)
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11 pages, 547 KiB  
Article
Neurological Surveillance in Moderate-Late Preterm Infants—Results from a Dutch–Canadian Survey
by Martine F. Krüse-Ruijter, Vivian Boswinkel, Anna Consoli, Ingrid M. Nijholt, Martijn F. Boomsma, Linda S. de Vries, Gerda van Wezel-Meijler and Lara M. Leijser
Children 2022, 9(6), 846; https://doi.org/10.3390/children9060846 - 8 Jun 2022
Cited by 1 | Viewed by 2011
Abstract
Preterm birth remains an important cause of abnormal neurodevelopment. While the majority of preterm infants are born moderate-late preterm (MLPT; 32–36 weeks), international and national recommendations on neurological surveillance in this population are lacking. We conducted an observational quantitative survey among Dutch and [...] Read more.
Preterm birth remains an important cause of abnormal neurodevelopment. While the majority of preterm infants are born moderate-late preterm (MLPT; 32–36 weeks), international and national recommendations on neurological surveillance in this population are lacking. We conducted an observational quantitative survey among Dutch and Canadian neonatal level I–III centres (June 2020–August 2021) to gain insight into local clinical practices on neurological surveillance in MLPT infants. All centres caring for MLPT infants designated one paediatrician/neonatologist to complete the survey. A total of 85 out of 174 (49%) qualifying neonatal centres completed the survey (60 level I–II and 25 level III centres). Admission of MLPT infants was based on infant-related criteria in 78/85 (92%) centres. Cranial ultrasonography to screen the infant’s brain for abnormalities was routinely performed in 16/85 (19%) centres, while only on indication in 39/85 (46%). In 57/85 (67%) centres, neurological examination was performed at least once during admission. Of 85 centres, 51 (60%) followed the infants’ development post-discharge, with follow-up duration ranging from 1–52 months of age. The survey showed a wide variety in neurological surveillance in MLPT infants among Dutch and Canadian neonatal centres. Given the risk for short-term morbidity and long-term neurodevelopmental disabilities, future studies are required to investigate best practices for in-hospital care and follow-up of MLPT infants. Full article
(This article belongs to the Special Issue Current Advances in Neonatal Care)
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Review

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9 pages, 248 KiB  
Review
Neurotoxic Impact of Individual Anesthetic Agents on the Developing Brain
by Dabin Ji and Joelle Karlik
Children 2022, 9(11), 1779; https://doi.org/10.3390/children9111779 - 19 Nov 2022
Cited by 3 | Viewed by 2307
Abstract
Concerns about the safety of anesthetic agents in children arose after animal studies revealed disruptions in neurodevelopment after exposure to commonly used anesthetic drugs. These animal studies revealed that volatile inhalational agents, propofol, ketamine, and thiopental may have detrimental effects on neurodevelopment and [...] Read more.
Concerns about the safety of anesthetic agents in children arose after animal studies revealed disruptions in neurodevelopment after exposure to commonly used anesthetic drugs. These animal studies revealed that volatile inhalational agents, propofol, ketamine, and thiopental may have detrimental effects on neurodevelopment and cognitive function, but dexmedetomidine and xenon have been shown to have neuroprotective properties. The neurocognitive effects of benzodiazepines have not been extensively studied, so their effects on neurodevelopment are undetermined. However, experimental animal models may not truly represent the pathophysiological processes in children. Multiple landmark studies, including the MASK, PANDA, and GAS studies have provided reassurance that brief exposure to anesthesia is not associated with adverse neurocognitive outcomes in infants and children, regardless of the type of anesthetic agent used. Full article
(This article belongs to the Special Issue Current Advances in Neonatal Care)
10 pages, 525 KiB  
Review
Neonatal Hyperglycemia and Neurodevelopmental Outcomes in Preterm Infants: A Review
by Silvia Guiducci, Leonardo Meggiolaro, Anna Righetto, Marco Piccoli, Eugenio Baraldi and Alfonso Galderisi
Children 2022, 9(10), 1541; https://doi.org/10.3390/children9101541 - 9 Oct 2022
Cited by 1 | Viewed by 1884
Abstract
Glucose impairment is common in preterm infants but the impact of early neonatal hyperglycemia on long term neurodevelopment is still highly controversial. This review reports current evidence of the effect of hyperglycemia on neurodevelopmental outcome. It was conducted according to the PRISMA guidelines. [...] Read more.
Glucose impairment is common in preterm infants but the impact of early neonatal hyperglycemia on long term neurodevelopment is still highly controversial. This review reports current evidence of the effect of hyperglycemia on neurodevelopmental outcome. It was conducted according to the PRISMA guidelines. We searched MEDLINE via PubMed; EMBASE via Ovid; the Cochrane Central Register of Controlled Trials; the Cochrane Library; ClinicalTrials.gov; and the World Health Organization’s International Trials Registry and Platform. We included studies that investigated the association between hyperglycemia, defined as at least one episode of glycemia ≥8 mmol/L, and neurodevelopment outcome evaluated either through the Griffiths Mental Developmental Scales (GMDS) or the Bayley Scales of Infant Development (BSID) for the first 5 years of life, and the Wechsler Intelligence Scale for Children (WISC) and the Movement Assessment Battery for Children (MABC) for the following age category. We selected six studies, comprising 2226 infants in total and which included 1059 (48%) infants for whom neurodevelopment assessment was available. We found an association between hyperglycemia and neurological delay in the first two years of life, especially for motor functions; this result was confirmed in later childhood. The quality of evidence was poor; therefore, the negative influence of neonatal hyperglycemia on the neurological development of preterm infants must be investigated in further studies. Full article
(This article belongs to the Special Issue Current Advances in Neonatal Care)
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