Tessera

An RCT (354 preemies) compared drying before plastic wrapping vs wet-in-bag at birth. Normothermia at NICU admission was similar (45.8% vs 46.3%; RR 0.99). Drying has no added benefit, and over half of infants were still outside the normal range. #Neosky #pedsky pubmed.ncbi.nlm.nih.gov/41774445/

Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial - PubMed

ClinicalTrials.gov Identifier: NCT05740072.

pubmed.ncbi.nlm.nih.gov

An infant on PGE1 infusion developed severe ethanol toxicity. The low-strength formulation, though similar in ethanol concentration, delivers ~25× more ethanol per dose. Lesson: drugs aren’t interchangeable by active ingredient alone. #Neosky #pedsky pubmed.ncbi.nlm.nih.gov/41401022/

Prostaglandin E1 Infusions for Duct Dependent Congenital Heart Defects Can Cause Severe Ethanol Intoxication - PubMed

Prostaglandin E1 Infusions for Duct Dependent Congenital Heart Defects Can Cause Severe Ethanol Intoxication

pubmed.ncbi.nlm.nih.gov

A new retrospective study shows MRI radiomics can accurately predict 18-month developmental outcomes in infants with HIE using only imaging data (R² ~0.87). Despite the objective neuroprognostication, the study still needs external validation. #Neosky #pedsky pubmed.ncbi.nlm.nih.gov/41692231/

Neuroprognostication via Radiomics and Machine Learning Following Neonatal Hypoxic-Ischemic Insult - PubMed

A machine learning model using only MRI-based radiomic measures from infants with HIE can reliably predict their 18-month developmental outcomes with high accuracy across motor, cognitive, and language domains, regardless of the severity of their brain injury. In addition, our approach allowed us to …

pubmed.ncbi.nlm.nih.gov

In a cohort of 32,634 infants <32 weeks, DCC (≥30 s) was linked to a 24 g higher first-recorded weight, ~ 18 mL/kg extra blood (~21% more volume). Though observational, these data support meaningful placental transfusion in very preterm infants. #Neosky #pedsky pubmed.ncbi.nlm.nih.gov/41720473/

Deferred cord clamping and weight difference for very preterm infants - PubMed

In very preterm infants, at least 30 seconds of DCC is associated with a modest increase (24g) in first-recorded weight. This finding reinforces evidence from small clinical trials showing increased blood volumes and weight gains attributed to deferred cord clamping.

pubmed.ncbi.nlm.nih.gov

Early prophylactic paracetamol for PDA in extremely preterm infants (RCT, n=778) increased ductal closure at day 7 (71% vs 52%) but did NOT improve survival without severe morbidity at 36w PMA (66% vs 64%). Routine prophylaxis? Not supported. #Neosky #pedsky jamanetwork.com/journals/jam...

A recent study reviewed 148 systematic reviews of RCTs. These interventions reduce severe IVH significantly • Antenatal steroid • MgSO4 for preterm birth • Volume-targeted ventilation • Early surfactant via LISA • Prophylactic indomethacin #neosky #pedsky pubmed.ncbi.nlm.nih.gov/41642734/

Interventions to Prevent Intraventricular Haemorrhage in Preterm Neonates: An Umbrella Review of Systematic Reviews and Meta-analyses - PubMed

Antenatal steroids and magnesium sulphate administration and early neonatal lung protective strategies reduce the rates of IVH in preterm neonates. Adequately powered RCTs evaluating IVH care bundles with long-term follow up are required.

pubmed.ncbi.nlm.nih.gov

A new study suggests that >50%of preterm birth in GDM is preventable. Smoking, depression, and obesity mattered in all pregnancies, while age, inactivity, and poor sleep raised PTB risk in GDM only —arguing for risk-stratified prenatal care. #Neosky #pedsky www.frontiersin.org/journals/ped...

Frontiers | Distinct modifiable risk factors and preventable burdens of preterm birth: a risk-stratified analysis of pregnancies with and without gestational diabetes mellitus

Background: Preterm birth (PTB) remains a major clinical and public health challenge worldwide. Gestational diabetes mellitus (GDM), complicating 14-25% of p...

frontiersin.org

Echo in 50 newborns shows the LV rarely lies under the lower third of the sternum. Current NRP chest compressions likely hit the RV/great vessels, not the LV, suggesting compression site or technique may need reconsideration to improve effectiveness. #Neosky #pedsky fn.bmj.com/content/earl...

Chest compression in newborn infants: what anatomical structures are we compressing?

Objective To identify the location of the left ventricle (LV) and identify the structures below the lower third of the sternum when chest compressions (CCs) are performed using transthoracic echocardi...

fn.bmj.com

Oral vitamin K for VKDB prevention—how effective? In a Swiss cohort of 505,708 births, 9 VKDB cases occurred, all were breastfed and with risk factors such as cholestasis. However, IM vitamin K administration remains the most reliable option. #Neosky #pedsky pubmed.ncbi.nlm.nih.gov/41545738/

Oral neonatal vitamin K deficiency bleeding prophylaxis in Switzerland (2018-2024), still valid guidelines for healthy infants - PubMed

• Switzerland's 2003 VKDB prophylactic regimen (2 mg oral Konakion® MM (hour 4, day 4, and week 4) remains a valid recommendation for healthy infants. • Again, parental VK prophylaxis refusal and/or unrecognized cholestasis remain risk factors for VKDB.

pubmed.ncbi.nlm.nih.gov

Funded by a CDC grant, a trial in Guinea-Bissau randomize newborns to either receive or be denied the hepatitis B birth dose—despite the fact that this vaccine is protective and is recommended by WHO. "Is this another Tuskegee?" #Neosky #pedsky insidemedicine.substack.com/p/scoop-the-...

Scoop: The leaked protocol of the CDC-funded Hepatitis B vaccine trial in Guinea-Bissau. “This is another Tuskegee.”

The protocol reveals that the trial will withhold the Hepatitis B birth dose from thousands—without placebos, without universal maternal screening, and with endpoints critics call indefensible.

insidemedicine.substack.com

Antenatal steroids and CP. A study of more than 20K preterm births (32–36 wks), used a regression discontinuity design at the 34-week cutoff, found no difference in CP risk just before vs after 34 weeks (RR 0.98; 95% CI 0.50–1.98). #Neosky #pedsky www.jpeds.com/article/S002...

Antenatal Corticosteroids and Risk of Cerebral Palsy: A Regression Discontinuity Study

To use a natural experiment to investigate the effect of antenatal corticosteroids on the risk of cerebral palsy.

jpeds.com

In a meta-analysis including more than 20,000 preterm infants, iNO use was linked to mild reduction in BPD, mortality (only in RCTs), higher ROP (but not the severe disease), and no significant effects on brain injury, IVH, or NEC. #Neosky #pedsky link.springer.com/article/10.1...

Inhaled nitric oxide in preterm infants with respiratory disease: a systematic review and meta-analysis - European Journal of Medical Research

Background Inhaled nitric oxide (iNO) has been shown to be effective in term and near-term infants with specific respiratory diseases. The effects and potential risks of iNO differ substantially in pr...

link.springer.com

In a cohort of very preterm infants, n = 713, exposure to sedation was associated with an increased risk of BPD or death (aOR, 5.32; 95% CI, 3.15–8.98; p < 0.001), but not with adverse neurodevelopmental outcomes at 18 months of corrected age. #Neosky #pedsky www.frontiersin.org/journals/med...

Frontiers | Analgesia and sedation increases bronchopulmonary dysplasia risk without significant neurodevelopmental impairment in very preterm infants

BackgroundThe associations between analgesia and/or sedation exposure and adverse outcomes in very preterm infants remain controversial. Evidence linking the...

frontiersin.org

#Neosky #pedsky Have you ever wondered why the certainty of evidence is frequently downgraded in neonatal Cochrane reviews? Here is the answer. Imprecision and risk of bias were the most common reasons for downgrading the certainty of evidence pubmed.ncbi.nlm.nih.gov/41379741/

Why is neonatal evidence mainly very low or low certainty - a meta-epidemiological review of Cochrane Neonatal reviews - PubMed

The neonatal evidence was mainly limited due to imprecision and risk of bias. This indicates that larger scale high-quality studies in various neonatal topics are still greatly warranted.

pubmed.ncbi.nlm.nih.gov

The NeoVitaA study evaluated the long-term effects of early high-dose enteral vitamin A supplementation in ELBW infants. At 24 months, no benefit was observed for pulmonary infections or neurodevelopmental outcomes. A disappointing result. #Neosky #pedsky www.thelancet.com/journals/ecl...

Two-year outcomes after early postnatal high-dose fat-soluble enteral vitamin A supplementation in extremely low birth weight infants: follow-up of the NeoVitaA randomized controlled trial

Early postnatal high-dose enteral fat-soluble vitamin A supplementation in ELBW infants did not affect pulmonary or developmental outcomes at 24 months’ CA.

thelancet.com

Not all monitors are created equal. In NICUs, we make critical decisions based on numbers — SpO₂, HR, etc. — assuming our tools are equally accurate. A new study found significant performance gaps between two commonly used pulse-ox systems. #Neosky #pedsky www.nature.com/articles/s41...

Identifying performance differences between two pulse oximetry systems in simulated critical neonatal conditions - Journal of Perinatology

Journal of Perinatology - Identifying performance differences between two pulse oximetry systems in simulated critical neonatal conditions

nature.com

A study of 15,102 infants (23–28 weeks GA) found that each 1-week delay in reaching full enteral feeds (≥120 mL/kg/day) was linked to: +16% risk of sepsis (ARR 1.16) Higher NEC risk (ARR 1.20) More growth faltering in weight, length, and HC. #Neosky #pedsky jamanetwork.com/journals/jam...

Time to Full Enteral Feeds and Late-Onset Sepsis in Extremely Preterm Infants

This cohort study of extremely preterm infants evaluates whether there is an association between full enteral feeding and late-onset sepsis, necrotizing enterocolitis, and growth faltering.

jamanetwork.com

#Neosky #pedsky this study produced a model that can safely reduce ROP screens. Trained on >100k infants and validated on >25k, the model has AUROC 0.916. With 100% sensitivity, NPV was 99.9% and screens dropped 12%. A good tool to improve risk-stratification. pubmed.ncbi.nlm.nih.gov/41252350/

Machine Learning Risk Prediction for Treated Retinopathy of Prematurity in Infants - PubMed

ML models can effectively predict the need for ROP treatment and stratify infants by risk, potentially reducing unneeded screening. Future work is needed to translate model-based ROP predictions to the clinical setting.

pubmed.ncbi.nlm.nih.gov

A pilot study evaluated whether hyperglycemia and HbA1c levels can predict severe ROP. It found that a 30-day mean glucose of ~ 5.2 mmol/L with HbA1c of 5.6% predicted severe ROP with a 94% PPV. Another step toward improving ROP prevention. #Neosky #pedsky www.frontiersin.org/journals/ped...

Frontiers | Identifying neonatal hyperglycemia thresholds in preterm infants based on retinopathy of prematurity outcomes: proof-of-concept study

PurposeNeonatal hyperglycemia significantly increases risk for retinopathy of prematurity (ROP) in preterm infants, independent of other major ROP risk facto...

frontiersin.org

3/3 #Neosky #pedsky Why it matters: Vaginal birth may provide cues that jump-start immune & stress pathways. C-section infants might miss this activation window, possibly contributing to slightly higher rates of asthma/allergies. pubmed.ncbi.nlm.nih.gov/41220118/

Comparative Study Showed Significant Gene Expression Differences in Newborn Infants After Vaginal and Caesarean Deliveries - PubMed

This study demonstrates that the mode of delivery significantly influences neonatal gene expression and immune system activation.

pubmed.ncbi.nlm.nih.gov

2/3 #Neosky #pedsky Key findings: - 95 genes were more active in the vaginal-birth group - IL-6 and IL-8 were also higher Suggesting vaginal birth “activates” the newborn immune system. After correction, effects weren’t significant—likely due to small sample size. Think trend, not conclusion

1/3 #Neosky #pedsky Does the mode of delivery program a newborn’s immune system? A new study from Finland suggests yes—possibly. The study compared babies born vaginally vs. via elective C-section and examined genes tied to immune & stress responses