Outborn Newborns Drive Birth Asphyxia Mortality Rates: A Nine-Year Analysis at a Rural Level 2 Nursery in Uganda

Birth asphyxia is a leading cause of global neonatal mortality, with the vast majority of cases in low- and middle- income countries. While the global death rate from asphyxia has decreased over the last 30 years, it is increasing in Uganda and makes up half of neonatal deaths. Improved understanding of the risk factors associated with mortality among these patients is needed.

Barriers Limiting Access to Caffeine for Preterm Infants with Apnea of Prematurity in Low- and Middle-Income Countries (LMICs): Findings from a Landscaping Conducted in Nigeria, Ethiopia, Kenya, South Africa, and India 

Every year, 15 million babies are born preterm. Preterm complications are the leading cause of death among children under five years of age, and responsible for one million deaths in 2015. A driver of premature deaths is apnea of prematurity (AOP), which is the cessation of breathing lasting more than 15 seconds. A drug, caffeine citrate, listed in the World Health Organization (WHO) Essential Medicines List (EML) and recommended as a drug of choice in neonatal guidelines, can prevent and treat AOP. While caffeine is the mainstay of prevention and treatment in high-income countries, it is not widely used in low-income countries, where more preterm deaths occur. An alternative, Aminophylline, is more commonly used in low- and middle-income countries (LMICs) even though evidence shows that caffeine has a better side effect profile, lower toxicity, and requires less monitoring.

Bubble Continuous Positive Airway Pressure (CPAP) with a Blender (Vayu) Is Associated with Immediate Improvement in Physiologic and Clinical Parameters 

Respiratory distress syndrome (RDS) often complicates the clinical course of premature infants less than 2,000 grams, with progressive respiratory failure if untreated. Continuous positive airway pressure (CPAP) has been shown to modulate the clinical course. A novel compact bubble CPAP system with an ambient/oxygen blender developed by Vayu has the potential to modify the course of RDS. The objective was to determine whether use of Vayu CPAP will be associated with improvement in physiologic and clinical parameters, i.e., heart rate (HR), O2 saturation, FiO2 requirement, respiratory rate (RR), respiratory distress assessed by Silverman score (SS), and whether it modifies the clinical course of premature infants with RDS.

Immediate Skin-to-Skin Contact May Have Beneficial Effects on the Cardiorespiratory Stabilisation in Very Preterm Infants 

The transition from foetal to newborn life is a period of rapid physiological change. The first hour of life is referred to as the golden hour, because initial strategies in newborn care may lead to a better start to life and subsequently optimal long-term health and development. Preterm newborns are typically cared for in incubators in the immediate period following birth. It is suggested that mother-infant regulation of physiological systems is desirable immediately after birth.