Neonatology
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Apnea and bradycardia of prematurity (ABP) are possible risks towards damage of the developing brain. ⋯ ABP is an age-specific phenomenon. However, more severe courses than expected for PMA or the resolution at a later PMA indicated an increased risk of neurodevelopmental disturbances at a corrected age of 13 months.
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Transient tachypnea of the newborn (TTN) is a mild form of neonatal respiratory distress which early in its course needs to be differentiated from other severe respiratory disorders. At present the diagnosis is based on radiological findings and clinical course. Lung sonography in TTN has not yet been assessed. ⋯ We found lung sonography reliable for the early diagnosis of TTN. We suggest that it should become the first approach for imaging of neonatal respiratory distress although further prospective studies with good blinding need to be performed.
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Inherited disorders of pulmonary surfactant-associated proteins are rare but provide important insights into unique mechanisms of surfactant dysfunction. Recessive loss-of-function mutations in the surfactant protein-B and the ATP-binding cassette family member A3 (ABCA3) genes present as lethal surfactant deficiency in the newborn, whereas other recessive mutations in ABCA3 and dominant mutations in the surfactant protein-C gene result in interstitial lung disease in older infants and children. The molecular basis and the genetic and tissue-based approaches to the evaluation of children suspected of having one of these disorders are discussed.
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Preterm infants are repeatedly exposed to painful experiences as part of their care in the neonatal intensive care unit. There is evidence from both animal and human studies that exposure to pain during the neonatal period may have persisting consequences for development. ⋯ Healthy preterm infants sensitize to heelstick-induced pain, as measured by their heart rate responses. These data suggest that greater attention to the effects of repeated pain for the neonate is needed.
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Comparative Study
Bruising at birth: antenatal associations and neonatal outcome of extremely low birth weight infants.
Early studies have identified severe cranial bruising as a risk factor for intraventricular hemorrhage (IVH) in premature infants but the nature of this association has not been evaluated. ⋯ Antenatal exposure to steroids and increasing gestational age are associated with a lower incidence of bruising at birth in extremely low birth weight infants. Severe bruising at birth is associated with increased incidence of severe intraventricular hemorrhage and mortality.