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Special Issue "New Research in Neonatal-Perinatal Medicine"

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: closed (25 January 2023) | Viewed by 13885

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Special Issue Editors

Prof. Dr. Huixia Yang

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Guest Editor

Department of Obstetrics and Gynecology, Peking University First Hospital, Peking University, Beijing 100034, China
Interests: maternal fetal medicine (especially in gestational diabetes mellitus, placenta accreta spectrum, preeclampsia, et al.); developmental origins of health and disease (DOHaD)
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Shangrong Fan

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Guest Editor

Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China
Interests: perinatal infection; preeclampsia and neonatal asphyxia

Dr. Juan Juan

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Guest Editor

Peking University First Hospital, Peking University, Beijing 100034, China
Interests: nutrition epidemiology; gestational diabetes mellitus; early essential newborn care

Special Issue Information

Dear Colleagues,

The first 1000 days of life indicates the period from conception to the second postnatal year, which is crucial for the growth and development of offspring.

The first 1000 days of life is a period where the foundations for optimum health, growth, and development are established, and is a “window of opportunity” with high plasticity to efficaciously intervene and reduce exposure to adverse factors.

As illustrated by the well-known developmental origins of health and disease (DOHaD) concept, factors in early life stages significantly affect the development of diseases in later life.

Substantial evidence has demonstrated the vital role of the first 1000 days of life and their importance in improving long-term health.

The goal of this special issue is to promote long-term health by focusing on the first 1000 days of life.

Contributors are invited to send original research articles, clinical trial articles, reviews, systematic reviews, meta-analyses, etc., addressing themes such as the following:

Fetal growth restriction (FGR);
Macrosomia;
Preterm birth;
Perinatal infection;
Antibiotics on neonatal;
Gut microbiota;
Asphyxia.

Prof. Dr. Huixia Yang
Prof. Dr. Shangrong Fan
Dr. Juan Juan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

fetal growth restriction (FGR)
macrosomia
preterm birth
perinatal infection
antibiotics on neonatal
gut microbiota
asphyxia

Published Papers (9 papers)

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Research

12 pages, 874 KiB

Open AccessArticle

Influence of Perinatal Factors on Blood Tryptase and Fecal Calprotectin Levels in Newborns

Justine Paysal

Charlotte Oris

Ugo Troin

Pierre-Nicolas Limeri

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Children 2023, 10(2), 345; https://doi.org/10.3390/children10020345 - 10 Feb 2023

Viewed by 835

Abstract

Background: Blood tryptase and fecal calprotectin levels may serve as biomarkers of necrotizing enterocolitis. However, their interpretation may be hindered by the little-known effects of perinatal factors. The aim of this study was to compare the tryptase and calprotectin levels in newborns according to their term, trophicity, and sex. Method: One hundred and fifty-seven premature newborns and 157 full-term newborns were included. Blood tryptase and fecal calprotectin were assayed. Results: Blood tryptase levels were higher in premature than in full-term newborns (6.4 vs. 5.2 µg/L; p < 0.001). In situations of antenatal use of corticosteroids (p = 0.007) and non-exclusive use of human milk (p = 0.02), these levels were also higher. However, in multiple linear regression analyses, only prematurity significantly influenced tryptase levels. Fecal calprotectin levels were extremely wide-ranging and were much higher in female than in male newborns (300.5 vs. 110.5 µg/g; p < 0.001). Conclusions: The differences in tryptase levels according to term could be linked to early aggression of the still-immature digestive wall in premature newborns, in particular, by enteral feeding started early. The unexpected influence of sex on fecal calprotectin levels remains unexplained. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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10 pages, 818 KiB

Open AccessArticle

Maternal Group B Streptococcal Rectovaginal Colonization after Intrapartum Antibiotic Prophylaxis

and

Children 2022, 9(12), 1848; https://doi.org/10.3390/children9121848 - 28 Nov 2022

Viewed by 1096

Abstract

Maternal rectovaginal colonization with Group B Streptococcus (GBS) during labor is a prerequisite for neonatal early-onset GBS disease. Intrapartum antibiotic prophylaxis (IAP) has been proven to prevent GBS perinatal infection, while there are few studies on the evaluation of the effectiveness of different antibiotic prophylaxis regimens. This study aimed to assess the maternal rectovaginal GBS colonization status after IAP, antimicrobial susceptibility and maternal and neonatal outcomes among women administered different antibiotic prophylaxis regimens. A prospective study was conducted between June 2018 and June 2022. GBS carriers identified at 35–37 weeks of gestation were provided IAP (penicillin, cefazolin or clindamycin) at delivery based on the local protocol for GBS prevention. Rectovaginal samples were obtained from participants again after delivery. Antimicrobial susceptibility testing in GBS isolates was performed using the broth microdilution method. A total of 295 cases were included in this study. In the postpartum re-examination for GBS, the overall negative rectovaginal culture rate was 90.8% (268/295). Women who received cefazolin prophylaxis had the highest negative culture rate (95.2%, 197/207), which was followed by those who received penicillin (80.7%, 67/83) and clindamycin (80.0%, 4/5) (p = 0.001). All GBS isolates achieved sensitivity to penicillin and cefazolin, whereas resistance to clindamycin was shown in 21.4% of the strains. There were no significant differences in maternal and neonatal outcomes among the IAP groups. The use of IAP is highly effective in reducing the maternal rectovaginal GBS colonization. Cefazolin may offer equivalent efficacy and safety compared to standard penicillin prophylaxis. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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10 pages, 652 KiB

Open AccessArticle

Association between Skin-to-Skin Contact Duration after Caesarean Section and Breastfeeding Outcomes

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Children 2022, 9(11), 1742; https://doi.org/10.3390/children9111742 - 12 Nov 2022

Cited by 4 | Viewed by 1823

Abstract

We aimed to explore the association between skin-to-skin contact (SSC) duration after caesarean sections (CSs) and breastfeeding outcomes. A prospective study was conducted in four hospitals in China during January and August 2021. A total of 679 participants with singleton pregnancy who delivered by elective CS after 37 gestational weeks using epidural or spinal anesthesia were included. Logistic regression was applied to assess the association between SSC duration and early initiation of breastfeeding (EIBF), as well as the promoting factors for exclusive breastfeeding (EBF) at hospital discharge. Immediate SSC after CSs was strongly associated with higher rates of EIBF (p < 0.001) and EBF at hospital discharge (p = 0.002). The EIBF rates increased with longer duration of SSC, with the at least 90 min SSC group having the highest EIBF rate (74.5%). Skin-to-skin contact durations of at least 90 min, 60–89 min and 30–59 min were significantly associated with 8.53 times (OR = 8.53, 95%CI: 4.94–14.72, P_adj < 0.001), 8.04 times (95%CI: 4.68–13.80, P_adj < 0.001) and 6.28 times (95%CI: 3.75–10.51, P_adj < 0.001), respectively, higher EIBF rates compared to those without immediate SSC. After multiple-testing correction, the rates of EBF at hospital discharge were found to be independent of the duration of SSC (P_adj = 0.12). Early initiation of breastfeeding was not a significant predictor of EBF. Our results suggested that SSC is important for EIBF in Chinese baby-friendly hospitals. Skin-to-skin contact should be practiced after CS to promote breastfeeding and providing SSC with longer duration is encouraged to obtain the full benefit; if it is not feasible, a minimum of 30 min SSC could achieve improved EIBF and EBF at discharge. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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11 pages, 1605 KiB

Open AccessArticle

Third Trimester Fetuses Demonstrate Priming, a Form of Implicit Memory, In Utero

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Children 2022, 9(11), 1670; https://doi.org/10.3390/children9111670 - 31 Oct 2022

Viewed by 1235

Abstract

Research examinations of changes in fetal heart rate (HR) to operationalize fetal memory suggests that human memory capacities emerge in utero. However, there is little evidence for a form of implicit memory or priming. The present aim was to determine if priming is evident in utero. Fetal HR, maternal HR and maternal respiratory rate (RR) were examined in 105 women during the third trimester of pregnancy. Women experienced two counterbalanced laboratory tasks, the Stroop task and the paced breathing task, and their cardiorespiratory activity functioned as a stimulus for fetuses. Repeated measures ANOVAs revealed maternal HR increased during the Stroop task but only when the Stroop task was presented first (89.64 bpm to 92.39 bpm) (p = 0.04). Maternal RR increased during the Stroop task, regardless of task order (17.72 bpm to 21.11 bpm; 18.50 bpm to 22.60 bpm) (p < 0.01). Fetal HR increased during the paced breathing task, but only when it followed maternal exposure to the Stroop task (141.13 bpm to 143.97 bpm) (p < 0.01). Fetuses registered maternal HR and RR reactivity to the Stroop task, which influenced their response during maternal engagement with a related task, suggesting priming. Further study of fetal memory may suggest another pathway by which prenatal exposures impact future development. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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15 pages, 1140 KiB

Open AccessArticle

Preterm ETs Are Significantly Reduced Compared with Adults and Partially Reduced Compared with Term Infants

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Children 2022, 9(10), 1522; https://doi.org/10.3390/children9101522 - 05 Oct 2022

Cited by 2 | Viewed by 1069

Abstract

The release of DNA by cells during extracellular trap (ET) formation is a defense function of neutrophils and monocytes. Neutrophil ET (NET) formation in term infants is reduced compared to adults. Objective: The aim was to quantify NET and monocyte ET (MET) release and the respective key enzymes myeloperoxidase (MPO) and neutrophil elastase (NE) in preterm infants. In this prospective explorative study, ET induction was stimulated by N-formylmethionine-leucyl-phenylalanine (fMLP), phorbol 12-myristate 13-acetate (PMA), lipopolysaccharide (LPS), and lipoteichoic acid (LTA) in the cord blood of preterm infants (n = 55, 23–36 weeks) compared to term infants and adults. METs were quantified by microscopy, and NETs by microscopy and flow cytometry. We also determined the MPO levels within NETs and the intracellular concentrations of NE and MPO in neutrophils. The percentage of neutrophils releasing ET was significantly reduced for preterm infants compared to adults for all stimulants, and with a 68% further reduction for PMA compared to term infants (p = 0.0141). The NET area was not reduced except for when fMLP was administered. The amount of MPO in NET-producing cells was reduced in preterm infants compared to term infants. For preterm infants, but not term infants, the percentage of monocytes releasing ETs was significantly reduced compared to healthy adults for LTA and LPS stimulation. Conclusion: In preterm infants, ETs are measurable parts of the innate immune system, but are released in a reduced percentage of cells compared to adults. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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10 pages, 806 KiB

Open AccessArticle

Oxidative Stress Biomarkers and Early Brain Activity in Extremely Preterm Infants: A Prospective Cohort Study

Manon J. N. L. Benders

and

Maria Luisa Tataranno

Children 2022, 9(9), 1376; https://doi.org/10.3390/children9091376 - 12 Sep 2022

Cited by 3 | Viewed by 1146

Abstract

Early brain activity, measured using amplitude-integrated EEG (aEEG), is correlated with neurodevelopmental outcome in preterm newborns. F₂-isoprostanes (IPs) are early biomarkers predictive for brain damage. We aimed to investigate the relationship between perinatal IPs concentrations and quantitative aEEG measures in preterm newborns. Thirty-nine infants (gestational age (GA) 24–27 ± 6 weeks) who underwent neuromonitoring using aEEG during the first two days after birth were enrolled. The rate of spontaneous activity transients per minute (SAT rate) and inter-SAT interval (ISI) in seconds were computed. Two postnatal time-points were examined: within 12 h (day 1) and between 24 and 48 h (day 2). IPs were measured in plasma from cord blood (cb-IPs) and between 24 and 48 h (pl-IPs). Multivariable regression analyses were performed to assess the correlation between IPs and brain activity. Cb-IPs were not associated with SAT rate and ISI at day 1. Higher pl-IPs were followed by longer ISI (R = 0.68; p = 0.034) and decreased SAT rate (R = 0.58; p = 0.007) at day 2 after adjusting for GA, FiO₂ and IVH. Higher pl-IPs levels are associated with decreased functional brain activity. Thus, pl-IPs may represent a useful biomarker of brain vulnerability in high-risk infants. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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7 pages, 543 KiB

Open AccessArticle

Pregnancy Outcomes of Non-Visualization of the Fetal Gallbladder from a Chinese Tertiary Single Centre and Literature Review

and

Children 2022, 9(9), 1288; https://doi.org/10.3390/children9091288 - 26 Aug 2022

Viewed by 3018

Abstract

Objection: To explore the clinical features and prognosis of non-visualization of the fetal gallbladder (NVFGB). Methods: Sixty-five cases diagnosed with NVFGB in the Peking University First Hospital were collected retrospectively from January 2019 to December 2020. Results: Forty-nine cases were successfully followed up. Among them, the gallbladder of 21 fetuses (42.9%) was present in the later pregnancy. In the rest 28 cases (57.1%), the gallbladders were absent during the whole pregnancy. Eleven of twenty-eight fetuses (39.3%) with NVFGB were complicated with other structural anomalies. In the remaining 17 cases of isolated NVFGB (60.7%) during the whole pregnancy, there was one case of congenital biliary atresia, three cases of a small gallbladder, one case of gallstone and one case of the gallbladder with several septa inside. A total of nine cases (18.4%) underwent prenatal diagnosis, four of which revealed abnormal copy number variant (CNV) results. Conclusion: Nearly half of NVFGB could be noted during the later pregnancy. The persistent NVFGB during the pregnancy has a higher risk to complicate gallbladder abnormality, other structural anomalies and abnormal CNV results. Other structures, especially the heart, gastrointestinal and urinary system, should be carefully examined when NVFGB is suspected. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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10 pages, 247 KiB

Open AccessArticle

Clinical Characteristics of Venous Thrombosis Associated with Peripherally Inserted Central Venous Catheter in Premature Infants

Weiwei Zhu

Hua Zhang

and

Yan Xing

Children 2022, 9(8), 1126; https://doi.org/10.3390/children9081126 - 28 Jul 2022

Cited by 2 | Viewed by 1279

Abstract

Background: This study aimed to analyze clinical characteristics and risk factors for peripherally inserted central catheter (PICC) placement in premature infants. Materials: This study included seven premature infants who were hospitalized in the neonatal intensive care unit (NICU) of Peking University Third Hospital from 1 January 2014–30 June 2021, and suffered PICC-related venous thrombosis. The control group included premature infants (n = 56) matched (1:8) by the following: Did not experience venous thrombosis; born with a similar gestational age (±2 w), birth weight (±200 g); and received PICC catheterization in the same period (±4 w). Clinical neonatal data were collected through the hospital electronic medical record system and analyzed using SPSS version 23. Results: The incidence of PICC-related thrombus was 0.23% (7/3043. Univariate analysis revealed that, compared to the non-thrombotic group, mothers in the thrombosis group had autoimmune diseases (χ² = 9.844, p = 0.030) and used anticoagulative drugs during pregnancy (χ² = 8.036, p = 0.025). The corrected gestational age when PICC-related thrombosis occurred in the thrombosis group was 32 + 6 (30 + 1, 34 + 1) weeks. The average time from catheter placement to thrombosis was 5 (1, 12) days. Among infants, 85.7% (6/7) experienced deep vein thrombosis, of which four were in the lower extremity veins; three occurred within 2 days after central venous catheter extubation, and four occurred during central venous catheter indwelling. The clinical manifestations of thrombosis include skin edema, color changes, and skin temperature changes in the affected limbs. The seven neonates had normal coagulation at the time of thrombus diagnosis, but D-dimers significantly increased 1–2 days after thrombosis, returning to normal 5–8 days after thrombus. The thrombus persisted for 4.5 (3, 8) days. All seven neonates were treated with low molecular weight heparin calcium anticoagulation for 10 (3, 17) days and recovered completely. Conclusions: PICC-related thrombosis occurred within 1 week after catheter placement, and thrombosis more likely happened in infants whose mothers had autoimmune disease. When this high-risk factor exists and the patient has been intubated for 1 week and has sudden swelling in the intubated limb, venous ultrasound should be performed immediately to diagnose, and treatment should be provided in a timely manner to reduce adverse events. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

10 pages, 264 KiB

Open AccessArticle

Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study

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Children 2022, 9(7), 935; https://doi.org/10.3390/children9070935 - 22 Jun 2022

Viewed by 1439

Abstract

The increased incidence of macrosomia has caused an enormous burden after the transition from the almost 40-year one-child policy to the universal two-child policy in 2015 and further to the three-child policy in 2021 in China. However, studies on risk factors of macrosomia in multipara under the new fertility policy in China are limited. We aim to explore the incidence and risk factors for macrosomia in multipara to provide the scientific basis for preventing macrosomia in multipara. A multi-center retrospective study was conducted among 6200 women who had two consecutive deliveries in the same hospital and their second newborn was delivered from January to October 2018 at one of 18 hospitals in 12 provinces in China. Macrosomia was defined as birth weight ≥ 4000 g. Logistic regression models were performed to analyze risk factors for macrosomia in multipara. The incidence of macrosomia in multipara was 7.6% (470/6200) and the recurrence rate of macrosomia in multipara was 27.2% (121/445). After adjusting for potential confounders, a higher prepregnancy BMI, higher gestational weight gain, history of macrosomia, a longer gestation in the subsequent pregnancy were independent risk factors of macrosomia in multipara (p < 0.05). Healthcare education and preconception consultation should be conducted for multipara patients with a history of macrosomia to promote maintaining optimal prepregnancy BMI and avoid excessive gestational weight gain to prevent macrosomia. Full article

(This article belongs to the Special Issue New Research in Neonatal-Perinatal Medicine)

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