Umbilical Cord Management at Term and Late Preterm Birth: A Meta-analysis. The authors evaluated 46 studies (9159 women and their infants). Compared with early cord clamping <30 seconds, delayed cord clamping ≥30 seconds (33 studies), intact-cord milking (1 study), and cut-cord milking (2 studies) may have improved hematologic measures in infants ≥34 weeks' gestation but did not alter survival without neurodisability, anemia in early infancy, or maternal postpartum hemorrhage. No differences in major neonatal morbidities were seen with optimized placental transfusion (DCC versus cut-cord milking [3 studies], longer delays in clamping [7 studies], or physiologic parameters [3 studies]). Strategies to promote placental transfusion might have been associated with greater phototherapy use. The evidence for all outcomes was low or very low certainty.
Multi-kingdom ecological drivers of microbiota assembly in preterm infants. The composition of the gut microbiota may be vital to the health of preterm. The authors used a technique of multi-kingdom absolute abundance quantification, ecological modelling and experimental validation in a longitudinal cohort of 178 preterm infants. They noted an inverse correlation between bacterial and fungal loads in the infant gut. A late-arriving member of the microbiome, Klebsiella, seems to exploit the pioneer microorganism, Staphylococcus, to gain a foothold within the gut. They also observed that interactions between different kingdoms can influence assembly, with a single fungal species, Candida albicans, inhibiting multiple dominant genera of gut bacteria. Microbe-microbe interactions may be important in shaping host-associated microbiota, an important finding in our understanding of microbiota ecology and for designing targeted microbiota interventions.
Genetic Factors Underlying Sudden Infant Death Syndrome. The causes of Sudden Infant Death syndrome (SIDS) remain unclear, but increasing information suggests that there may be some genetic underpinnings of this devastating phenomenon. The authors identify that some cases may be associated with abnormalities in genes involved in metabolic pathways, those associated with long QT syndrome and hereditary cardiac arrhythmias, serotonergic system in the brainstem, early-onset seizure disorders, inflammation, and rarely, with myasthenic syndrome, central hypoventilation, autonomic nervous system abnormalities, and some mitochondrial conditions.
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