Preface

Chapter 8 **Fungal Infections in Neonatal Intensive Care 109**

Chapter 10 **Pre- and Postnatal Surgery, Most Common Conditions,**

Chapter 11 **Update on Neonatal Male Circumcision: A Public Health**

**Section 4 Miscellaneous Topics in the Field of Neonatal Health 189**

Koichi Miyake, Noriko Miyake and Takashi Shimada

Chapter 13 **Endocrine Active Compounds Actions during Neonatal Period:**

Maria Slomczynska, Malgorzata Grzesiak and Katarzyna Knapczyk-

Chapter 12 **Neonatal Gene Therapy for Inherited Disorders 191**

Chapter 14 **Reducing Early Neonatal Mortality in Nigeria—The**

Hippolite O. Amadi and Mohammed B. Kawuwa

Reginaldo G. Lima-Neto

Esra Caliskan

**Perspective 167**

García

**VI** Contents

Stwora

**Solution 221**

**Section 3 Selected Topics in Surgical Problems 123**

Chapter 9 **Neonatal Care for Anesthesiologists 125**

**Diagnosis and Treatment 143**

Kriengkrai Srithanaviboonchai

**Effect on the Ovary 201**

Rejane P. Neves, Ana Maria R. de Carvalho Parahym, Carolina M. da Silva, Danielle P.C. Macêdo, André F.G. Leal, Henrique J. Neves and

Carlos Baeza Herrera, Alin Villalobos Castillejos and Ricardo Cortés

Neonatal care includes a wide range of aspects that are necessary to provide the support that assures the best outcome in the care of premature and sick newborn. The technoscientif‐ ic advances in this area have led to an increase in these babies' survival, who are sometimes in need of sophisticated care. However, there are essential levels of care that all centers that look after high-risk newborns must include.

During neonatal care, the health team faces a variety of crucial problems in the evolution of neonates. This book includes important topics related to neonatal care grouped into four sections. In 14 chapters that address relevant issues about neonatal care, the book seeks to contribute to the clinical work of the health teams of neonatal units.

The first section of this book focuses on the critical issues in neonatal care presented in the first hours of life. Chapter 1 introduces global and fundamental aspects of neonatal care. Chapter 2 refers to different procedures, scopes and possibilities in the very first hour of life, "the golden hour," both short and long term, and analyzes psychological and physiological aspects during this period. Chapter 3 develops important elements regarding the assessment of the hemody‐ namic stability of neonates and analyzes different measurement methods and their benefits and limitations. Chapter 4 assesses the relevant actions of respiratory care, analyzing the tran‐ sition from fetal to neonatal breathing and respiratory support in the delivery room to noninvasive and invasive respiratory support methods. Chapter 5 closes this section by showing the state of the art of the pathophysiology, diagnosis and therapy of neonatal hypoglycemia with emphasis on the pathogenesis of congenital hyperinsulinemic hypoglycemia.

Section II groups three selected topics on neonatal infection. Chapter 6 includes epidemio‐ logical, diagnostic, therapeutic and prognostic aspects of neonatal meningitis. Chapter 7 de‐ velops neonatal osteomyelitis, a problem that, although infrequent, can cause serious complications; it discusses the clinical presentation, general approach, diagnosis and thera‐ peutic management. This section is completed with Chapter 8 on fungal infections in the neonatal intensive care unit, in which the epidemiology of this type of infection is described, and candida infection, as well as other neonatal fungal infections, is also discussed.

Section III includes selected topics on surgical problems. This section includes Chapter 9 that develops important aspects of neonatal care related to anesthesia. This topic includes general principles, elements of anesthetic preparation and intraoperative management of anesthesia. Chapter 10 describes the most frequent surgical problems, and Chapter 11 updates the topic of neonatal male circumcision in the context of Thailand from a public health perspective.

Finally, section IV includes different miscellaneous topics in the field of neonatal health. Chapter 12 focuses on neonatal gene therapy for inherited disorders and explains through

experimental models the usefulness and potential of this type of therapy, beginning from the analysis of two of these problems: metachromatic leukodystrophy and hypophosphata‐ sia. Chapter 13 develops a review of the current knowledge regarding the effects of selected endocrine active compounds in the neonatal period. Chapter 14 concludes this section and the book with an interesting report on approaches carried out in Nigeria that could have a positive effect on early neonatal mortality reduction in that country.

As described, this book includes various topics of interest for all those health professionals who are dedicated to neonatal health care. It is necessary to thank each one of the authors who through their contributions, taken from both experience and context, have allowed the development of this interesting book, which it is hoped will be useful for professionals and students dedicated to neonatal care.

**R. Mauricio Barría P., DrPH**

**Section 1**

**Critical Issues in Neonatal Care**

Universidad Austral de Chile Faculty of Medicine, Nursing Institute Valdivia, Chile **Critical Issues in Neonatal Care**

experimental models the usefulness and potential of this type of therapy, beginning from the analysis of two of these problems: metachromatic leukodystrophy and hypophosphata‐ sia. Chapter 13 develops a review of the current knowledge regarding the effects of selected endocrine active compounds in the neonatal period. Chapter 14 concludes this section and the book with an interesting report on approaches carried out in Nigeria that could have a

As described, this book includes various topics of interest for all those health professionals who are dedicated to neonatal health care. It is necessary to thank each one of the authors who through their contributions, taken from both experience and context, have allowed the development of this interesting book, which it is hoped will be useful for professionals and

> **R. Mauricio Barría P., DrPH** Universidad Austral de Chile

> > Valdivia, Chile

Faculty of Medicine, Nursing Institute

positive effect on early neonatal mortality reduction in that country.

students dedicated to neonatal care.

VIII Preface

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Essential Issues in Neonatal Care**

 Mortality in infants and under 5-year olds has been a constant health concern. In 2015, of the total number of deaths in children under five worldwide, 45.1% corresponded to neonatal deaths, with the three leading causes of death being prematurity (15.9%), causes related to childbirth (10.7%), and sepsis or meningitis (6–8%) [1]. By the year 2030, one of the sustainable development goals (Goal 3) was to put an end to the avoidable deaths of newborns and children under 5 years of age, and it was defined that all countries must try to reduce mortality to

Neonatal deaths are unequally distributed worldwide, with 99% occurring in low- and middleincome countries. The lack of basic neonatal care technologies in low-resource countries is considered a relevant contributing factor to this inequality [3]. However, prevention of mortality due to the three main causes of death (complications associated to premature birth, causes related to childbirth, and sepsis) is possible with the implementation of simple and low-cost interventions, even in countries with limited resources [4]. In addition to increasing survival, the primary objective of obstetric and neonatal care is to reduce morbidity by emphasizing the

The frequency of premature births, occurring before 37 weeks of gestation, also shows regional and global differences. The results show that low-income countries have the highest rate of premature births, with figures such as 15.5 and 15.8% of the total number of births in Pakistan and Indonesia, respectively, in contrast to 12% in the United States, who also has a high percentage of premature babies compared to other developed and high-income coun-

However, extremely preterm infants disproportionately contribute to the burden of neonatal morbidity, mortality, and long-term neurodevelopmental disability, even though a significant

tries; providing an important contribution to infant mortality and morbidity [5].

**Introductory Chapter: Essential Issues in Neonatal Care**

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.79256

R. Mauricio Barría

**1. Introduction**

Additional information is available at the end of the chapter

at least 12 and 25 for every 1000 births, respectively [2].

need for interventions that improve the outcome of immature babies.

R. Mauricio BarríaAdditional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.79256

#### **Introductory Chapter: Essential Issues in Neonatal Care Introductory Chapter: Essential Issues in Neonatal Care**

DOI: 10.5772/intechopen.79256
