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Aragona E, Joshi NS, Birnie KL, Lysouvakon P, Basuray RG. Early Experiences With Nirsevimab: Perspectives From Newborn Hospitalists. Hosp Pediatr 2024; 14:e170-e172. [PMID: 38115681 DOI: 10.1542/hpeds.2023-007639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Affiliation(s)
| | - Neha S Joshi
- Stanford University School of Medicine, Stanford, California
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Gupta Basuray R, Cacioppo C, Inuzuka V, Cooper K, Hardy C, Perry MF. Increasing Exclusive Nursery Care of Late Preterm and Low Birth Weight Infants. Hosp Pediatr 2023; 13:992-1000. [PMID: 37818615 DOI: 10.1542/hpeds.2022-007037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Late preterm (LPT) and low birth weight (LBW) infants are populations at increased risk for NICU admission, partly due to feeding-related conditions. This study was aimed to increase the percentage of LPT and LBW infants receiving exclusive nursery care using quality improvement methodologies. METHODS A multidisciplinary team implemented interventions at a single academic center. Included infants were 35 to 36 weeks gestational age and term infants with birth weights <2500 g admitted from the delivery room to the nursery. Drivers of change included feeding protocol, knowledge, and care standardization. We used statistical process control charts to track data over time. The primary outcome was the percentage of infants receiving exclusive nursery care. Secondary outcomes included rates of hypoglycemia, phototherapy, and average weight loss. Balancing measures were exclusive breast milk feeding rates and length of stay. RESULTS Included infants totaled 1336. The percentage of LPT and LBW infants receiving exclusive nursery care increased from 83.9% to 88.8% with special cause variation starting 1 month into the postintervention period. Reduction in neonatal hypoglycemia, 51.7% to 45.1%, coincided. Among infants receiving exclusive nursery care, phototherapy, weight loss, exclusive breast milk feeding, and length of stay had no special cause variation. CONCLUSIONS Interventions involving a nursery feeding protocol, knowledge, and standardization of care for LPT and LBW infants were associated with increased exclusive nursery care (4.9%) and reduced rates of neonatal hypoglycemia (6.6%) without adverse effects. This quality initiative allowed for the preservation of the mother-infant dyad using high-value care.
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Affiliation(s)
- Rakhi Gupta Basuray
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
- Division of Pediatric Hospital Medicine
| | - Carrie Cacioppo
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio
- Division of Pediatric Hospital Medicine
| | - Vanessa Inuzuka
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Keri Cooper
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Charles Hardy
- Center for Clinical Excellence, Nationwide Children's Hospital, Columbus, Ohio
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Eid J, Post S, Guhde H, Basuray RG, Sanchez PJ, Costantine MM, Rood KM. Increasing rates of sars-cov-2 infection in newborns during the omicron variant epoch. Am J Reprod Immunol 2023; 90:e13742. [PMID: 37491920 DOI: 10.1111/aji.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
PROBLEM Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from infected pregnant individuals to the fetus or newborn occurs from 1.2% to 4.3%. Our aim was to determine the rate of positivity among newborns delivered to infected mothers during epochs of different variants predominance. METHOD OF STUDY This is a single academic center retrospective cohort study where we reviewed the electronic health records of pregnant individuals who tested positive for SARS-CoV-2 infection and their newborns from March 2020 through January 2022. Infants born to SARS-CoV-2-positive mothers at the time of delivery or within 10 days of admission were tested for SARS-CoV-2 infection at 24-36 h of age. RESULTS A total of 195 mothers were positive at delivery or within 10 days of admission and had their newborns tested for SARS-CoV-2. Seven newborns (3.6%) were positive. All positive infants were asymptomatic and born to unvaccinated mothers. Newborn positivity for SARS-CoV-2 was highest during the Omicron epoch (9.4%, p = .01). CONCLUSION Increasing positivity rate was seen during the Omicron variant predominance. This could be attributed to postnatal acquisition of the virus, as Omicron has been associated with higher transmissibility in older children and adults.
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Affiliation(s)
- Joe Eid
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio, USA
| | - Sara Post
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio, USA
| | - Heather Guhde
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio, USA
| | - Rakhi Gupta Basuray
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio, USA
| | - Pablo J Sanchez
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Maged M Costantine
- Department of Pediatrics, Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children's Hospital, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Kara M Rood
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio, USA
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Westphal K, Basuray RG, Keesari R, Jackson K, Reber K, Cacioppo C, Splinter A, Bode RS. Neonatal Use of Acute Care Services During the COVID-19 Pandemic. Hosp Pediatr 2022; 12:e190-e198. [PMID: 35506337 DOI: 10.1542/hpeds.2021-006397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe changes in neonatal use of acute care services during the coronavirus disease 2019 (COVID-19) pandemic. We hypothesized neonatal visits would decrease and the degree of decline would vary by condition. METHODS We conducted a retrospective cohort study of neonatal visits to the urgent cares, emergency departments, inpatient units, and intensive care units at a free-standing pediatric healthcare system during the COVID-19 pandemic and a comparator period. We included visits of infants presenting for acute care within the first 30 days of life. Transfers from a referring nursery, inpatient unit, or ICU were excluded. Data collected included demographics, patient characteristics, and visit characteristics. Descriptive statistics and χ2 tests were used for analyses and to determine statistically significant differences. RESULTS We identified 4439 neonatal acute care visits, of which 2677 occurred in the prepandemic period and 1762 in the COVID-19 pandemic period, representing a 34.2% decline. Urgent cares and emergency departments experienced the greatest decline in visits for infectious conditions (49%) and the proportion of these visits also significantly decreased. Similarly, the largest clinically significant declines in hospitalizations were for infectious and respiratory diagnoses (48% and 52%, respectively) and the proportions of these hospitalizations also significantly decreased. Despite a small decline in hospitalizations for jaundice, the proportion of jaundice hospitalizations significantly increased by 5.7% (P = .02). CONCLUSIONS The COVID-19 pandemic was associated with a significant reduction in neonatal visits across a spectrum of acute care settings. The impact on use varied by diagnosis with the most notable decline in visits for infectious conditions.
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Affiliation(s)
- Kathryn Westphal
- Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Rakhi Gupta Basuray
- Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Rohali Keesari
- Biostatistics Resource at Nationwide Children's Hospital, Columbus, Ohio
| | - Kenneth Jackson
- Biostatistics Resource at Nationwide Children's Hospital, Columbus, Ohio.,Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Kristina Reber
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.,Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
| | - Carrie Cacioppo
- Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Ansley Splinter
- Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
| | - Ryan S Bode
- Division of Hospital Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
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Nahata L, DaJusta D, Gupta Basuray R. The Male Genital Examination: Overcoming Barriers to Prevent Missed Diagnoses. Clin Pediatr (Phila) 2015; 54:1237-9. [PMID: 25813382 DOI: 10.1177/0009922815577962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Leena Nahata
- Nationwide Children's Hospital, Columbus, OH, USA
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