Garčinskienė, Jurgita

In clinical practice, it is crucial to identify diagnostic methods that can forecast the neurodevelopmental outcomes of very preterm neonates. Our study aimed to assess the predictive significance of amplitude-integrated electroencephalography (aEEG) for the neurodevelopmental outcomes of preterm infants at 12 months corrected age and to establish the cut-off score that could indicate potential neurodevelopmental impairments.

NTRODUCTION Neonatal infection (NI) is a worldwide problem – according to the World Health Organization (WHO), infections are the major cause of neonatal deaths worldwide (36%). About 8 out of 1,000 live-born neonates are diagnosed with NI, 1 to 3 newborns are diagnosed with early-onset neonatal sepsis (EONS), and even more neonates (1 to 5) are diagnosed with late-onset neonatal sepsis (LONS). About 5% to 60% of newborns who have received antibiotics to treat NI suddenly die. AIM The aim of this study was to analyze the incidence, epidemiology, causative agents, and clinical manifestations of neonatal sepsis (NS) and unspeci9ed neonatal infection (UNI) among newborns treated at the Department of Neonatology of the Lithuanian University of Health Sciences during 2007-2013. METHODS In total, 631 medical histories of newborns diagnosed with NS or UNI and treated at the Clinical Department of Neonatology of the Lithuanian University of Health Sciences during 2007-2013 were analyzed in retrospect. The data were analyzed using the statistical software IBM® SPSS® statistics 20.0; 95% con9dence intervals were calculated (p < 0.05). RESULTS The incidence of NS and UNI in Lithuania is 25 out of 1,000 live-born neonates (2.6%). The incidence of NS is 0.8%, and the incidence of UNI – 1.8%. In the study, the percentage of newborns diagnosed with NS in the group of newborns with ≤ 32 weeks of gestation was 39.8%, in those with 33 to 36 weeks of gestation – 38.8%, and in those with ≥ 37 weeks – 24.9%. Concerning birth weight, 46.3% of newborns weighing ≤ 1,500 had NS, and 26.9% of newborns weighing ≥ 2,500 grams had NS. The most common pathogens for EONS were group B Streptococcus (12%) and E. coli (10%), while for LONS – group B Streptococcus (32%) and S. aureus (22%). The incidence of NS and UNI were higher in neonates born via vaginal delivery than in those born via Cesarean section. The majority of the newborns with NS had normal body temperature. Newborns diagnosed with NS had higher temperature than those who were diagnosed with UNI. The mortality rates in newborns with NI were 1.4 out of 1,000 live-born neonates. More newborns with NS and UNI were registered during 2007-2009 than during 2010-2013, and the mortality rates were higher as well. CONCLUSIONS More cases of NS and UNI were registered during the period of 2007-2009 than during 2010-2013, the mortality rates were higher as well, (p < 0.05). Early neonatal infection (NS and UNI) was more common in newborns with birth weight ≥ 2,500 g, (p < 0.05). The most common pathogens for EONS were group B Streptococcus, E. coli, and S. aureus, while the most common pathogens for LONS – group B Streptococcus, S. aureus, and coagulasenegative staphylococci (p < 0.05).

INTRODUCTION According to the WHO data, ca. 3.9 million children are diagnosed with retinopathy of prematurity (ROP) worldwide. This disease is one of the main causes of blindness in children. AIMTo evaluate the incidence of ROP in the Department of Neonatology of the Lithuanian University of Health Sciences (LUHS), to identify the most common risk factors of this disease, and to evaluate the influence of these factors on the development of ROP. METHODS This retrospective study included 753 neonates (born at ≤ 32 weeks of gestation, weight ≤ 2,000 g) who were treated during 2003-2012 at the Department of Neonatology of the LUHS. The distribution of ROP and the frequency of its surgical treatment was evaluated in the subjects studied. We evaluated the influence of sex, gestational age (GA) (the subjects were distributed into the following groups: ≤ 25 GA, 26-27 GA, 28-30 GA, and 31-32 GA) and birth weight (the subjects were distributed into the following groups: 500-999 g, 1,000-1,499 g, and > 1,500 g) on ROP, and the distribution of this condition in groups. RESULTS ROP was diagnosed in 16% (n = 120) of subjects: 15.8% males and 16.1% females. A statistically significant correlation was found between the incidence of ROP and gestational age groups: ≤ 25 GA – 48.2%, 26-27 GA – 24.5%, 28-30 GA – 11.5%, and 31-32 GA – 4.4% (p < 0.05). The highest incidence of ROP (36.3%) was found in the group of neonates with birth weight of 500-999 g, while the incidence of this condition in other groups was much lower (1,000-1,499 g – 11%, and > 1,500 g – 0.6%); however, the difference was not statistically significant (p > 0.05). A statistically significant correlation was found between the development of ROP and congenital heart defect, hypoxia, congenital/acquired infection, bronchopulmonary dysplasia, anemia, and encephalopathy (p < 0.05). Surgical treatment was applied in 3% (n = 20) of the subjects, most frequently – in the groups with birth weight of < 1,000 g (18%) and > 1,000 g (14%) (p < 0.779). CONCLUSIONS ROP statistically significantly correlated with the neonates’ gestational age: the incidence of ROP decreased with increasing gestational age. Birth weight did not have any significant influence on the development of more severe stages of ROP or the application of surgical treatment. The incidence of ROP was statistically significantly influenced by perinatal hypoxia, congenital heart defect, infection, anemia, bronchopulmonary dysplasia, and encephalopathy.

Background. Premature infants – especially those born after short gestation – often have a complicated beginning of life due to a variety of health problems that impair such children’s further development. Aims. To evaluate the determinants of low weight up to one year of adjusted age in premature infants born before 32 weeks of gestation, and to compare neonates born at 22-26 with those born at 27-31 weeks of gestation. Methods. A follow-up study of 755 neonates who were born in 2003-2012 during the 22nd-31st weeks of gestation. We evaluated anthropometric data (weight) during 3 visits (at approximately 1, 6 and 12 months of adjusted age). Results. In our investigated group, the number of neonates born during the 27th-31st weeks of gestation was by four times higher than the number of those born during the 22nd-26th weeks of gestation. Premature infants born at 22-26 weeks of gestation were hypotrophic (< 3‰) more frequently than those born at 27-31 weeks of gestation (p < 0.05). The risk of being underweight (< 3‰) for their age was higher in newborns with congenital heart defect, acquired infection, retinopathy of prematurity, rickets, severe perinatal hypoxia, or pulmonary atelectasis (p < 0.05), and in newborns with sonographically diagnosed internal hydrocephalus, intraventricular hemorrhage (III), or periventricular leukomalacia (II) (p < 0.05). Male sex and developmental disorders were predisposing factors for low weight (p < 0.05). Conclusions. Further physical development of premature infants is greatly influenced by gestational age and a history of neonatal diseases.

Holt'o-Oram'o sindromas – tai autosominiu dominantiniu būdu paveldima liga. Ši liga pasireiškia viršutinių galūnių bei širdies vystymosi anomalijomis. Klinikinė raiška labai įvairi, tačiau riešų kaulų anomalijos būdingos visiems sergantiesiems šia liga. Holt'o-Oram'o sindromo diagnozė patvirtinama remiantis diagnostiniais kriterijais ir gali būti patvirtinta molekuliniais genetiniais testais. Nėštumo laikotarpiu, atliekant vaisiaus ultragarsinį tyrimą, galima nustatyti viršutinių galūnių vystymosi anomalijas bei širdies ydas.