Alejandro Perez - Academia.edu (original) (raw)

Papers by Alejandro Perez

Research paper thumbnail of Nt-probnp as a Screening for Low-risk Patent Ductus Arteriousus: a Follow-up Validation Study

Purpose: To test whether NT-proBNP serves as a screening for low-risk patent ductus arteriosus an... more Purpose: To test whether NT-proBNP serves as a screening for low-risk patent ductus arteriosus and safely avoids routine early echocardiography. Methods: Prospective observational study in preterm infants below 33 weeks of gestational age. Infants with >5100 pg/ml (positive screening) at 48-72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the first 7 days of life. Result: 125 infants were included; 82 had a negative and positive NT-proBNP screening respectively. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated (p<0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict treatment (AUC=0.967) Conclusions: NT-proBNP at 48-72 hours of life has an excellent performan...

Research paper thumbnail of Cuidados paliativos perinatales

Anales de Pediatría, 2021

Los contenidos de esta obra estan sujets a una lecencia de Reconocimiento-No comercial-Sinobrasde... more Los contenidos de esta obra estan sujets a una lecencia de Reconocimiento-No comercial-Sinobrasderivadas 4.

Research paper thumbnail of Sedoanalgesia en las unidades neonatales

Anales de Pediatría, 2020

Pain recognition and management continues to be a challenge for health professionals in Neonatal ... more Pain recognition and management continues to be a challenge for health professionals in Neonatal Intensive Care Units. Many of the patients are routinely exposed to repeated painful experiences with demonstrated short-and long-term consequences. Preterm babies are a vulnerable high-risk population. Despite international recommendations, pain remains poorly assessed and managed in many Neonatal Intensive Care Units. Due to there being no general protocol, there is significant variability as regards the guidelines for the approach and treatment of pain between the different Neonatal Intensive Care Units. The objective of this article is to review and assess the general principles of pain in the initial stages of development, its recognition through the use of standardised scales. It also includes its prevention and management with the combination of pharmacological and non-pharmacological measures, as well as to establish recommendations that help alleviate pain in daily clinical practice by optimising pain and stress control in the Neonatal Intensive Care Units.

Research paper thumbnail of Validation of an IGF1 Screening Method for Retinopathy of Pre-maturity

Frontiers in Pediatrics, 2020

Retinopathy of pre-maturity (ROP) is a retinal disease that causes arrest of vascularization of t... more Retinopathy of pre-maturity (ROP) is a retinal disease that causes arrest of vascularization of the retina and can result in retinal detachment and blindness. Current screening protocols may not be sufficiently accurate to identify all at-risk patients. The aim of this study is to validate a method for improved identification of newborns at risk of ROP. We conducted a prospective clinical trial of pre-term newborns <32 weeks of gestation and/or <1,500 g birth weight during a 6-year period in a tertiary care hospital. We applied our new method based on measurement of insulin-like growth factor 1 (IGF1) levels at 3 weeks of age and the presence of sepsis during the first 3 weeks of life. Our screening protocol allowed exclusion of 121 (79.1%) patients for whom American Academy of Pediatrics (AAP) guidelines recommended screening, had a negative predictive value of 100%, and correctly identified all patients with ROP. Following retrospective assessment of our data based on these ...

Research paper thumbnail of Rapid Phenotype-Driven Gene Sequencing with the NeoSeq Panel: A Diagnostic Tool for Critically Ill Newborns with Suspected Genetic Disease

Journal of Clinical Medicine, 2020

New genomic sequencing techniques have shown considerable promise in the field of neonatology, in... more New genomic sequencing techniques have shown considerable promise in the field of neonatology, increasing the diagnostic rate and reducing time to diagnosis. However, several obstacles have hindered the incorporation of this technology into routine clinical practice. We prospectively evaluated the diagnostic rate and diagnostic turnaround time achieved in newborns with suspected genetic diseases using a rapid phenotype-driven gene panel (NeoSeq) containing 1870 genes implicated in congenital malformations and neurological and metabolic disorders of early onset (<2 months of age). Of the 33 newborns recruited, a genomic diagnosis was established for 13 (39.4%) patients (median diagnostic turnaround time, 7.5 days), resulting in clinical management changes in 10 (76.9%) patients. An analysis of 12 previous prospective massive sequencing studies (whole genome (WGS), whole exome (WES), and clinical exome (CES) sequencing) in newborns admitted to neonatal intensive care units (NICUs) ...

Research paper thumbnail of Recommendations for the care of the umbilical cord in the newborn

Anales de Pediatría (English Edition), 2019

Abstract The care of the umbilical cord until its detachment still remains controversial. The lat... more Abstract The care of the umbilical cord until its detachment still remains controversial. The latest updated recommendations by the World Health Organisation advocate dry cord care in those countries with adequate obstetric care and low neonatal mortality rate. In recent years, new studies and reviews attribute some benefit to applying chlorhexidine on the umbilical stump. An analysis is presented here of the available evidence and results in the advisability of still recommending the dry cord care in the newborns in our setting.

Research paper thumbnail of Recomendaciones para la prevención, la detección y el manejo de la hiperbilirrubinemia en los recién nacidos con 35 o más semanas de edad gestacional

Anales de Pediatría, 2017

Cómo citar este artículo: Sánchez-Redondo Sánchez-Gabriel MD, et al. Recomendaciones para la prev... more Cómo citar este artículo: Sánchez-Redondo Sánchez-Gabriel MD, et al. Recomendaciones para la prevención, la detección y el manejo de la hiperbilirrubinemia en los recién nacidos con 35 o más semanas de edad gestacional. An Pediatr (Barc). 2017.

Research paper thumbnail of Implementation of NeoKissEs in Spain: A validated surveillance system for nosocomial sepsis in very low birth weight infants

Anales de Pediatría (English Edition), 2018

Background: Bloodstream infections (BSIs) are the most frequent nosocomial infections in neonatal... more Background: Bloodstream infections (BSIs) are the most frequent nosocomial infections in neonatal intensive care units (NICUs), especially in very low birth weight (VLBW) infants (birth weight ≤ 1500 g). An epidemiologic surveillance system may contribute to the prevention of infection by continuous monitoring of its frequency and associated risk factors. The aim of this article was to describe the implementation of the NeoKissEs surveillance system for BSIs in VLBW newborns in a group of Spanish NICUs.

Research paper thumbnail of Umbilical cord and visceral hemangiomas diagnosed in the neonatal period

Medicine, 2016

Background: Umbilical cord hemangioma is very rare and may not be detected prenatally. However, i... more Background: Umbilical cord hemangioma is very rare and may not be detected prenatally. However, it should be considered in differential diagnosis with other umbilical masses because it can cause significant morbidity. Methods: We report the case of a newborn referred with suspected omphalitis and umbilical hernia. Results: Physical examination showed an irreducible umbilical tumor, the size of olive, with dubious secretion. The initial suspected diagnosis was urachal or omphalomesenteric duct remnants. Abdominal ultrasound and magnetic resonance imaging showed an umbilical and a mesenteric mass. Tumor markers were negative. A definitive diagnosis of umbilical cord and intestinal hemangioma was established after surgical excision and histologic examination of the umbilical mass. Propranolol was prescribed due to the extent of the intestinal lesion. Conclusion: This report highlights the diagnostic challenges of hemangiomas in unusual locations. Apart from the rarity of these tumors, few tests are available to guide diagnosis, and surgery and histologic examination are generally required for a definitive diagnosis. Finally, it is essential to rule out associated malformations and hemangiomas in other locations. Abbreviations: MRI = magnetic resonance imaging, US = ultrasound.

Research paper thumbnail of Long-term pharmacological management of phenylketonuria, including patients below the age of 4 years

JIMD reports, 2012

BH4 therapy is an advancement in the treatment of phenylketonuria, reducing blood phenylalanine (... more BH4 therapy is an advancement in the treatment of phenylketonuria, reducing blood phenylalanine (phe) levels and increasing tolerance to natural proteins of responding patients. We report the results of 16 patients undergoing long-term BH4 treatment. Responding patients to BH4 was usually based on 24-h loading tests; a ≥30% decrease in blood phe was considered a positive response. Weekly loading made it possible to identify an additional "slow responder." The 16 responders constitute 24.6% of patients who completed the trial (87.5% of responders in mild hyperphenylalaninemia, 38.1% in mild PKU, and 2.8% in classical PKU).Mean dose of BH4 used was 9.75 ± 0.9 mg/kg per day, during a mean of 62 months. Age at treatment start was below 4 years in seven patients; five of which begun treatment during their first month since birth. All but one patient showed good treatment compliance; six continue on BH4 monotherapy without dietary phe restriction; six showed an increase in phe t...

Research paper thumbnail of Preclinical Screening for Retinopathy of Prematurity Risk Using IGF1 Levels at 3 Weeks Post-Partum

PLoS ONE, 2014

Following current recommendations for preventing retinopathy of prematurity (ROP) involves screen... more Following current recommendations for preventing retinopathy of prematurity (ROP) involves screening a large number of patients. We performed a prospective study to establish a useful screening system for ROP prediction and we have determined that measuring serum levels of IGF1 at week three and the presence of sepsis have a high predictive value for the subsequent development of ROP. A total of 145 premature newborn, with birthweight ,1500 g and/or ,32 weeks gestational age, were enrolled. 26.9% of them showed some form of retinopathy. A significant association was found between the development of retinopathy and each of the following variables: early gestational age, low birthweight, requiring mechanical ventilation, oxygen treatment, intracranial haemorrhage, sepsis during the first three weeks, bronchopulmonary dysplasia, the need for erythrocyte transfusion, erythropoietin treatment, and low levels of serum IGF1 in the third week. A multiple logistic regression analysis was used to obtain curves for the probability of developing ROP, based on the main factors linked with ROP, namely serum levels of IGF1 and presence of sepsis. Such preclinical screening has the ability to identify patients with high-risk of developing retinopathy and should lead to better prediction for ROP, while at the same time optimising the use of clinical resources, both human and material.

Research paper thumbnail of Corticoides antenatales y prevención del distrés respiratorio del recién nacido prematuro: utilidad de la terapia de rescate

Anales de Pediatría, 2014

Research paper thumbnail of Utilidad de la distracción mandibular en la secuencia de Pierre Robin en el período neonatal

Anales de Pediatría, 2014

Research paper thumbnail of Effects of Maternal Stress on Breast Milk Production and the Microbiota of Very Premature Infants

Nutrients

Perinatal stress experienced by mothers of very premature newborns may influence the mother’s mil... more Perinatal stress experienced by mothers of very premature newborns may influence the mother’s milk and the infant’s intestinal microbiota. This prospective study of mothers of very preterm infants fed with mother’s own milk (MOM) was carried out in a tertiary hospital over a 2-year period. The assessment of maternal stress in 45 mothers of 52 very preterm newborns using the parental stress scale (PSS:NICU) revealed an inverse relationship between stress and MOM production in the first days of life (p = 0.012). The greatest contributor to stress was the one related to the establishment of a mother–child bond. Maternal stress was lower in mothers in whom the kangaroo method was established early (p = 0.011) and in those with a higher educational level (p = 0.032). Levels of fecal calprotectin (FC) decreased with the passage of days and were directly correlated with birthweight (p = 0.044). FC levels 7 days post-delivery were lower in newborns that received postnatal antibiotics (p = 0...

Research paper thumbnail of Meconium plug syndrome in twins

Anales de Pediatría (English Edition)

Research paper thumbnail of Niveles asistenciales en las unidades neonatales en España: Una visión actualizada para una nueva realidad

Research paper thumbnail of Recomendaciones para la transfusión de hemoderivados en neonatología

Research paper thumbnail of Home births: A growing phenomenon with potential risks

Anales de Pediatría (English Edition), 2020

Home birth is a controversial issue that raises safety concerns for paediatricians and obstetrici... more Home birth is a controversial issue that raises safety concerns for paediatricians and obstetricians. Hospital birth was the cornerstone to reduce maternal and neonatal mortality. This reduction in mortality has resulted in considering pregnancy and childbirth as a safe procedure, which, together with a greater social awareness of the need for the humanisation of these processes, have led to an increase in the demand for home birth. Studies from countries such as Australia, the Netherlands, and United Kingdom show that home birth can provide advantages to the mother and the newborn. It needs to be provided with sufficient material means, and should be attended by trained and accredited professionals, and needs to be perfectly coordinated with the hospital obstetrics and neonatology units, in order to guarantee its safety. Therefore, in our environment, there are no safety data or sufficient scientific evidence to support home births at present.

Research paper thumbnail of La osteoartritis neonatal: diagnóstico a recordar

Acta pediátrica española, 2006

Research paper thumbnail of Parto domiciliario: un fenómeno creciente con potenciales riesgos

Anales de Pediatría, 2020

Recibido el 25 de marzo de 2020; aceptado el 2 de abril de 2020 PALABRAS CLAVE Humanización; Mort... more Recibido el 25 de marzo de 2020; aceptado el 2 de abril de 2020 PALABRAS CLAVE Humanización; Mortalidad perinatal; Parto de bajo riesgo; Recién nacido; Seguridad Resumen El parto extrahospitalario es un tema controvertido que genera dudas a obstetras y pediatras sobre su seguridad. El nacimiento hospitalario fue la pieza clave en la reducción de la mortalidad materna y neonatal. Esta reducción en la mortalidad ha derivado en considerar el embarazo y el parto como fenómenos seguros, lo que, unido a una mayor conciencia social de la necesidad de humanización de estos procesos, ha conducido a un aumento en la demanda del parto domiciliario. Estudios en países como Australia, Holanda y Reino Unido muestran que el parto en casa puede aportar ventajas para la madre y el recién nacido, pero es necesario que se dote de los suficientes medios materiales, que sea atendido por profesionales formados y acreditados, y que se encuentre perfectamente coordinado con las unidades de obstetricia y neonatología hospitalarias, para poder garantizar su seguridad. En nuestro medio, no hay suficientes datos de seguridad ni evidencia científica que avalen el parto domiciliario en la actualidad.

Research paper thumbnail of Nt-probnp as a Screening for Low-risk Patent Ductus Arteriousus: a Follow-up Validation Study

Purpose: To test whether NT-proBNP serves as a screening for low-risk patent ductus arteriosus an... more Purpose: To test whether NT-proBNP serves as a screening for low-risk patent ductus arteriosus and safely avoids routine early echocardiography. Methods: Prospective observational study in preterm infants below 33 weeks of gestational age. Infants with >5100 pg/ml (positive screening) at 48-72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the first 7 days of life. Result: 125 infants were included; 82 had a negative and positive NT-proBNP screening respectively. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated (p<0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict treatment (AUC=0.967) Conclusions: NT-proBNP at 48-72 hours of life has an excellent performan...

Research paper thumbnail of Cuidados paliativos perinatales

Anales de Pediatría, 2021

Los contenidos de esta obra estan sujets a una lecencia de Reconocimiento-No comercial-Sinobrasde... more Los contenidos de esta obra estan sujets a una lecencia de Reconocimiento-No comercial-Sinobrasderivadas 4.

Research paper thumbnail of Sedoanalgesia en las unidades neonatales

Anales de Pediatría, 2020

Pain recognition and management continues to be a challenge for health professionals in Neonatal ... more Pain recognition and management continues to be a challenge for health professionals in Neonatal Intensive Care Units. Many of the patients are routinely exposed to repeated painful experiences with demonstrated short-and long-term consequences. Preterm babies are a vulnerable high-risk population. Despite international recommendations, pain remains poorly assessed and managed in many Neonatal Intensive Care Units. Due to there being no general protocol, there is significant variability as regards the guidelines for the approach and treatment of pain between the different Neonatal Intensive Care Units. The objective of this article is to review and assess the general principles of pain in the initial stages of development, its recognition through the use of standardised scales. It also includes its prevention and management with the combination of pharmacological and non-pharmacological measures, as well as to establish recommendations that help alleviate pain in daily clinical practice by optimising pain and stress control in the Neonatal Intensive Care Units.

Research paper thumbnail of Validation of an IGF1 Screening Method for Retinopathy of Pre-maturity

Frontiers in Pediatrics, 2020

Retinopathy of pre-maturity (ROP) is a retinal disease that causes arrest of vascularization of t... more Retinopathy of pre-maturity (ROP) is a retinal disease that causes arrest of vascularization of the retina and can result in retinal detachment and blindness. Current screening protocols may not be sufficiently accurate to identify all at-risk patients. The aim of this study is to validate a method for improved identification of newborns at risk of ROP. We conducted a prospective clinical trial of pre-term newborns <32 weeks of gestation and/or <1,500 g birth weight during a 6-year period in a tertiary care hospital. We applied our new method based on measurement of insulin-like growth factor 1 (IGF1) levels at 3 weeks of age and the presence of sepsis during the first 3 weeks of life. Our screening protocol allowed exclusion of 121 (79.1%) patients for whom American Academy of Pediatrics (AAP) guidelines recommended screening, had a negative predictive value of 100%, and correctly identified all patients with ROP. Following retrospective assessment of our data based on these ...

Research paper thumbnail of Rapid Phenotype-Driven Gene Sequencing with the NeoSeq Panel: A Diagnostic Tool for Critically Ill Newborns with Suspected Genetic Disease

Journal of Clinical Medicine, 2020

New genomic sequencing techniques have shown considerable promise in the field of neonatology, in... more New genomic sequencing techniques have shown considerable promise in the field of neonatology, increasing the diagnostic rate and reducing time to diagnosis. However, several obstacles have hindered the incorporation of this technology into routine clinical practice. We prospectively evaluated the diagnostic rate and diagnostic turnaround time achieved in newborns with suspected genetic diseases using a rapid phenotype-driven gene panel (NeoSeq) containing 1870 genes implicated in congenital malformations and neurological and metabolic disorders of early onset (<2 months of age). Of the 33 newborns recruited, a genomic diagnosis was established for 13 (39.4%) patients (median diagnostic turnaround time, 7.5 days), resulting in clinical management changes in 10 (76.9%) patients. An analysis of 12 previous prospective massive sequencing studies (whole genome (WGS), whole exome (WES), and clinical exome (CES) sequencing) in newborns admitted to neonatal intensive care units (NICUs) ...

Research paper thumbnail of Recommendations for the care of the umbilical cord in the newborn

Anales de Pediatría (English Edition), 2019

Abstract The care of the umbilical cord until its detachment still remains controversial. The lat... more Abstract The care of the umbilical cord until its detachment still remains controversial. The latest updated recommendations by the World Health Organisation advocate dry cord care in those countries with adequate obstetric care and low neonatal mortality rate. In recent years, new studies and reviews attribute some benefit to applying chlorhexidine on the umbilical stump. An analysis is presented here of the available evidence and results in the advisability of still recommending the dry cord care in the newborns in our setting.

Research paper thumbnail of Recomendaciones para la prevención, la detección y el manejo de la hiperbilirrubinemia en los recién nacidos con 35 o más semanas de edad gestacional

Anales de Pediatría, 2017

Cómo citar este artículo: Sánchez-Redondo Sánchez-Gabriel MD, et al. Recomendaciones para la prev... more Cómo citar este artículo: Sánchez-Redondo Sánchez-Gabriel MD, et al. Recomendaciones para la prevención, la detección y el manejo de la hiperbilirrubinemia en los recién nacidos con 35 o más semanas de edad gestacional. An Pediatr (Barc). 2017.

Research paper thumbnail of Implementation of NeoKissEs in Spain: A validated surveillance system for nosocomial sepsis in very low birth weight infants

Anales de Pediatría (English Edition), 2018

Background: Bloodstream infections (BSIs) are the most frequent nosocomial infections in neonatal... more Background: Bloodstream infections (BSIs) are the most frequent nosocomial infections in neonatal intensive care units (NICUs), especially in very low birth weight (VLBW) infants (birth weight ≤ 1500 g). An epidemiologic surveillance system may contribute to the prevention of infection by continuous monitoring of its frequency and associated risk factors. The aim of this article was to describe the implementation of the NeoKissEs surveillance system for BSIs in VLBW newborns in a group of Spanish NICUs.

Research paper thumbnail of Umbilical cord and visceral hemangiomas diagnosed in the neonatal period

Medicine, 2016

Background: Umbilical cord hemangioma is very rare and may not be detected prenatally. However, i... more Background: Umbilical cord hemangioma is very rare and may not be detected prenatally. However, it should be considered in differential diagnosis with other umbilical masses because it can cause significant morbidity. Methods: We report the case of a newborn referred with suspected omphalitis and umbilical hernia. Results: Physical examination showed an irreducible umbilical tumor, the size of olive, with dubious secretion. The initial suspected diagnosis was urachal or omphalomesenteric duct remnants. Abdominal ultrasound and magnetic resonance imaging showed an umbilical and a mesenteric mass. Tumor markers were negative. A definitive diagnosis of umbilical cord and intestinal hemangioma was established after surgical excision and histologic examination of the umbilical mass. Propranolol was prescribed due to the extent of the intestinal lesion. Conclusion: This report highlights the diagnostic challenges of hemangiomas in unusual locations. Apart from the rarity of these tumors, few tests are available to guide diagnosis, and surgery and histologic examination are generally required for a definitive diagnosis. Finally, it is essential to rule out associated malformations and hemangiomas in other locations. Abbreviations: MRI = magnetic resonance imaging, US = ultrasound.

Research paper thumbnail of Long-term pharmacological management of phenylketonuria, including patients below the age of 4 years

JIMD reports, 2012

BH4 therapy is an advancement in the treatment of phenylketonuria, reducing blood phenylalanine (... more BH4 therapy is an advancement in the treatment of phenylketonuria, reducing blood phenylalanine (phe) levels and increasing tolerance to natural proteins of responding patients. We report the results of 16 patients undergoing long-term BH4 treatment. Responding patients to BH4 was usually based on 24-h loading tests; a ≥30% decrease in blood phe was considered a positive response. Weekly loading made it possible to identify an additional "slow responder." The 16 responders constitute 24.6% of patients who completed the trial (87.5% of responders in mild hyperphenylalaninemia, 38.1% in mild PKU, and 2.8% in classical PKU).Mean dose of BH4 used was 9.75 ± 0.9 mg/kg per day, during a mean of 62 months. Age at treatment start was below 4 years in seven patients; five of which begun treatment during their first month since birth. All but one patient showed good treatment compliance; six continue on BH4 monotherapy without dietary phe restriction; six showed an increase in phe t...

Research paper thumbnail of Preclinical Screening for Retinopathy of Prematurity Risk Using IGF1 Levels at 3 Weeks Post-Partum

PLoS ONE, 2014

Following current recommendations for preventing retinopathy of prematurity (ROP) involves screen... more Following current recommendations for preventing retinopathy of prematurity (ROP) involves screening a large number of patients. We performed a prospective study to establish a useful screening system for ROP prediction and we have determined that measuring serum levels of IGF1 at week three and the presence of sepsis have a high predictive value for the subsequent development of ROP. A total of 145 premature newborn, with birthweight ,1500 g and/or ,32 weeks gestational age, were enrolled. 26.9% of them showed some form of retinopathy. A significant association was found between the development of retinopathy and each of the following variables: early gestational age, low birthweight, requiring mechanical ventilation, oxygen treatment, intracranial haemorrhage, sepsis during the first three weeks, bronchopulmonary dysplasia, the need for erythrocyte transfusion, erythropoietin treatment, and low levels of serum IGF1 in the third week. A multiple logistic regression analysis was used to obtain curves for the probability of developing ROP, based on the main factors linked with ROP, namely serum levels of IGF1 and presence of sepsis. Such preclinical screening has the ability to identify patients with high-risk of developing retinopathy and should lead to better prediction for ROP, while at the same time optimising the use of clinical resources, both human and material.

Research paper thumbnail of Corticoides antenatales y prevención del distrés respiratorio del recién nacido prematuro: utilidad de la terapia de rescate

Anales de Pediatría, 2014

Research paper thumbnail of Utilidad de la distracción mandibular en la secuencia de Pierre Robin en el período neonatal

Anales de Pediatría, 2014

Research paper thumbnail of Effects of Maternal Stress on Breast Milk Production and the Microbiota of Very Premature Infants

Nutrients

Perinatal stress experienced by mothers of very premature newborns may influence the mother’s mil... more Perinatal stress experienced by mothers of very premature newborns may influence the mother’s milk and the infant’s intestinal microbiota. This prospective study of mothers of very preterm infants fed with mother’s own milk (MOM) was carried out in a tertiary hospital over a 2-year period. The assessment of maternal stress in 45 mothers of 52 very preterm newborns using the parental stress scale (PSS:NICU) revealed an inverse relationship between stress and MOM production in the first days of life (p = 0.012). The greatest contributor to stress was the one related to the establishment of a mother–child bond. Maternal stress was lower in mothers in whom the kangaroo method was established early (p = 0.011) and in those with a higher educational level (p = 0.032). Levels of fecal calprotectin (FC) decreased with the passage of days and were directly correlated with birthweight (p = 0.044). FC levels 7 days post-delivery were lower in newborns that received postnatal antibiotics (p = 0...

Research paper thumbnail of Meconium plug syndrome in twins

Anales de Pediatría (English Edition)

Research paper thumbnail of Niveles asistenciales en las unidades neonatales en España: Una visión actualizada para una nueva realidad

Research paper thumbnail of Recomendaciones para la transfusión de hemoderivados en neonatología

Research paper thumbnail of Home births: A growing phenomenon with potential risks

Anales de Pediatría (English Edition), 2020

Home birth is a controversial issue that raises safety concerns for paediatricians and obstetrici... more Home birth is a controversial issue that raises safety concerns for paediatricians and obstetricians. Hospital birth was the cornerstone to reduce maternal and neonatal mortality. This reduction in mortality has resulted in considering pregnancy and childbirth as a safe procedure, which, together with a greater social awareness of the need for the humanisation of these processes, have led to an increase in the demand for home birth. Studies from countries such as Australia, the Netherlands, and United Kingdom show that home birth can provide advantages to the mother and the newborn. It needs to be provided with sufficient material means, and should be attended by trained and accredited professionals, and needs to be perfectly coordinated with the hospital obstetrics and neonatology units, in order to guarantee its safety. Therefore, in our environment, there are no safety data or sufficient scientific evidence to support home births at present.

Research paper thumbnail of La osteoartritis neonatal: diagnóstico a recordar

Acta pediátrica española, 2006

Research paper thumbnail of Parto domiciliario: un fenómeno creciente con potenciales riesgos

Anales de Pediatría, 2020

Recibido el 25 de marzo de 2020; aceptado el 2 de abril de 2020 PALABRAS CLAVE Humanización; Mort... more Recibido el 25 de marzo de 2020; aceptado el 2 de abril de 2020 PALABRAS CLAVE Humanización; Mortalidad perinatal; Parto de bajo riesgo; Recién nacido; Seguridad Resumen El parto extrahospitalario es un tema controvertido que genera dudas a obstetras y pediatras sobre su seguridad. El nacimiento hospitalario fue la pieza clave en la reducción de la mortalidad materna y neonatal. Esta reducción en la mortalidad ha derivado en considerar el embarazo y el parto como fenómenos seguros, lo que, unido a una mayor conciencia social de la necesidad de humanización de estos procesos, ha conducido a un aumento en la demanda del parto domiciliario. Estudios en países como Australia, Holanda y Reino Unido muestran que el parto en casa puede aportar ventajas para la madre y el recién nacido, pero es necesario que se dote de los suficientes medios materiales, que sea atendido por profesionales formados y acreditados, y que se encuentre perfectamente coordinado con las unidades de obstetricia y neonatología hospitalarias, para poder garantizar su seguridad. En nuestro medio, no hay suficientes datos de seguridad ni evidencia científica que avalen el parto domiciliario en la actualidad.