Severe Neonatal Morbidity Across Gestational Age: Monitoring Infants at High Risk of Mortality

Acta Paediatrica, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 24, 2025

This study aimed to quantify temporal trends in severe neonatal morbidity (SNM) and examine its association with mortality, stratified by gestational age. included all live births Sweden from 2007 2021. SNM types subtypes were identified based on diagnoses procedure codes for ≥ 22 weeks' gestation, including complications within 27 days. Rates calculated age, changes assessed using rate ratios (RR) 95% confidence intervals (CI). Adjusted relative risks (aRR) of death also estimated. From 2021, 47,048 (2.8%) cases identified, rising 2.2% 3.6% mainly due increased resuscitation/mechanical ventilation rates across ages. Infections rose among infants born at 37 weeks (0.59% 2007-2011 0.77% 2017-2021, RR 1.30, CI, 1.24-1.37), but declined those 22-31 weeks. Neurological morbidity, especially seizures, slightly term moderately preterm infants. Except 22-27 weeks, mortality higher greater Despite advances care, prevalence 2021

Language: Английский

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Antimicrobial Therapies for Early-Onset Group B Streptococcal Sepsis: Insights from an Italian Multicenter Study

Antibiotics, Journal Year: 2025, Volume and Issue: 14(4), P. 410 - 410

Published: April 16, 2025

Background: Antimicrobial therapies used for treating group B streptococcus (GBS) early-onset sepsis (EOS) provide insight into clinicians’ adherence to antimicrobial stewardship (AMS) guidelines. Methods: We reviewed given treat newborns with GBS-EOS. Data were obtained from an Italian surveillance network (including 35 birthing centers) and prospectively collected 1 January 2003 31 December 2024. Empiric definitive classified as adequate inadequate. Results: There 967,054 live births 200 cases of GBS-EOS, which 43 (21.5%) preterm 157 (78.5%) full-term; (17.5%) out showed no signs illness. Fourteen (7.0%) died (one full-term thirteen under 34 weeks gestation). Based on the available information, antibiotics in 106/137 (77.4%) empiric 48/119 (40.3%) therapies. The duration antibiotic courses did not differ between severe (median 10 days, IQR 8.0–14.0) non-severe (median: days; IQR: 10.0–12.5; p = 0.68). Antibiotic treatments lasted ≥ 15 days (20.1%) 169 information. Conclusions: In this large multicenter study, deviations international recommendations GBS-EOS critical. Our findings underscore importance timely de-escalation need avoid excessively prolonged antimicrobials.

Language: Английский

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Incidence of Antibiotic Exposure for Suspected and Proven Neonatal Early-Onset Sepsis between 2019 and 2021: A Retrospective, Multicentre Study

Antibiotics, Journal Year: 2024, Volume and Issue: 13(6), P. 537 - 537

Published: June 10, 2024

Management of suspected early-onset sepsis (EOS) is undergoing continuous evolution aiming to limit antibiotic overtreatment, yet current data on the level overtreatment are only available for a select number countries. This study aimed determine initiation and continuation rates EOS, along with incidence culture-proven EOS in The Netherlands. In this retrospective from 2019 2021, were collected 15 Dutch hospitals, comprising 13 regional hospitals equipped Level I-II facilities 2 academic IV facilities. Data included birth rates, neonates started antibiotics that continued treatment beyond 48 h EOS. Additionally, blood culture results documented. analysed both collectively separately hospitals. A total 103,492 live-born included. 4755 (4.6%, 95% CI 4.5-4.7), therapy was 2399 (2.3%, 2.2-2.4), h. Incidence 1.1 cases per 1000 live births (0.11%, 0.09-0.14). Overall, each case, 40.6 21.7 continued. Large variations observed across all initiated case varying 4 90 56, respectively. high prescriptions compared wide variety clinical practice among Netherlands underscore need potential novel approach management

Language: Английский

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Concerns about Mis-/Overuse of Antibiotics in Neonates Born at ≤32 Weeks Gestational Age in Latin American Neonatal Units: Eight Years of Experience in the EpicLatino Database

Newborn, Journal Year: 2024, Volume and Issue: 3(2), P. 83 - 89

Published: June 21, 2024

Language: Английский

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Beyond the incubator: applying a “one health” approach in the NICU

Pediatric Research, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 30, 2024

A "one health" approach recognises that human health, animal health and planetary are closely interlinked a transdisciplinary is required to fully understand maintain global health. While, by necessity, Neonatal Intensive Care has traditionally focused on the acutely unwell newborn, avoidance of long-term harm core many management decisions. The COVID 19 pandemic climate crisis have brought into sharp relief importance as part promotion in holistic care neonates, who may survive experience burden future environmental crises. This narrative review seeks integrate what we know about issues neonatal intensive unit, notably antimicrobial resistance change, suggest "everyday changes" which can be utilised practitioners minimise impact these issues. Many changes suggested not only represent important improvements for but also good practice. IMPACT: patients likely bear crises including pandemics related disasters. While focus acute illness, awareness problems our smallest preventing harm. High quality benefit both planet patients.

Language: Английский

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Perinatal Environmental Risks for Eosinophilic Esophagitis: A Systemic Review and Meta-Analysis

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 6, 2024

There are limited data on the association of eosinophilic esophagitis (EoE) and environmental risk factors. The aim this study was to determine potential associations between perinatal factors EoE. A search conducted for relevant studies published up December 12th, 2023, using MEDLINE, EMBASE, Scopus, Web Sciences, Cochrane databases. Risk ratios with 95% confidence interval (CI) were estimated a random-effects model. Case-control or cohort that determined within first year life their EoE included. Six case-control included in analysis. (2,087 6,786 controls) infant antibiotic use pooled ratio 1.30 (95%CI: 1.11-1.52, I2 = 76%), five cesarean section 1.22 1.10-1.34, 5%). three breastfeeding 1.07 1.00-1.15, 0%); preterm birth 1.52 1.14-2.04, 48%). neonatal intensive care unit admission 1.75 (95% CI: 1.41-2.18, 0%). Publication bias found section, but not birth, admission, breastfeeding. This meta-analysis suggests weak during life, possible Further warranted confirm these findings as they may be indirect rather than causal.

Language: Английский

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Antimicrobial therapy in newborns: from theory to practice

Archives of Pediatrics and Pediatric Surgery, Journal Year: 2024, Volume and Issue: 2(2), P. 80 - 90

Published: Sept. 15, 2024

Currently, there are no uniform accurate statistical data on the development of neonatal sepsis. This critical condition is difficult to diagnose in early stages due lack reliable markers with high prognostic value, and use currently available sepsis specificity and/or sensitivity limited large tertiary level obstetric hospitals. In this regard, as part diagnosis sepsis, issues related amultifactorial assessment risk becoming relevant, basis which indications for prescribing therapy prevention will be justified. The most common etiological cause numerous pathogens: bacteria, viruses fungi. again leaves difficulties choosing right therapeutic tactics, especially within framework antibiotic therapy, protocols vary from hospital not only our country, but throughout world. Based practice domestic foreign colleagues, it necessary discuss management patients such acomplex

Language: Английский

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Implementation of an EOS calculator-based protocol decreased infant antibiotic exposure in chorioamnionitis without correlation with placental histopathology

Journal of Perinatology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 9, 2024

Language: Английский

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