We are delighted to share that the information brochure about the European Standards of Care for Newborn Health (ESCNH) is now also available in Hungarian! Translating the brochure into Hungarian is an essential step in enhancing accessibility to the ESCNH for healthcare professionals, parents, and policymakers across Hungary, thereby facilitating progress in the implementation process. EFCNI would like to thank BT (British Telecommunication), for providing the Hungarian translation of the information brochure, and Professor Dr Ertl Tibor for his great expertise in proofreading the translation. A very special thanks goes to Lívia Nagy Bonnard, founding member of our partner parent organisation “Melletted a helyem – Egyesület a koraszülött ellátásért“ (in English: “Right(s) Beside You – Association for the care of preterm infants”), who has coordinated and supported the entire translation process. Lívia is not only an Ambassador of the ESCNH, actively supporting the implementation of the standards across Hungary and beyond, but also a member of the Parent, Patient, and Public Advisory Board of the ESCNH. The information brochure is currently available in English, Bulgarian, German, Greek, Hungarian, Portuguese, Romanian and Ukrainian. You can download these, and other materials, at: https://newborn-health-standards.org/downloads/ Download your copy in Hungarian! © EFCNI

Despite being widely recommended, immunisation of preterm infants is frequently delayed, exposing this vulnerable group to various preventable diseases. The review article “An update on vaccination in preterm infants” by Lillian de Santos Rodrigues Sadeck and Renato de Ávila Kfouri delves into recent research on vaccine safety, effectiveness, and immunogenicity in preterm infants, shining a light on the importance of timely vaccination.    Preterm infants more at risk for preventable illnesses Compared to full-term infants, preterm infants face increased susceptibility to morbidity and mortality caused by vaccine-preventable diseases. This heightened vulnerability is primarily linked to their underdeveloped immune system, which has not fully matured yet and is not fully functional. Additionally, the transfer of maternal antibodies through the placenta begins around the 17th to 18th week of gestation, gradually increasing and reaching peak levels with greater gestational age at birth. Consequently, antibody levels are lower in preterm infants, leaving them more vulnerable to infections.  Prolonged hospitalisation in the Neonatal Intensive Care Unit (NICU) poses additional risks. Infants are exposed to resistant pathogens and administered broad-spectrum antibiotics or steroids. Additionally, they often experience a lack of breastfeeding and disruption of protective barriers due to invasive medical procedures. Reasons for delayed vaccinations  Research indicates that preterm infants frequently encounter delays in their vaccination schedules, particularly those with lower gestational age and birth weight. These delays stem from concerns surrounding their vulnerability and the development of their immune system as well as apprehensions regarding vaccine safety. This highlights a gap in understanding vaccine safety and effectiveness among healthcare providers and parents, often driven by fear of adverse reactions. While preterm infants may exhibit higher rates of post-vaccination fever and cardiorespiratory events compared to full-term infants, these effects are typically temporary and mild, with no lasting clinical impact. Immunisation just as safe for preterm infants  Several studies have indicated that preterm infants generate an adequate immune response, according to their chronological age, as recommended, for instance by the German Standing Committee on Vaccination (“Ständige Impfkommission” in German, abbreviated as STIKO) and by the American Academy of Pediatrics Committee on Infectious Diseases. While their initial antibody responses may be lower than those of full-term infants, when vaccinated according to chronological age, most reach protective antibody concentrations. Provided they are clinically stable and there are no contraindications, preterm infants should receive vaccines according to the schedule recommended for full-term infants and based on their chronological age.  Given that preterm infants tolerate vaccination well and exhibit protective immune responses, studies have shown that preterm infants undergo unjustified delays in their vaccination schedule. To address this, several actions are necessary: evidence-based education for healthcare professionals,   widespread dissemination in lay-friendly formats for parents and caregivers,  improved access to immunisation, and  administration of vaccines prior to NICU discharge. Education initiatives should stress the importance of chronological age, alongside clinical conditions, in commencing the immunisation process.  Paper available at: https://pubmed.ncbi.nlm.nih.gov/36608935/   Full list of authors: Lilian dos Santos Rodrigues Sadeck, Renato de Ávila Kfouri.  DOI: 10.1016  Keywords: #PretermBirth #FollowUp #ESCNH #ResearchNews 

© Unsplashed Mothers and children share a close bond. Latest research shows just how close this bond is: maternal resilience and the long-term health and developmental trajectories of very preterm (VPT) children show a significant connection. The seminal cross-national study, conducted in 11 European countries by Lena Wohlers et al., furnishes invaluable insights into this connection, demonstrating how carefully designed targeted interventions can bolster maternal coping abilities, thus optimising outcomes for both mothers and their VPT infants.   Differences within countries Among the 2,605 mothers, the mean score of the MHI-5 assessment was 71.3. The mean scores in Sweden (74.5), Denmark (79.4) and the Netherlands (82.3) were higher than the mean of the overall cohort. In contrast, the mean scores in France (65.3) and Poland (63.5) were significantly lower, indicating overall poorer emotional well-being within mothers compared to the northern countries and the score average. Maternal factors associated with low scores Various factors are linked to low emotional wellbeing within mothers. Lower scores were found for non-European born mothers (68.2) compared to native born mothers or mothers born in other European countries (71.7 and 71.6). Furthermore, even lower MHI-5 scores were found in single mothers (66.6) compared to mothers living with a partner (71.9). Mothers with a low educational level (mean 68.9) attained a lower score in comparison to those with a higher educational level (72.2). These mothers represented a vulnerable group within the sample, being at a higher risk for poor mental health. Regarding perinatal and neonatal characteristics, scores were reduced for mothers with one previous delivery (70.3) and even lower for mothers with two or more deliveries (67.5) compared to mothers having their first child (72.6). These results indicate that caring for several children leads to higher stress in mothers when at least of one of them is VPT. Infant components contributing low scores All child’s health and developmental problems at five years of age were associated with a lower MHI-5 score in mothers. Examples for health problems are sensory impairment, cerebral palsy, developmental delay, speech delay, ADHD, autism, and epilepsy. Higher scores were found for mothers with children born at 28-29 weeks of gestation and with a physical or functional abnormality that is present at birth. What about the fathers? As 85% of the respondents of the questionnaire were mothers, the authors decided to shift their attention towards maternal wellbeing. However, they recognised that fathers are also affected by the VPT birth of their children. They advocated for further research on the fathers’ wellbeing. Emotional wellbeing as part of regular check-ups Given the interdependence of maternal emotional wellbeing and child development , assessments of maternal emotional wellbeing should become part of the obstetric, prenatal, and postnatal check-ups, as well as paediatric visits in early childhood. Also, an infant- and family-centred approach can empower both parents to better cope with the situation. Previous research has shown that mothers attending early intervention programs have lower levels of stress. The interventions should meet the individual needs of parents and families in terms of methods, duration, and frequency. The study authors suggest, however, that these interventions commence during the NICU stay and are continued at home to ensure the best possible outcomes for mothers, children, and other caregivers. These findings demonstrate that very preterm birth has a negative influence on maternal and, presumably, paternal emotional well-being at five years after birth. Furthermore, the need for support and interventions for parents of VPT children is highlighted, starting in the NICU, and extending as necessary.   Paper available at: Children | Free Full-Text | Maternal Wellbeing Five Years after a Very Preterm Delivery: Prevalence and Influencing Factors in a European Cohort (mdpi.com) Full list of authors: Lena Wohlers, Rolf Maier, Marina Cuttini, Emilija Wilson, Valérie Benhammou, Jo Lebeer, Sabine Laroche, Iemke Sarrechia, Stavros Petrou, Nicole Thiele, Jennifer Zeitlin, Adrien Aubert. DOI: https://doi.org/10.3390/children11010061