Paracetamol preceding very preterm birth: Is it safe?

Laitala, Aliisa; Saarela, Timo; Vääräsmäki, Marja; Hallman, Mikko; Aikio, Outi

doi:10.1111/aogs.14405

Cited by 3 publications

(3 citation statements)

References 37 publications

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“…Also, less sensitive equipment was used to detect foetal breathing in the clinical setting, compared to the experimental setting [65,66]. An observational study in premature infants exposed to antenatal paracetamol 24 h prior to birth showed less acute rescue interventions at birth, predominantly due to less need for surfactant administration [68]. In this study, infants exposed to antenatal paracetamol also required lower maximum ventilation pressures after birth compared to matched controls and antenatal paracetamol exposure correlated positively with all Apgar scores at birth [68].…”

Section: Possible Interventionsmentioning

confidence: 99%

“…An observational study in premature infants exposed to antenatal paracetamol 24 h prior to birth showed less acute rescue interventions at birth, predominantly due to less need for surfactant administration [68]. In this study, infants exposed to antenatal paracetamol also required lower maximum ventilation pressures after birth compared to matched controls and antenatal paracetamol exposure correlated positively with all Apgar scores at birth [68]. While caution is needed when interpreting observational studies, there seems to be an association between improved respiratory function in premature infants and antenatal paracetamol exposure.…”

Section: Possible Interventionsmentioning

confidence: 99%

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The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review

Panneflek,

Kuypers,

Polglase

et al. 2024

Eur J Pediatr

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Most very premature infants breathe at birth but require respiratory support in order to stimulate and support their breathing. A significant proportion of premature infants are affected by chorioamnionitis, defined as an umbrella term for antenatal inflammation of the foetal membranes and umbilical vessels. Chorioamnionitis produces inflammatory mediators that potentially depress the respiratory drive generated in the brainstem. Such respiratory depression could maintain itself by delaying lung aeration, hampering respiratory support at birth and putting infants at risk of hypoxic injury. This inflammatory-mediated respiratory depression may contribute to an association between chorioamnionitis and increased requirement of neonatal resuscitation in premature infants at birth. This narrative review summarises mechanisms on how respiratory drive and spontaneous breathing could be influenced by chorioamnionitis and provides possible interventions to stimulate spontaneous breathing. Conclusion: Chorioamnionitis could possibly depress respiratory drive and spontaneous breathing in premature infants at birth. Interventions to stimulate spontaneous breathing could therefore be valuable. What is Known:• A large proportion of premature infants are affected by chorioamnionitis, antenatal inflammation of the foetal membranes and umbilical vessels. What is New:• Premature infants affected by chorioamnionitis might be exposed to higher concentrations of respiratory drive inhibitors which could depress breathing at birth.• Premature infants affected by chorioamnionitis seem to be associated with a higher and more extensive requirement of resuscitation at birth.

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Section: Possible Interventionsmentioning

confidence: 99%

Section: Possible Interventionsmentioning

confidence: 99%

The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review

Panneflek,

Kuypers,

Polglase

et al. 2024

Eur J Pediatr

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“…Late preterm infants are the highest percentage of preterm infants and deserve special attention. However, the current studies mainly focused on very preterm infants or early preterm infants, and the research on animal models of late preterm infants is limited ( 34 ). Therefore, the goal of this study was to create a group of late preterm newborn pigs (at 113 gestational age) by C-section ( 6 ), with full-term newborn pigs (at 114 gestational age) born naturally as the control.…”

Section: Introductionmentioning

confidence: 99%

Exploring functional metabolites and proteomics biomarkers in late-preterm and natural-born pigs

Chong,

Wang,

Zhong

et al. 2024

Front. Vet. Sci.

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IntroductionPigs are often used to study the intestinal development of newborns, particularly as preterm pig models that mimic the intestinal growth of human preterm infants. Neonatology’s study of delivery mode’s impact on neonatal development is crucial.MethodsWe established 14 newborn pigs delivered via cesarean sections (C-section, at 113 days of gestational age, CS group) and 8 naturally born pigs were used as controls (at 114 days of gestational age, NF group). The impact of two alternative delivery procedures (C-section and natural birth) on the levels of short-chain fatty acids (SCFAs) and organic acids in the hepatic and intestines of newborn pigs were compared using metabolomics. The underlying molecular pathways are examined at the “protein-metabolite” level by integrating proteomic data.ResultsThe findings demonstrated that the mode of delivery changed the metabolism of SCFAs in newborn pigs, perhaps by affecting the physiology levels of cyclic intermediates such as lactate and malate in the pyruvate metabolic pathway. Additionally, by participating in the fatty acid metabolism pathway, two distinct proteins (FASN and HSD17B4) may impact the physiological concentration of these tiny metabolites.DiscussionIn conclusion, this study provided reliable animal model data for understanding the physiological SCFA metabolic information and its affecting mechanism of large-gestational age preterm infants.

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