Infants suffering from neonatal sepsis face an increased risk of early death and long-term neurodevelopmental delay. This paper analyses and summarises the existing data on shortterm and long-term outcomes of neonatal sepsis, based on 12 studies published between January 2000 and 1 April 2012 and covering 3,669 neonates with sepsis. Conclusion: infants who have suffered neonatal sepsis face an increased risk of mortality and severe complications such as brain damage and, or, neurodevelopmental delay.

Acta Paediatrica. 2014. Vol. 103. Р. 1211–1218. doi:10.1111/apa.12764

Aim. To determine, among very preterm newborns, whether those who are growthrestricted are at increased risk of retinopathy of prematurity (ROP), and to explore whether the mixed findings of prior studies are the consequence of sampling based upon birthweight instead of gestational age.

Methods. Using data from the ELGAN Study, we created logistic regression models of prethreshold ROP risk to adjust for confounders and calculate odds ratios and 99% confidence intervals. We created scatter plots to display the gestational age/birthweight relationship in infants enrolled in studies with different selection criteria.

Results. Low gestational age [23–24 weeks, OR 11.6 (2.9, 47); 25–26 weeks, 8.1 (2.1, 32)] and severe growth restriction [birthweight Z-score <-2, OR 9.1 (1.1, 76)] were associated with increased risk of prethreshold ROP. We documented in scatter plots that a sample defined by birthweight has an excess of gestationally older, severely growthrestricted newborns.

Conclusion. In this sample, low gestational age and severe growth restriction were associated with increased risk of prethreshold ROP.

Acta Paediatr. 2015. Vol. 104, N 1. P. 27–31. doi: 10.1111/apa.12799

Aim. Providing less invasive surfactant administration (LISA) to spontaneously breathing preterm infants has been reported to reduce mechanical ventilation and bronchopulmonary dysplasia (BPD) in randornised controlled trials. This large cohort study compared these outcome measures between LISA treated infants and controls.

Methods. Infants receiving LISA, who were born before 32 gestational weeks and enrolled in the German Neonatal Network, were matched to control infants by gestational age, umbilical cord pH, Apgarscore at five minutes, small for gestational age status, antenatal treatment with steroids, gender and highest supplemental oxygen during the first 12 hours of life. Outcome data were compared with chi-square and Mann–Whitney U tests and adjusted for multiple comparisons.

Results. Between 2009 and 2012, 1,103 infants were treated with LISA at 37 centres. LISA infants had lower rates of mechanical ventilation (41% versus 62%, p<0.001), postnatal dexamethasone treatment (2.5% versus 7%, p<0.001), BPD (12% versus 18%, p=0.001) and BPD or death (14% versus 21%, p<0.001) than the controls.

Conclusion. Surfactant treatment of spontaneously breathing infants was associated with lower rates of mechanical ventilation and BPD. Additional large scale randomised controlled trials are needed to assess the possible long-term benefits of LISA.

The article represents basic laws of growth for very and extremely low birth weight infants. According to the available literature data analysis and the author's own experience methodology for estimating of physical development indexes throughout the first year of life were formulated. Basic laws of extremely preterm infants after hospital discharge are described, including conditions requiring the use of fortifier, specialized formulas, timing for complementary feeding, necessity for vitamin D and iron preparations supplement.

Respiratory distress syndrome (RDS) today is one of the major causes of morbidity and mortality in preterm infants. Surfactant replacement therapy (SRT) is one of the main methods of RDS treatment. But optimal drug choice, timing of medication administration, dosage and specific features of surfactant therapy in newborns of different gestational age (GA) are not precisely defined and have to be thoroughly examined. Two surfactants (poractant alpha and beractant) are clear market leaders in neonatology. Both of them were registered in the Russian Federation in 2015.

The selection of drug should be guided by clinical indications, it is necessary to consider a dosedependent effect of surfactant therapy. 200 mg/kg (2.5 ml/kg) of poractant alpha is more effective then 100 mg/kg of poractant alpha or 100 mg/kg (4 ml/kg) of beractant. Results of modern cohort and randomized studies highlight possibility of poractant and beractant differences levelling (no significant difference in mortality) under the conditions of noninvasive respiratory support as the start of respiratory therapy (<32 weeks GA, median body weight 1200 g), and also in relatively large cohort of premature neonates (70% of children with GA 27–36 weeks). American Academy of Pediatrics recommendations indicate that currently there are no significant differences in clinical efficacy of poractant alpha and beractant.

Pharmacoeconomic component for same indications and equal or similar clinical efficacy can be used as one of medication selection criteria for surfactant therapy. According to estimates beractant administration for respiratory distress syndrome treatment in group of premature neonates with 28 weeks GA and birth weight 1300 g reducing the burden on the health care budget.

Objective. Glutamine, proposed to be conditionally essential for critically ill patients, is not added routinely to parenteral amino acid formulations for premature infants. Parenteral feeding is the basic way of nutrition in the first days of life of premature infants. The authors examined the clinical benefits and the safety of parenteral glutamine dipeptide supplementation in very low birth weight (VLBW) preterm neonates.

Material and methods. From November 2012 to February 2014 63 VLBW premature infants were given either standard or glutamine dipeptide supplemented parenteral nutrition in Neonatal Intensive Care Unit (NICU). 33 infants were in glutamine dipeptide supplemented group, 30 infants were in control group. There were no differences in birth weight, gestation age and medical condition between the two groups. Clinical manifestations and biochemical indices were monitored throughout the duration of hospital stay. Data between groups were analyzed with Student's t test. A twotailed P value <0,05 was considered statistically significant.

Results. Parenteral glutamine supplementation in VLBW premature infants can shorten days on parenteral nutrition and length of stay in NICU, and decrease severity of feeding intolerance and the incidence of necrotizing enterocolitis. It had reduced the time to achieving full enteral nutrition. On the other hand, in the comparison groups were no significant differences in duration of mechanical ventilation, length of whole hospitalization, total mortality, laboratory markers.

Conclusion. Parenteral glutamine dipeptide appears to be well tolerated and safe in the preterm neonate. The obtained results are of a preliminary nature, the problem requires a multicenter randomized trials.

Recently, transcutaneous bilirubin determination (TCB) is a valuable method of screening for neonatal jaundice. The purpose of this study was to compare transcutaneous and traditional spectrophotometric determination of bilirubin in the group term infants with gestational age 37–40 weeks. Bilirubin level was assessed using the traditional method of spectrophotometry device Bilimet K and transcutaneously, with the help of two devices – Bilitest (Bilitest 2000) and JM-105, the application of which was carried out in parallel. The level of total bilirubin in the serum was in a wide range (100 to 350 μmol/l). The study included 102 term infants with a gestational age of 37 to 40 weeks, with birth weight in the range from 2500 to 4400 grams, aged from 12 to 240 hours of life. As a result of newborn screening in general, during the correlation analysis with calculation of the correlation coefficient results are as follows: When bilirubinemia levels from 100 to 255 μmol/l of a correlation between a traditional method and JM-105 (r=0,97), Bilimet and Bilitest (r=0,87). When bilirubinemia levels from255 to 350 μmol/l: JM-105 (r=0,83), Bilitest (r=0,84). When conducting screening for bilirubinemia better performance demonstrated JM-105, but the level of serum bilirubin above 255 μmol/l transcutaneous screening loses its effectiveness in both cases.

Dynamics of physical and neuro-developmental outcomes was assessed in extremely low birth weight (ELBW) infants at one year for corrected postconceptional age. In addition, analysis of morbidity among ELBW infants at one year postconceptional age was also performed.

Aim of this study was to assessment the patterns of growth and development of ELBW infants during the first year of life. The study involved 50 children, who was born and observed in the Yaroslavl Regional Perinatal Center during 2011–2012 years.