Introduction: There are no clear guidelines to support adequate nutrition and growth for our neonates. We have used the difference in weight Z-score medians between birth and discharge (∆ Z-score) to assess the nutritional outcomes in EpicLatino. The ∆ Z-score is often negative, accounting for the desirable fluid contraction at birth that sends the preterm baby usually between 0.5-1 weight Z-score point down the curve. From then on, most researchers accepted a healthy and safe growth parallel to the intrauterine rate. No consensus on the optimal timing for assessment or the ideal growth monitoring tool has been achieved, and an ongoing debate persists on the appropriate terminology to express poor postnatal growth.Methods: We analyzed data from the past 8 years (2015-2022) in surviving home to at least 34 weeks corrected age infants with ≤ 32 weeks gestational age at birth (GA). We conducted a series of statistical comparisons with variables that have been mentioned as potential causes of poor nutrition in the literature. We used the weight ∆ Z-score from birth to discharge as a surrogate for nutrition. We obtained the weight median and interquartile range (IQR) from all the EpicLatino units. We also calculated the correlation between weight ∆ Z-score and gestational age and head circumference (HC) at discharge.Results: There were 480 cases that meet the established criteria. Gestational age at birth, necrotizing enterocolitis (NEC), unit of origin, rupture of membranes (ROM) > 24 hours, temperature at admission, and intraventricular hemorrhage (IVH) were significantly different. There was a negative correlation between ∆ Z-score and corrected gestational age at discharge. Head circumference at discharge also correlated with weight ∆ Z-score. Discussion: There is an important variability in the different units of origin. Also, when looking for risk factors, we confirmed that the characteristics of the study population are determinant to extrauterine growth restriction (EUGR) at discharge. As is known, these associations do not establish causality, some of these variables may identify the challenge of nourishing a sick or very small preterm infant, but the unit of origin variable identifies nutrition policies and practices that can be modified through a quality improvement program.

Introduction: Parameters used for neonatal mortality calculation vary among publications. Mortality in < 33 weeks gestational age at birth display global variations across different healthcare units. Objective: This study aims to explore trends in neonatal mortality among infants born preterm in the different units in Latin America and the Caribbean utilizing the EpicLatino Network Database in comparison to Canadian Neonatal Network (CNN) 2022. Materials and Methods: This study focused on an eight-year period, with a particular attention to mortality rates during the pre-pandemic (2015-2019) and pandemic/post pandemic (2020-2022) periods. Survival rates from CNN 2022 were included in the comparison analysis. Logistic regression analysis was confined to the 2020-2022 period. Adjustments were made for factors including gestational age, small for gestational age (SGA), Snape II score, inborn/outborn status, and center. As major malformations could account for mortality differences among units. The incidence of major congenital malformations, as defined by CNN, was compared among deceased patients. Results: A total of 15,454 records from 2015-2019 and 10,711 records from 2020-2022 were scrutinized. Overall, there were no significant differences in mortality rates between the two time periods (p=0.22). Moreover, the originating unit during the 2020-2022 period significantly influenced all statistical computations. Conclusions: Survival rates among infants < 26 weeks of gestation in Latin America and the Caribbean are on an upward trajectory, with the healthcare unit playing a pivotal role in this outcome within the EpicLatino database. Major malformations do not seem to be a significant contributing factor. These findings underscore the imperative of implementing quality improvement initiatives to elevate neonatal care standards in Latin America and the Caribbean.

Respiratory support use in neonatal intensive care units (NICUs) varies worldwide, influenced by clinical practices, resources, and patient populations. Whether high-altitude independently affects the duration of respiratory support in preterm infants remains unclear. This study aimed to determine whether altitude is independently associated with the duration of respiratory support in preterm infants ≤32 weeks' gestational age (GA) admitted to Latin American NICUs. We performed a multicenter, observational cohort study by secondary analysis of prospectively collected data from the EpicLatino Network, a registry of NICUs across Latin America (2015–2022). Infants ≤32 weeks who received invasive or non-invasive respiratory support were included; supplemental oxygen delivered via low-flow nasal cannula or oxygen hood was not considered respiratory support, and those with missing outcome data were excluded. The primary outcome was total duration of respiratory support, measured as total days of support until discontinuation, discharge, transfer, or truncation by death. Altitude was classified as high (≥2,000 m) or low (<2,000 m). Multivariable analyses were adjusted for neonatal, maternal, and unit characteristics. A total of 4,428 infants were included; 2,723 (61.5%) in low-altitude NICUs and 1,705 (38.5%) in high-altitude NICUs. Overall, 81.4% discontinued respiratory support and 18.6% died. Mortality was 19.1% in low-altitude and 17.9% in high-altitude NICUs. Median duration of support was 8 days (interquartile range [IQR]: 5–14) overall, with 9 days (IQR: 4–27) in low-altitude and 7 days (IQR: 3–17) in high-altitude NICUs. High-altitude centers showed shorter respiratory support in unadjusted analyses. After adjustment for neonatal, maternal, and unit factors, altitude was not independently associated with support duration. After adjustment for neonatal, maternal, and unit factors, altitude was not independently associated with the duration of respiratory support. Importantly, high altitude was never associated with worse outcomes.

Objetivo: Evaluar la prevalencia de las dificultades de alimentación y los trastornos del procesamiento sensorial en niños de 3 a 6 años en Bogotá, y explorar de manera preliminar sus posibles repercusiones sobre la dinámica familiar y el bienestar infantil. Métodos: Se realizó un estudio transversal entre enero y marzo de 2024 con 128 niños de 3 a 6 años de una institución privada en Bogotá. Se aplicaron la Escala Argentina de Dificultades Alimentarias en Niños (EADAN) y el Perfil Sensorial de Dunn, ambos instrumentos validados. Se incluyó la descripción del proceso de consentimiento informado y aprobación ética. Resultados: El 46,9 % presentó dificultades de alimentación; de estos, un tercio fueron moderadas a graves. El 72,6 % evidenció alteraciones en el procesamiento sensorial, predominando la baja respuesta sensorial y la hipersensibilidad. Conclusiones: Las dificultades de alimentación y los trastornos sensoriales son frecuentes en preescolares. Aunque los resultados son descriptivos y limitados a una muestra pequeña, refuerzan la necesidad de estudios multicéntricos con análisis inferencial que permitan explorar el impacto familiar y conductual de estos trastornos.

Background. Antibiotic use in bronchiolitis is generally discouraged by international guidelines, given that concurrent bacterial superinfection is uncommon. Reported prevalence varies widely across countries and settings, with no prior comparable data for Latin American neonatal units.Objective. To describe, for antimicrobial stewardship surveillance, the prevalence of documented antibiotic use during bronchiolitis episodes in a Latin American neonatal cohort (2010–2025) not explained by an identifiable alternative reason, and to place it in context against the international literature.Methods. Descriptive, retrospective, multicenter study. Bronchiolitis episodes were identified through free-text searching of the diagnosis field. An antibiotic exposure window was defined from one day before to 20 days after diagnosis. Every case with documented antibiotic use underwent manual case-by-case review, cross-referencing treatment duration (≤3 documented days = unconfirmed suspicion) against other recorded diagnoses to identify reasonable alternative reasons for use, distinct from bronchiolitis itself. Sites were randomly pooled into 6 anonymized groups.Results. 685 bronchiolitis episodes were identified; 19 (2.8%) were excluded for infection documented at diagnosis, leaving 666 analytic episodes. Documented antibiotic use was observed in 48 episodes (7.2%; 95% CI 5.5–9.4%). After manual review, 28 of 48 (58%) had an identifiable alternative cause, leaving 20 episodes (3.0%; 95% CI 2.0–4.6%) without one. Group 5 showed the highest relative prevalence (33.3%; 7/21). No significant baseline differences were found between exposed and unexposed infants. One death occurred among all 685 episodes, in a case excluded for concurrent infection (685 g, 26 weeks, group B Streptococcus sepsis); no deaths occurred within the analytic cohort (0/666).Conclusions. Documented antibiotic use in bronchiolitis without an identified alternative cause in this Latin American cohort (3.0%) is considerably lower than reported in most international literature (typical ranges 13%–55%). Nearly 60% of crude antibiotic use is explained by causes other than uncomplicated bronchiolitis, underscoring the importance of individual case review over administrative records alone.