Differential classification of infants in United States neonatal intensive care units for weight, length, and head circumference by United States and international growth curves

Ferguson, Nicole; Olsen, Irene E.; Clark, Reese H.; Yockey, Bryan D; Boardman, Jonathan; Biron, Kyle; Jannuzzo, Cooper; Waskiewicz, Daniel; Mendoza, Amanda; Lawson, M. Louise

doi:10.1080/03014460.2020.1817555

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Inclusion criteria for analysis were singleton pregnancy, receipt of 2 doses or more of messenger RNA (mRNA)–based COVID-19 vaccines before delivery, availability of paired maternal and cord samples, no history of prior COVID-19 infection, nondetectable antinucleocapsid (anti-N) antibody, no known fetal genetic anomaly, and infant birth weight appropriate for gestational age (>10th percentile) based on Olsen 2010 growth curves. 10 , 11 Participants were excluded from the analysis if they received 1 dose or less of a COVID-19 vaccine before delivery or received a non–mRNA-based vaccine.…”

Section: Methodsmentioning

confidence: 99%

Timing of Maternal COVID-19 Vaccine and Antibody Concentrations in Infants Born Preterm

Kachikis,

Pike,

Eckert

et al. 2024

JAMA Netw Open

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ImportanceCOVID-19 vaccine–derived antibodies in pregnant people may protect infants from severe infection in the first 6 months of life via transplacental antibody transfer. Few data exist on maternally derived SARS-CoV-2 antibodies in preterm compared with full-term infants in association with vaccination timing.ObjectiveTo compare SARS-CoV-2 anti-Spike (anti-S) antibody levels in preterm and full-term infants in the context of vaccine dose timing before delivery.Design, Setting, and ParticipantsThis prospective cohort study enrolled pregnant individuals and collected paired maternal and cord blood samples at delivery at the University of Washington between February 1, 2021, and January 31, 2023. Participants who had received at least 2 doses of a messenger RNA COVID-19 vaccine before delivery and did not have a history of prior COVID-19 infection or detectable anti–SARS-CoV-2 nucleocapsid antibodies were included.ExposuresTiming of the last vaccine dose and preterm or full-term gestational age at delivery.Main Outcomes and MeasuresPaired maternal and cord samples were tested for anti-S antibody, and linear regression was used to evaluate associations between preterm delivery and anti-S antibody levels. Covariates included timing of last dose, number of doses, insurance status, and immunosuppressing medications.ResultsA total of 220 participants (median [IQR] age, 34 [32-37] years; 212 [96.4%] female) with 36 preterm and 184 full-term deliveries were studied. Before delivery, 121 persons received 2 vaccine doses and 99 persons received 3 or more vaccine doses. The geometric mean concentration of maternal anti-S antibodies was 674 (95% CI, 577-787) after 2 doses and 8159 (95% CI, 6636-10 032) after 3 or more doses (P &lt; .001). The cord anti-S antibody geometric mean concentration was 1000 (95% CI, 874-1144) after 2 doses and 9992 (95% CI, 8381-11 914) after 3 or more doses (P &lt; .001). After adjustment for vaccine timing and number of doses before delivery, no association was found between preterm delivery and cord anti-S antibody levels (β = 0.44; 95% CI, −0.06 to 0.94).Conclusions and RelevanceIn this prospective cohort study of pregnant individuals with preterm and full-term deliveries, receipt of 3 or more compared with 2 doses of COVID-19 vaccine before delivery resulted in 10-fold higher cord anti-S antibody levels. Maternal antibody concentration appeared more important than delivery gestational age in determining cord anti-S antibody levels. The number of doses and timing considerations for COVID-19 vaccine in pregnancy should include individuals at risk for preterm delivery.

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Section: Methodsmentioning

confidence: 99%

Timing of Maternal COVID-19 Vaccine and Antibody Concentrations in Infants Born Preterm

Kachikis,

Pike,

Eckert

et al. 2024

JAMA Netw Open

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“…Weight, length, and head circumference Z -scores will be calculated for birth and weekly postnatal growth measurements using Fenton and Olsen growth curves for preterm infants [ 55 ]. A temporal growth curve model will be developed for each group of babies.…”

Section: Methodsmentioning

confidence: 99%

The NICU Antibiotics and Outcomes (NANO) trial: a randomized multicenter clinical trial assessing empiric antibiotics and clinical outcomes in newborn preterm infants

Morowitz

Katheria

Polin

et al. 2022

Trials

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Background Early-onset sepsis is an important cause of neonatal morbidity and mortality in the preterm population. Infants perceived to be at increased risk for early-onset sepsis are often treated empirically with broad-spectrum antibiotics while awaiting confirmatory blood cultures, despite an overall incidence of early-onset sepsis of 2–3% among extremely-low-birthweight (ELBW) infants. Recent observational studies associate perinatal antibiotic use with an increased incidence of necrotizing enterocolitis, late-onset sepsis, and mortality among ELBW infants. Given currently available data and variability in clinical practice, we designed a prospective multi-institutional randomized controlled trial to determine the safety of early antibiotic use in ELBW infants. Methods The NICU Antibiotics and Outcomes (NANO) trial is a multicenter, double-blinded, randomized controlled trial. A sample of 802 ELBW preterm infants will undergo web-based stratified block randomization to receive empiric antibiotics (EA; ampicillin and gentamicin) or placebo during routine evaluation for early-onset sepsis. Participating sites will use preexisting institutional protocols for antibiotic dosage and duration. Infants born at participating sites with a gestational age of 29 weeks or less are eligible for enrollment. Exclusion criteria include maternal intrauterine infection, hemodynamic or respiratory instability, delivery by caesarean section for maternal indications without labor or prolonged rupture of membranes, and prior administration of antibiotics. The primary outcome is the composite incidence of necrotizing enterocolitis, late-onset sepsis, or death during participants’ index hospitalization. Maternal and infant samples will be collected longitudinally and assessed for differences in microbiome composition and diversity. Discussion The NANO trial is designed to compare the rate of adverse outcomes of EA use at birth versus placebo in ELBW preterm infants. If EA at birth worsens clinical outcomes, then the results of the trial may help providers decrease antibiotic utilization in the NICU and subsequently decrease the incidence of complications associated with early antibiotic use in ELBW infants. If we instead find that EA improve outcomes, then the trial will validate a longstanding clinical practice that has not previously been supported by high-quality data. Future studies will assess long-term clinical and microbial outcomes in infants who received empiric antibiotics following delivery. Trial registration Trial registration data: June 25, 2019 NCT03997266.

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“…6 Newborns were assessed according to the BW by using the Fenton intrauterine growth curves. 7 Antenatal and natal risk factors including maternal age, usage of antenatal corticosteroids, preeclampsia/eclampsia, infants of diabetic mothers, chorioamnionitis (clinical or histopathological), in vitro fertilization, multiple births, and mode of delivery were recorded from the mothers' files. Postnatal risk factors for the development of ROP such as intracranial hemorrhage (according to the classification of Papile et al 8 ) resuscitation in the delivery room, respiratory distress syndrome (RDS), surfactant treatment, duration of invasive/noninvasive mechanical ventilation and oxygen therapy, patent ductus arteriosus (PDA), neonatal sepsis (clinically proven or culture positive), necrotizing enterocolitis (NEC) (in accordance with the Bell criteria 9 ), and BPD (according to the oxygen requirement at 36 weeks postmenstrual age or 28 days after birth 10 ), were recorded for each patient.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

A Retrospective Analysis of Retinopathy of Prematurity (ROP) in a Tertiary Newborn Intensive Care Unit: Incidence and Risk Factors of ROP

Varol

Ogreten

Ozdogan

et al. 2022

Journal of Child Science

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Background Retinopathy of prematurity (ROP) is the most frequent problem which causes blindness in preterm babies. In our study we evaluate the frequency of retinopathy, the risk factors, and their effects on disease development in premature newborns admitted to our neonatal intensive care unit (NICU). Methods A total of 139 premature infants with gestational ages less than 34 weeks followed in our NICU between January 1, 2008 and January 1, 2011. The infants were divided into two groups as group 1 (no ROP/mild ROP) and as group 2 (severe ROP). Results The demographics of 139 patients were as follows: 79 (56.83%) were female and 60 (43.17%) were male. Overall, 104 (74.8%) patients were found to have no or mild ROP and 35 (25.2%) had severe ROP. Among the patients in the severe ROP group, 25 of them had plus disease. With logistic regression analysis, lower gestational age (odds ratio [OR]: 4.1, confidence interval [CI]: 1.9–9.2), the central catheter usage (OR: 13.4, CI: 1.2–146.6), hypotension (OR: 7.5, CI: 1.1–49.6), perinatal asphyxia (OR: 261.3, CI: 8.8–7725.4), apnea (OR: 18.1, CI: 1.6–202.6), and high FiO 2 (OR: 1.2 CI: 1.0–1.5) were found to be related to severe ROP. Conclusion Among the preterms with very low body weight included in our study, we found that the frequency of severe ROP requiring treatment was low. The most important factors related to severe ROP were found to be low gestational age and birth weight. Being aware of the risk factors related to severe ROP in addition to screening every preterm infant carrying these risk factors is extremely important for the early diagnosis and treatment to prevent blindness due to severe retinopathy.

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Differential classification of infants in United States neonatal intensive care units for weight, length, and head circumference by United States and international growth curves

Cited by 7 publications

References 22 publications

Timing of Maternal COVID-19 Vaccine and Antibody Concentrations in Infants Born Preterm

Timing of Maternal COVID-19 Vaccine and Antibody Concentrations in Infants Born Preterm

The NICU Antibiotics and Outcomes (NANO) trial: a randomized multicenter clinical trial assessing empiric antibiotics and clinical outcomes in newborn preterm infants

A Retrospective Analysis of Retinopathy of Prematurity (ROP) in a Tertiary Newborn Intensive Care Unit: Incidence and Risk Factors of ROP

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