Weekly courses of antenatal corticosteroids did not reduce composite neonatal morbidity compared with a single course of treatment. Weekly courses of antenatal corticosteroids should not be routinely prescribed for women at risk of preterm delivery.

Infants with RDS treated with poractant had a lower FiO2 requirement during the first 48 h compared to infants who received beractant. Infants who received poractant also had fewer PDAs than infants who received beractant. The difference in FiO2 was not associated with a difference in age of first extubation, total intubation time, or incidence of bronchopulmonary dysplasia between groups.

Neonates having Fetal Inflammatory Response Syndrome at delivery may later develop BPD. Pyogenic bacteria, such as Escherichia coli, may be implicated more frequently.

A characteristic liver lesion can be seen on sonography with hepatic erosion by UVCs. Our study shows the importance of a high index of suspicion of UVC erosion into the liver in neonates with catheters positioned in the liver. When such neonates have abdominal distension, prompt abdominal sonograms should be obtained.

ObjectiveNecrotizing enterocolitis (NEC) is characterized by macrophage infiltration into affected tissues. Because intestinal macrophages are derived from recruitment and in situ differentiation of blood monocytes in the gut mucosa, we hypothesized that increased recruitment of monocytes to the intestine during NEC reduces the blood monocyte concentration, and that this fall in blood monocytes can be a useful biomarker for NEC.Patients and methodsWe reviewed medical records of very low birth weight (VLBW) infants treated for NEC, and compared them with a matched control group comprised of infants with feeding intolerance but no signs of NEC. Clinical characteristics and absolute monocyte counts (AMC) were recorded. Diagnostic accuracy of AMC values was tested using receiver-operator characteristics (ROC).ResultsWe compared 69 cases and 257 controls (median 27 weeks, range 26–29 in both groups). In stage II NEC, AMC decreased from median 1.7 × 109/L (interquartile range (IQR) 0.98–2.4) to 0.8 (IQR 0.62–2.1); p <0.05. In stage III NEC, monocyte counts decreased from median 2.1 × 109/L (IQR 0.1.5–3.2) to 0.8 (IQR 0.6–1.9); p <0.05. There was no change in AMC in control infants. ROC of AMC values showed a diagnostic accuracy (area under the curve) of 0.76. In a given infant with feeding intolerance, a drop in AMC of >20% indicated NEC with sensitivity of 0.70 (95% CI 0.57–0.81) and specificity of 0.71 (95% CI 0.64–0.77).ConclusionsWe have identified a fall in blood monocyte concentration as a novel biomarker for NEC in VLBW infants.