The smallest of the small: short-term outcomes of profoundly growth restricted and profoundly low birth weight preterm infants

Griffin, Ian J.; Lee, H C; Profit, Jochen; Tancedi, D J

doi:10.1038/jp.2014.233

Cited by 29 publications

(38 citation statements)

References 18 publications

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“…Self-reported ethnicity does not adequately capture inherent biological differences, and ancestral markers are a more reliable way of obtaining biologically relevant information that accounts for admixture (Yaeger et al, 2008). Additionally, the cesarean section rates were high (nearly 76%), though this finding is similar to that in a recent study of a nearly 71% cesarean section rate among VLBW infants (Griffin, Lee, Profit, & Tancedi, 2015). …”

Section: Discussionsupporting

confidence: 89%

Maternal Interleukin Genotypes Are Associated With NICU Outcomes Among Low-Birth-Weight Infants

Baumgartel

Groër

Cohen

et al. 2016

Biological Research For Nursing

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Background Maternal interleukin (IL) single nucleotide polymorphisms (SNPs) are associated with obstetrical outcomes. Conversely, infant SNPs are associated with subsequent neonatal intensive care unit (NICU) outcomes. Little is known about relationships between maternal SNPs and neonatal outcomes. Purpose To examine the relationships between maternal IL genotypes and neonatal outcomes. Methods An ancillary study was conducted among mothers (N = 63) who delivered very low-birth-weight infants (N = 74). Maternal DNA was extracted from breast milk and genotyped. Outcomes included fecal calprotectin, length of stay, scores for neonatal acute physiology with perinatal extension (SNAPPE-II), weight gain, oxygen needs, necrotizing enterocolitis, intraventricular hemorrhage, sepsis, retinopathy of prematurity, blood transfusions, and feeding intolerance. Multivariate analyses examined the relationships between maternal IL SNPs and outcomes, controlling for gestational age and the ratio of maternal milk to total milk. Results Absence of a minor allele in 2 IL6 SNPs was associated with fecal calprotectin (p = .0222, p = .0429), length of stay (p = .0158), SNAPPE-II (p = .0497), weight gain (p = .0272), and days on oxygen (p = .0316). IL6 genotype GG (rs1800795) was associated with length of stay (p = .0034) and calprotectin (p = .0213). Minor-allele absence in 2 IL10 SNPs was associated with days on oxygen (p = .0320). There were associations between IL10 genotype TT (rs1800871) and calprotectin (p = .0270) and between IL10 genotypes AA (rs1800872 and rs1800896) and calprotectin (p = .0158, p = .0045). Conclusion Maternal IL SNPs are associated with NICU outcomes. A potential clinical application includes an antenatal risk profile to identify neonatal needs.

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Section: Discussionsupporting

confidence: 89%

Maternal Interleukin Genotypes Are Associated With NICU Outcomes Among Low-Birth-Weight Infants

Baumgartel

Groër

Cohen

et al. 2016

Biological Research For Nursing

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“…Data collected by organizations such as Vermont Oxford Network (VON), 1 -3 National Institute of Child Health and Development Neonatal Research Network, 4 Pediatrix, 5 Children's Hospitals Neonatal Database, 6 and California Perinatal Quality Care Collaborative 7 have contributed greatly to our understanding of the characteristics and outcomes of infants born <1500 g or <29 weeks in the United States.…”

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confidence: 99%

Variation in Use by NICU Types in the United States

Edwards

Horbar

2018

Pediatrics

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BACKGROUND: Increased admissions of higher birth weight and less acutely ill infants to NICUs suggests that intensive care may be used inappropriately in these populations. We describe variation in use of NICU services by gestational age and NICU type. METHODS:Using the Vermont Oxford Network database of all NICU admissions, we assessed variation within predefined gestational age categories in the following proportions: admissions, initial NICU hospitalization days, high-acuity cases ≥34 weeks' gestation, and short-stay cases ≥34 weeks' gestation. High acuity was defined as follows: death, intubated assisted ventilation for ≥4 hours, early bacterial sepsis, major surgery requiring anesthesia, acute transport to another center, hypoxic-ischemic encephalopathy or a 5-minute Apgar score ≤3, or therapeutic hypothermia. Short stay was defined as an inborn infant staying 1 to 3 days with discharge from the hospital. RESULTS:From 2014 to 2016, 486 741 infants were hospitalized 9 657 508 days at 381 NICUs in the United States. The median proportions of admissions, initial hospitalized days, highacuity cases, and short stays varied significantly by NICU types in almost all gestational age categories. Fifteen percent of the infants ≥34 weeks were high acuity, and 10% had short stays. CONCLUSIONS:There is substantial variation in use among NICUs. A campaign to focus neonatal care teams on using the NICU wisely that addresses the appropriate use of intensive care for newborn infants and accounts for local context and the needs of families is needed. abstract a Vermont Oxford Network,

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“…It is well known that SGA infants have a lower survival compared with AGA infants 30, 31 . The largest proportion of SGA infant mortality has been reported to occur during the first 12 hours of life 30 .…”

Section: Discussionmentioning

confidence: 99%

“…The largest proportion of SGA infant mortality has been reported to occur during the first 12 hours of life 30 . Inclusion in the current study relied on the presence of at least three days of oxygen saturation waveform data and, correspondingly, survival of at least three days duration.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

Fiore

Martin

et al. 2017

The Journal of Pediatrics

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Objective To characterize actual achieved patterns of oxygenation in appropriate (AGA) versus small (SGA) for gestational age infants randomized to a lower (85–89%) versus higher (91–95%) oxygen saturation target in the Surfactant, Positive Pressure and Oxygen Trial (SUPPORT). To determine the association between achieved oxygen saturation levels and survival in AGA and SGA infants enrolled in SUPPORT. Study design Median oxygen saturation and intermittent hypoxemia events (<80%, 20sec–5min) were documented in 1054 infants of 24–27 6/7wks gestation while receiving supplemental oxygen during the first three days of life. Results Lower target SGA infants had the lowest oxygen saturation and highest incidence of IH during the first three days of life. The lowest quartile of oxygen saturation (≤92%) during the first three days of life was associated with lower 90 day survival for both AGA and SGA infants. An increased incidence of IH events during the first three days of life was associated with lower 90 day survival only in SGA infants. Conclusion Lower achieved oxygen saturation during the first three days of life was associated with lower 90 day survival in extremely preterm infants. SGA infants had enhanced vulnerability to lower oxygen saturation targets as evidenced by lower achieved oxygen saturation and an association between increased IH events and lower survival.

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The smallest of the small: short-term outcomes of profoundly growth restricted and profoundly low birth weight preterm infants

Cited by 29 publications

References 18 publications

Maternal Interleukin Genotypes Are Associated With NICU Outcomes Among Low-Birth-Weight Infants

Maternal Interleukin Genotypes Are Associated With NICU Outcomes Among Low-Birth-Weight Infants

Variation in Use by NICU Types in the United States

Patterns of Oxygenation, Mortality, and Growth Status in the Surfactant Positive Pressure and Oxygen Trial Cohort

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