The vitamin D level in umbilical cord blood in premature infants with or without intra-ventricular hemorrhage: A cross-sectional study

Background: Intra-ventricular hemorrhage (IVH) is acute cerebral complications of premature infants which may lead to the long-term problems. Objective: According to the role of vitamin D in the stability of the blood vessels, the present study was carried out in order to compare the vitamin D level in the premature infants with or without IVH. Materials and Methods: This cross-sectional study was carried out on 180 premature infants in the Ghaem Hospital, Mashhad, Iran 97 infants without IVH (53.9%) and 83 with IVH (46.1%) through convenience sampling technique in 2015-2017. Serum vitamin D level of funiculus in the two groups was compared. A researcher made questionnaire was used which includes infants&rsquo; personal and laboratory information; and their mother's information. Results: Seventy nine percent of infants suffered from vitamin D deficiency in which 33.9% had a severe deficiency (less than 10 ng/ml), 30% moderate deficiency (10.1-20 ng/ml), 15% slight deficiency (20.1-30 ng/ml) and 21.1% had normal vitamin D (>30.1 ng/ml). Vitamin D mean&plusmn;SD of infants in the control group, 23.71&plusmn;12.98 ng/ml and case group 15.92&plusmn;10.27 ng/ml (p<0.001). In total 92.8% of infants with IVH had levels of vitamin D below30 ng/ml, while this rate was 67% in infants without IVH. Conclusion: Vitamin D deficiency in the premature infants is very common. Also, the serum vitamin D level in infants with IVH was less than infants without IVH. Therefore, the recommendation of vitamin D may be effective in the prevention of neonatal IVH

Serum level of vitamin D in preterm infants and its association with premature-related respiratory complications: a case-control study

Background and aim: Prematurity and related problems, especially respiratory distress, are one of the main challenges for neonatal medicine. The aim of this study was to compare vitamin D levels in preterm infants with, and those without respiratory distress. Methods: This case-control study was conducted in Ghaem and Emam Reza Hospitals in Mashhad (Iran) from 2015 to 2016. In this study, we examined 160 preterm infants weighing less than 2000 grams and born at less than 34 weeks’ gestation. Serum vitamin D levels were measured in preterm infants without- and those with respiratory distress, and their mothers. Neonatal characteristics, including age, sex, birth weight, gestational age, Apgar score and needs for oxygen, resuscitation, ventilation and surfactant were documented. The data were analyzed using SPSS version 16.0. Results: Means serum level of maternal vitamin D in control and case groups were 16.66±14.29 ng/dl and 21.23±15.19 ng/dl, respectively (p=0.029). In addition, mean serum level of neonatal vitamin D in control and case groups were 11.69±8.66 ng/dl 17.9±12.55 ng/dl, respectively (p=0.001). Vitamin D levels in premature neonates without respiratory distress and their mothers were significantly different from other preterm neonates with respiratory distress (p=0.029). There was a direct correlation with neonatal and maternal vitamin D levels (r=0.713, p=0.001). The duration of hospitalization (p=0.001), gestational age (p=0.073), birth weight (p=0.001), one- and (p=0.001) five- minute (p=0.001) Apgar scores and head circumference (p=0.002) had significant relation with vitamin D levels in neonates. Death (12.5%) and pneumothorax (7.5%) were the main complications among cases with respiratory distress. Conclusion: According to the results of present research, neonatal vitamin D levels have a significant association with respiratory distress syndrome and maternal vitamin D levels

Corticosteroid therapy for liver abscesses in a neonate with Chronic granulomatous disease

Chronic granulomatous disease (CGD) is a rare inherited immunodeficiency disorder, characterized by susceptibility to recurrent infections, including hepatic abscess. These abscesses are typically resistant to antibiotics and surgical procedures.Here, we describe an infant with CGD and liver abscesses that was successfully treated with corticosteroids and antibiotics. A 19-day-old neonate was admitted after presenting with malaise, fever, poor feeding, abdominal distension, and hepatomegaly. Routine laboratory evaluation for sepsis and polymerase chain reaction (PCR) testing for SARS-CoV-2 was done. The PCR test results was negative in two different samples 15 days apart. Ultrasound image showed numerous focal hypoechoic masses in the liver suspected to liver abscess. Nitroblue tetrazolium (NBT) test was sent which showed less than 5% positive leukocytes. The neonate recovered completely, and the liver abscesses were removed once oral prednisolone was started in combination with antibiotic therapy.Corticosteroid therapy and prolonged antibiotic courses can be effective for the management of CGD-related hepatic abscesses

Prolonged Oral Motor Stimulation Treatment was Effective for Breastfeeding Achievement in Full Term Infants With Feeding Problems

Objectives: Feeding problems can occur in early-term infants born at 37 weeks. Early-term and full-term infants may benefit from oral motor therapy to attain successful breastfeeding. The present study aims to determine the impact of the 5-minute premature infant oral motor intervention (PIOMI) and the 15-minute oral stimulation program (15-minute oral stimulation program) on 37 to 41 weeks infants in attaining successful breastfeeding. Methods: This clinical trial was conducted on early-term and full-term infants in the neonatal intensive care units (NICUs) of two hospitals in Mashhad City, Iran. They were randomly divided into two intervention groups (5-minute PIOMI or 15-minute oral stimulation program) and one control group (17 infants in each group). These three groups were then compared to each other after the intervention by pediatricians and speech and language specialists regarding their breastfeeding. All statistical analysis was performed using R software, version 4.0.2, and the significance level was set at 0.05. Results: Infants in both intervention groups attained different levels of breastfeeding compared to pre-intervention. This outcome could be due to our interventions or natural growth and development (P<0.05). However, the longer the infants’ oral motor therapy time was, the more likely they were to breastfeed successfully. The 15-minute oral stimulation program group had a significantly higher number of male infants attaining breastfeeding after treatment than the control and PIOMI groups (P=0.03).  Discussion: The PIOMI has been confirmed as an effective early intervention for small preterm infants as young as 29 weeks, and the short 5-minute therapy time is accepted in the preterm infant population. The program affects the brain’s plasticity and improves neurosensory and motor skill development for feeding. The current study indicates that PIOMI remains effective versus the control group in the full-term babies. However, the longer 15-minute oral stimulation program, is more effective in full-term infants. This finding shows that full-term infants can endure and benefit from longer than 5 minutes per day of oral motor therapy