The importance of understanding hospital and country-specific case-mix for neonatal patients
Journal Title: Jornal de Pediatria - Year 2015, Vol 91, Issue 3
Abstract
The study by Grandi et al. provides important information about the prevalence and impact of maternal diabetes mellitus on the outcomes of very low birth weight infants in South American neonatal intensive care units (NICUs). They report an overall rate of maternal diabetes of 2.8%, with an increase in prevalence from 2001-2005 of 2.4% to 3.2% over the period between 2006-2010. Also, of the numerous perinatal and neonatal outcomes examined in this cohort of almost 12,000 infants, only severe necrotizing enterocolitis was associated with diabetes mellitus in multivariable regression.1 These data differ from other published results. Prior studies of the prevalence of gestational diabetes range from an estimated 2-6% of cases across European countries,2 5-11% within 15 states of the US,3 and 16% in Qatar.4 Several studies from both low- and middle-income countries5 and developed countries6 also show diabetes as a risk factor for adverse pregnancy and neonatal outcomes, albeit in the entire population versus a specific, high-risk population such as that studied by Grandi et al.1 What do these findings, or any similar findings, mean for the clinicians or policy makers overseeing the care delivered to high-risk newborns, especially in light of data suggesting that rates of gestational diabetes in other countries is increasing?7 Practitioners should assess the validity of the results and then determine the potential impact of these results on their practice.
Authors and Affiliations
Scott Lorch
Keywords
Related Articles
- EP ID EP558343
- DOI 10.1016/j.jped.2015.01.003
- Views 47
- Downloads 0
Left ventricular assessment in patients with mucopolysaccharidosis using conventional echocardiography and myocardial deformation by two-dimensional speckle-tracking method
Objective Mucopolysaccharidosis is a rare genetic disease characterized by the intralysosomal deposition of glycosaminoglycans. Cardiovascular impairment is a common feature. Cardiac signs and symptoms are underestimated...
Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting
Objective Two randomized controlled clinical trials have shown that Lactobacillus (L) reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial...
Who cares for adolescents and young adults with cancer in Brazil?
Objective Approximately 6% of all cancers arise in adolescents and young adults. Currently, the ward type best placed to treat this patient group remains controversial. The aim of this study was to evaluate exactly where...
Effect of 4′galactooligosaccharide on constipation symptoms
Objective Fructooligosacharides and galactooligosacharides soften fecal bolus and increase frequency of depositions when added to infant formula. This study aimed to determine the effects of galactooligosaccharide in ped...
Pneumococcal meningitis: epidemiological profile pre- and post-introduction of the pneumococcal 10-valent conjugate vaccine
Objectives To evaluate the possible effects of the introduction of the pneumococcal conjugate 10-valent vaccine schedule in the state of Parana on pneumococcal meningitis cases and to assess the distribution of serotypes...