MyMedR

Fulltext The risk factors for unexplained antepartum stillbirths in Scotland, 1994 to 2003

Sutan R, Campbell D, Prescott GJ, Smith WC

J Perinatol, 2010 May;30(5):311-8.

PMID: 19829298 DOI: 10.1038/jp.2009.158

To determine the factors contributing to unexplained antepartum stillbirth in Scotland.

Cost-effectiveness analysis of Malaysian neonatal intensive care units

Cheah IG, Soosai AP, Wong SL, Lim TO, Cost-Effectiveness NICU Study Group

J Perinatol, 2005 Jan;25(1):47-53.

PMID: 15372062

To perform a cost-effective analysis on the care of infants between 1000 and 1500 g birthweight (the study group), where outcomes are measured as survival to 1 year of age.

Genetic association of AKAP10 gene polymorphism with reduced risk of preterm birth

Langmia IM, Apalasamy YD, Suki SZ, Omar SZ, Mohamed Z

J Perinatol, 2015 Sep;35(9):700-4.

PMID: 26110499 DOI: 10.1038/jp.2015.68

Preterm birth (PTB) is a multifactorial complication in which genetic and environmental factors contribute to the phenotype. The AKAP10 protein encoded by AKAP10 gene has a vital role in the maintenance of myometrial quiescence and pregnancy. This study aimed to investigate whether polymorphisms in the AKAP10 gene are associated with the risk of PTB.

Fulltext COVID-19 preparedness-a survey among neonatal care providers in low- and middle-income countries

Klingenberg C, Tembulkar SK, Lavizzari A, Roehr CC, Ehret DEY, Vain NE, et al.

J Perinatol, 2021 05;41(5):988-997.

PMID: 33850282 DOI: 10.1038/s41372-021-01019-4

OBJECTIVE: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents.

STUDY DESIGN: Cross-sectional, web-based survey administered between May and June, 2020.

RESULTS: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making.

CONCLUSIONS: Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

Fulltext Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia

Mat Bah MN, Tan RYH, Razak H, Sapian MH, Abdullah N, Alias EY

J Perinatol, 2021 04;41(4):786-793.

PMID: 33589728 DOI: 10.1038/s41372-021-00962-6

OBJECTIVE: This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).

STUDY DESIGN: This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.

RESULTS: The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.

CONCLUSIONS: Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.

Reimagining the NICU: a human-centered design approach to healthcare innovation

Mohammed S, Savage T, Smith J, Shepley MM, White RD

J Perinatol, 2023 Dec;43(Suppl 1):40-44.

PMID: 38086966 DOI: 10.1038/s41372-023-01794-2

Design charettes have been utilized in architectural and design practice to generate innovative ideas. The Reimagining Workshop is a version that combines practical and blue-sky thinking to improve healthcare facility design. The workshop engages diverse stakeholders who follow a human-centered design framework. The Reimagining the Neonatal Intensive Care Unit workshop sought to generate ideas for the future, optimal NICU without specific site or client constraints. Key themes include family-centered care, technology-enabled care, neighborhood and village design and investing in the care team. Recommendations include a supportive physical environment, celebrating milestones, complementary and alternative medicine, enhancing the transition of care, aiding the transition period, and leveraging technology. The workshop showcased the potential for transformative change in NICU design and provided a roadmap for future advancements. These findings can inform regulatory standards for NICU design and drive improvements in family-centered care, patient experiences, and outcomes within the NICU environment.

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