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Children
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Intensive Care for Very Preterm Infants
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Intensive Care for Very Preterm Infants

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

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 8542

Special Issue Editor

Dr. Yung-Chieh Lin

E-Mail Website
Guest Editor
Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan 704302, Taiwan
Interests: care for very preterm infants; neonatal nutrition; neonatal follow-up

Special Issue Information

Dear Colleagues,

Very preterm infants, whose gestational age is less than 32 completed weeks, account for 1% of babies every year. Though this population's survival has improved in recent decades, the intensive care for them is still challenging to improve the short-term and long-term outcome beyond survival. Multidisciplinary care for very preterm infants is always required in antenatal care and consultation, the golden hour intervention after birth, acute-phase care of the first 72 hours of life, transition care in the first week of life, and continuous care extra-uterine growth phase to discharge. Strategies targeting better care involve respiratory support, pharmaceutical intervention, nutritional supplements, neurodevelopmental care such as kangaroo care and early rehabilitation, and meticulous nursing care. In the artificial intelligence era, high technology may also help the care of very preterm infants for early detection or prevention of the morbidities or mortality of very preterm infants. Long-term follow-up after graduation from intensive care units is important for feeding back to improving clinical care.

We welcome review articles, original research, and case reports from across the globe relating to the issues of intensive care and follow-up for very preterm infants. The authors are welcome to contact the editor directly at [email protected] for questions or clarifications.

Dr. Yung-Chieh Lin
Guest Editor

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

  • very preterm infants
  • intensive care
  • intervention
  • nursing
  • respiratory/nutrition care
  • new technique
  • growth
  • neurodevelopment
  • follow-up

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Published Papers (3 papers)

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Research

10 pages, 658 KiB  
Article
Risk Factors of Language Delay at Two Years of Corrected Age among Very-Low-Birth-Weight Preterm Infants: A Population-Based Study
by Wei-Lun Tseng, Chia-Huei Chen, Jui-Hsing Chang, Chun-Chih Peng, Wai-Tim Jim, Chia-Ying Lin, Chyong-Hsin Hsu, Tzu-Yu Liu, Hung-Yang Chang and on behalf of the Taiwan Premature Infant Follow-up Network
Children 2023, 10(2), 189; https://doi.org/10.3390/children10020189 - 19 Jan 2023
Cited by 4 | Viewed by 2697
Abstract
Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the [...] Read more.
Language delays are often underestimated in very-low-birth-weight (VLBW) preterm infants. We aimed to identify the risk factors of language delay at two years of corrected age in this vulnerable population. VLBW infants, who were assessed at two years of corrected age using the Bayley Scale of Infant Development, third edition, were included using a population-based cohort database. Language delay was defined as mild to moderate if the composite score was between 70 and 85 and severe if the score was < 70. Multivariable logistic regression analysis was used to identify the perinatal risk factors associated with language delay. The study comprised 3797 VLBW preterm infants; 678 (18%) had a mild to moderate delay and 235 (6%) had a severe delay. After adjusting for confounding factors, low maternal education level, low maternal socioeconomic status, extremely low birth weight, male sex, and severe intraventricular hemorrhage (IVH) and/or cystic periventricular leukomalacia (PVL) were found to be significantly associated with both mild to moderate and severe delays. Resuscitation at delivery, necrotizing enterocolitis, and patent ductus arteriosus requiring ligation showed significant associations with severe delay. The strongest factors predicting both mild to moderate and severe language delays were the male sex and severe IVH and/or cystic PVL; thus, early targeted intervention is warranted in these populations. Full article
(This article belongs to the Special Issue Intensive Care for Very Preterm Infants)
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10 pages, 522 KiB  
Article
The Presence of PDL-1 on CD8+ Lymphocytes Is Linked to Survival in Neonatal Sepsis
by Lyudmila L. Akhmaltdinova, Zhibek A. Zhumadilova, Svetlana I. Kolesnichenko, Alyona V. Lavrinenko, Irina A. Kadyrova, Olga V. Avdienko, Lyudmila G. Panibratec and Elena V. Vinogradskaya
Children 2022, 9(8), 1171; https://doi.org/10.3390/children9081171 - 4 Aug 2022
Cited by 5 | Viewed by 1670
Abstract
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Neonatal sepsis is the main cause of death in newborns, especially preterm infants. The pathogenesis of sepsis is based on a hyper-inflammatory syndrome combined with an immunosuppressive mechanism in sepsis. [...] Read more.
Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Neonatal sepsis is the main cause of death in newborns, especially preterm infants. The pathogenesis of sepsis is based on a hyper-inflammatory syndrome combined with an immunosuppressive mechanism in sepsis. This study aimed to find critical parameters that are associated with the outcome of newborns with suspected sepsis. Understanding the association might have clinical relevance for immuno-monitoring, outcome prediction, and targeted therapy. Methods: A total of 210 newborn infants no older than 4 days with suspected sepsis at admission in Karaganda (Kazakhstan) were prospectively enrolled. Blood cultures were incubated, and pathogens in positive cultures were determined by MALDI-TOF. An immunological assay for blood cell components was conducted by flow cytometry with antibody cocktails. The diagnostic criteria for neonatal sepsis were identified by qualified neonatologists and included both clinical sepsis and/or positive blood culture. The analyzed infants were grouped into non-septic infants, surviving septic infants, and deceased septic infants. The results showed that deceased septic newborns had a lower level of CD8+ lymphocytes and higher PDL-1 expression in comparison with surviving septic newborns. PDL-1 expression on CD8+ T cells might play an immunosuppressive role during neonatal sepsis and might be used as a laboratory biomarker in the future. Full article
(This article belongs to the Special Issue Intensive Care for Very Preterm Infants)
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8 pages, 224 KiB  
Article
Survival of Hydrops Fetalis with and without Fetal Intervention
by Yu-Yun Huang, Yu-Jun Chang, Lih-Ju Chen, Cheng-Han Lee, Hsiao-Neng Chen, Jia-Yuh Chen, Ming Chen and Chien-Chou Hsiao
Children 2022, 9(4), 530; https://doi.org/10.3390/children9040530 - 8 Apr 2022
Cited by 5 | Viewed by 3690
Abstract
Objectives: To investigate the survival rate of hydrops fetalis after fetal interventions and neonatal intensive care. Methods: We reviewed the medical records of patients diagnosed with hydrops fetalis from January 2009 to December 2019 at Changhua Christian Children’s Hospital. All cases had abnormal [...] Read more.
Objectives: To investigate the survival rate of hydrops fetalis after fetal interventions and neonatal intensive care. Methods: We reviewed the medical records of patients diagnosed with hydrops fetalis from January 2009 to December 2019 at Changhua Christian Children’s Hospital. All cases had abnormal fluid accumulation in at least two body compartments during pre- and postnatal examination. The primary outcome measure was the mortality rate. We also collected information regarding disease etiology, duration of hospital stay, Apgar score, gestational age at birth, initial hydrops fetalis diagnosis, fetal intervention, first albumin and pH levels, and maternal history. Results: Of the 42 cases enrolled, 30 survived and 12 died; the mortality rate was 28.6%. Furthermore, 22 cases received fetal intervention, while 20 cases did not; there was no significant difference in their survival rates (75% and 68%, respectively). Survival rate was associated with gestational age at birth, initial diagnosis time, birthweight, Apgar score, initial albumin and pH levels, and gestational hypertension. Only one case was immune-mediated. Among the nonimmune-mediated cases, the three most common etiologies were lymphatic dysplasia (12/42), idiopathic disorders (10/42), and cardiovascular disorders (5/42). Conclusions: Overall, hydrops fetalis was diagnosed early, and fetal intervention was performed in a timely manner. Preterm births were more frequent, and birthweight was lower in the cases that underwent fetal intervention than in those that did not, but there was no significant between-group difference in mortality. The initial diagnosis time, gestational age at birth, birthweight, Apgar score, and first albumin and pH levels were independently associated with mortality. Full article
(This article belongs to the Special Issue Intensive Care for Very Preterm Infants)
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