Neonatal World
@kaltirkawi.bsky.social
Funded by a CDC grant, a trial in Guinea-Bissau randomize newborns to either receive or be denied the hepatitis B birth dose—despite the fact that this vaccine is protective and is recommended by WHO.
"Is this another Tuskegee?"
#Neosky #pedsky
insidemedicine.substack.com/p/scoop-the-...
"Is this another Tuskegee?"
#Neosky #pedsky
insidemedicine.substack.com/p/scoop-the-...
Scoop: The leaked protocol of the CDC-funded Hepatitis B vaccine trial in Guinea-Bissau. “This is another Tuskegee.”
The protocol reveals that the trial will withhold the Hepatitis B birth dose from thousands—without placebos, without universal maternal screening, and with endpoints critics call indefensible.
insidemedicine.substack.com
January 16, 2026 at 5:13 PM
Funded by a CDC grant, a trial in Guinea-Bissau randomize newborns to either receive or be denied the hepatitis B birth dose—despite the fact that this vaccine is protective and is recommended by WHO.
"Is this another Tuskegee?"
#Neosky #pedsky
insidemedicine.substack.com/p/scoop-the-...
"Is this another Tuskegee?"
#Neosky #pedsky
insidemedicine.substack.com/p/scoop-the-...
Antenatal steroids and CP.
A study of more than 20K preterm births (32–36 wks), used a regression discontinuity design at the 34-week cutoff, found no difference in CP risk just before vs after 34 weeks (RR 0.98; 95% CI 0.50–1.98).
#Neosky #pedsky
www.jpeds.com/article/S002...
A study of more than 20K preterm births (32–36 wks), used a regression discontinuity design at the 34-week cutoff, found no difference in CP risk just before vs after 34 weeks (RR 0.98; 95% CI 0.50–1.98).
#Neosky #pedsky
www.jpeds.com/article/S002...
Antenatal Corticosteroids and Risk of Cerebral Palsy: A Regression Discontinuity Study
To use a natural experiment to investigate the effect of antenatal corticosteroids
on the risk of cerebral palsy.
www.jpeds.com
January 14, 2026 at 3:23 PM
Antenatal steroids and CP.
A study of more than 20K preterm births (32–36 wks), used a regression discontinuity design at the 34-week cutoff, found no difference in CP risk just before vs after 34 weeks (RR 0.98; 95% CI 0.50–1.98).
#Neosky #pedsky
www.jpeds.com/article/S002...
A study of more than 20K preterm births (32–36 wks), used a regression discontinuity design at the 34-week cutoff, found no difference in CP risk just before vs after 34 weeks (RR 0.98; 95% CI 0.50–1.98).
#Neosky #pedsky
www.jpeds.com/article/S002...
In a meta-analysis including more than 20,000 preterm infants, iNO use was linked to mild reduction in BPD, mortality (only in RCTs), higher ROP (but not the severe disease), and no significant effects on brain injury, IVH, or NEC.
#Neosky #pedsky
link.springer.com/article/10.1...
#Neosky #pedsky
link.springer.com/article/10.1...
Inhaled nitric oxide in preterm infants with respiratory disease: a systematic review and meta-analysis - European Journal of Medical Research
Background Inhaled nitric oxide (iNO) has been shown to be effective in term and near-term infants with specific respiratory diseases. The effects and potential risks of iNO differ substantially in pr...
link.springer.com
January 5, 2026 at 6:31 PM
In a meta-analysis including more than 20,000 preterm infants, iNO use was linked to mild reduction in BPD, mortality (only in RCTs), higher ROP (but not the severe disease), and no significant effects on brain injury, IVH, or NEC.
#Neosky #pedsky
link.springer.com/article/10.1...
#Neosky #pedsky
link.springer.com/article/10.1...
In a cohort of very preterm infants, n = 713, exposure to sedation was associated with an increased risk of BPD or death (aOR, 5.32; 95% CI, 3.15–8.98; p < 0.001), but not with adverse neurodevelopmental outcomes at 18 months of corrected age.
#Neosky #pedsky
www.frontiersin.org/journals/med...
#Neosky #pedsky
www.frontiersin.org/journals/med...
Frontiers | Analgesia and sedation increases bronchopulmonary dysplasia risk without significant neurodevelopmental impairment in very preterm infants
BackgroundThe associations between analgesia and/or sedation exposure and adverse outcomes in very preterm infants remain controversial. Evidence linking the...
www.frontiersin.org
December 28, 2025 at 11:00 AM
In a cohort of very preterm infants, n = 713, exposure to sedation was associated with an increased risk of BPD or death (aOR, 5.32; 95% CI, 3.15–8.98; p < 0.001), but not with adverse neurodevelopmental outcomes at 18 months of corrected age.
#Neosky #pedsky
www.frontiersin.org/journals/med...
#Neosky #pedsky
www.frontiersin.org/journals/med...
#Neosky #pedsky
Have you ever wondered why the certainty of evidence is frequently downgraded in neonatal Cochrane reviews?
Here is the answer.
Imprecision and risk of bias were the most common reasons for downgrading the certainty of evidence
pubmed.ncbi.nlm.nih.gov/41379741/
Have you ever wondered why the certainty of evidence is frequently downgraded in neonatal Cochrane reviews?
Here is the answer.
Imprecision and risk of bias were the most common reasons for downgrading the certainty of evidence
pubmed.ncbi.nlm.nih.gov/41379741/
Why is neonatal evidence mainly very low or low certainty - a meta-epidemiological review of Cochrane Neonatal reviews - PubMed
The neonatal evidence was mainly limited due to imprecision and risk of bias. This indicates that larger scale high-quality studies in various neonatal topics are still greatly warranted.
pubmed.ncbi.nlm.nih.gov
December 23, 2025 at 2:34 PM
#Neosky #pedsky
Have you ever wondered why the certainty of evidence is frequently downgraded in neonatal Cochrane reviews?
Here is the answer.
Imprecision and risk of bias were the most common reasons for downgrading the certainty of evidence
pubmed.ncbi.nlm.nih.gov/41379741/
Have you ever wondered why the certainty of evidence is frequently downgraded in neonatal Cochrane reviews?
Here is the answer.
Imprecision and risk of bias were the most common reasons for downgrading the certainty of evidence
pubmed.ncbi.nlm.nih.gov/41379741/
The NeoVitaA study evaluated the long-term effects of early high-dose enteral vitamin A supplementation in ELBW infants. At 24 months, no benefit was observed for pulmonary infections or neurodevelopmental outcomes. A disappointing result.
#Neosky #pedsky
www.thelancet.com/journals/ecl...
#Neosky #pedsky
www.thelancet.com/journals/ecl...
Two-year outcomes after early postnatal high-dose fat-soluble enteral vitamin A supplementation in extremely low birth weight infants: follow-up of the NeoVitaA randomized controlled trial
Early postnatal high-dose enteral fat-soluble vitamin A supplementation in ELBW infants
did not affect pulmonary or developmental outcomes at 24 months’ CA.
www.thelancet.com
December 15, 2025 at 7:26 AM
The NeoVitaA study evaluated the long-term effects of early high-dose enteral vitamin A supplementation in ELBW infants. At 24 months, no benefit was observed for pulmonary infections or neurodevelopmental outcomes. A disappointing result.
#Neosky #pedsky
www.thelancet.com/journals/ecl...
#Neosky #pedsky
www.thelancet.com/journals/ecl...
Not all monitors are created equal.
In NICUs, we make critical decisions based on numbers — SpO₂, HR, etc. — assuming our tools are equally accurate. A new study found significant performance gaps between two commonly used pulse-ox systems.
#Neosky #pedsky
www.nature.com/articles/s41...
In NICUs, we make critical decisions based on numbers — SpO₂, HR, etc. — assuming our tools are equally accurate. A new study found significant performance gaps between two commonly used pulse-ox systems.
#Neosky #pedsky
www.nature.com/articles/s41...
Identifying performance differences between two pulse oximetry systems in simulated critical neonatal conditions - Journal of Perinatology
Journal of Perinatology - Identifying performance differences between two pulse oximetry systems in simulated critical neonatal conditions
www.nature.com
December 7, 2025 at 8:27 AM
Not all monitors are created equal.
In NICUs, we make critical decisions based on numbers — SpO₂, HR, etc. — assuming our tools are equally accurate. A new study found significant performance gaps between two commonly used pulse-ox systems.
#Neosky #pedsky
www.nature.com/articles/s41...
In NICUs, we make critical decisions based on numbers — SpO₂, HR, etc. — assuming our tools are equally accurate. A new study found significant performance gaps between two commonly used pulse-ox systems.
#Neosky #pedsky
www.nature.com/articles/s41...
A study of 15,102 infants (23–28 weeks GA) found that each 1-week delay in reaching full enteral feeds (≥120 mL/kg/day) was linked to:
+16% risk of sepsis (ARR 1.16)
Higher NEC risk (ARR 1.20)
More growth faltering in weight, length, and HC.
#Neosky #pedsky
jamanetwork.com/journals/jam...
+16% risk of sepsis (ARR 1.16)
Higher NEC risk (ARR 1.20)
More growth faltering in weight, length, and HC.
#Neosky #pedsky
jamanetwork.com/journals/jam...
Time to Full Enteral Feeds and Late-Onset Sepsis in Extremely Preterm Infants
This cohort study of extremely preterm infants evaluates whether there is an association between full enteral feeding and late-onset sepsis, necrotizing enterocolitis, and growth faltering.
jamanetwork.com
November 30, 2025 at 6:09 PM
A study of 15,102 infants (23–28 weeks GA) found that each 1-week delay in reaching full enteral feeds (≥120 mL/kg/day) was linked to:
+16% risk of sepsis (ARR 1.16)
Higher NEC risk (ARR 1.20)
More growth faltering in weight, length, and HC.
#Neosky #pedsky
jamanetwork.com/journals/jam...
+16% risk of sepsis (ARR 1.16)
Higher NEC risk (ARR 1.20)
More growth faltering in weight, length, and HC.
#Neosky #pedsky
jamanetwork.com/journals/jam...
#Neosky #pedsky
this study produced a model that can safely reduce ROP screens. Trained on >100k infants and validated on >25k, the model has AUROC 0.916. With 100% sensitivity, NPV was 99.9% and screens dropped 12%. A good tool to improve risk-stratification.
pubmed.ncbi.nlm.nih.gov/41252350/
this study produced a model that can safely reduce ROP screens. Trained on >100k infants and validated on >25k, the model has AUROC 0.916. With 100% sensitivity, NPV was 99.9% and screens dropped 12%. A good tool to improve risk-stratification.
pubmed.ncbi.nlm.nih.gov/41252350/
Machine Learning Risk Prediction for Treated Retinopathy of Prematurity in Infants - PubMed
ML models can effectively predict the need for ROP treatment and stratify infants by risk, potentially reducing unneeded screening. Future work is needed to translate model-based ROP predictions to the clinical setting.
pubmed.ncbi.nlm.nih.gov
November 24, 2025 at 2:50 PM
#Neosky #pedsky
this study produced a model that can safely reduce ROP screens. Trained on >100k infants and validated on >25k, the model has AUROC 0.916. With 100% sensitivity, NPV was 99.9% and screens dropped 12%. A good tool to improve risk-stratification.
pubmed.ncbi.nlm.nih.gov/41252350/
this study produced a model that can safely reduce ROP screens. Trained on >100k infants and validated on >25k, the model has AUROC 0.916. With 100% sensitivity, NPV was 99.9% and screens dropped 12%. A good tool to improve risk-stratification.
pubmed.ncbi.nlm.nih.gov/41252350/
A pilot study evaluated whether hyperglycemia and HbA1c levels can predict severe ROP. It found that a 30-day mean glucose of ~ 5.2 mmol/L with HbA1c of 5.6% predicted severe ROP with a 94% PPV. Another step toward improving ROP prevention.
#Neosky #pedsky
www.frontiersin.org/journals/ped...
#Neosky #pedsky
www.frontiersin.org/journals/ped...
Frontiers | Identifying neonatal hyperglycemia thresholds in preterm infants based on retinopathy of prematurity outcomes: proof-of-concept study
PurposeNeonatal hyperglycemia significantly increases risk for retinopathy of prematurity (ROP) in preterm infants, independent of other major ROP risk facto...
www.frontiersin.org
November 21, 2025 at 4:44 PM
A pilot study evaluated whether hyperglycemia and HbA1c levels can predict severe ROP. It found that a 30-day mean glucose of ~ 5.2 mmol/L with HbA1c of 5.6% predicted severe ROP with a 94% PPV. Another step toward improving ROP prevention.
#Neosky #pedsky
www.frontiersin.org/journals/ped...
#Neosky #pedsky
www.frontiersin.org/journals/ped...
3/3
#Neosky #pedsky
Why it matters:
Vaginal birth may provide cues that jump-start immune & stress pathways.
C-section infants might miss this activation window, possibly contributing to slightly higher rates of asthma/allergies.
pubmed.ncbi.nlm.nih.gov/41220118/
#Neosky #pedsky
Why it matters:
Vaginal birth may provide cues that jump-start immune & stress pathways.
C-section infants might miss this activation window, possibly contributing to slightly higher rates of asthma/allergies.
pubmed.ncbi.nlm.nih.gov/41220118/
Comparative Study Showed Significant Gene Expression Differences in Newborn Infants After Vaginal and Caesarean Deliveries - PubMed
This study demonstrates that the mode of delivery significantly influences neonatal gene expression and immune system activation.
pubmed.ncbi.nlm.nih.gov
November 19, 2025 at 1:24 PM
3/3
#Neosky #pedsky
Why it matters:
Vaginal birth may provide cues that jump-start immune & stress pathways.
C-section infants might miss this activation window, possibly contributing to slightly higher rates of asthma/allergies.
pubmed.ncbi.nlm.nih.gov/41220118/
#Neosky #pedsky
Why it matters:
Vaginal birth may provide cues that jump-start immune & stress pathways.
C-section infants might miss this activation window, possibly contributing to slightly higher rates of asthma/allergies.
pubmed.ncbi.nlm.nih.gov/41220118/
2/3
#Neosky #pedsky
Key findings:
- 95 genes were more active in the vaginal-birth group
- IL-6 and IL-8 were also higher
Suggesting vaginal birth “activates” the newborn immune system.
After correction, effects weren’t significant—likely due to small sample size. Think trend, not conclusion
#Neosky #pedsky
Key findings:
- 95 genes were more active in the vaginal-birth group
- IL-6 and IL-8 were also higher
Suggesting vaginal birth “activates” the newborn immune system.
After correction, effects weren’t significant—likely due to small sample size. Think trend, not conclusion
November 19, 2025 at 1:24 PM
Accurate assessment of heart rate is critical for decision-making in the delivery room. However, the opimsl method for assessing HR in this setting is uncertain. A recent meta-analysis found that the quality of available evidence is low to very low.
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
Fast and accurate newborn heart rate monitoring at birth: A systematic review
To examine speed and accuracy of newborn heart rate measurement by various assessment methods employed at birth.A search of Medline, SCOPUS, CINAHL an…
www.sciencedirect.com
November 16, 2025 at 11:59 AM
Accurate assessment of heart rate is critical for decision-making in the delivery room. However, the opimsl method for assessing HR in this setting is uncertain. A recent meta-analysis found that the quality of available evidence is low to very low.
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
3/3
Takeaway
Automated O₂ control improved oxygen stability and reduced key complications in preterm infants; BPD and oxygen dependency.
Larger trials are needed before routine clinical adoption.
#Neosky #Pedsky
fn.bmj.com/content/earl...
Takeaway
Automated O₂ control improved oxygen stability and reduced key complications in preterm infants; BPD and oxygen dependency.
Larger trials are needed before routine clinical adoption.
#Neosky #Pedsky
fn.bmj.com/content/earl...
Closed-loop automated oxygen control in preterm ventilated infants: a randomised controlled trial
Objective To compare the duration of mechanical ventilation between preterm infants receiving closed-loop automated oxygen control (CLAC) or manual oxygen control.
Design Randomised controlled trial....
fn.bmj.com
November 13, 2025 at 2:48 PM
3/3
Takeaway
Automated O₂ control improved oxygen stability and reduced key complications in preterm infants; BPD and oxygen dependency.
Larger trials are needed before routine clinical adoption.
#Neosky #Pedsky
fn.bmj.com/content/earl...
Takeaway
Automated O₂ control improved oxygen stability and reduced key complications in preterm infants; BPD and oxygen dependency.
Larger trials are needed before routine clinical adoption.
#Neosky #Pedsky
fn.bmj.com/content/earl...
2/3
Infants managed with CLAC had:
• Shorter ventilation (11 vs. 40 days, p=0.02)
• Less time on O₂ (33 vs. 47 days, p=0.03)
• Lower rates of BPD (55% vs. 84%, p=0.02)
• Fewer required home O₂ (27% vs. 51%, p=0.02)
CLAC reduced hypo- or hypoxemia episodes (p<0.001).
#Neosky #Pedsky
Infants managed with CLAC had:
• Shorter ventilation (11 vs. 40 days, p=0.02)
• Less time on O₂ (33 vs. 47 days, p=0.03)
• Lower rates of BPD (55% vs. 84%, p=0.02)
• Fewer required home O₂ (27% vs. 51%, p=0.02)
CLAC reduced hypo- or hypoxemia episodes (p<0.001).
#Neosky #Pedsky
November 13, 2025 at 2:39 PM
1/3
A new RCT tested closed-loop automated oxygen control (CLAC) vs. manual oxygen adjustment in preterm ventilated infants, aiming to compare how long infants stayed on mechanical ventilation.
N= 69 infants (median GA 27 wks) were randomized within 48 hours of ventilation start
#Neosky #Pedsky
A new RCT tested closed-loop automated oxygen control (CLAC) vs. manual oxygen adjustment in preterm ventilated infants, aiming to compare how long infants stayed on mechanical ventilation.
N= 69 infants (median GA 27 wks) were randomized within 48 hours of ventilation start
#Neosky #Pedsky
November 13, 2025 at 2:36 PM
2/2
Among overlapping SRs, 21% reached conflicting conclusions and 69% disagreed on evidence certainty.
Takeaway:
redundant, low-quality SRs waste resources and mislead clinicians. Every new SR should justify its purpose and follow rigorous methods.
#Neosky #pedsky
www.jclinepi.com/article/S089...
Among overlapping SRs, 21% reached conflicting conclusions and 69% disagreed on evidence certainty.
Takeaway:
redundant, low-quality SRs waste resources and mislead clinicians. Every new SR should justify its purpose and follow rigorous methods.
#Neosky #pedsky
www.jclinepi.com/article/S089...
Systematic reviews on the same topic are common but often fail to meet key methodological standards: a research-on-research study
To 1) assess the frequency of overlapping systematic reviews (SRs) on the same topic
including overlap in outcomes, 2) assess whether SRs meet some key methodological
characteristics, and 3) describe ...
www.jclinepi.com
November 10, 2025 at 1:33 PM
2/2
Among overlapping SRs, 21% reached conflicting conclusions and 69% disagreed on evidence certainty.
Takeaway:
redundant, low-quality SRs waste resources and mislead clinicians. Every new SR should justify its purpose and follow rigorous methods.
#Neosky #pedsky
www.jclinepi.com/article/S089...
Among overlapping SRs, 21% reached conflicting conclusions and 69% disagreed on evidence certainty.
Takeaway:
redundant, low-quality SRs waste resources and mislead clinicians. Every new SR should justify its purpose and follow rigorous methods.
#Neosky #pedsky
www.jclinepi.com/article/S089...
3/3
Takeaway:
Early rapid genome sequencing not only finds more answers—it saves major costs for the sickest infants.
Researchers call for expanded reimbursement to make early rGS standard care.
#Neosky #pedsky
pubmed.ncbi.nlm.nih.gov/41177396
Takeaway:
Early rapid genome sequencing not only finds more answers—it saves major costs for the sickest infants.
Researchers call for expanded reimbursement to make early rGS standard care.
#Neosky #pedsky
pubmed.ncbi.nlm.nih.gov/41177396
Rapid Genome Sequencing Compared with a Gene Panel in Critically Ill Infants with a Suspected Genetic Disorder: An Economic Evaluation - PubMed
Early rGS results in substantial healthcare cost savings, highlighting the need to expand reimbursement to improve access early in a hospitalization for critically ill infants.
pubmed.ncbi.nlm.nih.gov
November 9, 2025 at 6:44 PM
3/3
Takeaway:
Early rapid genome sequencing not only finds more answers—it saves major costs for the sickest infants.
Researchers call for expanded reimbursement to make early rGS standard care.
#Neosky #pedsky
pubmed.ncbi.nlm.nih.gov/41177396
Takeaway:
Early rapid genome sequencing not only finds more answers—it saves major costs for the sickest infants.
Researchers call for expanded reimbursement to make early rGS standard care.
#Neosky #pedsky
pubmed.ncbi.nlm.nih.gov/41177396
1/3
New study (GEMINI) compares two ways to diagnose genetic disorders in critically ill infants:
1- Early rapid genome sequencing (rGS) for all
2- Targeted neonatal sequencing (NewbornDx) + later rGS if needed
Goal: find which approach saves more & helps faster.
#Neosky #pedsky
New study (GEMINI) compares two ways to diagnose genetic disorders in critically ill infants:
1- Early rapid genome sequencing (rGS) for all
2- Targeted neonatal sequencing (NewbornDx) + later rGS if needed
Goal: find which approach saves more & helps faster.
#Neosky #pedsky
November 9, 2025 at 6:42 PM
Constructive feedback
November 9, 2025 at 2:57 PM
Constructive feedback
2/2
#pedsky
#Neosky
Although PA was "more" common in this age group, it was not a key driver of outcomes; no significant association with mortality, IVH, or NDIs.
pubmed.ncbi.nlm.nih.gov/41150609/
#pedsky
#Neosky
Although PA was "more" common in this age group, it was not a key driver of outcomes; no significant association with mortality, IVH, or NDIs.
pubmed.ncbi.nlm.nih.gov/41150609/
The incidence and outcomes of perinatal asphyxia in spontaneous extreme preterm birth: a retrospective cohort study - PubMed
PA occurred more frequently in this extreme preterm cohort than in term neonates, yet did not independently influence mortality or morbidity. A major limitation is the use of ACOG criteria, originally developed for term births, which may have led to over- or underestimation of PA's true incidence an …
pubmed.ncbi.nlm.nih.gov
November 8, 2025 at 10:10 AM
2/2
#pedsky
#Neosky
Although PA was "more" common in this age group, it was not a key driver of outcomes; no significant association with mortality, IVH, or NDIs.
pubmed.ncbi.nlm.nih.gov/41150609/
#pedsky
#Neosky
Although PA was "more" common in this age group, it was not a key driver of outcomes; no significant association with mortality, IVH, or NDIs.
pubmed.ncbi.nlm.nih.gov/41150609/