Explore the vast range of titles available.

ObjectivesOver the last few decades different strategies have been proposed to treat persistent ductal patency in premature infants. The advent of the Amplatzer Duct Occluder II Additional Size (ADOIIAS) provided the potential to close the patent ductus arteriosus (PDA). Opinions differ on the significance and treatment of PDA in premature neonates. Because surgical ligation and medical therapy both have their drawbacks, interventional catheterisation can be considered as an alternative means of closing the ductus arteriosus. Our aim was to analyse the feasibility, safety and efficacy of this device in premature infants weighing <1200 g at procedure.MethodsEighteen premature infants underwent transcatheter closure. The procedure was performed in the catheterisation laboratory by venous cannulation without angiography. The position of the occluder was directed by X-ray and ultrasound. We looked at procedural details, device size selection, complications and short-term and mid-term outcomes.ResultsEighteen infants born at gestational ages ranging between 23.6 and 29+6 weeks (mean±SD 25+6±3 weeks) underwent transcatheter PDA closure. Their mean age and weight at the time of the procedure was 20 days (range 8–44 days) and 980 g (range 680–1200 g), respectively. The mean PDA and device waist diameters were 3.2±0.6 mm (range 2.2–4 mm) and 4.5±0.6 mm, respectively, and the mean PDA and device lengths were 4.3±1.2 mm (range 2–10 mm) and 2.5±0.9 mm, respectively. Complete closure was achieved in all but one patient. There was no device migration. One patient developed a left pulmonary artery obstruction. Three infants died. Two deaths were related to complications of prematurity and one to the procedure.ConclusionsTranscatheter closure of a PDA is feasible in very low weight infants with ADOIIAS and is an alternative to surgery. Success requires perfect selection and placement of the occluder.

Objective To investigate the physical growth and neurodevelopmental indicators of Gestational age(GA)< 32 weeks infants at 6 months corrected age. Methods This study included 116 infants, retrospectively analyzing GA<32 weeks infants who discharged from Tianjin Central Hospital of Gynecology and Obstetrics between April 2023 and August 2024. General movements (GMs) assessment was performed at 1 month corrected age. Physical Growth Indicators, GMs and Gesell Developmental Diagnosis Scale (GDDS) assessments were conducted at 3 and 6 months corrected age. Results The proportion of abnormal GMs at 3 months corrected age (3.44%) was lower than that at 1 month corrected age (86.21%).At 6 months corrected age, the proportion of infants with a developmental quotient (DQ) ≤ 75 was 43.10%, lower than 69.82% at 3 months corrected age. GA and multiple births were independent risk factors for DQ ≤ 75 at 3 months corrected age. GA, early intervention, and intracranial hemorrhage were independent risk factors for DQ ≤ 75 at 6 months corrected age. Conclusion At 6 months corrected age, GA<32 weeks infants exhibited greater neurodevelopmental outcome. Standardized follow-up and early neurodevelopmental interventions should be further strengthened for preterm infants to reduce the occurrence of adverse outcomes.

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

Background To assess the baseline level of care for very preterm (VPI) and extremely preterm infants (EPI) in Shenzhen using the Triple Aim framework. Methods This retrospective analysis utilized data from the Shenzhen Neonatal Data Network (SNDN) for 2022–2023. We assessed mortality rate, major morbidity rate, benefit metric (a risk-adjusted composite morbidity index), and per capita costs. Results The study included 995 infants from 11 NICUs in the SNDN, with an overall mortality rate of 7.5%. The rates for the eight major morbidities were: bronchopulmonary dysplasia 22.6%, grade III-IV intraventricular hemorrhage 5.2%, periventricular leukomalacia 2.2%, stage II-III necrotizing enterocolitis 3.9%, focal intestinal perforation 0.8%, stage 3–5 retinopathy of prematurity 3.8%, discharge weight < 10th percentile 12.1%, and late-onset infections 9.4%. The benefit metric ranged from 0.7 to 3.3, with per capita costs between $212.3 and $342.4. Conclusion This study provides baseline data on NICU preterm infant management in Shenzhen using the Triple Aim framework, highlights areas for quality improvement.

The dynamic changes of the hematopoietic system during fetal development may be disrupted by preterm birth. Hematopoietic stem and progenitor cell (CD34 ) levels are poorly investigated in preterm infants, particularly in relation to immune responses and morbidities. This is partly because of low blood volumes, which raise ethical concerns and limit specific sampling for research studies. To overcome this problem, we used residual blood from routine clinical testing to monitor CD34 cell counts in the first months of life. Our aim was to characterize the dynamics of circulating CD34 cells and explore associations with prenatal and postnatal clinical events. We retrieved residual blood samples from nine infants born <28 weeks gestational age (GA), collected from birth through eight postnatal weeks. CD34 cell count was assessed using flow cytometry. The number of nucleated red and white blood cells, and hemoglobin concentration were also measured. Median (min-max) GA was 25+0 (22+3─27+5) weeks. CD34 cell counts at birth ranged from 19 to 284 x 10 cells/L. Between days 0 and 1, CD34 cell count increased in four infants and decreased in four. By day 7, the proportion of CD34 of total nucleated blood cells was significantly lower than at birth (p=0.018). High inter- and intra-individual variability in CD34 cell count was observed. Notably, the highest CD34 cell levels coincided with maternal or infant infections. This pilot study demonstrates the feasibility of longitudinal monitoring of CD34 hematopoietic stem and progenitor cells in extremely preterm infants using residual clinical blood samples. While limited by a small sample size, the study provides preliminary insights into early immune function and highlights directions for future research in larger cohorts.

Background Because the respiratory system of extremely/very preterm infants is immature, respiratory support is essential to their care; however, the effects of invasive and non-invasive ventilation modes on prognosis and complications remain controversial. The efficacy and safety of invasive mechanical ventilation (IMV), nasal continuous positive airway pressure (NCPAP), and non-invasive high-frequency oscillatory ventilation (NHFOV) were to be compared in extremely/very preterm infants.  Methods Clinical data from 220 extremely/very preterm infants admitted between January 2024 and March 2025 were retrospectively analyzed. Infants were stratified by initial ventilation modality into the invasive group (AG, n  = 87), the non-invasive NCPAP group (BG, n  = 82), and the non-invasive NHFOV group (CG, n  = 51); treatment outcomes and complications were compared.  Results The CG had the shortest total ventilation time (8.5 ± 2.8 days), the lowest rate of reintubation (17.6%), and the highest weaning success rate (88.2%), all of which were superior to the other groups ( P <  0.05); the AG had the highest incidence of bronchopulmonary dysplasia (37.9%) and intracranial hemorrhage (13.8%) ( P <  0.05). Mortality, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and sepsis incidence not statistically significant among the three groups ( P  > 0.05). Conclusion Non-invasive ventilation, especially NHFOV, was found to optimize treatment outcomes and reduce complications in extremely/very preterm infants; its preferential use was recommended.

Although evidence is available about preterm newborns’ spontaneous behavioral repertoire during the first weeks of life in the neonatal intensive care unit (NICU), studies on infant behavioral responses to external social stimuli are scarce. The main aim of this study was to analyze preterm infant behaviors in response to the maternal voice, speaking or singing, in the NICU, compared with a control condition when the mother was not present. We hypothesized that the infants’ self-touch, eye-opening, and oral behaviors would increase in the singing and speaking conditions. The neonates’ behavior was video recorded and then coded by using the System for Coding Perinatal Behavior. Preterm newborns showed increased self-touch and eye-opening behaviors during maternal-directed speech and songs in the NICU. Oral movements were modulated differently by the singing and speaking conditions: the singing condition was specifically associated with infants’ rhythmical sucking behaviors and smiles, whereas maternal speech was associated with non-rhythmical mouth movements. In both speaking and singing conditions, yawning occurred more frequently than in the control condition. The findings of this pilot study suggest that preterm newborns from 32 weeks’ postmenstrual age respond to social and contingent stimuli with a general activation of self-touch and eye-opening behaviors. However, they respond to live maternal speech versus songs by showing different oral behaviors. The differential responses and clinical implications of the findings are discussed.

Background Late preterm infants suffer from more complications and are less likely to be breastfed compared to term infants and their mothers experience higher levels of stress than mothers with term infants. The physiological or hormonal responses that influence milk ejection, milk production, and/or maternal behaviour are possible mechanisms by which maternal distress could negatively influence breastfeeding success. Maternal mood might also affect infant behaviour (feeding, sleeping, and crying) through changes in milk volume and composition, and consequently breastfeeding success and infant growth. Previous research, using relaxation therapy in 64 Malaysian first-time mothers breastfeeding their full-term infants, demonstrated that the therapy was effective in reducing maternal stress and improving infant growth. We hypothesise that expected benefits are even greater in a more vulnerable population where additional breastfeeding support is especially needed, such as in mothers of late preterm infants. Methods/design This protocol describes our randomised controlled trial that tests whether a breastfeeding meditation audio reduces maternal stress in mothers of late preterm infants in London. Home visits will be conducted at 2–3 and 6–8 weeks post-delivery. Participants will be randomised to a control group or an intervention group, where mothers will be asked to listen to a meditation tape on a daily basis while breastfeeding. The main outcomes of the intervention will be maternal stress markers and infant weight Z-score. Potential mediators will be the secondary outcomes and include breast milk macronutrient and hormone levels (ghrelin, leptin, cortisol, and adiponectin), milk volume assessed by 48-h test-weighing, and maternal engagement with the infant. Infant behaviour, including crying and sleeping, and infant appetite will be evaluated. Data about other mediators such as maternal perception of milk supply and salivary oxytocin will be collected. Discussion We hypothesise that the use of the breastfeeding meditation will reduce maternal stress and consequently improve infant growth mediated by changes in milk composition and volume and maternal behaviour. This study will allow us to understand the mother–infant factors that influence breastfeeding in late preterm infants and potentially identify a method that could improve mother, infant, and breastfeeding outcomes. Trial registration ClinicalTrials.gov, NCT03791749 . Registered 1 January 2019.

Background Delayed meconium evacuation is an important cause of intestinal dysfunction in preterm infants. There are many methods to induce defecation in preterm infants: however, the effects are controversial. Finding a new intervention method to promote meconium evacuation in premature infants is necessary. Therefore, in the proposed study, the effectiveness of breast milk enema on complete meconium evacuation and time to achieve full enteral feeding will be investigated in preterm infants. Methods/design The study is a randomized, open-label, parallel-group, and single-center clinical trial. A total of 294 preterm infants will be recruited and stratified based on gestational age. Then, the infants will be assigned in a randomized block design to the intervention and control groups with a 1:1 ratio. Preterm infants in the control and intervention groups will receive saline enema and breast milk enema, respectively. The primary outcomes will be the time to achieve complete meconium evacuation from birth and time to achieve full enteral feeding from birth in preterm infants. The secondary outcomes will include hospitalization days, body weight at discharge, duration of total parenteral nutrition, cholestasis, and adverse events. Discussion The results of this trial will determine whether breast milk enema shortens the time to complete meconium evacuation and the time to achieve full enteral feeding in extremely preterm and preterm infants. Furthermore, the study results may provide a new, safe, inexpensive, and easy-to-use intervention to effectively evacuate meconium in preterm infants. Trial registration ISRCTN Registry ISRCTN17847514 . Registered on September 14, 2019

Objective: The aim of this study was to explore mothers’ perceived level of stress one month after hospital discharge following the birth of singleton and multiple preterm infants. Design: A cross-sectional design was used to compare mother’s perceived stress in two groups of postpartum mothers and the relationship of the theoretical antecedents and these variables. Setting: A neonatal intensive care unit in a medical center in Taiwan. Participants: Mothers of 52 singletons and 38 multiple premature infants were recruited. One month after the infant was discharged, the participants completed a self-reported questionnaire that included demographic data about the mother and infant, the 21-item Social Support Scale, and the 15-item Perceived Stress Scale. This was returned by email or completed at the outpatient unit. Analysis: Descriptive and inferential analysis. Results: The mean social support scores were 76.6 and 76.5 (out of 105) for mothers with singleton and multiple birth infants, respectively. The most important supporter was the husband. The mean perceived stress scores of 25.8 and 31.0 for mothers with singleton and multiple birth infants, respectively, were significantly different (p = 0.02). Sleep deprivation and social support were predictive indicators of perceived stress in mothers with preterm infants. Conclusions: We suggest that the differences in stress and needs of mothers with singleton and multiple births should be recognized and addressed in clinics. The findings of this study serve as a reference for promoting better preterm infant care.