Silvia Gulden

University of Milan | UNIMI

Retinopathy of prematurity (ROP) is a vasoproliferative retinal disease in preterm infants. Oxidative stress plays a key role in the pathogenesis of ROP. Due to its antioxidant effects, bilirubin has been proposed to be protective against ROP. This study explored the association between hyperbilirubinemia and ROP. We analyzed a 10-year cohort from...

Purpose. Retinopathy of prematurity (ROP) is a vasoproliferative retinal disease in preterm infants. Oxidative stress plays a key role in the pathogenesis of ROP. Bilirubin has been proposed to be protective against ROP due to its antioxidant effects. This study explored the association between hyperbilirubinemia and ROP. Methods. We analyzed a 10-...

Bronchiolitis is a common cause of hospitalization in infants. The long-lasting impact of hygiene and social behavior changes during the pandemic on this disease is debated. We investigated the prevalence of hospitalized cases, clinical severity, and underlying risk factors before and during pandemic. The study was conducted in 27 hospitals in Ital...

Background: We aimed to conduct a systematic review and Bayesian model-averaged meta-analysis (BMA) on the association between platelet counts and severe retinopathy of prematurity (ROP). Methods: We searched for studies reporting on platelet counts (continuous variable) or thrombocytopenia (categorical variable) and severe ROP or aggressive pos...

Background: Retinopathy of prematurity (ROP) is generally considered to be more frequent in males than in females. However, it is not known whether sex differences in ROP affect all degrees of the condition, are global and have changed as neonatology has developed. We aimed to conduct a systematic review and meta-analysis of studies addressing sex...

Necrotizing enterocolitis (NEC) is a devastating gut disease in preterm neonates. In NEC animal models, mesenchymal stromal cells (MSCs) administration has reduced the incidence and severity of NEC. We developed and characterized a novel mouse model of NEC to evaluate the effect of human bone marrow-derived MSCs (hBM-MSCs) in tissue regeneration an...

Millions of infants are born prematurely every year worldwide. Prematurity, particularly at lower gestational ages, is associated with high mortality and morbidity and is a significant global health burden. Pregnancy complications and preterm birth syndrome strongly impact neonatal clinical phenotypes and outcomes. The vascular endothelium is a piv...

Extracorporeal membrane oxygenation (ECMO) is a life-saving support for cardio-respiratory function. Over the last 50 years, the extracorporeal field has faced huge technological progress. However, despite the improvements in technique and materials, coagulation problems are still the main contributor to morbidity and mortality of ECMO patients. In...

Extracorporeal membrane oxygenation (ECMO) is a lifesaving support for respiratory and cardiovascular failure. However, ECMO induces a systemic inflammatory response syndrome that can lead to various complications, including endothelial dysfunction in the cerebral circulation. We aimed to investigate whether ECMO-associated endothelial dysfunction...

In recent years, magnetic resonance imaging (MRI) has largely increased our knowledge and predictive accuracy of congenital diaphragmatic hernia (CDH) in the fetus. Thanks to its technical advantages, better anatomical definition, and superiority in fetal lung volume estimation, fetal MRI has been demonstrated to be superior to 2D and 3D ultrasound...

Very preterm infants are exposed to prenatal inflammatory processes and early postnatal hemodynamic and respiratory complications, but limited data are available about the endothelial effect of these conditions. The present pilot study investigates the perinatal endothelial phenotype in very preterm infants (VPIs) and explores its predictive value...

Background Viscoelastic coagulation tests provide valuable information in neonatal intensive care units (NICUs), but the lack of reference intervals still limits their decision-making power according to gestational age. The aim of the present study is to evaluate the hemostasis of a cohort of full-term (FT) and late-preterm (LP) infants using the v...

Fresh frozen plasma (FFP) is largely misused in the neonatal setting. The aim of the study is to evaluate the impact of a Thromboelastography (TEG)-based Quality Improvement (QI) project on perioperative FFP use and neonatal outcomes. Retrospective pre-post implementation study in a level-III NICU including all neonates undergoing major non-cardiac...

Neonatal pulmonary air leak commonly occurs as a complication of mechanical ventilation in infants with underlying hyaline membrane disease. They can commonly be managed conservatively or with the application of a chest drain, but some severe cases pose a significant challenge in finding an alternative therapeutic solution. Selective bronchial occl...

May–Hegglin anomaly (MHA) is a rare autosomal dominant disorder in the spectrum of myosin heavy chain-related disorders (MYH9-RD), characterized by congenital macrothrombocytopenia and white blood cell inclusions. MHA carries a potential risk of hemorrhagic complications. Bleeding diathesis is usually mild, but sporadic, life-threatening events hav...

Congenital hemolytic anemias (CHAs) are a group of diseases characterized by premature destruction of erythrocytes as a consequence of intrinsic red blood cells abnormalities. Suggestive features of CHAs are anemia and hemolysis, with high reticulocyte count, unconjugated hyperbilirubinemia, increased lactate dehydrogenase (LDH), and reduced haptog...

Background: The role of hemostasis in the closure of patent ductus arteriosus (PDA) in preterm infants is controversial. Objective: To assess thromboelastography (TEG) at birth in very-low-birth-weight (VLBW) infants affected by PDA. Methods: This was an ancillary study of a prospective observational study aimed at defining the TEG profile in...

Umbilical vessels have a low sensitivity to dilate, and this property is speculated to have physiological implications. We aimed to investigate the different relaxing responses of human umbilical arteries (HUAs) and veins (HUVs) to agonists acting through the cAMP and cGMP pathways. Vascular rings were suspended in organ baths for isometric force m...

The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched Pub...

Meta-regression plot of association between CA and stages 1–2 ROP controlling for difference in gestational (GA) between exposed and non-exposed groups. CA: chorioamnionitis; ROP: retinopathy of prematurity; GA: gestational age. (TIF)

Meta-regression of the relationship between the effect of CA on difference in mean BW and risk of stages 1–2 ROP. CA: chorioamnionitis; BW: birth weight; ROP: retinopathy of prematurity. (TIF)

Meta-analysis of CA and risk of ROP, in the subgroup of studies that did not show a significant difference in GA between CA-exposed and CA-unexposed infants. GA: gestational age; CA: chorioamnionitis; ROP: retinopathy of prematurity. (TIF)

Meta-analysis of funisitis and risk of ROP, compared to CA in the absence of funisitis. CA: chorioamnionitis; ROP: retinopathy of prematurity. (TIF)

Search strategy for PubMed/Medline. (DOCX)

Synoptic table of all included studies. GA: gestational age; BW: birth weight; ACS: antenatal steroids. (DOCX)

PRISMA checklist of this review. (DOC)

Meta-analysis of crude and adjusted risk of severe ROP (stage ≥3). BW: birth weight; GA: gestational age; Histol.: histological; OR: odds ratio; ROP: retinopathy of prematurity. (DOCX)

Funnel plot for assessment of publication bias of studies reporting on CA (any type) and all stages ROP (A), severe ROP (B), and stage 1–2 ROP (C). CA: chorioamnionitis; ROP: retinopathy of prematurity. (TIF)

Meta-regression of risk of confounding factors and risk of ROP. Log: logarithm; OR: odds ratio; ROP: retinopathy of prematurity; k: number of studies included; CI: confidence interval. (DOCX)

Meta-analysis of crude and adjusted risk of all stages ROP. BW: birth weight; GA: gestational age; Histol.: histological; OR: odds ratio; ROP: retinopathy of prematurity. (DOCX)

Database of included studies and extracted data. (XLSX)

Meta-analysis of CA and risk of stage ≥1 ROP. CA: chorioamnionitis; ROP: retinopathy of prematurity. (TIF)

Meta-regression of the relationship between the effect of CA on difference in mean birth weight (BW) and risk of all stages ROP. CA: chorioamnionitis; ROP: retinopathy of prematurity. (TIF)

The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) is difficult to establish, because CA-exposed and CA-unexposed infants frequently present different baseline characteristics. We performed an updated systematic review and meta-analysis of studies reporting on the association between CA and ROP. We searched Pub...