Respiratory disorders and neonatal outcomes of triplet pregnancies – our ten year experience

Objective. To compare respiratory disorders (respiratory distress syndrome, requirement for respiratory support, development of chronic lung disease), duration of hospitalization and other neonatal outcomes between newborns born from triplet pregnancies over a ten year period. Methods. A retrospective analysis of 34 triplet pregnancies delivered between 2006 and 2015 in one perinatal tertiary centre. Ninety-nine newborns from these pregnancies were divided into 2 groups: one consisted of 56 neonates (19 sets of triplets) born between 2006 and 2011 and the second contained 43 neonates delivered from 15 triplet pregnancies between 2012 and 2015. Results. There were no differences in the incidence of respiratory distress syndrome and chronic lung disease between group I and group II. In both groups, a similar amount of patients required respiratory support. We did not notice any significant differences in the type of ventilation (mechanical ventilation or nasal continuous positive airway pressure -nCPAP), duration of ventilation, length of hospitalization or the incidence of complications of prematurity, such as 3rd or 4th grade intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) stage > 2, between both groups. Conclusion. Despite important progress in perinatal care and wide use of advanced technologies in neonatal intensive care there has been no significant improvement in neonatal outcomes of triplets during the past 10 years. Multiple pregnancies still remain a risk factor for respiratory disorders and other neonatal complications in prematurely delivered newborns

Comparison of selected elements of neonate immunological system with relation to indications for cesarean section and time of delivery

Abstract Aim of study: To define to what degree time and the way of delivery cause changes in CD3+ lymphocytes and their subpopulations CD4+, CD8+, CD25+ and CD19+ lymphocytes and their subpopulations CD5+, CD23+. Material and methods: 49 healthy neonates born in the years 1998-2003 in the Clinical Ward of Perinatology and Gynecology of Silesian Medical University in Zabrze were examined. Taking into account the time of pregnancy and the way of delivery, the children were divided into the following groups: Group Ib - 23 full-term neonates born by Cesarean section, including 15 neonates with elective indications (Ibe), 8 with emergency indications (Ibn). Group IIb – 26 pre-term neonates born by Cesarean section, including 18 with elective indications (IIbe) and 8 with emergency indications (IIbn). Our study applied a method of umbilical blood sampling with the following red blood cells lysis. Results: Statistically significant lower mean number of B CD5+ lymphocytes was found in full-term neonates born by Cesarean section in comparison to pre-term neonates born by the same method. Similar differences concern full-term and pre-term neonates born by elective Cesarean section. Statistically significant lower mean number of CD3+, CD4+ and CD25+ lymphocytes was found in pre-term neonates born by elective Cesarean section in comparison to pre-term neonates by emergency Cesarean section. Conclusions: Time of pregnancy termination in a mother by Cesarean section can be related to the occurrence of statistically significant changes in B CD5+ lymphocytes quantities in her neonate. Emergency Cesarean section in a mother can be related to the increased quantity of T lymphocytes, helper T lymphocytes , activated T lymphocytes in her pre-term born neonate. No statistically significant differences were found in mean values of other immunological parameters among study groups

Pneumocystis jirovecii colonization in preterm newborns with respiratory distress syndrome

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected] describe the prevalence of Pneumocystis jirovecii in mother-infant pairs of very low birth weight newborns <32 weeks gestation. Molecular and microscopic methods were used for detection of P. jirovecii in patients' specimens. Pneumocystis DNA was detected in eight nasopharyngeal aspirates (14%) of 56 newborns and in seven oral washes (21%) of 34 mothers. Pneumocystis detection immediately after birth suggests the possibility of its transplacental transmission. Comparing to non-colonized infants, more frequent occurrence of bronchopulmonary dysplasia was seen in colonized ones (P=0.02), suggesting a potential clinical importance of this pathogen in abnormal lung development.publishersversionpublishe

Zmiany ilościowe populacji limfocytów CD3+ i CD45RA+ we krwi szczurów poddanych działaniu wolnozmiennego pola elektromagnetycznego

It was reported that an extremely low frequency (ELF) electromagnetic field causes biological effects in vitro and in vivo. The major functions of the immune system are to develop the concept of "self" and eliminate what is "non-self". In our preliminary study we proved that an extremely low frequency (ELF) magnetic field increased IgG concentration in the serum of rats. The study was carried out on male Wistar rats. The rats were exposed during 3 or 6 days (8 minute a day) to an ELF magnetic field of a complex shape generated by a device used in medicine. Five groups were used in this experiment: Group I - control group, absence of ELF magnetic field, Group II - exposure during 3 days (B = 0.06 mT), Group III - exposure during 3 days (B = 0.14 mT), Group IV - exposure during 6 days (B = 0.06 mT), Group V - exposure during 6 days (B = 0.14 mT). The animals were sacrificed for the experiment on the 2nd day after exposure to the ELF magnetic field. The leukocytosis and lymphocytes subpopulations (CD3+ and CD45RA+) in the blood of rats were assayed. Our results did not show significant changes of leukocytosis in groups II, III and IV. In rats of group V the leukocytosis decreased. In all groups we observed a decrease of CD3+ lymphocytes during the experiment. ELF magnetic field (B = 0.14 mT) induced a decrease of CD45RA+ lymphocytes in rats of groups III and V

Extremely Preterm Infant Admissions Within the SafeBoosC-III Consortium During the COVID-19 Lockdown

Objective: To evaluate if the number of admitted extremely preterm (EP) infants (born before 28 weeks of gestational age) differed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019. Design: This is a retrospective, observational study. Forty-six out of 79 NICUs (58%) from 17 countries participated. Principal investigators were asked to report the following information: (1) Total number of EP infant admissions to their NICU in the 3 months where the lockdown restrictions were most rigorous during the first phase of the COVID-19 pandemic, (2) Similar EP infant admissions in the corresponding 3 months of 2019, (3) the level of local restrictions during the lockdown period, and (4) the local impact of the COVID-19 lockdown on the everyday life of a pregnant woman. Results: The number of EP infant admissions during the first wave of the COVID-19 pandemic was 428 compared to 457 in the corresponding 3 months in 2019 (−6.6%, 95% CI −18.2 to +7.1%, p = 0.33). There were no statistically significant differences within individual geographic regions and no significant association between the level of lockdown restrictions and difference in the number of EP infant admissions. A post-hoc analysis based on data from the 46 NICUs found a decrease of 10.3%in the total number of NICU admissions (n = 7,499 in 2020 vs. n = 8,362 in 2019). Conclusion: This ad hoc study did not confirm previous reports of a major reduction in the number of extremely pretermbirths during the first phase of the COVID-19 pandemic. Clinical Trial Registration: ClinicalTrial.gov, identifier: NCT04527601 (registered August 26, 2020), https://clinicaltrials.gov/ct2/show/NCT04527601

Impact of refusal to vaccine in the neonatal period on the implementation of the vaccination calendar in the first year of life

Introduction The level of vaccination coverage with obligatory preparations in Poland reaches 98%. This is facilitated by the introduction of the Individual Vaccination Calendar (IVC) compliant with medical contraindications to vaccination. Aim The aim of the study was to assess whether the refusal of vaccinations after birth has an impact on the proper implementation of the vaccination calendar in the first year of life. Methods The study involved healthy, term newborns who were born in the Department of Neonatology in 2011–2015. There were 156 patients enrolled to the study. Among them, 133 were in the control group – vaccinated after birth, and 23 constituted the study group – not vaccinated after birth. Results Not all healthy newborns are vaccinated after birth, statistical significance was obtained between the study and control group (p < 0,00001). Only 48% of patients not vaccinated after birth received TB-vaccine during the first year (p < 0,00053). Parents of 26% of infants in the study and of 2% of infants in the control group declared using the IVC (p < 0,001). Conclusions Proper implementation of the vaccination schedule in the first year of life results from the initiation of vaccinations after birth. Unreasonable introduction of the IVC promotes incorrect timing of mandatory vaccinations

Foods to Avoid While Breastfeeding? Experiences and Opinions of Polish Mothers and Healthcare Providers

Popular beliefs regarding a mother&rsquo;s diet during lactation have a significant impact on breastfeeding practices among mothers, as well on breastfeeding counseling among healthcare providers worldwide. The objective of this study was to assess mothers&rsquo; and medical professionals&rsquo; knowledge and opinions on the &ldquo;lactating mother&rsquo;s diet&rdquo;. An electronic survey, prepared in Polish, was administered to healthcare providers, as well as mothers who have breastfed a child. The chi-square test, logistic regression, and Mann Whitney U test were used for statistical calculations. Out of a total of 1180 responses received, 1159 were analyzed, and 21 were excluded because they did not meet the inclusion criteria. The survey was completed by 407 (35%) medical healthcare providers and 752 (65%) lactating mothers in non-medical professions. In total, the study included 1074 mothers who have breastfed a child, and 29.14% of them reported that they eliminated certain foods from their diet when breastfeeding. There was no statistically significant difference in the responses received from mothers and medical staff providing maternal care (for each of 17 products, e.g., steak tartare, sushi, legumes, dairy products, p &gt; 0.05 by the Mann-Whitney test). However, a logistic regression revealed some significant correlations with other variables (e.g., duration of lactation). The respondents revealed an appropriate level of knowledge on nutrition during lactation and the majority of participants neither adhered to nor recommended a prophylactic elimination diet. Among other evaluated factors, the experience of following an elimination diet affected respondents&rsquo; knowledge of nutrition during breastfeeding. Both mothers and healthcare providers require good nutritional education

Non-Nutritional Use of Human Milk Part 1: A Survey of the Use of Breast Milk as a Therapy for Mucosal Infections of Various Types in Poland

The use of home remedies for the treatment of moderately severe ailments is a common practice in the Polish population. Currently, the topic of the potential non-nutritional properties of human milk is attracting the attention of breastfeeding mothers. This study was aimed at understanding lactating women&#8217;s knowledge, attitudes, and practices of non-nutritional breast milk on mucous membranes. The study was conducted among lactating women, who filled out a questionnaire consisting of questions about their knowledge and experiences with non-nutritional use of human milk. Statistical calculations were conducted with chi-square test and c-Pearson coefficient. A total of 1187 women were acted on, whereby 768 of respondents claimed to have knowledge of the non-nutritional use of human milk on mucous membranes, whilst 404 of them claimed that they had used at least one method. Among the most frequently used methods were the treatment of rhinorrhea, lacrimal canaliculi obstruction, and conjunctivitis. A correlation between length of breastfeeding (p &lt; 0.001) and knowledge of non-nutritional human milk usage in prophylaxis and treatment of mucous membrane inflammation was found. Breastfeeding duration (p &lt; 0.001) and parity (p &lt; 0.005) were correlated with the application of those methods in practice. Due to a high propensity to testing those methods, parents&#8217; education in the field of possible risks and importance of medical consultations is necessary

Breast Milk Macronutrient Components in Prolonged Lactation

Human milk (HM) is the first dietary exposure in infancy and the best nutritional option for growth and healthy development of the newborn and infant. The concentrations of macronutrients, namely proteins, carbohydrates and lipids, change during lactation stages. HM has been studied extensively in the first 6 months of lactation, but there are limited data regarding milk composition beyond 1 or 2 years postpartum. The aim of our study was to describe longitudinal changes in HM macronutrient concentrations during the prolonged lactation of healthy mothers from the 1st to the 48th month. For the macronutrient content of milk of mothers breastfeeding for longer than 18 months, fat and protein increased and carbohydrates decreased significantly, compared with milk expressed by women breastfeeding up to 12 months. Moreover, the concentration of fat, protein and carbohydrates in HM over 2 years of lactation from the 24th to the 48th month remained at a stable level. However, analyzed macronutrients were positively (carbohydrate, r = 0.51) or negatively (fat, r = &#8722;0.36 and protein, r = &#8722;0.58) correlated with the amount of feeding. Our results create a greater potential for understanding the nutritional contribution of HM over 2 years of lactation and showed that the source of calories in breast milk for older children is mainly fat, while carbohydrates play a greater role in infant nutrition in the early stage. The observed changes of macronutrient concentrations from the 1st to the 48th month of lactation are probably related to the adaptation of milk composition to the increased energy demand of the intensively growing child