Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

INTRODUCTIONMorphofunctional multiple organ immaturity in preterm infants who weigh < 1,000 g at birth often results in severe diseases. Preterm birth occurs at a time when the digestive, excretory and nervous systems are still immature. Although the gastrointestinal (GI) tract is anatomically fully developed at 20 weeks of gestation, several GI functions develop later. Therefore, preterm infants experience certain limitations in GI function.(1) With the sudden interruption of placental transfer following the preterm birth, these infants require early nutritional intake in order to stop weight loss, compensate for metabolic deficiencies and ensure growth needs are met according to their metabolic potential.(2) Preterm infants need nutrition to ensure that their growth and functional maturity after birth is steady and similar to that of full-term infants of the same postconceptional age.(3) The American Academy of Pediatrics recommends that the diet of preterm infants results in a growth ratio comparable to that in the third trimester of pregnancy, without putting stress on the infants' immature metabolic and renal functions. Early enteral nutrition, also known as minimal enteral nutrition, refers to the commencement of feeding of preterm infants (using either human breast milk or formula) within the first 72 hours of life.(1,5,6) The benefits of early enteral nutrition are that it (a) ensures intake of active trophic substances that stimulate the development of mucosal epithelium, the intestinal immune system and microbiocenosis; (b) stimulates motility, enzyme production, GI hormone release, the emergence of the swallowing reflex and, later, the emergence of the sucking reflex; (c) improves digestive tolerance, allows a faster increase in volume rate, helps infants achieve full enteral nutrition and ensures their nutritional needs; and (d) limits postnatal weight loss and ensures a height-weight growth similar to that of full-term infants of the same postconceptional age.(1-3,5,7) In fact, a delay in minimal enteral nutrition may increase the risk of necrotising enterocolitis (NEC).(7) The administration of minimal enteral nutrition together with parenteral nutrition may help to reduce intestinal mucosal atrophy and prevent bacterial translocation. (8)(9)(10) Parenteral nutrition is recommended when typical nutritional and metabolic needs are not adequately met by enteral nutrition; it significantly impacts the nutritional status of the infant and reduces neonatal mortality. (11,12) Exclusive enteral nutrition can be provided during the first 5-10 days of life. (3,5) The use of human breast milk for enteral nutrition is preferred for preterm infants, as it provides adequate amounts of energy, proteins, lipids, carbohydrates, microelements, and water for growth and development. Furthermore, breast milk contains antimicrobial factors (e.g. immunoglobulin A, leucocytes, lactoferrin and lysozymes), and growth hormones and factors.The present study aimed to: (a) determine the effects of early enteral nutrition on th...

Coronavirus disease 2019 (COVID-19) has rapidly evolved into a worldwide pandemic causing a serious global public health problem. The risk of vertical transmission of SARS-CoV-2 is still debated, and the consequences of this virus on pregnant women and their fetuses remain unknown. We report a case of pregnancy complicated with hydrops fetalis that developed 7 weeks after recovery from a mild SARS-CoV-2 infection, leading to intrauterine death of the foetus. Evidence of SARS-CoV-2 placentitis was demonstrated by the presence of viral particles in the placenta identified by immunohistochemistry. As we excluded all possible etiological factors for non-immunologic hydrops fetalis, we believe that the fetal consequences of our case are related to vertical transmission of SARS-CoV-2 virus. To the best of our knowledge, this is the second reported case in the literature of COVID-19 infection complicated with hydrops fetalis and intrauterine fetal demise.

Perinatal hypoxic-ischemic encephalopathy (HIE) represents a major cause of neonatal death or long-term disability. Inflammation plays an important role in mediating brain damage induced by neonatal hypoxic-ischemic encephalopathy. The mechanisms underlying the inflammatory response in hypoxia and ischemia are complex and are still being extensively researched. The objective of this study was to determine the predictive value of peak lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT) and of the evolution of leukocytes, neutrophils and lymphocytes in the first 96 h after birth for the grade of encephalopathy and neurodevelopmental outcome in newborns with HIE. In order to reveal this relationship we used comparisons between the above mention parameters. The observed hematological changes were nonspecific. The vast majority of the 78 newborns included in the study had PCT values above normal in the first 24 h, contrasting with CRP values that were positive in only 15.8% of the patients. A total of 76.9% of the patients had LDH values higher than the upper limit of normal values. The mean LDH values in patients with an unfavorable prognosis were 1,235 U/l. We can conclude that LDH is a good predictor of HIE in the first 12/24 h after birth.

When the first vaccines against SARS-CoV-2 emerged, pregnant women were excluded from clinical trials, so vaccine recommendations were initially adjourned, with late initiation for this populational category. The present study aims to quantify the serum and breastmilk values of SARS-CoV-2 spike protein antibodies in both the mother and her newborn after complete vaccination during pregnancy. Ninety-one vaccinated patients were included, some of whom presented COVID-19 infection during pregnancy. In the delivery room, venous blood was collected from the mother and umbilical cord blood from her offspring. All samples were processed using the ECLIA (electrochemiluminescence) method. Breastmilk was collected and tested during the third postnatal day. The highest maternal serum values were 19,523 U/mL (detection limit > 0.8 U/mL) and in breastmilk, 206.7 U/mL. Every single newborn had antibody values higher than 0, with a mean serum value (M = 5288.37, SD = 5661.49) significantly higher than 0, t(90) = 8.91, p < 0.001. Consequently, this study intents to emphasize the importance of vaccination against SARS-CoV-2 during pregnancy. This double kind of neonatal protection, attained by placental and breastmilk transfer, can be accomplished by encouraging vaccination, breastfeeding, bonding, and providing maternal empowerment to participate in her infant’s care.