Introduction: Various cytokines have been associated to the occurrence of bronchopulmonary dysplasia (BPD) in preterm neonates. AIM: To establish an association between cord blood cytokines and BPD, so that they could be used, in clinical practice, as early markers of BPD. Material and methods: Preterms less than 30 weeks gestational age, were analysed by ELISA microassay for venous cord blood IL-1β, IL-6, IL-8, TNF-α and IL-10, and compared between the BPD and non-BPD groups. Results: One hundred and fifty neonates completed the study; 31 (21%) small for gestational age (SGA); 16 were deceased before 28 days of life; 36 developed mild BPD and 20 developed moderate/severe BPD. Elevated cord blood IL-8 was associated with death or moderate/severe BPD. SGA patients with moderate/severe BPD presented higher cord blood values of IL-8, lower IL-6 and IL-10 when compared with SGA without moderate/severe BPD; and higher IL-8 levels when compared with patients without moderate/severe BPD. Conclusion: These results support an association between cord blood IL-8 and moderate/severe BPD, independently of the intra-uterine growth; and the association of cord blood IL-6 and IL-10 and moderate/severe BPD in SGA preterm newborns.
RESUMO Material and Methods:A retrospective analysis of the newborns admitted to the Neonatal Intensive Care Unit with a diagnosis at discharge of one or more bone fractures from January 1996 to June 2013. Results: Eighty neonates had one or more fractures. In 76 (95%) infants the fractures were attributed to birth injury. The most common fracture was the clavicle fracture in 60 (79%) neonates, followed by skull fracture in 6 (8%). In two (2.5%) neonates, extremely low birth weight infants, fractures were interpreted as resulting from osteopenia of prematurity. Both had multiple fractures, and one of them with several ribs. Conclusion: A change in obstetric practices allied to improvement premature neonate's care contributed to the decreased incidence of fractures in neonatal period. But in premature infants the diagnosis may be underestimated, given the high risk of fracture that these infants present. Keywords: Fractures, Bone/epidemiology; Infant, Newborn; Intensive Care Units, Neonatal; Portugal. INTRODUÇÃOAs fraturas ósseas são raras no período neonatal. 1 No entanto, durante o parto podem ocorrer fraturas de ossos longos, nomeadamente da clavícula, associada a eventos como a distocia de ombros, bem como fraturas cranianas, na grande maioria dos casos decorrentes do uso de fór-ceps ou ventosa.2 Por outro lado, os recém-nascidos (RNs) internados em Unidades de Cuidados Intensivos Neonatais (UCIN) têm um risco aumentado de fraturas ósseas por várias razões incluindo prematuridade, baixo peso ao nascimento, malnutrição, traumatismo secundário a intervenções médicas bem como a efeitos colaterais de fárma-cos. [1][2][3][4][5] No RN pré-termo, a causa específica da fratura é geralmente difícil de estabelecer, sendo muitas vezes atribuída à osteopenia da prematuridade. 1 A maioria dos casos são identificados acidentalmente em radiografias feitas por outras razões, pelo que a incidência exata das fracturas nos prematuros é desconhecida.2 De acordo com os poucos estudos publicados, a incidência das fraturas é muito variável, entre 1,2 a 10,5%, sendo maior em RNs de muito baixo peso (MBP). 1,6 O objetivo deste estudo foi avaliar a incidência e caracterizar as fraturas ósseas nos RNs internados numa UCIN nível III, com o propósito de otimizar as melhores práticas preventivas e terapêuticas.
The proposed strategy, based on predischarge bilirubin level and gestational age data, was a valid method for significant hyperbilirubinemia risk assessment in our population.
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