Rudolf Trawöger

Adverse neurodevelopmental outcome in preterm infants: risk factor profiles for different gestational ages.

Aim: Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in preterm infants with a gestational age <30 weeks (Group I) and 30–32 weeks (Group II).

Smoking in pregnancy: a risk factor for adverse neurodevelopmental outcome in preterm infants?

Aim:  To assess whether smoking in pregnancy influences neurodevelopmental outcome at 2‐years of age in preterm infants with a gestational age <32 weeks.

Maternal cigarette smoking and its effect on neonatal lymphocyte subpopulations and replication

BackgroundSignificant immunomodulatory effects have been described as result of cigarette smoking in adults and pregnant women. However, the effect of cigarette smoking during pregnancy on the lymphocyte subpopulations in newborns has been discussed, controversially.MethodsIn a prospective birth cohort, we analyzed the peripheral lymphocyte subpopulations of smoking (SM) and non-smoking mothers (NSM) and their newborns and the replicative history of neonatal, mostly naive CD4 + CD45RA + T cells by measurements of T-cell-receptor-excision-circles (TRECs), relative telomere lengths (RTL) and the serum cytokine concentrations.ResultsSM had higher lymphocyte counts than NSM. Comparing SM and NSM and SM newborns with NSM newborns, no significant differences in proportions of lymphocyte subpopulations were seen. Regardless of their smoking habits, mothers had significantly lower naive T cells and higher memory and effector T cells than newborns. NSM had significantly lower percentages of CD4 + CD25++ T cells compared to their newborns, which was not significant in SM. There were no differences regarding cytokine concentrations in newborns of SM and NSM. However, NSM had significantly higher Interleukin-7 concentrations than their newborns. Regardless of smoking habits of mothers, newborns had significantly longer telomeres and higher TRECs than their mothers. Newborns of SM had significantly longer telomeres than newborns of NSM.ConclusionsApart from higher lymphocyte counts in SM, our results did not reveal differences between lymphocyte subpopulations of SM and NSM and their newborns, respectively. Our finding of significantly longer RTL in newborns of SM may reflect potential harm on lymphocytes, such as cytogenetic damage induced by smoking.

Congenital varicella syndrome in a very low birthweight preterm infant

Congenital varicella syndrome (CVS) is a rare but deleterious consequence of primary varicella zoster virus (VZV) infection during pregnancy. Typical CVS stigmata are cerebral abnormalities, eye diseases and segmentally distributed, cicatricial skin lesions. In this paper the authors report on a male preterm infant, born at 30 weeks of gestation, who developed pustular skin lesions at the age of 4 weeks. The mother had suffered from chickenpox at 14 weeks of gestation. Apart from skin manifestations, critical bronchopulmonary dysplasia made the infant conspicuous. The VZV genome was detected in blood, respiratory secretions and skin lesions. At age 10 weeks he presented with extensive intestinal wall perforation, considered to be related to CVS, which finally led to death. This case shows for the first time the clinical course of CVS in a preterm infant. It illustrates the need for discussion of comprehensive VZV vaccination for seronegative women of childbearing age.

Need for quality control for aEEG monitoring of the preterm infant: a 2-year experience.

Aim:  To establish and apply a questionnaire for the evaluation of amplitude‐integrated electroencephalogram (aEEG) with respect to practicability and feasibility in the NICU, to reveal strategies for improvements in daily use and to investigate the level of staff know‐how with regard to performance and evaluation of bedside aEEG for the purpose of quality control.

PO-0569 Pasteurisation Of Human Breast Milk: A Neonatal Dilemma

Background Preterm infants are at risk of postnatal transmission of cytomegalovirus (CMV) via breast milk. Although most infants remain asymptomatic in the neonatal period, doubts about adverse effects on neurodevelopmental outcome have been raised. Pasteurisation prevents transmission of CMV via breast milk, which concomitantly inactivates immune and bioactive components. Data indicate that necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are less common in preterm infants fed with breast milk, as compared to infants fed with formula or pasteurised breast milk. Aim To assess whether feeding preterm infants with unpasteurized breast milk i) decreases the rate of LOS and NEC and ii) increases the rate of postnatally acquired CMV infections. Methods Between January 2008 and July 2013 preterm infants <32 weeks gestational age admitted to the neonatal intensive care unit Innsbruck (n = 341) were eligible for the study. Of those 323 fed with breast milk were retrospectively enrolled in the study. Two groups were formed with 164 infants being fed with unpasteurized and 159 infants with pasteurised breast milk. Results The number of infants diagnosed with postnatally acquired CMV infections was significantly higher in the non-pasteurised group as compared to the pasteurised group (6.7% vs. 0.6%, p = 0.006). There was no significant difference regarding rate of LOS (15.9% vs. 15.1%, p = 0.486) or NEC (2.4% vs. 4.4%, p = 0.254). Conclusion Feeding preterm infants with unpasteurized breast milk increases the rate of CMV infections. Of interest, we also show a non-significant trend to decreased rates of NEC, but this needs to be confirmed in larger studies.

Clinical presentation and diagnostic work-up of isolated oesophageal lung in a neonate

A term female baby presented with respiratory distress at the age of 30 min. Chest X-ray revealed suspicion of pneumonia; antibiotic therapy was started (figure 1). On day 7 of life, the infant developed respiratory insufficiency. Chest X-ray showed complete opacification of the right hemithorax with positive air bronchogram. Ultrasonography of the mediastinum showed no vascular sling and bronchoscopy showed no malformation. CT revealed suspicion of high-grade stenosis …

P261 - Dilatation segmentaire congénitale du tractus intestinal - À propos de 4 cas

Objectifs Une dilatation segmentaire congenitale intestinale est une anomalie rare qui se presente avec des signes d’obstruction, en cas special avec celles d’un M. Hirschsprung. Materiels Pendant les derniers 20 ans 4 nouveau-nes (3 ♀ et un ♂) ont ete traites a cause d’une dilatation segmentaire concernant le duodenum, l’ileum, le colon ascendens et le rectum. Les segments dilates du duodenum et du colon ascendens ont ete reduit, dans le dernier cas. combine avec une transversostomie a cause d’une atresie coloanale. Les segments dilates de l’ileum et du rectum ont ete resecte, combine avec une ileo-ileostomie resp. Une sigmoideostomie terminale et une fermeture du cul-de-sac rectal. Resultats 3 des 4 patients vivent. 2 ont eu une correction de leur defaut cardiaque, un avec le duodenum retrecit est decede, le 2e, avec l’ileo-ileostomie a vecu. La fille avec le colon ascendens reduit a ete corrige selon la technique de Pena. Le 4 e patient a recu une anastomose colorectale a l’âge de 5 mois ; il a des problemes avec la defecation. L’examen histologique a montre de cellules ganglionnaires dans toutes les preparations, dans un cas une anomalie musculaire. Conclusion Si l’etiologie d’une dilatation segmentaire n’est pas connue, la therapie de choix est la resection de ce segment.