Category: Extreme prematurity

Early low-dose hydrocortisone to prevent BPD

A multicenter double-blind randomized study from France of over 500 infants less than 28 weeks gestation compared the use of a ten-day course of intravenous hydrocortisone started by 24 hours after birth to placebo. Infants receiving hydrocortisone had a higher…

Outcomes of pregnancies delivered at 23 weeks

A prospective cohort study of pregnancies delivered at 23 weeks gestation from women admitted to one of sixteen Canadian tertiary perinatal units included 248 women and 287 infants. The rate of Cesarean section was 11%, and 40% of women had…

Outcome of infants less than 500 grams birth weight

A retrospective review of admissions to a NICU with a birthweight of less than 500 grams found that that proportion of liveborn infants weighing less than 500 grams increased from 0.1% to 0.2% over the years. These infants (n =…

The costs of prematurity

A review of published literature since 1990 summarized the results of eighteen studies reporting the costs of prematurity. These studies varied in methodology and in the types of subjects included. There was considerable variability across studies in costs within the…

Maternal-child interaction and developmental outcome

A prospective study of 48 babies born before 28 weeks gestation assessed the association of maternal-child interactions with neurodevelopmental outcome. The maternal-infant interaction was assessed when the infants were two years of corrected age, in a structured play situation using…

Periviable birth: Workshop summary

The findings of a Joint Workshop held by leading organizations in obstetric and pediatric/neonatal care were recently published in multiple journals and contains summaries and recommendations about obstetric and neonatal management. Highlights of this report: The term perviable birth was…

The dying neonate – a mother’s perspective

An article written by the mother of a critically ill 24 week gestation infant describes the emotions that parents experience when in the throes of intensive care decisions. There are tips to NICU professionals on how best to interact with…

Dilemmas in the care of extremely preterm infants – an essay

An essay written by a neonatologist describes the dilemmas faced by NICU teams when faced with decisions about resuscitation of extremely preterm infants. In the ‘Gray Zone’. Suresh 2013 Listen to the podcast Tweet

Aggressive phototherapy in ventilated babies < 751 grams may increase mortality

The NICHD Neonatal Research Network conducted a randomized trial of aggressive versus conservative phototherapy in babies with a birth weight of 1000 grams or less. Aggressive phototherapy was provided at a total serum bilirubin value of 5 mg/dL or higher in…

Saving versus creating: implicit bias against newborns

Ethical principles of resuscitation should be applied uniformly to neonates, older children and adults. However, many health professionals are willing to withhold or withdraw life-sustaining therapy in newborns at high risk of disability (e.g., a baby born at 24 weeks…

Japanese outcome data for babies born at 22 – 23 weeks gestation

A study from the Japanese Neonatal Research Network, from 48 NICUs, reports the rates of death and neurodevelopmental outcomes (at age three) of infants between 22 – 26 weeks of gestation. Survival without neurodevelopmental impairment or only mild impairment at…

Which formula you use for ultrasound estimation of fetal gestation matters

In a Swedish study three different formulae were applied to mid-trimester ultrasound measurements of fetal biparietal diameter and femur length in order to calculate gestational age in infants less than 27 weeks gestation. These estimates were compared to gestation determined…

Self-reported health of ELBW infants in adolescence

Extremely low birth weight children born in the early 90’s were evaluated at age 14 and compared to normal birth weight controls. The ELBW adolescents rated their (self-reported) health similar to that of normal birth weight controls in areas such…

Caffeine for apnea of prematurity: five-year outcomes

Does caffeine therapy for apnea of prematurity improve long-term neurodevelopmental outcome? In a study reporting the five-year follow up results of the randomized placebo-controlled Caffeine for Apnea of Prematurity (CAP) trial in babies 500 – 1250 grams, the combined outcome…

Hypertension during follow-up of extremely preterm infants

Blood pressure data from a Swedish national population-based cohort of extremely preterm infants who survived were analyzed. At the age of 2.5 years 44% of the 68 extremely preterm infants had a systolic blood pressure at or above the 90th…