Editorial

WOS: 00042985030000

Hindmilk for procedural pain in term neonates

WOS: 000287629200010PubMed ID: 21428195Altun-Koroglu O, Ozek E, Bilgen H, Cebeci D. Hindmilk for procedural pain in term neonates. Turk J Pediatr 2010; 52: 623-629. The aim of this study was to investigate whether repeated doses of hindmilk were effective for pain relief during routine heel stick in term neonates. Infants enrolled in this double-blind placebo-controlled study were randomly assigned to hindmilk, 12.5% sucrose and distilled water groups. Infants were given 1 ml of the test solution 1 minute prior to, immediately before and 1 minute after the heel stick. Pain responses were assessed by physiologic and behavioral parameters and also according to the Neonatal Facial Coding System (NFCS). There were significant reductions in crying time, duration of the first cry and tachycardia, time needed for return to baseline heart rate, and the average and 1- and 5-minute NFCS scores in the hindmilk group when compared with the distilled water group. When the hindmilk group was compared to the sucrose group, only the NFCS scores at 1 and 2 minutes reached statistical significance in favor of the sucrose group. Repeated dose hindmilk administration is an effective analgesic intervention in term newborns during heel stick. Although the analgesic effect of 12.5% sucrose is slightly superior, hindmilk may be considered as a physiologically suitable alternative to sucrose

Both parents of neonatal intensive care unit patients are at risk of depression

WOS: 000341416500010PubMed ID: 24911852Postpartum depression is a serious disorder that can be seen not only in mothers but also in fathers; therefore, it negatively affects the whole family. Hospitalization in the neonatal intensive care unit (NICU) is a stress factor for the parents and contributes to depression. We aimed to detect the frequency of postpartum depression and the contributing risk factors in parents of NICU patients. The Edinburgh Postnatal Depression Scale was used for mothers and the Beck Depression Inventory was performed for fathers in the 2nd and 6th weeks after delivery. At the 2nd week, maternal depression frequency was found as 38.3%, with a mean score [ms] of 10.97 +/- 6.93. At the 6th week, maternal depression frequency was 33.3% (ms: 9.57 +/- 5.78). Paternal depression was 11.7% (ms= 7.13 +/- 7.35) at the 2nd week and 10.0% (ms: 6.50 +/- 5.79) at the 6th week. The frequency of maternal depression remained stable, but mean maternal depression scores were decreased at the 6th week compared to the 2nd week (p=0.023). However, paternal depression scores were similar in both periods (p=0.428). The infants' disease severity at admission to the NICU, as shown by SNAPPE-II risk scores, was positively correlated with Edinburgh depression scores of the mothers at the postnatal 2nd week, but not at the 6th week. In conclusion, NICU stay of high-risk infants may cause depression in their mothers and fathers, even in the absence of any previous risk factor. Although at a lower rate than in mothers, fathers may also suffer from depression. Parental depression screening and whole family support during NICU hospitalization are strongly recommended

Medical closure of patent ductus arteriosus does not reduce mortality and development of bronchopulmonary dysplasia in preterm infants

WOS: 000347553800011PubMed ID: 25657754Background: Although, patent ductus arteriosus (PDA) is associated with significant morbidity due to hemodynamic instability in preterm infants, the effect of ductus closure on mortality and morbidity is a controversial issue. The aim is to evaluate the efficacy of oral and intravenous (IV) ibuprofen treatment on ductal closure and effects on mortality and bronchoplumonary dysplasia. Materials and Methods: The medical records of 292 premature infants treated at Ege University Neonatal Intensive Care Unit were retrospectively evaluated. Patients were classified into 3 groups as; No PDA, hemodynamically insignificant PDA (hiPDA) and hemodynamically significant PDA (hsPDA) according to the presence and hemodynamical significance of PDA by echocardiography. hsPDA group was treated with IV or oral ibuprofen. Results: Patent ductus arteriosus was diagnosed by routine echocardiography in 145 patients, of whom 78 (53.7%) had hsPDA. All 65 infants with hiPDA had spontaneous PDA closure. Echocardiographic measurements were similar to those patients treated with oral or IV ibuprofen, as in the response rate to treatment without serious adverse effects. The presence of respiratory distress syndrome, surfactant therapy, late sepsis, bronchopulmonary dysplasia (BPD) and mortality rates were significantly higher in patients with hsPDA. However, with stepwise logistic regression; 5th min Apgar score (odds ratio [OR], 1.321, 95% confidence interval [CI], 1.063-1.641, P = 0.012) and gestational age (OR, 1.422, 95% CI, 1.212-1.662, P < 0.001) were the only significant variables associated with mortality. Gestational age (OR, 0.680, 95% CI, 0.531-0.871, P = 0.002) was the only significant variable associated with BPD shown with logistic regression. Conclusion: Ibuprofen treatment is effective for hsPDA closure with minimal side effects. HiPDA can close spontaneously; therefore treatment decision should be individualized. However, medical treatment of PDA does not reduce mortality and BPD