Hyperbilirubinemia and Neurodevelopmental Outcome of Very Low Birthweight Infants: Results from the LIFT Cohort

Bilirubin-related neurotoxicity is an important clinical issue in very low birthweight (VLBW) infants, and the existing literature is inconsistent.To analyze the relationship between maximal serum unconjugated bilirubin levels (SBL) and neurodevelopmental outcome at 2-year corrected age in VLBW infants.Phototherapy was initiated in all infants born before 33 weeks of gestation, according to Maisels' recommendations. Neurodevelopmental assessment at 2-year corrected age was performed in all infants that survived. SBLs collected during the first week of life were used to define three tertiles of max-SBL. The first tertile corresponded to infants with the lowest max-SBL. percentile curves of SBLs in infants with an optimal outcome). When Maisels' recommendations were applied, max SBLs were higher in 8% of infants weighing 1001–1500 g and in 15% of infants weighing less than 1001 g. Our data seems to validate Maisels' recommendations in the overall population of infants born before 33 weeks of gestation, but not in infants weighing less than 1001 g

Description de la flore bactérienne digestive per-opératoire néonatale (résultats intermédiaires)

La colonisation microbienne du tube digestif en période néonatale peut être étudiée à l'occasion d'interventions chirurgicales digestives. Ainsi, notre étude montre que les prélèvements réalisés avant 48 heures de vie sont dans leur grande majorité stériles alors qu' après 48 heures, ils sont positifs dans plus de la moitié des cas et composés principalement de Staphylocoques à coagulase négative, d'entérocoques et des bacilles Gram négatif. Ces résultats microbiologiques ont été confirmés par l analyse en DHPLC. De plus, nous montrons que la flore fécale de chaque nouveau-né est différente de sa flore per-opératoire et ne peut donc être utilisée pour déterminer une antibioprophylaxie en chirurgie digestive. Enfin, notre travail propose des schémas d antibioprophylaxie per-opératoire qui devront être confirmés à la fin de l étude (90 nouveau-nés).NANTES-BU Médecine pharmacie (441092101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Characteristics of the study population.

<p>Characteristics of the study population.</p

Association between maximal serum non-conjugated bilirubin level and non-optimal neurological outcome at 2-year corrected age (n = 631).

<p>Pregnancy characteristics included prenatal corticosteroid treatment, multiple pregnancies, hypertension during pregnancy, premature rupture of membranes >24 h and cesarean section. Mother characteristics included health insurance for low financial income and upper socio-demographic level. Infant characteristics included GA, birthweight, small for GA and gender. Neonatal hospitalization characteristics included surfactant therapy, maternofetal sepsis, nosocomial sepsis, bronchopulmonary dysplasia, hemodynamic failure and patent ductus arteriosus requiring treatment.</p

Association between neonatal characteristics of 631 infants and non-optimal neurological outcome at 2-year corrected age.

<p>Association between neonatal characteristics of 631 infants and non-optimal neurological outcome at 2-year corrected age.</p

Association between maximal non conjugated bilirubin level and non-optimal neurological outcome in 631 infants at 2-year corrected age (subpopulations studies).

<p>Adjustment was performed for pregnancy, infant and neonatal hospitalization characteristics. Pregnancy characteristics included prenatal corticosteroid treatment, multiple pregnancies, hypertension during pregnancy, premature rupture of membranes >24 h, and cesarean section. Mother characteristics included health insurance for low financial income and upper socio-demographic level. Infant characteristics included GA, birthweight, small for GA, gender. Neonatal hospitalization characteristics included surfactant therapy, maternofetal sepsis, nosocomial sepsis, bronchopulmonary dysplasia, hemodynamic failure and patent ductus arteriosus requiring treatment.</p

Changes in mean serum unconjugated bilirubin levels (SBL) during the first week of life in relation to birthweight.

<p>This figure shows three graphs: (1) the upper graph concerns infants with birthweight under 1500 g; (2) the intermediary graph concerns infants with birthweight between 1001 and 1500 g, and (3) the lower graph concerns the smallest infants (under 1001 g). Each graph is composed by four curves: three curves representing changes in mean SBL in infants of the first tertile (line a), second tertile (line b) and third tertile (line c). The fourth curve (dotted line or line d) represents the 95^th percentile of SBL in infants with an optimal neurological outcome at 2-year corrected age.</p

Expanding the spectrum of congenital myopathy linked to recessive mutations in SCN4A

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