Bacterial vaginosis is common and is caused by a disruption of the microbiological environment in the lower genital tract. In the US, reported prevalence of bacterial vaginosis among pregnant women ranges from 5.8% to 19.3% and is higher in some races/ethnicities. Bacterial vaginosis during pregnancy has been associated with adverse obstetrical outcomes including preterm delivery, early miscarriage, postpartum endometritis, and low birth weight.
The USPSTF recommends against screening for bacterial vaginosis in pregnant persons not at increased risk for preterm delivery. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for bacterial vaginosis in pregnant persons at increased risk for preterm delivery.
https://jamanetwork.com/journals/jama/fullarticle/2764189
#preterm #neonatology #vaginosis
The USPSTF recommends against screening for bacterial vaginosis in pregnant persons not at increased risk for preterm delivery. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for bacterial vaginosis in pregnant persons at increased risk for preterm delivery.
https://jamanetwork.com/journals/jama/fullarticle/2764189
#preterm #neonatology #vaginosis
Jamanetwork
USPSTF Recommendation: Screening for Bacterial Vaginosis to Prevent Preterm Delivery
This 2020 Recommendation Statement from the US Preventive Services Task Force recommends against screening for bacterial vaginosis (BV) in pregnant persons not at increased risk for preterm delivery (D recommendation) and concludes that current evidence is…
👉Heart Rate Determination in Newborns at Risk for Resuscitation in a Low-Resource Setting: A Randomized Controlled Trial
📌HR assessment by auscultation was more accurate compared with cord palpation, but both may provide adequate clinical information to healthcare providers in terms of HR ranges. The clinical advantage of providing a stethoscope in low-resource settings remains to be established.
🔗https://www.jpeds.com/article/S0022-3476(20)30183-9/fulltext
#resuscitation #neonatology #heartrate #auscultation
📌HR assessment by auscultation was more accurate compared with cord palpation, but both may provide adequate clinical information to healthcare providers in terms of HR ranges. The clinical advantage of providing a stethoscope in low-resource settings remains to be established.
🔗https://www.jpeds.com/article/S0022-3476(20)30183-9/fulltext
#resuscitation #neonatology #heartrate #auscultation
👉Breast Milk–Acquired Cytomegalovirus in Premature Infants
📌Infection with human cytomegalovirus (CMV) is ubiquitous, with a global seroprevalence of approximately 85%. In all human history, most CMV infections have probably been acquired from breastfeeding. Hayes et al in 1972 demonstrated that CMV could be cultured in breast milk, and breastfeeding was proposed as a mechanism by which the virus could be transmitted to the neonate. Subsequent work showed that such postnatal infections are generally innocuous in full-term infants, in contrast to the potentially devastating neurodevelopmental and audiological consequences of CMV infections acquired in utero.
🔗https://jamanetwork.com/journals/jamapediatrics/article-abstract/2755410
#cmv #virus #cytomegalovirus #breastmilk #breastfeeding #neonatology #preterm #jama
📌Infection with human cytomegalovirus (CMV) is ubiquitous, with a global seroprevalence of approximately 85%. In all human history, most CMV infections have probably been acquired from breastfeeding. Hayes et al in 1972 demonstrated that CMV could be cultured in breast milk, and breastfeeding was proposed as a mechanism by which the virus could be transmitted to the neonate. Subsequent work showed that such postnatal infections are generally innocuous in full-term infants, in contrast to the potentially devastating neurodevelopmental and audiological consequences of CMV infections acquired in utero.
🔗https://jamanetwork.com/journals/jamapediatrics/article-abstract/2755410
#cmv #virus #cytomegalovirus #breastmilk #breastfeeding #neonatology #preterm #jama
👉Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice
📌The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.
🔗https://onlinelibrary.wiley.com/doi/full/10.1111/apa.14754
#skintoskin #newborn #neonatology #care #wiley #birth
📌The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.
🔗https://onlinelibrary.wiley.com/doi/full/10.1111/apa.14754
#skintoskin #newborn #neonatology #care #wiley #birth
👉ELBW infants receive inadvertent sodium load above the recommended intake
📌Sodium load during the first 2 postnatal weeks of ELBW infants was significantly higher than recommended owing to inadvertent sodium intake and was associated with a higher risk of subsequent morbidity and mortality, although the study design does not allow conclusions on causality. Replacement of 0.9% saline with alternative carrier solutions might reduce sodium intake.
🔗https://www.nature.com/articles/s41390-020-0867-9?platform=hootsuite
#na #neonatology #resuscitation #infusion #nature
📌Sodium load during the first 2 postnatal weeks of ELBW infants was significantly higher than recommended owing to inadvertent sodium intake and was associated with a higher risk of subsequent morbidity and mortality, although the study design does not allow conclusions on causality. Replacement of 0.9% saline with alternative carrier solutions might reduce sodium intake.
🔗https://www.nature.com/articles/s41390-020-0867-9?platform=hootsuite
#na #neonatology #resuscitation #infusion #nature
👉Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies
📌In this study, EOS incidence and associated mortality disproportionately occurred in preterm infants. Contemporary cases have demonstrated the limitations of current GBS prevention strategies. The increase in E coli infections among very low-birth-weight infants warrants continued study. Ampicillin and gentamicin remained effective antibiotics in most cases, but ongoing surveillance should monitor antibiotic susceptibilities of EOS pathogens.
🔗https://jamanetwork.com/journals/jamapediatrics/article-abstract/2765163
#sepsis #streptococcus #ecoli #jama #eos #neonatology #infection
📌In this study, EOS incidence and associated mortality disproportionately occurred in preterm infants. Contemporary cases have demonstrated the limitations of current GBS prevention strategies. The increase in E coli infections among very low-birth-weight infants warrants continued study. Ampicillin and gentamicin remained effective antibiotics in most cases, but ongoing surveillance should monitor antibiotic susceptibilities of EOS pathogens.
🔗https://jamanetwork.com/journals/jamapediatrics/article-abstract/2765163
#sepsis #streptococcus #ecoli #jama #eos #neonatology #infection
👉Health and nutrition claims for infant formula are poorly substantiated and potentially harmful
📌Despite improvements in infant formula over its 150 year history, it is still associated with health risks for mother and infant compared with breastfeeding.
🔗https://www.bmj.com/content/369/bmj.m875
👉open access
#formula #breastfeeding #nutrition #newborn #neonatology
📌Despite improvements in infant formula over its 150 year history, it is still associated with health risks for mother and infant compared with breastfeeding.
🔗https://www.bmj.com/content/369/bmj.m875
👉open access
#formula #breastfeeding #nutrition #newborn #neonatology
👉Interpreting Umbilical Cord Blood Gases:
Technical Issues.
📌Part 1: http://www.neonatologytoday.net/newsletters/nt-mar20.pdf (p.34).
#cordblood #gases #neonatology #neonatologytoday
Technical Issues.
📌Part 1: http://www.neonatologytoday.net/newsletters/nt-mar20.pdf (p.34).
#cordblood #gases #neonatology #neonatologytoday
👉Interpreting Umbilical Cord Blood Gases:
Technical Issues.
📌Part 2: http://www.neonatologytoday.net/newsletters/nt-may20.pdf (p.53).
#cordblood #gases #neonatology #neonatologytoday
Technical Issues.
📌Part 2: http://www.neonatologytoday.net/newsletters/nt-may20.pdf (p.53).
#cordblood #gases #neonatology #neonatologytoday
👉A Comparison of UK Preterm Anthropometric Charts and INTERGROWTH-21st: Is It Time to Change Growth Charts?
📌Existing UK NICM reference charts are significantly different to the growth standards of INTERGROWTH-21st. The choice of which growth chart to adopt in the UK could have important consequences on premature infants’ future adult health and therefore requires further prospective observational studies with larger data sets including length measurements and more comprehensive population characteristics.
🔗https://www.karger.com/Article/Abstract/507024
🔗https://intergrowth21.tghn.org/
#intergrowth #gharts #neonatology #growth
📌Existing UK NICM reference charts are significantly different to the growth standards of INTERGROWTH-21st. The choice of which growth chart to adopt in the UK could have important consequences on premature infants’ future adult health and therefore requires further prospective observational studies with larger data sets including length measurements and more comprehensive population characteristics.
🔗https://www.karger.com/Article/Abstract/507024
🔗https://intergrowth21.tghn.org/
#intergrowth #gharts #neonatology #growth
👉Guidelines for Management of Neonatal Hypoglycemia
Are They Actually Applicable?
🔗https://jamanetwork.com/journals/jamapediatrics/fullarticle/2765824
#glucose #hypoglycemia #jama #neonatology #guide
Are They Actually Applicable?
🔗https://jamanetwork.com/journals/jamapediatrics/fullarticle/2765824
#glucose #hypoglycemia #jama #neonatology #guide
👉Evaluation for Neonatal HSV in Infants Undergoing Workup for Serious Bacterial Infection: A 5-Year Retrospective Review
📌Neonatal herpes simplex virus (HSV) infection carries a high risk of mortality and, among survivors, morbidity, including developmental delay and seizures. Accurate and timely diagnosis, which is necessary to reduce mortality, is complicated by the range of clinical presentations, which can include few or no signs, symptoms, or characteristic laboratory findings. Although diagnosis in infants with skin-eye-mucosal (SEM) disease may be immediately apparent on the basis of the presence of vesicles,9 other manifestations of HSV may be more difficult to identify. Infants with disseminated disease, for example, can present with fulminant sepsis and disseminated intravascular coagulation or simply with hypothermia and lethargy.Similarly, infants with isolated central nervous system (CNS) HSV can present with few nonspecific clinical and laboratory findings, especially early in the disease.
🔗https://hosppeds.aappublications.org/content/early/2020/05/07/hpeds.2020-0033
👉open access
#herpes #infections #aap #pediatricshospital #neonatology
📌Neonatal herpes simplex virus (HSV) infection carries a high risk of mortality and, among survivors, morbidity, including developmental delay and seizures. Accurate and timely diagnosis, which is necessary to reduce mortality, is complicated by the range of clinical presentations, which can include few or no signs, symptoms, or characteristic laboratory findings. Although diagnosis in infants with skin-eye-mucosal (SEM) disease may be immediately apparent on the basis of the presence of vesicles,9 other manifestations of HSV may be more difficult to identify. Infants with disseminated disease, for example, can present with fulminant sepsis and disseminated intravascular coagulation or simply with hypothermia and lethargy.Similarly, infants with isolated central nervous system (CNS) HSV can present with few nonspecific clinical and laboratory findings, especially early in the disease.
🔗https://hosppeds.aappublications.org/content/early/2020/05/07/hpeds.2020-0033
👉open access
#herpes #infections #aap #pediatricshospital #neonatology
👉Updated Strategies for Pulse Oximetry Screening for Critical Congenital Heart Disease
📌Seven years after its addition to the US Recommended Uniform Screening Panel, newborn screening for critical congenital heart disease (CCHD) using pulse oximetry became mandatory in the United States. Although CCHD newborn screening reduces morbidity and mortality, there remain important opportunities to improve. An expert panel convened for a 1-day meeting in September 2018, including subject matter experts and representatives from stakeholder organizations. Presentations on CCHD outcomes, variations in approach to screening, and data and quality improvement helped identify improvement opportunities. The expert panel concluded that sufficient evidence exists to recommend modifying the current American Academy of Pediatrics algorithm by (1) requiring an oxygen saturation of at least 95% in both (formerly either) the upper and lower extremities to pass and (2) requiring only 1 repeat screen instead of 2 for cases that neither pass nor fail initially. The panel underscored the importance of improving public health reporting by further specifying the targets of screening and criteria for reporting outcomes (false-negative and false-positive cases). The panel also highlighted the need to ensure sufficient public health funding for CCHD newborn screening and opportunities for education and global implementation. Newborn screening for CCHD using pulse oximetry has led to significant improvements in child health outcomes. However, further important work is required to understand and improve the effectiveness and efficiency of screening.
🔗https://pediatrics.aappublications.org/content/early/2020/06/02/peds.2019-1650
#cardiology #screening #guide #aap #neonatology #cchd
📌Seven years after its addition to the US Recommended Uniform Screening Panel, newborn screening for critical congenital heart disease (CCHD) using pulse oximetry became mandatory in the United States. Although CCHD newborn screening reduces morbidity and mortality, there remain important opportunities to improve. An expert panel convened for a 1-day meeting in September 2018, including subject matter experts and representatives from stakeholder organizations. Presentations on CCHD outcomes, variations in approach to screening, and data and quality improvement helped identify improvement opportunities. The expert panel concluded that sufficient evidence exists to recommend modifying the current American Academy of Pediatrics algorithm by (1) requiring an oxygen saturation of at least 95% in both (formerly either) the upper and lower extremities to pass and (2) requiring only 1 repeat screen instead of 2 for cases that neither pass nor fail initially. The panel underscored the importance of improving public health reporting by further specifying the targets of screening and criteria for reporting outcomes (false-negative and false-positive cases). The panel also highlighted the need to ensure sufficient public health funding for CCHD newborn screening and opportunities for education and global implementation. Newborn screening for CCHD using pulse oximetry has led to significant improvements in child health outcomes. However, further important work is required to understand and improve the effectiveness and efficiency of screening.
🔗https://pediatrics.aappublications.org/content/early/2020/06/02/peds.2019-1650
#cardiology #screening #guide #aap #neonatology #cchd