Effects of cord blood vitamin D levels on the risk of neonatal sepsis in premature infants

PurposeVitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants.MethodsOne hundred seventeen premature infants with gestational age of <37 weeks were enrolled. In the present study, severe vitamin D deficiency (group 1) was defined as a 25-hydroxyvitamin D (25(OH)D) concentration <5 ng/mL; vitamin D insufficiency (group 2), 25(OH)D concentration ≥5 ng/mL and <15 ng/mL; and vitamin D sufficiency (group 3), 25(OH)D concentration ≥15 ng/mL.ResultsSixty-three percent of the infants had deficient levels of cord blood vitamin D (group 1), 24% had insufficient levels (group 2), and 13% were found to have sufficient levels (group 3). The rate of neonatal sepsis was higher in group 2 than in groups 1 and 3.ConclusionThere was no significant relationship between the cord blood vitamin D levels and the risk of neonatal sepsis in premature infants

Evaluation of prolonged pain in preterm infants with pneumothorax using heart rate variability analysis and EDIN (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) scores

Purpose The EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) and heart rate variability has been used for the evaluation of prolonged pain. The aim of our study was to assess the value of the newborn infant parasympathetic evaluation (NIPE) index and EDIN scale for the evaluation of prolonged pain in preterm infants with chest tube placement due to pneumothorax. Methods This prospective observational study assessed prolonged pain in preterm infants with a gestational age between 33 and 35 weeks undergoing installation of chest tubes. Prolonged pain was assessed using the EDIN scale and NIPE index. Results There was a significant correlation between the EDIN scale and NIPE index (r=-0.590, P=0.003). Prolonged pain is significantly more severe in the first 6 hours following chest tube installation (NIPE index: 60 [50–86] vs. 68 [45–89], P<0.002; EDIN score: 8 [7–11] vs. 6 [4–8], P<0.001). Conclusion Prolonged pain can be accurately assessed with the EDIN scale and NIPE index. However, evaluation with the EDIN scale is time-consuming. The NIPE index can provide instantaneous assessment of prolonged and continuous pain

Indications for Human Albumin Infusion in a Neonatal Population: A Single Center Experience

Objective: To evaluate the indications for human albumin infusion, the suitability of albumin infusion in neonatal intensive care units and neonatal outcomes after human albumin administration. Study Design: Infants who had hypoalbuminemia (HAlb) (albumin level <20 g/L) and were given albumin infusion at any time during hospitalization between December 2012 and December 2013 were included in the study. Mortality (group 1 (alive), group 2 (died during hospitalization)) and morbidities were recorded. Demographic properties were assessed retrospectively. Results: 38 neonates required HA transfusion therapy 61 times during the study, 89.5% were premature birth. 9 (23.7%) of 38 patients underwent major surgery. Group I =survived and are currently alive (n=22, 58%), Group II= died during hospitalization (n=16, 42%). In the groups, aspartate aminotransferase, creatinine and albumin levels were significantly different before and after infusion. Conclusion: The value of HA in the clinical setting continues to be controversial and well-designed guidelines for its use in NICUs should be established for the neonatal period

Influence of Maternal Preeclampsia on Neurodevelopmental Outcomes of Preterm Infants

Objective: The aim of this study was to determine the neurodevelopmental outcome of preterm infants born to mothers with preeclampsia and to compare them with preterm controls. Study design: This was a retrospective, observational study in a large, tertiary, neonatal intensive care unit. Neurodevelopmental evaluations using Bayley Scales of Infant Development II were performed in 226 two-year-old infants with birth weight ≤1500 g and gestational age ≤32 weeks who were born to mothers with preeclampsia and in 493 infants who were born after normotensive pregnancies, matched for gestational age and gender. Results: The mean gestational ages of the infants in the preeclampsia and control groups were 29.9±2.3 weeks and 28.7±4.1 weeks, respectively (p<0.001). A total of 372 infants with a mean age of 19.2±3.2 months were assessed for long-term outcome. The mean mental developmental index score was significantly higher, and the percentage of infants with cerebral palsy was significantly lower, in the preeclampsia group compared with the control group (p=0.03 and p=0.02, respectively). However, no overall significant differences in neurodevelopmental impairment rates were found between the two groups (p=0.08). Conclusion: Maternal preeclampsia seems to be a protector factor for the development of cerebral palsy in preterm infants

Cord blood ischemia‐modified albumin: Is it associated with abnormal D

Aim To evaluate the significance of the cord blood ischemia-modified albumin (IMA) level as a diagnostic marker for perinatal asphyxia and to determine the associations of IMA levels with the complexity of pregnancy and abnormal Doppler findings, regardless of perinatal asphyxia. Methods This prospective study included 169 newborns, sixteen of whom had perinatal asphyxia and 33 who were from complicated pregnancies. Doppler measurements were obtained from the uterine, umbilical and middle cerebral arteries, and the cerebro/placental ratio (C/P). IMA was measured by means of commercially available ELISA kits and was expressed as picomoles per milliliter. Results Ischemia-modified albumin levels were significantly higher in neonates of complicated pregnancies as compared to uncomplicated pregnancies (P<0.0001). They were higher in newborns with perinatal asphyxia as compared to healthy controls (P=0.015). The C/P ratio-pulsatility index (PI) showed a significant difference between normal and complicated pregnancies without perinatal asphyxia (P<0.0001). IMA levels were significantly increased in cases with abnormal C/P ratio-PI. Conclusions Elevated cord blood IMA levels may be accepted as a useful marker in perinatal asphyxia. Abnormal Doppler examinations are associated with elevated IMA levels in complicated pregnancies