Newborn Physiological Immaturity

Juvé‐Udina, Maria‐Eulàlia; Fabrellas-Padrés, Núria; Delgado‐Hito, Pilar; Hurtado‐Pardos, Bárbara; Martí-Cavallé, Montserrat; Gironès-Nogué, Marta; García-Berman, Rosa-Maria; Alonso‐Fernández, Sergio

doi:10.1097/anc.0000000000000162

Cited by 3 publications

(3 citation statements)

References 38 publications

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“…1,3, Factors such as gestational age at delivery, mode of delivery, a significant intrapartum event, a congenital defect or infection can delay this process. 4 Even though the majority of newborns successfully adapt to extra uterine life, some experience difficulty. 1,[4][5][6] Therefore, if delay or compromise during this time is not recognised in a timely manner, the newborn can experience a serious adverse event.…”

Section: Introductionmentioning

confidence: 99%

Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Paliwoda

New

Davies

et al. 2018

International Journal of Nursing Studies

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Section: Introductionmentioning

confidence: 99%

Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Paliwoda

New

Davies

et al. 2018

International Journal of Nursing Studies

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“…16,62 Factors such as gestational age at birth, mode of birth, a significant intrapartum event, a congenital defect or infection can delay this process. 63 Although the majority of newborns successfully adapt to extra uterine life, some experience difficulty. 16,[63][64][65] If delay or compromise during this time is not recognised in a timely manner, the newborn can experience a serious adverse event.…”

Section: Introductionmentioning

confidence: 99%

“…63 Although the majority of newborns successfully adapt to extra uterine life, some experience difficulty. 16,[63][64][65] If delay or compromise during this time is not recognised in a timely manner, the newborn can experience a serious adverse event.…”

Section: Introductionmentioning

confidence: 99%

Quantifying physiological vital sign differences in newborns from 34+0/7 weeks of gestation and establishment of vital sign reference ranges for the late preterm population

Paliwoda¹

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BackgroundTo ensure continued adaptation to extra-uterine life, all newborns have their physiological vital signs monitored intermittently post birth until discharge; these are tracked against predefined 'normal' reference ranges. Ascertaining an evidence base for 'normal' reference ranges is important for the early detection of deterioration in this population, who are at risk of not adapting to the extra-uterine environment due to being born prior to term. AimThe studies in this thesis aim to determine physiological vital sign reference ranges for well newborns between 34 +0/7 and 36 +6/7 weeks of gestation. ObjectivesThe objectives of the studies in this thesis were to: systematically summarise the evidence in peer-reviewed literature on physiological vital sign reference ranges for well newborns greater than or equal to 34 weeks of gestation; to review contemporary neonatal and midwifery textbooks and publicly available grey literature (i.e. organisational websites, hospital policies and early warning tools) for vital sign reference ranges pertaining to well newborns of ≥ 34 +0/7 weeks of gestation; to determine whether there are differences in vital signs in gestational age groups; and, if differences are identified, to establish physiological vital sign reference ranges for the well late preterm group and validate the reference ranges. Research DesignA systematic review of literature was initially undertaken followed by a scoping review of textbooks and grey literature to identify vital sign reference ranges for newborns ≥ 34 +0/7 weeks of gestation. Quantitative research methods were used to meet the remaining study objectives. Study One was conducted as a single site prospective observational study of 30 newborns, comprised of three gestational age groups: late preterm (34 +0/7 -36 +6/7 ), early term (37 +0/7 -38 +6/7 ), and term (39 +0/7 -40 +6/7 ). This involved continuously recording heart rate, respiratory rate, and peripheral oxygen saturation for up to six hours and periodic monitoring of temperature and blood pressure to determine whether physiological vital signs differed between the groups. The results of Study One informed the design of Study Two. This involved a shorter recording time of up to two hours and periodic monitoring of ii 0 Abstract temperature and blood pressure on 120 well, late preterm newborns in a single site prospective observational study. The reference ranges established in Study Two underwent validation in Study Three, in which a cross-sectional design was used to validate the data with data from the medical records of a group of late preterm newborns. ResultsThe searches of literature resulted in primary studies (n = 10), textbooks (n = 7) and grey literature (n = 11). Inconsistencies in and a dearth of vital sign ranges for gestational age groups other than term were identified. Details of how reference ranges were calculated were only provided in the peer reviewed literature.Study One generated a combined total of 284,542 heart rate values, 275,826 respiratory rate values...

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The Effects of Different Nursing Positions During Preterm Infants Feeding on Gastric Residual Volume and Emptying Rate: A Systematic Review and Network Meta‐Analysis

Elhusein,

Fadlalmola

2024

Int J of Nursing Practice

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Background and ObjectivesPreterm infants need nutritional support due to their premature digestive system, undeveloped anatomy and functional limitations. Neonatal positioning in the proper position is one of the nurses' main principles that affect the residual volume. We performed our systematic review and network meta‐analysis to determine the best feeding position for preterm infants in reducing gastric residual volume and increasing the rate of gastric emptying.MethodsWe systematically searched PubMed, Cochrane, CINHAL, Scopus and Web of Science from their inception to August 2023. We included studies that assess the effect of different feeding positions for preterm infants on gastric residuals. The Cochrane risk of bias tool (ROB2) appraised the included clinical trials. Cohort studies were assessed by the NIH tool and quasi‐experimental studies by the relevant items from (Downs and Black) checklist. RevMan Version 5.4 was used for analysing the pooled data. Our study included a frequentist network meta‐analysis of the aggregate data to obtain network estimates for the outcomes of interest. Network meta‐analysis was done using R software.ResultsWe included 16 studies with 1139 premature infants, comparing six preterm feeding positions. The pooled MD and 95% CI for GRV at 30 min for right lateral, prone, right anterior oblique and left lateral compared to supine position were as follows: (−12.08 [−20.09, −4.07]), (−11.14 [−18.26, −4.01]), (−9.02 [−21.66, 3.61]) and (−0.18 [−7.87, 7.5]), respectively. Moreover, the pooled MD and 95% CI for GRV at 180 min for right lateral, prone and left lateral compared to supine position were as follows: (−0.69 [−1.29, −0.09]), (−0.56 [−1.22, 0.1]) and (0.09 [−0.63, 0.81]), respectively. Nevertheless, the pooled MD and 95% CI for GRV at 120 min for right anterior oblique, prone, right lateral and left lateral compared to supine position were as follows: (−6.09 [−11.33, −0.86]), (−5.07 [−7.71, −2.43]), (−3.08 [−5.89, −0.27]) and (−0.44 [−3.41, 2.53]), respectively.ConclusionWe concluded that the best nursing position after preterm infants feeding for lower gastric residuals and higher gastric emptying rate is the right lateral position after 30 and 180 min post‐feeding. Also, the right anterior oblique was the best after 120 min. Although the prone position can lower the GRV better than the left lateral and supine positions, it is not advisable to use this position because it raises the SIDS risk. Our results could help healthcare professionals to provide the appropriate positioning of preterm infants.

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Newborn Physiological Immaturity

Cited by 3 publications

References 38 publications

Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Quantifying physiological vital sign differences in newborns from 34+0/7 weeks of gestation and establishment of vital sign reference ranges for the late preterm population

The Effects of Different Nursing Positions During Preterm Infants Feeding on Gastric Residual Volume and Emptying Rate: A Systematic Review and Network Meta‐Analysis

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Newborn Physiological Immaturity

Cited by 3 publications

References 38 publications

Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Physiological vital sign ranges in newborns from 34 weeks gestation: A systematic review

Quantifying physiological vital sign differences in newborns from 34+0/7&nbsp;weeks of gestation and establishment of vital sign reference ranges for the late preterm population

The Effects of Different Nursing Positions During Preterm Infants Feeding on Gastric Residual Volume and Emptying Rate: A Systematic Review and Network Meta‐Analysis

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Quantifying physiological vital sign differences in newborns from 34+0/7 weeks of gestation and establishment of vital sign reference ranges for the late preterm population