Causes of neonatal mortality differ in US home, hospital births | Group releases updated recommendations on underwater labor, delivery | Preemies with RSV have high ICU admission rates, study says
November 7, 2016
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Causes of neonatal mortality differ in US home, hospital births
Midwife-attended home births in the US had a mortality rate of nearly 13 deaths per 10,000 deliveries, 39% of which were linked to labor and delivery problems, while 30% were tied to birth defects and 12% to infections. The findings in the Journal of Perinatal Medicine, based on data involving 15.9 million babies born between 2008 and 2012, found a mortality rate of 6 deaths for every 10,000 hospital deliveries by a doctor and 3.5 for hospital midwife-attended deliveries, most of which were due to congenital defects.
Reuters (11/2) 
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Patient Safety & Clinical Update
Group releases updated recommendations on underwater labor, delivery
The American College of Obstetricians and Gynecologists has issued updated guidance saying that healthy women with uncomplicated pregnancies of 37 to 45 weeks can receive water immersion during the first stage of labor but should not deliver in water. The guidelines, published in the journal Obstetrics & Gynecology, caution that water deliveries can lead to serious health problems.
AAP News (10/26),  HealthDay News (10/25) 
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Preemies with RSV have high ICU admission rates, study says
Premature infants under the age of 3 months who had not received immunoprophylaxis had higher rates of ICU admission and mechanical ventilation for respiratory syncytial virus than those ages 3 months to 1 year, researchers reported at IDWeek 2016. Researchers said the youngest infants with severe RSV had ICU admission rates of 60% or higher in the first RSV season of the study and up to 40% in the second season.
Healio (free registration)/Infectious Diseases in Children (10/28) 
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Preemies may benefit from partial antenatal steroid treatment
Researchers found that extremely preterm infants who underwent complete steroid treatment had the lowest rates of mortality and complications such as bronchopulmonary dysplasia, necrotizing enterocolitis, neurodevelopmental impairment and severe intracranial hemorrhage, but those who received partial treatment had better outcomes than those who didn't receive steroid treatment. The findings in JAMA Pediatrics "support prompt administration of antenatal steroids, with the goal of a complete course prior to delivery," researchers wrote.
Physician's Briefing/HealthDay News (10/10) 
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Study links mom's SSRI use to higher risk of NICU admission
Infants born to women who used selective serotonin reuptake inhibitors during pregnancy were more likely to be admitted to a NICU, compared with infants of mothers who did not use the medications. Researchers reported in Pediatrics that a mother's use of SSRI antidepressants during pregnancy was linked to a higher risk of infant respiratory disorders and other complications, and SSRI use in late pregnancy was tied to a higher risk of feeding difficulties.
2 Minute Medicine (10/25) 
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HPV-vaccinated women may need fewer cervical cancer screenings
Women who received vaccination against human papillomavirus may require less frequent cervical cancer screenings than recommended -- every 10 years beginning at age 30 or 35 until age 65 for those vaccinated with HPV 9-valent vaccine and every five years starting at age 25 or 30 for those who received earlier versions of the vaccine, according to a study in the Journal of the National Cancer Institute. Researchers concluded health care providers could use an HPV test, instead of a Pap smear, for HPV-vaccinated women. (10/18),  HealthDay News (10/17) 
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Birth timing after bariatric surgery affects health risks
Researchers found that infants whose mothers underwent bariatric surgery before birth were 93%, 57% and 25% more likely to be small for gestational age, premature and admitted to the NICU, respectively, compared with those whose mothers didn't have the surgery. The findings in JAMA Surgery, based on birth certificates and hospital records involving 10,296 mothers, also showed a nearly 50% higher underweight, preterm birth and NICU admission risk among those whose mothers gave birth less than two years after surgery, compared with those whose mothers conceived at least four years later.
Reuters (10/19),  HealthDay News (10/20) 
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Professional Practice
RNs: Hospital details make a difference when women give birth
Registered nurses in the maternity ward at Community Hospital in Grand Junction, Colo., say details make a difference to women giving birth and their families. "There are lots of studies out there that prove changing the environment, whether it be through clothing such as a different gown, scents on their own pillow, or their own music; those kinds of things actually provide comfort," said RN Kristel Vanhoose.
KJCT-TV (Grand Junction, Colo.) (10/27) 
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Policy, Ethics & Legal Update
USPSTF calls for improved breast-feeding interventions
The US Preventive Services Task Force recommended that health care professionals encourage breast-feeding among women during pregnancy, offer one-on-one counseling to new mothers, and provide psychological support to those needing breast-feeding reassurance. However, the recommendations in the Journal of the American Medical Association, based on a review of 43 studies, advised against unnecessary pressure on mothers who don't wish to or cannot breast-feed.
Los Angeles Times (tiered subscription model) (10/25),  Reuters (10/25) 
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Technology & Trends
Researchers use fMRI technique to monitor fetal brain activity
A breakthrough functional MRI-based 4D video of fetal default mode network activity, created by University of Washington researchers, provides insight on brain development before and after birth, according to a study in Human Brain Mapping. The findings, based on imaging from eight fetuses between 32 and 37 weeks of gestation, suggest the approach could be used to determine brain development differences between preterm and full-term infants and those with neurodevelopmental disorders such as autism and alcohol or drug exposure, researchers said.
United Press International (10/13),  ScienceDaily/News release (10/12) 
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News from NCC
NCC president inducted into American Academy of Nursing as a fellow
NCC President, Suzanne Staebler
NCC President Suzanne Staebler
The National Certification Corporation (NCC) is pleased to announce the induction of NCC President, Suzanne Staebler, DNP, APRN, NNP-BC, FAANP, FAAN into the American Academy of Nursing as a fellow. NCC is proud of the achievements of its president and know that her dedication and passion will continue to enhance neonatal nursing practice and improve patient outcomes. Read more.
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The Alternate Certification Program (ACP) for Nurse Practitioners
The National Certification Corporation (NCC) is pleased to announce The Alternate Certification Program (ACP) for Neonatal Nurse Practitioners and Women's Health Care Nurse Practitioners. This program offers graduate prepared Neonatal or Women's Health Care Nurse Practitioners who wish to achieve national certification, but are not currently eligible, an opportunity to sit for their NCC national board certification exam. Read more.
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Resources from NCC ... most are free!
The National Certification Corporation (NCC) has various programs that support specific specialties, best practices and recognition for the certified professional -- most are free! Visit the sites and take advantage of these resources. Read more.
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Would you like a free Golden Hour Book?
Golden Hours
Share your story using our video app for your chance to win. NCC will randomly select five of the videos uploaded this month to receive a prize. Those selected will have an opportunity to choose either a free NCC CE module or a copy of Golden Hours -- Care of the Very Low Birth Weight Infant an essential resource for providers or students who desire a practical guide for most common clinical situations and problems that may arise. Read more.
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Learn more about NCC:
National Certification Corporation
The goal is not always meant to be reached, but to serve as a mark for our aim.
Joseph Joubert,
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About NCC
The National Certification Corporation is a not for profit organization that provides national credentialing programs and continuing education opportunities to nurses, physicians and other licensed health care professionals within the obstetric, neonatal and women's health care specialties. NCC has awarded more than 115,000 certifications or certificates of added qualification since its inception in 1975.
Learn more about certification and continuing education opportunities for obstetric, neonatal and women's health care professionals –
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