The available data are not sufficient to determine whether allopurinol has clinically important benefits for newborn infants with hypoxic-ischaemic encephalopathy. Much larger trials are needed. Such trials could assess allopurinol as an adjunct to therapeutic hypothermia in infants with moderate and severe encephalopathy and should be designed to exclude important effects on mortality and adverse long-term neurodevelopmental outcomes.
The available data are not sufficient to determine whether allopurinol has clinically important benefits for newborn infants with hypoxic-ischaemic encephalopathy and, therefore, larger trials are needed. Such trials could assess allopurinol as an adjunct to therapeutic hypothermia in infants with moderate and severe encephalopathy and should be designed to exclude clinically important effects on mortality and adverse long-term neurodevelopmental outcomes.
Rh D prophylaxis has increased positive DAT results, which may increase the number of unnecessary bilirubin measurements. A low or high DAT grade is strongly predictive of whether an infant does or does not require phototherapy. However, an intermediate DAT requires concomitant bilirubin measurements to determine phototherapy requirements.
Blood pressure (BP) measurements have been increasingly used across neonatal intensive care units to determine and monitor hemodynamic status in neonates. A number of studies have attempted to derive normative blood pressure data in both preterm and term infants. However, this still remains a complex process, as several maternal and neonatal factors influence neonatal blood pressure. Maternal conditions, including hypertension and preeclampsia, seem to have some impact on neonatal BP, while maternal drugs, in particular antenatal steroids, seem to have a strong influence. Among the neonatal factors, gestational age, post-conceptual age and weight seem to have the strongest influence. The paucity of data on the short and long term effects of maternal conditions and medication on neonatal BP requires further research.
Objective To determine the prevalence of Vitamin D (VitD) deficiency/insufficiency in mothers of preterm neonates less than or equal to 32 weeks of gestation and determine if the current level of VitD supplementation used for preterm neonates is appropriate. Design Prospective study from 10th May 2015 to 1st November 2016. Setting Neonatal Intensive Care Unit at the Canberra Hospital. Patients Mothers and their preterm neonates born less than or equal to 32 weeks gestation. Interventions Maternal VitD levels were obtained within 3-4 days following delivery. Neonatal VitD levels were obtained in the first 3-4 days of life, at 3-4 weeks of age, and at 6-8 weeks of age. Demographic data and data on VitD intake from parenteral nutrition, enteral feeds, and vitamin supplementation agents were collected. Results 70 neonates were enrolled into the study. Median gestation was 29 (27-30) weeks and median birth weight 1197 (971.2-1512.5) grams. Median maternal VitD level was 54.5 (36-70.7) nmol/L, median neonatal Vit D level at birth was 57 (42-70) nmol/L. Median Vit D level at 3 weeks and 6 weeks were 63.5 nmol/L (53-80.2) nmol/L and 103 (71.5-144) nmol/L respectively. 22/55 (40%) mothers were VitD deficient/insufficient. 25/70 (36%) neonates were VitD deficient/insufficient at birth. Of those neonates who were VitD deficient/insufficient at birth 5/25(10%) were deficient/insufficient at 6 weeks. The median intake of VitD at 6 weeks was 826.5 (577.5-939.5) IU/day. Conclusions VitD deficiency/insufficiency in mothers of preterm neonates and in preterm neonates at birth is common. Routine screening of maternal VitD and their preterm neonates along with individualized supplementation regimens in mothers and preterm infants may optimize VitD status and reduce risk of ongoing VitD deficiency/insufficiency.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.