Scribd Logo
Upload

Welcome to Scribd!

  • 87 views

    2017-Journal of Paediatrics and Child Health

    Uploaded by

    Ana Sopa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    2017-Journal of Paediatrics and Child Health

    Uploaded by

    Ana Sopa
    87 views1 page

    Original Title

    2017-Journal_of_Paediatrics_and_Child_Health

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    87 views1 page

    2017-Journal of Paediatrics and Child Health

    Uploaded by

    Ana Sopa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    Abstracts

    controlled trials (RCTs) involving 15,851 children. Effective inter- SHOULD PRETERM INFANTS IN THE NICU BE
    ventions (high quality evidence of effectiveness): therapeutic SLEEPING IN THE PRONE POSITION?
    hypothermia versus standard care in late preterm or term infants
    with hypoxic ischaemic encephalopathy (RR 0.66; 95% CI 0.54- Kelsee Shepherd1*, Stephanie Yiallourou2, Alexsandria
    0.82; 7 RCTs, 881 children). Possibly effective interventions (moder- Odoi2, Emma Yeomans3, Rosemary Horne2, Flora Wong4
    1
    ate quality evidence of effectiveness): prophylactic caffeine versus Monash University/ Hudson Institute of Medical Research,
    placebo for endotracheal extubation in preterm infants. Possibly the 2Hudson Institute of Medical Research and Department of
    ineffective interventions (moderate quality evidence of harm): early Paediatrics, Monash University, the 3Monash Newborn, Monash
    (<8 days) postnatal corticosteroids versus placebo/no treatment Children’s Hospital, the 4Hudson Institute of Medical Research/
    for preventing chronic lung disease in preterm infants. Possibly Monash University and Monash Newborn
    ineffective interventions (moderate quality evidence of lack of effec- Background: Placing a preterm infant in the prone position,
    tiveness): interventions assessed in 5 reviews. No conclusions the opposite position recommended for term infants, is frequently
    possible (low to very low quality evidence): interventions in employed to improve respiratory function in the nursery. Prone
    35 reviews. sleeping impairs cerebral oxygenation in term and preterm
    Conclusions: This overview summarises evidence on neonatal infants after term-corrected age, however the effect of prone
    interventions for preventing cerebral palsy and can be used by sleeping on cerebral oxygenation in preterm infants in the NICU
    researchers, funding bodies, policy-makers, clinicians and consu- remains unknown.
    mers to aid decision-making and evidence translation. A minority Method: Seventeen extremely preterm (<29 weeks’ gestation)
    of reviews report on cerebral palsy. There is an urgent need for and 14 preterm (?29 weeks’ gestation) infants were studied
    long-term follow-up of RCTs of neonatal interventions to meas- weekly for 3 weeks after birth, in prone and supine positions, in
    ure impact on cerebral palsy. active (AS) and quiet sleep (QS) in NICU. Routine cardiorespira-
    tory monitoring, oximetry (SaO2), and cerebral tissue oxygena-
    tion index (TOI) were recorded. Cerebral fractional oxygen
    PROGRESSING TOWARDS CORE OUTCOMES FOR extraction (CFOE) was calculated as (SaO2-TOI)/SaO2.
    MATERNAL AND PERINATAL CLINICAL TRIALS AND Results: The extremely preterm infants had higher TOI in
    REVIEWS prone compared to the supine position, in AS at 2 weeks of age
    and in QS at 3 weeks of age (P < 0.05). SaO2 in the prone position
    Emily Shepherd1*, Philippa Middleton1, Caroline Crowther2 was also significantly higher compared to supine in AS, at all post-
    1
    Robinson Research Institute, University of Adelaide, natal age (P < 0.05), and was higher in QS compared to AS at all
    the 2Liggins Institute, University of Auckland postnatal ages. CFOE tended to be elevated in the prone position
    Background: As defined by the Core Outcome Measures in in the extremely preterm infants at 1 week of age (P = 0.06).
    Effectiveness Trials (COMET) initiative, core outcome sets (COS) Conclusions: In extremely preterm infants, the increase in
    are an agreed minimum set of outcomes to be measured and CFOE in the prone position may represent lower cerebral blood
    reported in randomised controlled trials (RCTs) in a specific area, flow and hence an increased risk of hypoxic-ischaemic injury,
    making it easier for results to be compared, contrasted and com- despite both cerebral TOI and SaO2 being higher in the prone
    bined. We assessed progress made towards COS for maternal and position during the first 2 weeks of life.
    perinatal RCTs and reviews.
    Method: We searched the COMET Database (12/11/2016),
    limiting to the health areas ‘Pregnancy and Childbirth’ and ‘Neo- WEIGHT GAIN PATTERN OF PREGNANT WOMEN IN
    natal Care’, and extracted information related to scope and meth- PASAR REBO PRIMARY HEALTH CARE, JAKARTA
    odology of relevant COS studies. We searched the Cochrane Edo Prabudi Thamrin1, Andrew Sieman1, Muhammad Reza
    Database of Systematic Reviews (12/11/2016) using the term Yunusi1, Mohammad Risandi Priatama1*, Luther
    ‘core outcome*’, limiting to ‘Pregnancy and Childbirth’ and ‘Neo- Napitupulu1, Anasthasia Devina Sutedja1, Julia Remi
    natal’ protocols and reviews. Chandra1, Felicia Felicia1, Mahendri Dewita2, Mila Maidarti2
    Results: We identified 46 COS studies in the ‘Pregnancy and 1
    Faculty of Medicine Universitas Indonesia,
    Childbirth’ area, and 15 focused on ‘Neonatal Care,’ predomi- the 2Ciptomangunkusumo Hospital
    nately planned or ongoing and being led by investigators in Background: Nutrition is an essential factor determining the
    Europe and North America. Scope of the COS varies greatly, from outcomes of pregnancy. More than 850 million people worldwide
    COS for studies in ‘pregnant women requiting ventilation’ to are malnourished. Malnutrition in pregnant women can cause vari-
    ‘neonatal care’ generally. Commonly COS development is invol- ous complications during pregnancy. Doctors should monitor nutri-
    ving a systematic review of outcomes in relevant trials, followed tional adequacy from weight measurements throughout
    by Delphi surveys and a final consensus meeting. To date, only pregnancy, based on the guideline from Institute of Medicine
    2% (15/890) of Cochrane Pregnancy and Childbirth and Neona- (IOM), although it has not been widely applied in Indonesia. There-
    tal protocols or reviews make reference to a COS. fore, this study aims to analyze the weight gain pattern of pregnant
    Conclusions: In order to increase value and reduce waste in women based on their body mass index (BMI) before pregnancy.
    future research, there is now an urgent need for international Methods: This was a cross-sectional study involving 111 sub-
    engagement in maternal and perinatal COS development. Meth- jects by consecutive sampling. BMI and weight during each tri-
    odological research and guidance to support COS development, mester were obtained from medical records of patients who had
    reporting and implementation is required. normal delivery in Pasar Rebo Primary Health Care (PHC) from

    Journal of Paediatrics and Child Health 53 (Suppl. 2) (2017) 3–117 91


    © 2017 Paediatrics and Child Health Division (Royal Australasian College of Physicians)

    You might also like