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  • 1
    Online Resource
    Online Resource
    Maternal and Newborn Hospital Outcomes of Perinatal SARS-CoV-2 Infection: A National Registry
    American Academy of Pediatrics (AAP) ; 2023
    In:  Pediatrics Vol. 151, No. 2 ( 2023-02-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 151, No. 2 ( 2023-02-01)
    Abstract: The American Academy of Pediatrics National Registry for the Surveillance and Epidemiology of Perinatal coronavirus disease 2019 (COVID-19) (NPC-19) was developed to provide information on the effects of perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS National Registry for the Surveillance and Epidemiology of Perinatal COVID-19 participating centers entered maternal and newborn data for pregnant persons who tested positive for SARS-CoV-2 infection between 14 days before and 10 days after delivery. Incidence of and morbidities associated with maternal and newborn SARS-CoV-2 infection were assessed. RESULTS From April 6, 2020 to March 19, 2021, 242 centers in the United States centers reported data for 7524 pregnant persons; at the time of delivery, 78.1% of these persons were asymptomatic, 18.2% were symptomatic but not hospitalized specifically for COVID-19, 3.4% were hospitalized for COVID-19 treatment, and 18 (0.2%) died in the hospital of COVID-related complications. Among 7648 newborns, 6486 (84.8%) were tested for SARS-CoV-2, and 144 (2.2%) were positive; the highest rate of newborn infection was observed when mothers first tested positive in the immediate postpartum period (17 of 125, 13.6%). No newborn deaths were attributable to SARS-CoV-2 infection. Overall, 15.6% of newborns were preterm: among tested newborns, 30.1% of polymerase chain reaction-positive and 16.2% of polymerase chain reaction-negative were born preterm (P & lt; .001). Need for mechanical ventilation did not differ by newborn SARS-CoV-2 test result, but those with positive tests were more likely to be admitted to a NICU. CONCLUSIONS Early in the pandemic, SARS-CoV-2 infection was acquired by newborns at variable rates and without apparent short-term effects. During a period that preceded widespread availability of vaccines, we observed higher than expected numbers of preterm births and maternal in-hospital deaths.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2022-059595
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2023
    detail.hit.zdb_id: 1477004-0
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  • 2
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    Online Resource
    Factors Associated With Attendance for Cardiac Neurodevelopmental Evaluation
    American Academy of Pediatrics (AAP) ; 2023
    In:  Pediatrics Vol. 152, No. 3 ( 2023-09-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 152, No. 3 ( 2023-09-01)
    Abstract: Neurodevelopmental evaluation of toddlers with complex congenital heart disease is recommended but reported frequency is low. Data on barriers to attending neurodevelopmental follow-up are limited. This study aims to estimate the attendance rate for a toddler neurodevelopmental evaluation in a contemporary multicenter cohort and to assess patient and center level factors associated with attending this evaluation. METHODS This is a retrospective cohort study of children born between September 2017 and September 2018 who underwent cardiopulmonary bypass in their first year of life at a center contributing data to the Cardiac Neurodevelopmental Outcome Collaborative and Pediatric Cardiac Critical Care Consortium clinical registries. The primary outcome was attendance for a neurodevelopmental evaluation between 11 and 30 months of age. Sociodemographic and medical characteristics and center factors specific to neurodevelopmental program design were considered as predictors for attendance. RESULTS Among 2385 patients eligible from 16 cardiac centers, the attendance rate was 29.0% (692 of 2385), with a range of 7.8% to 54.3% across individual centers. In multivariable logistic regression models, hospital-initiated (versus family-initiated) scheduling for neurodevelopmental evaluation had the largest odds ratio in predicting attendance (odds ratio = 4.24, 95% confidence interval, 2.74–6.55). Other predictors of attendance included antenatal diagnosis, absence of Trisomy 21, higher Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery mortality category, longer postoperative length of stay, private insurance, and residing a shorter distance from the hospital. CONCLUSIONS Attendance rates reflect some improvement but remain low. Changes to program infrastructure and design and minimizing barriers affecting access to care are essential components for improving neurodevelopmental care and outcomes for children with congenital heart disease.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2022-060995
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2023
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  • 3
    Online Resource
    Online Resource
    Benzyl Alcohol Toxicity: Impact on Mortality and Intraventricular Hemorrhage Among Very Low Birth Weight Infants
    American Academy of Pediatrics (AAP) ; 1986
    In:  Pediatrics Vol. 77, No. 4 ( 1986-04-01), p. 500-506
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 77, No. 4 ( 1986-04-01), p. 500-506
    Abstract: Benzyl alcohol preservative in intravascular flush solutions has been reported to cause neurologic deterioration and death in very low birth weight infants. Following the widespread discontinuation of the use of such solutions in newborns, scattered reports of decreased mortality and decreased incidence of intraventricular hemorrhage among small premature infants appeared in the pediatric literature. To better assess the true impact of benzyl alcohol toxicity in this group of infants, we undertook a detailed review of the medical records of all babies & lt;1,250 g birth weight admitted to our neonatal intensive care unit for 13 months before and 13 months after the use of solutions containing benzyl alcohol was stopped. Significant decreases were found in both mortality rate (from 80.7% to 45.7%) and incidence of grade III/IV intraventricular hemorrhage (from 46% to 19%) among infants & lt;1,000 g birth weight who did not receive the preservative compared with those who did. No significant changes were found in several other prenatal factors that could have contributed to this improvement in survival. We conclude that benzyl alcohol toxicity contributed significantly to both mortality and the occurrence of major intraventricular hemorrhage among infants weighing & lt;1,000 g at birth and that solutions containing benzyl alcohol should never again be used in the care of such infants.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.77.4.500
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 1986
    detail.hit.zdb_id: 1477004-0
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