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Preemie Matters - August 2014

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In this issue of Preemie Matters: NICU Helping Hands • Preemie Parent Alliance Summit • Online Calculator Predicts Sepsis in NICU Newborns • High-Volume Neonatal Units May Increase Survival for Preterm Newborns • Late Preterm Birth May Alter Brain Growth • RSV Prophylactic Policy Statement from AAP

NICU Helping Hands

NICU Helping Hands-Family Support for Fragile Beginnings was first created in response to the growing need in Fort Worth, Texas for a local organization to support preemie families during their stay in the NICU and transition home. Their reach has since expanded nationwide to provide emotional, educational, and financial support to parents coping with the challenges of having a premature infant. Programs include mentorships that connect NICU families with experienced graduate families, opportunities for parent and professional education, and a robust hospital program, Project NICU, to enhance the support and education that NICU staff provide to families. In addition, NICU Helping Hands' Angel Gown Program comforts grieving families in the hospital by providing a beautiful infant burial gown to honor their child. To learn more, visit their website.

Preemie Parent Alliance Summit: September 12-14, 2014

The Preemie Parent Alliance (PPA) will host its annual summit September 12-14 in Phoenix, Arizona. This weekend-long event will bring together preemie parent leaders from across the country to learn about the latest research in family support and preemie development and to share best practices and ideas for reaching families affected by preterm birth. New topics this year include: "Newborn Behavior Observation," "Resolving through Sharing," "Big Data in the NICU," and "Forming Lasting Partnerships." Among this year's speakers are Alan R. Spitzer, MD-- a leader in academic neonatal medicine, Jill Wilke, RN, BSN, CPLC-- Lead Educator for Resolve Through Sharing at Bereavement Services, and Nick Hall-- Graham's Foundation President. For more information and to register for the summit, visit the PPA website.

Online Calculator Predicts Sepsis in NICU Newborns

Kaiser Permanente's Division of Research has developed an online calculator to help NICU providers predict if newborn babies are at risk for sepsis, a much more comprehensive method than previously used. By entering in the gestational age, the highest maternal antepartum temperature, rupture of membranes (ROM), and other information related to the pregnancy, the calculator yields a probability of early-onset sepsis per 1,000 babies. The calculator employs an algorithm based on extensive research using patient data from Kaiser's electronic health records. They are also using large data sets to determine ways to reduce bowel infections in preterm infants, the time the infants spend in the NICU, and the frequency of blood-stream infections they acquire from central intravenous lines.

High-Volume Neonatal Units May Increase Survival for Preterm Newborns

In a new study published in BMJ Open, researchers in the UK determined that high-volume neonatal units were associated with increased chances of survival for prematurely born infants. The neonatal units were defined as high-volume if they provided at least 3,480 days of care each year to babies born before 32 weeks of pregnancy. The researchers examined 17,955 premature infants (born between 27-32 weeks of pregnancy) and 2,559 very premature infants (born after less than 27 weeks) admitted to 165 British National Health Service hospital neonatal units in England. Of these babies, the increase in survival rate ranged from 30 percent for premature babies to 50 percent for very premature babies if they were admitted to a high-volume unit. The researchers emphasized that their findings have important implications for policymakers deciding the future organization of neonatal care.

Late Preterm Birth May Alter Brain Growth

A recent study published in Radiology conducted by Walsh and colleagues from Royal Women's Hospital in Melbourne, Australia concluded that late preterm babies experience different brain development than babies born full-term. The study involved performing MRI exams on 199 late preterm infants born between 32 and 36 weeks and 50 infants born after 37 weeks gestation. Walsh was surprised to learn the extent of brain formation differences that the late preterm babies exhibited compared to their full-term counterparts, "Many areas of the brain were affected, and their brains looked less mature than might have been anticipated." The late preterm infants displayed less-developed myelination and immature gyral folding, essential processes in early brain development that could potentially result in intellectual challenges, cerebral palsy, and difficulties breathing, seeing, and hearing. In response to the study's finding, Dr. Edward McCabe, senior vice president and chief medical officer of the March of Dimes, reiterated the importance of allowing pregnancies to reach full term to ensure optimal brain development. The researchers acknowledged that further research is needed to determine what these brain differences mean and whether they will lead to adverse long-term health effects.

RSV Prophylactic Policy Statement from AAP

The AAP's Committee on Infectious Diseases and Bronchiolitis Guidelines Committee--in collaboration with other AAP groups and external partners--recently revised their guidance on palivizumab prophylaxis (Synagis®) for the prevention of severe lower respiratory tract infection caused by respiratory syncytial virus (RSV) in high-risk pediatric patients. Most notably, palivizumab prophylaxis is now only recommended for infants at less than 29 weeks gestation and for infants with chronic lung disease who require supplemental oxygen for more than 28 days after birth. Prophylaxis is not recommended during the second year of life except under certain circumstances, nor is monthly prophylaxis recommended for children who experience a breakthrough RSV hospitalization. A detailed summary of the updated guidance is available in AAP's official policy statement and technical report. The NPIHC supports parent and professional input on guidelines. To provide comments or review the PreemieWorld petition, click here.

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Information is reported as provided and does not necessarily represent the view of the National Healthy Mothers, Healthy Babies Coalition. A complete copy of HMHB’s disclaimer is available on our website.

Renee Klink