No abstract

No abstract

Background:The incidence of severe sepsis and septic shock is higher among preterm infants. Prevention of neonatal sepsis has remained a global challenge in recent decades. The role of intravenous immunoglobulin (IVIG) as an adjunctive treatment in sepsis has been shown in experimental and clinical trials. Objective: The present controlled clinical trial was carried out with the objective of determining the effect of intravenous immunoglobulin in prevention of preterm neonatal sepsis. Methods: This single-blind randomized clinical trial was performed in Hormozgan in Iran in 2015. Preterm neonates with low birth weight (LBW) were recruited in the study and were randomly divided into two groups. The intervention group received IVIG in addition to routine and general care, including antibiotic treatment, while the control group was given routine and general care without IVIG. IVIG was given to members of the intervention group at slow intravenous infusions at a dose of 500 mg/kg within 12 h and 3 days of birth, respectively. At the end of first week, two groups were compared for mortality rate, total number of days of hospitalization, incidence of intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia (BPD). Statistical analysis was conducted by SPSS version 19 using means ± standard deviation, number (%), Chi-square test, and Independent-samples-t-test. Results: A total of 92 infants were enrolled, 46 in intervention and 46 in control group. Administration of IVIG as an adjunctive treatment significantly improved the prevalence of sepsis (0.0487; 95% CI, 0.0027-0.8711, pvalue=0.04) and C-reactive protein (0.1869; 95% CI, 0.0380-0.9194, p-value=0.0391) in intervention group in comparison with the control group. No significant differences were observed in IVH, BPD, and NEC between the experimental groups (p-value>0.05). Duration of hospitalization was 13.86 ± 7.31 days in IVIG group and 20.84 ± 11.93 days in control group (p-value<0.05). Conclusion: Prophylactic IVIG is effective in reducing nosocomial infections and duration of hospitalization in preterm and LBW neonates, but has no effect on IVH, BPD, and NEC. We recommend prophylactic IVIG in preterm infants with LBW. Trial registration: The trial is registered at the ClinicalTrials.gov with the identification number NCT02954926. Founding: The authors received financial support from Research

Background: Neonatal sepsis is one of the most important causes of an infant’s death, and the identification of its factors has been the subject of many studies. Some new evidence suggested the role of vitamin D in the occurrence of sepsis in infants. Objectives: The aim of this study was to compare the serum levels of vitamin D in neonates with sepsis in the first week of birth and healthy neonates. Methods: This case-control study was performed on 72 term neonates (36 neonates with sepsis as the case and 36 healthy neonates as the control group) who referred to Bandar Abbas children's hospitals, Bandar Abbas, Iran, from 2016 - 2017. Results: Serum vitamin D levels were measured in all infants and their mothers in both sepsis and control groups. In addition, data were collected, including sex, birth weight, C-reactive protein (CRP), and duration of hospitalization in neonates with sepsis. The mean serum level of vitamin D was 18.52 ± 11.49 ng/mL in sepsis and 20.52 ± 13.75 ng/mL in neonates of the control group (P ≥ 0.05). The mean maternal serum level of vitamin D in sepsis control groups was 22.44 ± 11.26 and 24.36 ± 12.82 ng/mL, respectively (P ≥ 0.05). There was a positive correlation between maternal and neonatal vitamin D levels in the sepsis (r = 0.803) and the control (r = 0.756) groups. However, there was no significant difference between vitamin D level and CRP (P = 0.148) and length of hospital stay (P = 0.396) in the sepsis group. Conclusions: Although the results of the present study showed a correlation between serum vitamin D levels in mothers and neonates with neonatal sepsis, there was no significant correlation between neonates with and without sepsis regarding vitamin D levels.

Background: Hyperbilirubinemia is common in the neonatal period; however, delayed diagnosis or inadequate treatment can cause irreparable damage to the neonates. We aimed to evaluate the efficacy of oral fenofibrate for hyperbilirubinemia in term neonates. Methods: This singleblind randomized controlled trial included 86 term neonates aged 3-7 days, with birth weight ≥2500 g, admitted to Bandar Abbas Children's Hospital, Bandar Abbas Iran, from July 23, 2019, to July 22, 2020. The fenofibrate group received 10 mg/kg oral fenofibrate and phototherapy, while controls only received phototherapy. Serum total bilirubin was measured at 24 and 48 h and at the time of discharge. Hospital length of stay was also noted. Results: The two study groups were comparable regarding age, gender, gestational age, birth weight, and baseline total serum bilirubin levels. Serum total bilirubin levels at 48 h (P < 0.001) and at discharge (P < 0.001) were significantly lower in the fenofibrate group compared to controls. Although hospital length of stay was lower in the fenofibrate group compared to controls, the difference was not statistically significant (P = 0.612). Fenofibrate was more effective on the reduction of serum bilirubin in neonates aged 3-4.5 days starting at the 24 th hour. Moreover, it was more effective in female neonates compared to males starting at the 48 th hour. Conclusions: A single dose of oral fenofibrate reduced total serum bilirubin in term neonates with hyperbilirubinemia without any side effects; however, this effect was more prominent after 48 h.