Neonatal Updates #36

Shaw RJ, St John N, Lilo EA, Jo B, Benitz W, Stevenson DK, Horwitz SM: Prevention of traumatic stress in mothers with preterm infants: A randomized controlled trial. Pediatrics 2013. This looks really interesting, an RCT of a clinical psychologist led intervention to help mothers (what about the dads?!) cope with the stress of NICU and prevent depression. And it worked. There were fewer symptoms of trauma and less depression 4 to 5 weeks after birth for those parents who received the 6 sessions. Now I must admit that I don’t know what they actually did, it is described as ‘psychoeducation, cognitive restructuring, progressive muscle relaxation, and development of their trauma narrative. The intervention also incorporated material targeting infant redefinition’ (I only understand the relaxation bit). It was also apparently ‘highly manualized’ which I think just means all the stuff they were supposed to do was written down, in a manual. But, whatever they did, it worked in the short term, and if the benefits are prolonged then we all will have to get manualized.

Ganapathy V, Hay J, Kim J, Lee M, Rechtman D: Long term healthcare costs of infants who survived neonatal necrotizing enterocolitis: A retrospective longitudinal study among infants enrolled in texas medicaid. BMC Pediatrics 2013, 13(1):127. Two of the authors of this study are from Prolacta, but I must say, after being rude about one of their other studies, this looks quite reliable. Up to a year of age survivors of medical NEC have higher health care costs than controls and surgical NEC cases much more. Surgical cases continue to have higher costs out to 36 months.

Belsches TC, Tilly AE, Miller TR, Kambeyanda RH, Leadford A, Manasyan A, Chomba E, Ramani M, Ambalavanan N, Carlo WA: Randomized trial of plastic bags to prevent term neonatal hypothermia in a resource-poor setting. Pediatrics 2013. Full term babies in Zambia were put in plastic bags (don’t worry, just up to the armpits), in the first 10 minutes of life. They were less likely to be hypothermic at one hour, but that reduction was from 73% to 60%, so more needs to be done. Just in case you weren’t already aware, Dr Wally Carlo is one of my heroes, I don’t think he ever sleeps, but I am sure he doesn’t have time to write a blog!

McCarthy LK, Molloy EJ, Twomey AR, Murphy JFA, O’Donnell CPF: A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags. Pediatrics 2013. If you aren’t in the field you may not realize that we already put preterm babies in plastic bags. For the same reason, to keep them warm. This trial from Dublin, which tends to be cooler than Zambia, but has the advantage of electricity, showed that you can keep preterm babies warm with plastic bags (and radiant heaters and incubators), and adding a special heat generating mattress doesn’t help, in fact it tends to overheat the little ones.

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
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