Abstracts of the XXVI Congresso Nazionale - Società Italiana di Neonatologia

Abstract

s of the XXVI Congresso Nazionale Società Italiana di Neonatologia Venezia, Italy. 7-10 October 2020 Published: 29 April 2021 A1: The COVID National Neonatal Registry of the Italian Society of Neonatology (SIN) Camilla Gizzi, Lorenza Pugni, Elena Spada, Claudio Bellù Department of Pediatrics, Ospedale Sandro Pertini, Rome, Italy; NICU, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Geos Consult S.r.l., Milan, Italy Correspondence: Camilla Gizzi ([email protected]) Italian Journal of Pediatrics 2021, 47(Suppl 1):A1: Background: The COVID National Neonatal Registry aims to collect clinical data of infants born from mothers with SARS-CoV-2 virus infection diagnosed at any time during pregnancy and data from infants with acquired SARS-CoV-2 virus infection within the first month of life. Methods: After obtaining the approval by the Ethics Committee of the Coordinating Center (IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan), on March 2020 all the Italian birth centres were invited to participate. The database, designed by LP and CG and constructed on a REDCAP platform by CB, is composed of 5 sessions, asking for: birth hospital; mothers; infants born from a positive mother at the time of delivery; infants admitted for COVID infection acquired within the first month of life; infants born from a negative mother at delivery but positive during pregnancy. ES was responsible for data analysis. Results: As of September 2020, 305 records were entered. Data analysis was performed on 291 infants, 238 of which born from a positive mother, 13 with an infection acquired after birth and 40 born from a mother with previous positivity. Most of the records were inserted by Lombardia (70.7%), Emilia Romagna (13%) and Piemonte (8.2%). Among the 278 infants born from a positive mother, 63% were delivered vaginally, 23% by elective and 14% by emergency CS. Of the 238 positive mothers at birth, 208 had a known positivity, 19 were under diagnostic assessment, and 11 showed symptoms and tested positive following delivery. At delivery, 23.5% of women were symptomatic, in most cases with mild to moderate flu-like symptoms. Fourteen% of infants had a GA<37wks showing a prematurity rate double than before the pandemic and in line with the literature data; 12.5% of infants had a BW<2500g. Seventy three% of infants born from positive mothers were isolated with her in rooming-in, 19.7% were isolated in the NICU, 2.9% in the Nursery, 2.5% with their mother and subsequently separated and 10.5% were transferred. Seventy nine% of infants were fed exclusively with breast milk. Overall, 2.8% of infants (n. 6) isolated in rooming-in with their mothers tested positive for SARS-CoV-2 during hospitalization. Of these, 1 was positive on day 1 and subsequently confirmed. Two were negative at birth and became positive during hospitalization, on day 7 and 9. Three were born to a mother not tested at delivery, but positive during hospitalization. In all cases, newborns were asymptomatic or paucisymptomatic. Thirteen infants were admitted for home-acquired SARS-CoV-2 infection; they were all symptomatic (mostly fever and feeding difficulties), requiring a ventilatory support only in 2 cases. The infection was contracted between 5 30 days of life and in 5 cases a contact with a positive family member was reported. Conclusion: The COVID National Neonatal Registry improved epidemiological and scientific knowledge in this field and helped in creating a network which improves uniformity of management and high quality of care to infants and their mothers. None of the authors have competing interest. A2: Feeding difficulties in the very preterm infant in the first year of life Eleonora Pontello , Federica De Osti , Nadia Battajon , Gianluca Visintin , Silvia Vendramin , Marika Buffo , Paola Lago 1 Neonatal Intensive Care Unit, Ca’ Foncello Hospital, Treviso, Italy; Department of Woman’s and Child’s Health, University of Padova, Padova, Italy Correspondence: Eleonora Pontello ([email protected]) Italian Journal of Pediatrics 2021, 47(Suppl 1):A2: Background: Feeding disorders affect about 25-45% of preschool children; they are especially common in children with developmental disorders, including premature babies. They are one of the most common causes of delayed discharge, increased maternal stress and health care costs. During extrauterine life, the premature baby s nervous system is exposed to sensory overstimulation, resulting in an alteration of sensory processing and the highest risk of developing oro-buccal dyspraxia, hypersensitivity, and food aversion even after discharge . Several studies support an early intervention in NICU, in order to improve the maturation of infants’ proper oral feeding skills . Our primary outcome was to evaluate the incidence of feeding disorders on a VLBWI cohort during the 1st year of life. Secondary outcome was to identify any relationship between extreme prematurity, prolonged passive tube feeding and future feeding disorders. Materials and methods: During NICU stay, we evaluated potential factors that could be correlated with the development of feeding difficulties, such as the duration of tube feeding, the transition time from tube to oral feeding, and the start of independent oral feeding. Italian Journal of Pediatrics 2021, 47(Suppl 1):96 https://doi.org/10.1186/s13052-021-01039-y © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. We examined also feeding difficulties in the first year of life and the incidence of GER, following in the weaning phase and at 12 months of life. We compare infant born GA≤28 with those ≥29 to understand the role of extreme prematurity in the development of feeding disorders. The demographic characteristics and clinical data were collected from electronic medical records by investigators. Prism 8 (GraphPad Software, San Diego, CA, USA) was used for statistical processing. Results: We included 85 VLBW infants born in 2017-2018. The incidence of eating disorders in the first year of life was 29.4%. A statistically significant increase in feeding difficulties was found in VLBWIs with extreme prematurity (44.7% vs 17.0%, p <0.05), but there was no statistically significant difference in specific disorders (difficulty in weaning phase, difficulties at 12 months and GER). Conclusions: Feeding disorders affect about one third of preterm babies in the first year of life. Poor feeding skills in infancy can continue to be problematic later on, for months or even years and become a serious concern for caregiver. This work helps to raise awareness among NICU staff, to reduce as much as possible the exposure to invasive procedures and to rehab these subjects early.