Gestational age at birth and hospitalisations for infections among individuals aged 0–50 years in Norway: a longitudinal, register-based, cohort study

Nilsen, Sara Marie; Valand, Jonas; Rogne, Tormod; Asheim, Andreas; Yin, Weiyao; Metsälä, Johanna; Opdahl, Signe; Døllner, Henrik; Damås, Jan Kristian; Kajantie, Eero; Solligård, Erik; Sandin, Sven; Risnes, Kari

doi:10.1016/j.eclinm.2023.102108

Cited by 3 publications

(2 citation statements)

References 43 publications

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“… 79 , 80 While the sequence of events predisposing preterm babies to HAI is multifactorial, the impact of interrupting the developing immune system that starts in utero has strongly been emphasized. 81 Similarly, poorly developed mucosal (respiratory and gastrointestinal) barriers in preterm babies further increase neonatal exposures to microbial invasion by infective organisms. Overcrowding was also identified as a neonatal risk factor for HAI, and this may be related to the huge demographic shift from home-based to hospital-based deliveries in the last two decades in SSA, without the concomitant expansion of infrastructure or investment in infection prevention and control (IPC) to cope with it.…”

Section: Discussionmentioning

confidence: 99%

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

Melariri,

Freercks,

van der Merwe

et al. 2024

eClinicalMedicine

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Section: Discussionmentioning

confidence: 99%

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

Melariri,

Freercks,

van der Merwe

et al. 2024

eClinicalMedicine

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“…10 The proinflammatory responses of monocytes to pathogens are reduced in preterm infants, 11 and they have an increased risk of hospitalisation because of infections after infancy as well. 12 While some differences in immune responses between preterm and term infants resolve with age, 13 certain immune discrepancies may not be alleviated but further exacerbated 3 months after birth. 14 We have previously observed notable differences in T-cell frequencies in EPT infants, with several differences that persisted up to Gw36.…”

Section: Introductionmentioning

confidence: 99%

Effects of extremely preterm birth on cytokine and chemokine responses induced by T‐cell activation during infancy

Govindaraj,

Jensen,

Rahman Qazi

et al. 2024

Clin & Trans Imm

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ObjectivesExtremely preterm (EPT; gestational week < 28 + 0, < 1000 g) neonates are vulnerable to infections and necrotising enterocolitis, important contributors to mortality and morbidity. However, knowledge regarding their immune maturation remains limited. We here investigated the longitudinal development of functional T‐cell capacity in EPT infants.MethodsPeripheral blood mononuclear cells were isolated at 14th and 28th day (D) and at gestational week 36 + 0 (Gw36) from EPT infants, participated in a randomised, double‐blind, placebo‐controlled study of Lactobacillus reuteri DSM 17938 probiotic supplementation. Blood collected from 25 full‐term (FT) infants at D14 was used as control. The secretion of immune mediators was determined through comprehensive Luminex panels after stimulation with human T‐cell activator CD3/CD28 beads.ResultsThe levels of many mediators were low in EPT infants at D14, whereas the secretion of several chemokines was higher in EPT than in FT infants. Furthermore, Th2:Th1 cytokine ratios were higher in EPT than in FT infants. Progressively elevated secretion of, for example, IFN‐γ, TNF and IL‐17A in EPT infants was observed from D14 to D28 and then at Gw36. Elevated levels were observed for many proinflammatory mediators at D28. Probiotic supplementation or perinatal factors (e.g. clinical chorioamnionitis, preeclampsia and delivery mode) did not influence the cytokine and chemokine responses.ConclusionsImmune mediators induced by T‐cell activation in EPT infants were mainly reduced at D14 and Th2 skewed compared to those in FT infants, but mostly recovered at Gw36, indicating immune maturation. Increased proinflammatory responses at D28 may be related to the heightened risk of severe immune‐associated complications seen in EPT infants.

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Use of tissue adhesive for neonatal intravenous access devices: A scoping review

de Souza,

Takashima,

Silva

et al. 2024

Eur J Pediatr

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Neonates often require vascular access devices for medication or fluid therapy, but a third of devices fail before treatment completion or end with a complication. For adults and children, securing these devices with tissue adhesive (TA) increases the dwell and reduces complications. However, there is a lack of evidence for the neonatal population. This scoping review aimed to assess the evidence of TA for vascular access devices in neonates. The Arksey and O’Malley’s (2005) framework was used. The inclusion criteria covered studies published from 2007 (when TA was first reported for use in vascular access devices) to June 2024, available in English, Portuguese, and Spanish, across six databases. Two independent reviewers assessed the studies using Covidence software, with a third reviewer resolving conflicts. Quality assessment was performed using the Mixed Methods Appraisal Tool. From 981 identified studies, 12 were included. Most studies (n = 5, 41.7%) enrolled between 100 and 500 neonates with vascular access devices. Publications originated from four regions and were observational studies (n = 6, 50%), quasi-experimental (n = 3, 25%), and case series (n = 2, 16.7%) with one randomized controlled trial (8.3%) focusing on umbilical venous catheters (UVC). The most common TA composition used was a combination of n-butyl- and 2-octyl- cyanoacrylate (n = 4, 33.3%). The amount of TA applied varied across studies, and often TA was part of a bundle (n = 7, 58.3%). Most studies applied TA to central venous access devices (n = 10, 83.3%) and 2 (16.7%) in peripheral devices. Although there was variation in device failure, the studies generally indicated a reduction in complications such as dislodgment (central catheter: 11.3% [peripherally inserted central catheter {PICC}] to 24.6% [UVC] in non-TA group vs 0.7% [PICC] to 7.7% [UVC] in TA group), device-associated bloodstream infections (central: 7.7% [UVC] and incidence of 2.76/1000 catheter days [PICC] in non-TA group vs 3.1% [UVC] and incidence of 0.99/1000 catheter day [PICC] in TA group), and phlebitis (13% in non-TA group vs 3% in TA-group), as well as increased dwell time in peripheral catheters. Most studies included both term and preterm neonates but did not differentiate between them in their analyses. Skin assessment, life of first dressing, and follow-up of catheters and patients were not reported in most studies. Conclusion: TA may reduce complications in vascular access devices, but the evidence in neonates is limited and varied. Many studies include TA as part of bundle, making it difficult to isolate its effects. Additionally, the current evidence lacks robustness due to the design limitations of the studies. Future research should focus on randomized controlled trials to evaluate TA’s effectiveness and safety in preventing device failures and complications in neonates, considering different subgroups, to ensure the safety of TA in these nuanced populations. What is Known:• Research in adults and pediatrics provides evidence supporting the use of tissue adhesive (TA) for vascular access devices, showing a positive impact in reducing failures and complications.• The use of TA in neonates needs to be carefully considered due to their unique characteristics.What is New:• There is a gap in the literature on the use of TA for securing vascular access devices in neonates, particularly regarding its safety and effectiveness in preventing failures and complications.• Further studies are needed to provide robust evidence verifying the effectiveness and safety of TA in this population.

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Gestational age at birth and hospitalisations for infections among individuals aged 0–50 years in Norway: a longitudinal, register-based, cohort study

Cited by 3 publications

References 43 publications

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

Effects of extremely preterm birth on cytokine and chemokine responses induced by T‐cell activation during infancy

Use of tissue adhesive for neonatal intravenous access devices: A scoping review

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