Category Archives: Neonatal Research

What dose of caffeine to use?

The dose of caffeine that we used for the CAP trial was the dose that was being widely used at the time. It seemed to be a safe dose, that did not require serum concentration surveillance, but was not based … Continue reading

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Toxicity of antenatal steroids on the developing brain.

A new study from Finland this time, raises similar concerns to those from a Canadian study. (Raikkonen K, et al. Associations Between Maternal Antenatal Corticosteroid Treatment and Psychological Developmental and Neurosensory Disorders in Children. JAMA Netw Open. 2022;5(8):e2228518). It is … Continue reading

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Cord milking and resuscitation, an alternative?

My recent posts about resuscitation with an intact cord were rapidly followed by a publication of another multicentre randomized controlled trial, this time a cluster randomized crossover trial, of cord milking in babies who needed intervention. (Katheria AC, et al. … Continue reading

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Resuscitation before clamping the cord, some physiologic considerations

Delaying cord clamping until respiration is well established is a physiologically pleasing approach, and avoids the dramatic decrease in left ventricular preload, simultaneously with an increase in afterload that occurs with early clamping. But does delaying clamping during positive pressure … Continue reading

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Is glucose gel safe? Is it necessary?

The Auckland group has been studying the treatment and implications of neonatal hypoglycaemia for many years now, with unique high quality studies. Two of their recent publications have addressed the safety of glucose gel for hypoglycaemia, the first (St Clair … Continue reading

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Anti VEGF treatment of retinopathy: and the long term?

There remains some doubt about the impacts on cerebral development, and thus on developmental progress of anti-VEGF treated babies. It is possible that there are cerebral effects of VEGF inhibition (or interception) and it isn’t clear what the exposure of … Continue reading

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Anti-VEGF vs laser therapy for retinopathy, not worse, but not not worse?

A newer anti-VEGF drug has been invented, and evaluated in retinopathy therapy. This new drug aflibercept works differently to the “-mab” drugs we have been using. Those others are monoclonal antibodies (hence mab) directed against VEGF, whereas this new stuff … Continue reading

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Resuscitation before clamping the cord?

Delayed cord clamping is now standard of care for all deliveries, at term or preterm. In term deliveries it leads to improved iron stores in the baby which difference persists during the first year of life. In very preterm infants … Continue reading

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Erythropoietin does not protect the brain, what next?

The latest trial to fail to find a benefit of erythropoietin (Epo) for neonatal brain protection has just been published (Wu YW, et al. Trial of Erythropoietin for Hypoxic-Ischemic Encephalopathy in Newborns. N Engl J Med. 2022;387(2):148-59). The HEAL trial, … Continue reading

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What is happening for the most preterm deliveries.The Completed Week Heuristic.

There are several recent publications about deliveries at 22 to 25 weeks gestation, evaluating the frequency of intensive care support of the babies, factors associated with support, and survival. The California Perinatal Quality Care Collaborative reports the proportion of “active … Continue reading

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