@article {10801, title = {Infant Analgesia With a Combination of Breast Milk, Glucose, or Maternal Holding.}, journal = {Pediatrics}, volume = {142}, year = {2018}, month = {2018 Sep}, abstract = {

OBJECTIVES: We studied neonatal cortical brain response to 4 types of nonpharmacological analgesia (oral glucose, expressed breast milk, maternal holding plus oral glucose, breastfeeding). We aimed to assess the differential effect of oral solutions (glucose, breast milk) given alone or combined with the maternal-infant relationship (holding, breastfeeding).

METHODS: Eighty healthy term newborns undergoing a heel stick were randomly assigned to 4 parallel groups of 20 infants each: group 1, infants received a glucose solution on a changing table; group 2, infants received expressed breast milk on a changing table; group 3, infants received a glucose solution in their mothers{\textquoteright} arms; and group 4, infants were breastfed by their mothers. Cortical activation in parietal, temporal, and frontal cortices was assessed by multichannel near-infrared spectroscopy. Pain expression was also evaluated.

RESULTS: Oral glucose alone or combined with maternal holding was associated with no cortical activation during heel stick. Expressed breast milk was associated with localized bilateral activation of somatosensory and motor cortices ( < .01). Breastfeeding was associated with extensive bilateral activation of somatomotor, somatosensory, and right parietal cortices ( < .01). Pain expression was lower with the maternal-infant relationship ( = .007).

CONCLUSIONS: Oral glucose, either alone or combined with maternal holding, appears to block or weaken cortical pain processing. Breast milk alone is associated with localized cortical activation. Breastfeeding is associated with extensive activation and may act by extending cortical processing. Maternal relationship, both combined with oral glucose and in breastfeeding, shows the greatest analgesic effect, although the neural patterns involved are distributed differently.

}, issn = {1098-4275}, doi = {10.1542/peds.2017-3416}, author = {Bembich, Stefano and Cont, Gabriele and Causin, Enrica and Paviotti, Giulia and Marzari, Patrizia and Demarini, Sergio} } @article {10545, title = {Higher growth, fat and fat-free masses correlate with larger cerebellar volumes in preterm infants at term.}, journal = {Acta Paediatr}, volume = {106}, year = {2017}, month = {2017 Jun}, pages = {918-925}, abstract = {

AIM: Smaller cerebellar volumes in very low-birthweight (VLBW) infants at term have been related to adverse cognitive outcomes, and this study evaluated whether these volumes were associated with a growth in body composition during hospital stays.

METHODS: We prospectively recruited 42 VLBW infants from an Italian neonatal unit between January 2013 and August 2015. Cerebellar volumes and body composition were measured by magnetic resonance imaging (MRI) and air-displacement plethysmography, respectively, at 40 weeks of gestational age and anthropometric and nutritional data were collected. We also included 20 term-born controls.

RESULTS: The mean gestational age and birthweight of the VLBW infants were 29.4 ({\textpm}1.9) weeks and 1120 ({\textpm}290) g. There was a positive correlation between cerebellar volumes and daily weight gain from birth to term (R = 0.26, p = 0.001), weight (R = 0.25, p = 0.001), length (R = 0.16, p = 0.01), fat mass (R = 0.15, p = 0.01) and fat-free mass at term (R = 0.20, p = 0.003). In multiple regression analysis, daily weight gain, mechanical ventilation and postconceptional age at MRI were independently associated with cerebellar volumes. Anthropometric data and cerebellar volumes were similar between VLBW and control infants.

CONCLUSION: Higher growth, higher fat mass and fat-free mass were associated with larger cerebellar volumes in VLBW infants at term.

}, keywords = {Body Composition, Cerebellum, Child Development, Female, Humans, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Male, Nutritional Status, Organ Size, Prospective Studies, Regression Analysis}, issn = {1651-2227}, doi = {10.1111/apa.13829}, author = {Paviotti, Giulia and De Cunto, Angela and Zennaro, Floriana and Boz, Giulia and Travan, Laura and Cont, Gabriele and Bua, Jenny and Demarini, Sergio} } @article {10496, title = {Theophylline increases diaphragmatic contractility in mechanically ventilated newborns.}, journal = {J Crit Care}, volume = {37}, year = {2017}, month = {2017 02}, pages = {264-265}, keywords = {Diaphragm, Humans, Infant, Newborn, Muscle Contraction, Theophylline}, issn = {1557-8615}, doi = {10.1016/j.jcrc.2016.10.001}, author = {De Cunto, Angela and Paviotti, Giulia and Bua, Jenny and Demarini, Sergio} } @article {8308, title = {Body mass index curves for Italian preterm infants are comparable with American curves for infants born before 34 weeks of gestational age.}, journal = {Acta Paediatr}, volume = {105}, year = {2016}, month = {2016 May}, pages = {483-9}, abstract = {

AIM: Body mass index (BMI)-for-age curves have been developed in the USA, but not compared with other populations. This study created gender-specific intrauterine BMI-for-age curves for Italian preterm infants and compared them with the USA version.

METHODS: Data on 92 262 newborn infants, born at 26-42 weeks of gestational age in the north-eastern Italian region of Friuli Venezia Giulia between 2005 and 2013, were analysed to create gender-specific BMI-for-age curves. Gender-specific and age-specific BMI Z scores for Italian infants were calculated using the parameters of the USA growth curves and the World Health Organization charts.

RESULTS: Gender-specific BMI-for-age at birth curves were developed for premature Italian infants from 26 gestational weeks. The comparison with the USA charts showed no significant difference in BMI percentiles in Italian infants born at <=33 gestational weeks, but infants born at >=34 gestational weeks had a significantly higher BMI than the USA population, by 0.2 standard deviations.

CONCLUSION: We developed the first European BMI-for-age at birth curves for premature infants. According to our findings, the Italian curves were comparable to the USA curves for the subgroup of infants born at <=33 gestational weeks, but not >=34 gestational weeks.

}, issn = {1651-2227}, doi = {10.1111/apa.13364}, author = {Paviotti, Giulia and Monasta, Lorenzo and Ronfani, Luca and Montico, Marcella and Copertino, Marco and De Cunto, Angela and Demarini, Sergio} } @article {7710, title = {Impact of Surgery for Neonatal Gastrointestinal Diseases on Weight and Fat Mass.}, journal = {J Pediatr}, volume = {167}, year = {2015}, month = {2015 Sep}, pages = {568-71}, abstract = {

OBJECTIVE: To compare growth, fat mass (FM), and fat-free mass in surgical infants vs matched controls at similar postconceptional age (PCA).

STUDY DESIGN: Anthropometric and body composition measurements by air-displacement plethysmography (PeaPod-Infant Body Composition System; LMI, Concord, California) were performed at the same PCA in 21 infants who received gastrointestinal surgery and in 21 controls matched for gestational age, birth weight, and sex.

RESULTS: Despite similar anthropometry at birth, postsurgical infants were shorter (50.4 [4.7] cm vs 53.2 [4.1] cm, P = .001), lighter (3516 [743] g vs 3946 [874] g, P < .001), and had lower FM content (\%FM 14.8 [4.7]\% vs 20.2 [5.8]\%, P < .0001) than their peers at similar PCA (43 [4] weeks). All surgical infants but 1 (20/21) received parenteral nutrition (PN). Mean PN duration was 40 (30) days. Five infants in the control group received PN because of prematurity for 15 (9-30) days. Nine infants in the surgical group and 1 in the control group had PN-associated cholestasis.

CONCLUSIONS: Neonates having surgery for gastrointestinal diseases were shorter, had lower weight, and lower FM content than their peers, despite receiving more PN. Body composition evaluation and monitoring may help optimize growth in these newborns.

}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2015.06.013}, author = {De Cunto, Angela and Paviotti, Giulia and Travan, Laura and Bua, Jenny and Cont, Gabriele and Demarini, Sergio} } @article {3630, title = {Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding.}, journal = {J Hum Lact}, volume = {31}, year = {2015}, month = {2015 Feb}, pages = {47-52}, abstract = {

Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on the mother-infant relationship and breastfeeding. Close mother-infant body contact immediately after birth positively enhances exclusive breastfeeding during the hospital stay, with a dose-response relationship. Skin-to-skin contact may ease the infant{\textquoteright}s transition to extra-uterine life and helps regulate the infant{\textquoteright}s body temperature and nursing behavior. However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term neonates, in association with SSC, have raised concerns about the safety of this practice. Based on available evidence, we developed a surveillance protocol in the delivery room and postnatal ward of the Institute for Maternal and Child Health of Trieste (Italy). The aim of our protocol is (a) to promote safe mother and infant bonding and (b) to establish successful breastfeeding, without increasing the risk of SUPC. As there is no known effective intervention to prevent SUPC, our protocol has been conceived as a potential best practice.

}, issn = {1552-5732}, doi = {10.1177/0890334414554927}, author = {Davanzo, Riccardo and De Cunto, Angela and Paviotti, Giulia and Travan, Laura and Inglese, Stefania and Brovedani, Pierpaolo and Crocetta, Anna and Calligaris, Chiara and Corubolo, Elisa and Dussich, Valentina and Verardi, Giuseppa and Causin, Enrica and Kennedy, Jaquelyn and Marrazzo, Francesca and Strajn, Tamara and Sanesi, Cecilia and Demarini, Sergio} } @article {3496, title = {Can body mass index accurately predict adiposity in newborns?}, journal = {Arch Dis Child Fetal Neonatal Ed}, volume = {99}, year = {2014}, month = {2014 May}, pages = {F238-9}, abstract = {

Body mass index (BMI) is correlated with body fatness and risk of related diseases in children and adults. Proportionality indexes such as BMI and ponderal index (PI) have been suggested as complementary measures in neonatal growth assessment. Yet, they are still not used in neonates and their correlation with fatness is unknown. The aim of the study was to test the hypothesis that BMI z-score would predict neonatal adiposity. Body composition measurements (ie, fat mass, fat-free mass) by air displacement plethysmography (PEA POD, LMI, Concord-USA), weight and length were obtained in 200 infants >=36 weeks{\textquoteright} gestational age (GA) at birth. Linear regression analysis showed a direct association between BMI z-score and \%fat mass (r(2)=0.43, p<0.0001). This association was confirmed independently from sex, GA and maternal prepregnancy BMI. BMI z-score predicted adiposity better than PI. However, both BMI z-score and PI were poor predictors of adiposity at birth.

}, keywords = {Adiposity, Adult, Anthropometry, Body Composition, Body Mass Index, Cross-Sectional Studies, Female, Gestational Age, Humans, Infant, Newborn, Male, Mothers, Plethysmography, Predictive Value of Tests, Regression Analysis, Reproducibility of Results, Sex Factors}, issn = {1468-2052}, doi = {10.1136/archdischild-2013-305386}, author = {De Cunto, Angela and Paviotti, Giulia and Ronfani, Luca and Travan, Laura and Bua, Jenny and Cont, Gabriele and Demarini, Sergio} } @article {3534, title = {High-frequency percussive ventilation as rescue treatment in severe hypoxemic respiratory failure in term neonates.}, journal = {J Crit Care}, volume = {29}, year = {2014}, month = {2014 Aug}, pages = {662-3}, keywords = {Female, High-Frequency Ventilation, Humans, Male, Oxygen, Pulmonary Gas Exchange, Respiratory Insufficiency}, issn = {1557-8615}, doi = {10.1016/j.jcrc.2014.02.018}, author = {Paviotti, Giulia and Bua, Jenny and De Cunto, Angela and Travan, Laura and Demarini, Sergio} } @article {3536, title = {When does postnatal catch-up fat occur in late preterm infants?}, journal = {Acta Paediatr}, volume = {103}, year = {2014}, month = {2014 Aug}, pages = {e325}, keywords = {Body Composition, Humans, Infant, Premature}, issn = {1651-2227}, doi = {10.1111/apa.12668}, author = {De Cunto, Angela and Paviotti, Giulia and Demarini, Sergio} } @article {1753, title = {Endothelial progenitor cells, bronchopulmonary dysplasia and other short-term outcomes of extremely preterm birth.}, journal = {Early Hum Dev}, volume = {87}, year = {2011}, month = {2011 Jul}, pages = {461-5}, abstract = {

AIM: To evaluate the impact of endothelial progenitor cells (EPCs), a subset of committed circulatory stem cells, on the development of bronchopulmonary dysplasia (BPD) and other short term outcomes in a cohort of extremely premature newborns.

METHODS: Progenitor cells were quantified by flow cytometry at birth in 36 neonates born <=28 weeks of gestation and at 36 postmenstrual weeks in 18 of them. Cells expressing the stemness markers CD34, CD133, or both were defined as circulating progenitor cells (CPCs). EPCs were defined as CPCs co-expressing the endothelial marker KDR.

RESULTS: Mean (SD) gestational age and birth weight of the infants studied were 26.2(1.5) weeks and 761.6(171.8) grams, respectively. EPC levels at birth did not differ between infants who subsequently developed BPD (n=9) and those who did not (n=24) [CD34(+)KDR(+) EPCs: 81(34-41) vs 80(56-110), p=0.7] and were not correlated with the duration of mechanical ventilation or O2-dependence, nor with the need of surfactant replacement. Infants with a hemodynamically significant patent ductus arteriosus (PDA) (n=22) had significantly lower EPC levels at birth than those with no PDA (n=11) [CD34(+)KDR(+) cells: 47(34-92) vs 142(84.5-221), p=0.008]. Data from the 18 infants studied both at birth and at 36 postmenstrual weeks showed that, while CPCs sharply decline over time, levels of all EPCs phenotypes are preserved after delivery.

CONCLUSIONS: Levels of EPCs at birth did not affect the risk of developing BPD in our group of extremely premature neonates. However, the association between low EPC counts at birth and PDA may be clinically relevant, and deserves further studies.

}, keywords = {Blood Cell Count, Bronchopulmonary Dysplasia, Cohort Studies, Ductus Arteriosus, Patent, Endothelial Cells, Female, Flow Cytometry, Humans, Infant, Newborn, Infant, Premature, Italy, Pregnancy, Prospective Studies, Regression Analysis, Stem Cells}, issn = {1872-6232}, doi = {10.1016/j.earlhumdev.2011.03.011}, author = {Paviotti, Giulia and Fadini, Gian Paolo and Boscaro, Elisa and Agostini, Carlo and Avogaro, Angelo and Chiandetti, Lino and Baraldi, Eugenio and Filippone, Marco} }