Latest news with #prematureinfants
Medscape
2 days ago
- Health
- Medscape
NIPPV Outperforms NCPAP in Premature Infant Lung Care
TOPLINE: Nasal intermittent positive pressure ventilation (NIPPV) reduced the risk of requiring invasive ventilation and developing bronchopulmonary dysplasia by nearly half compared with nasal continuous positive airway pressure (NCPAP) in premature infants with respiratory distress syndrome. METHODOLOGY: Researchers conducted an updated meta-analysis of 14 randomized trials involving 1755 premature infants (< 37 weeks' gestation) with respiratory distress syndrome to compare NIPPV with NCPAP as their initial respiratory support. Data were gathered through systematic searches of Medline, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials for studies published between 1980 and February 2022. Primary outcomes were the incidence of invasive ventilation and bronchopulmonary dysplasia. Subgroup analyses were stratified by — infants who received surfactant treatment, gestational age (> 30 or ≤ 30 weeks), and birth weight (> or ≤ 1500 g). Secondary outcomes included mortality, pulmonary air leaks, retinopathy of prematurity stage ≥ 2, necrotizing enterocolitis Bell stage ≥ 2, and intraventricular hemorrhage grade ≥ 3. TAKEAWAY: NIPPV demonstrated superior efficacy with a 47% reduction in the incidence of invasive ventilation requirement (relative risk [RR], 0.53; P < .001) and a 49% reduction in the incidence of bronchopulmonary dysplasia (RR, 0.48; P = .004) compared with NCPAP. Benefits of NIPPV on invasive ventilation incidence persisted across subgroups defined by gestational age, birth weight, and surfactant treatment. However, reductions in bronchopulmonary dysplasia were significant only when stratified by gestational age. Secondary outcomes showed no significant differences between groups. No increase in pneumothorax was observed with NIPPV. IN PRACTICE: 'While these findings are promising, higher-quality randomized controlled trials with standardized protocols are needed before definitive clinical recommendations can be established,' the authors of the study wrote. SOURCE: This study was led by Juan Zeng, Southwest Hospital of Army Medical University, and Rong Tan, Jiulongpo People's Hospital, both in Chongqing, China. It was published online on June 28, 2025, in the European Journal of Pediatrics. LIMITATIONS: Although synchronized NIPPV may offer advantages over nonsynchronized NIPPV, insufficient data prevented subgroup comparisons of the two modes. As most trials enrolled infants with gestational age > 30 weeks, the findings may not be generalizable to extremely premature neonates. Finally, the overall low methodological quality and limited number of robust, high-quality studies reduce confidence in these conclusions. DISCLOSURES: The authors declared that they did not receive any funds, grants, or other support. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Reuters
04-06-2025
- Health
- Reuters
Thousands of lawsuits over baby formula should stay where filed, court says
CHICAGO, June 4 (Reuters) - An Illinois appeals court said on Tuesday that thousands of lawsuits claiming baby formula made by Abbott Laboratories and a Reckitt Benckiser subsidiary causes a dangerous disease in preterm infants should stay in the court where they were filed, a venue considered plaintiff friendly. The Appellate Court of Illinois' 5th District upheld, opens new tab a lower court's ruling rejecting Abbott and Mead Johnson's motions to transfer the lawsuits out of Madison County, Illinois. The decision allows the claims to move forward in what is often viewed as a plaintiff-friendly county court. Madison County is often flagged by tort reform groups as a jurisdiction known for outsize jury verdicts against corporate defendants. The appellate court, however, reversed the lower court's ruling denying the companies' separate motion to transfer or dismiss the lawsuits based on their argument that the cases were filed in an inconvenient location. The appeals court sent that ruling back to the lower court for reconsideration. A representative for Mead Johnson said in a statement that the company will continue to pursue dismissal of the cases in Madison County, many of which don't involve Mead Johnson products or injuries that occurred in the county. The representative said that plaintiffs' lawyers were trying to "coerce settlement by building a large inventory of claims, even when plaintiffs' lawyers have no intention of ever trying them,' the company said. A spokesperson for Abbott Laboratories did not respond to a request for comment. Tor Hoerman, one of the attorneys for the plaintiffs said in a statement that the ruling "reinforces the importance of corporate accountability and helps ensure that families impacted by these tragic injuries can seek justice in the appropriate forum." All of the lawsuits allege that the companies failed to warn that their specialized formulas used by newborn intensive care units in hospitals could cause necrotizing enterocolitis, a disease that almost exclusively affects premature infants and has an estimated mortality rate of more than 20%. The companies have denied the claims, saying that while breast milk protects against NEC, formula does not cause it, and that the benefits of breast milk have long been known to clinicians. In addition to state court cases in Illinois, Missouri and Pennsylvania, a federal multidistrict litigation with more than 700 cases over the claims is moving forward in Chicago, according to court records. The same Illinois appeals court is also considering a similar dispute over transferring more cases over the preterm formula that are currently pending in St. Clair County, Illinois, another court targeted by tort reformers for being plaintiff-friendly. In 2024, a jury in St. Clair County ordered Mead Johnson to pay $60 million to the mother of a premature baby who died after being fed the company's Enfamil baby formula. A few months later, a St. Louis, Missouri, jury ordered Abbott to pay $495 million in damages in another case. Both companies prevailed in the most recent trial, in October. However, the judge in that case in March ordered a new trial, finding that lawyers for the defendants had acted improperly. The case is Jupiter v. Mead Johnson and Co LLC, Appellate Court of Illinois, Fifth District, No. 230248. For the plaintiffs: Ashley Keller and Benjamin Whiting of Keller Postman; Tor Hoerman of TorHoerman Law; and David Cates of Cates Law Firm For Abbott Laboratories: Linda Coberly and Stephen D'Amore of Winston & Strawn; Thomas Kilbride and Adam Vaught of Kilbride & Vaught; and W. Jason Rankin and Emilee Bramstedt of HeplerBroom For Mead Johnson: Joel Bertocchi of Akerman; Anthony Anscombe and Darlene Alt of Steptoe & Johnson; and Donald Flack of Bartholomew, Shevlin & Flack
Medscape
22-05-2025
- Health
- Medscape
Exposure to Antibiotics Preterm May Affect Lung Function
Premature infants exposed to multiple courses of antibiotics around the time of birth had weaker lung function and a higher risk for asthma episodes by early school age than those with lower exposure. METHODOLOGY: The study analyzed 3820 premature infants born between 22 and 36 weeks of gestation with low birth weights (< 1500 g); the infants were enrolled from 58 hospitals across Germany over an 8-year period starting in January 2009. Researchers divided the infants into three groups: Low-risk, or those exposed via their mothers who were given surgical antimicrobial prophylaxis in the 30 minutes before delivery; intermediate-risk, or children exposed prenatally and after birth; and high-risk, or children who had been exposed within 7 days of delivery prenatally, again at 30 minutes prior to birth, and after birth. The primary outcome was the lung function and the amount of air each infant exhaled in the first second of forced exhalation, measured at ages 5-7 years. Secondary outcomes included the total amount of air exhaled or forced vital capacity and asthma episodes during childhood. The analysis included 3109 participants born by cesarean delivery, with 292 (9.4%) in the low-risk group, 1329 (42.7%) in the intermediate-risk group, and 1488 (47.9%) in the high-risk group. TAKEAWAY: Children with intermediate risk scores had poorer lung function than those with low risk scores, as shown by lower forced exhalation in one second outcomes (β, −0.31; 95% CI, −0.59 to −0.02; P = .03). = .03). Those with high-risk antibiotic exposure vs intermediate risk had lower forced vital capacity scores (β, −0.23; 95% CI, −0.43 to −0.03; P = .02). = .02). Children with the highest level of exposure to antibiotics had a higher risk for early childhood asthma episodes than those with intermediate risk (odds ratio, 1.91; 95% CI, 1.32-2.76; P = .001). IN PRACTICE: 'Early identification of high-risk neonates may enable targeted strategies to support respiratory health and optimize long-term outcomes,' the study authors wrote. SOURCE: The study was led by Ingmar Fortmann, MD, of the Department of Pediatrics at the University Hospital of Schleswig-Holstein at Campus Lübeck in Lübeck, Germany. It was published online on May 12 in JAMA Network Open . LIMITATIONS: The study had a low median follow-up rate that varied across clinics. The researchers did not have details on the dosage of antibiotics. Only children well enough to take lung function tests were included. Infants who received more antibiotics already had poor health status, which may have accounted for some of the findings. DISCLOSURES: One or more study authors reported receiving financial support fromthe Advanced Clinician Scientist Program and Section of Medicine at the University of Lübeck, personal fees from Chiesi, and grants from the German Federal Ministry of Education and Research. No other disclosures were reported.
