Barbara Królak-Olejnik

• Prof. assist., MD, PhD
• Head of Department at Wroclaw Medical University

Objectives: Gestational diabetes mellitus (GDM) is associated with an increased risk of both neonatal and maternal morbidity. The aim of this retrospective study was to evaluate the frequency of perinatal complications due to GDM in the Department of Neonatology at the Medical University of Wroclaw, Poland, considering the treatment of GDM-diet an...

Purpose The study presents a cross-sectional analysis of the population of Ukrainian women who received maternity care in 11 Polish hospitals. Methods Multidirectional lactation counseling was implemented from March to November 2023 by the Human Milk Bank Foundation in cooperation with UNICEF Refugee Response Office in Poland. Medical data were co...

Background: Gestational diabetes mellitus (GDM) is one of the most prevalent complications associated with pregnancy, exhibiting a gradual rise in prevalence worldwide. Given the potential for numerous short- and long-term complications for both mother and child, patients diagnosed with GDM require individualised treatment to compensate for metabol...

Background: Gestational diabetes mellitus (GDM) is defined by an insufficient insulin response to counteract the insulin resistance (IR) that arises from the physiological adaptations associated with pregnancy. However, the pathophysiology of IR is complex and unclear, as it encompasses elements such as epigenetics, environmental factors, modifiabl...

Background: The composition of breast milk is dependent on numerous factors. However, the precise impact of maternal health conditions on breast milk composition remains to be fully elucidated. Similarly, there is a paucity of evidence regarding the correlation between neonatal body composition and human milk. The objective of the study was to eval...

Importance Red blood cell (RBC) transfusions are frequently administered to preterm infants born before 32 weeks of gestation in the neonatal intensive care unit (NICU). Two randomized clinical trials (Effects of Transfusion Thresholds on Neurocognitive Outcomes of Extremely Low-Birth-Weight Infants [ETTNO] and Transfusion of Prematures [TOP]) foun...

Introduction and objective: Gestational diabetes mellitus (GDM), in case of inadequate glycaemic control, is associated with an increased risk of maternal and neonatal complications. The aim of this study was to evaluate data concerning outcomes of neonates born to mothers with GDM, treated with only diet (GDM G1) compared to diet and insulin thera...

Lactoferrin (Lf), which is particularly abundant in human breast milk during the early stages of lactation, provides protection against a variety of infections, including viral infections, and has demonstrated activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The objective of this study was to measure the concentrations...

Background Extremely preterm infants have a high mortality and morbidity. Here, we present a statistical analysis plan for secondary Bayesian analyses of the pragmatic, sufficiently powered multinational, trial—SafeBoosC III—evaluating the benefits and harms of cerebral oximetry monitoring plus a treatment guideline versus usual care for such infan...

The nutritional adequacy of human milk (HM) from vegan/vegetarian mothers has been a matter of debate, and a variety of recommendations regarding the eligibility of these mothers as human milk donors exists. According to the latest evidence, HM from vegans/vegetarians is similar in its composition to that from omnivores, however, some differences m...

Fetal alcohol syndrome (FAS, Fetal Alcohol Syndrome) is a syndrome of congenital malformations, including deformities, chro- mosomal abnormalities, mental and behavioral disorders, found in children whose mothers consumed alcohol during pregnancy. In Poland, the incidence of FAS is ≥ 4 per 1,000, while symptoms most often manifest between the secon...

Background: The use of cerebral oximetry monitoring in the care of extremely preterm infants is increasing. However, evidence that its use improves clinical outcomes is lacking. Methods: In this randomized, phase 3 trial conducted at 70 sites in 17 countries, we assigned extremely preterm infants (gestational age, <28 weeks), within 6 hours afte...

Pregnancy is a period which requires special care and attention. Maintaining health during pregnancy helps to avoid birth related complications and is the best way of promoting a healthy birth. Besides a daily intake of folic acid, iron, iodine, vitamin D3 and A, calcium and polyunsaturated fatty-acids, as recommended by health agencies, supplement...

Very preterm infants are usually supported by parenteral nutrition delivered through central lines (CLs) while progressing with enteral intake, although the optimal time point for their removal is unclear. This study evaluated the impact of the CL discontinuation time on the short-term growth outcomes of preterm infants. A non-inferiority, parallel...

There is accumulating evidence on the perinatal aspects of COVID-19, but available data are still insufficient. The reports on perinatal aspects of COVID-19 have been published on a small group of patients. Vertical transmission has been noted. The SARS-CoV-2 genome can be detected in umbilical cord blood and at-term placenta, and the infants demon...

Objective Human milk contains antibodies against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which may serve as a protective factor through passive immunization in infants. The objective of this study was to measure the levels of anti-SARS-CoV-2 IgG and IgA in human milk and serum after a SARS-CoV-2 infection. Design Breast milk a...

Objectives: Newborns of diabetic mothers are at increased risk of abnormal nutritional status at birth, thus developing metabolic disorders. The aim of this study was to evaluate the anthropometric measurements and body composition of newborns born to mothers with gestational diabetes in comparison to newborns born to mothers with normal glucose t...

Objective To investigate the efficacy and safety of nebulized Poractant alfa (at 200 and 400 mg/kg doses) delivered in combination with nasal continuous positive airway pressure (nCPAP) compared with nCPAP alone in premature babies with diagnosed RDS. Study design This randomized, controlled, multinational study was conducted in 28+0 to 32+6 weeks...

Objectives: A novel coronavirus - SARS CoV-2 - outbreak has, for sure, been the greatest medical challenge in recent years. The maternal and neonatal consequences of the infection are still largely unknown. Material and methods: This prospective study aims to describe the perinatal care and outcomes of SARS-CoV-2 positive pregnant women and thei...

Congenital chloride diarrhea (CCD) is caused by a recessive mutation in the SLC26A3 gene and characterized mainly by watery diarrhea, hypochloremia and metabolic alkalosis. Various different mutations in SLC26A3 are responsible for the disease. In the prenatal period, the symptoms of CCD may include polyhydramnios, preterm labor and abdominal diste...

Background Data monitoring of clinical trials is a tool aimed at reducing the risks of random errors (e.g. clerical errors) and systematic errors, which include misinterpretation, misunderstandings, and fabrication. Traditional ‘good clinical practice data monitoring’ with on-site monitors increases trial costs and is time consuming for the local i...

The influence of the blood group on the occurrence and severity of diseases has aroused the curiosity of scientists for many years. The AB0 group system is the best known and described blood group system. It is also the only system whose antibodies are constantly present in the blood serum. The most common blood type in Poland, according to data pr...

Cronobacter sakazakii can cause severe life-threatening invasive infections in neonates, with a high mortality rate mostly associated with powdered infant formula consumption. The study describes a fatal C. sakazakii infection in premature infant fed only with expressed human milk. Despite the identification of etiological factor from patient’s blo...

Background: There are multiple misconceptions concerning the breastfeeding mother's diet and its adverse impact on breast milk composition and the breastfed child's health, which might lead to breastfeeding cessation. Although prophylactic maternal dietary restrictions are not recommended, mothers all over the world are often recommended to avoid...

Objective: To evaluate if the number of admitted extremely preterm (EP) infants (born before 28 weeks of gestational age) differed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019. Design: This is a retrospective, observational study. Forty...

Background: Initially, there were no data on the safety of COVID-19 vaccines in lactating women. The aim of our study was to evaluate the immune response to COVID-19 vaccinations in breastfeeding women. Methods: The study included 32 breastfeeding women who, regardless of the study, had decided to be vaccinated. Maternal serum and breast milk sa...

We describe the prevalence of Pneumocystis jirovecii in mother-infant pairs of very low birth weight newborns <32 weeks gestation. Molecular and microscopic methods were used for detection of P. jirovecii in patients' specimens. Pneumocystis DNA was detected in eight nasopharyngeal aspirates (14%) of 56 newborns and in seven oral washes (21%) of 34...

Aim: To evaluate how useful it is to make measurements of gentamicin concentrations in newborns' b/ood in order to optimize antibiotic therapy. Material and methods: 73 newborns empirically treated with gentamicin, in doses consistent with the Neofax® guidelines. There were 152 measurements of maximum and minimum serum gentamicin concentrations....

The aim: To study the effect of therapeutic intervention on the improvement of the rhythmicity of non-nutritive and nutritive sucking in premature newborns and on the suck central pattern generator. Material and methods: Stimulation of the breast zone was performed in two premature newborns by means of the Vojta method. Intraoral pressure was me...

Introduction: Wady letalne prowadzą do wewnątrzmacicznego zgonu płodu lub dziecka bezpośrednio po urodzeniu lub we wczesnym okresie niemowlęcym, bez względu na zastosowane leczenie. W przypadku wad letalnych nie ma możliwości skutecznej pomocy dziecku, mimo postępu mi zeadsytcoysnoyw ania najnowocześniejszej aparatury lub terapii. Rodzice, którzy...

Aim: To evaluate the effect of the initial dose of poractant alfa on clinical outcomes in neonatal respiratory distress syndrome (RDS) and to assess adherence to treatment guidelines recommending a dose of 200 mg/kg. Methods: Records of neonates who received poractant alfa with a less invasive technique (LISA) or with the INtubate-SURfactant-Extuba...

Hypophosphatasia, also known as alkaline phosphatase deficiency, is a rare congenital metabolic disorder characterised by early bone and dental defects. First reports on hypophosphatasia date back to 1950s. The prevalence of the disorder in Europe is 1:300,000 births; data on the prevalence in Poland is missing. An abnormal structure of the region...

Objective To evaluate if the number of admitted extremely preterm (EP) infants (born before 28 weeks of gestational age) has changed in the neonatal intensive care units (NICUs) of the SafeBoosC-III consortium during the global lockdown when compared to the corresponding time period in 2019. Design This is a retrospective, observational study. For...

Respiratory diseases are among the most common disorders found in the clinical practice of every pediatrician. It is estimated that a total of 10-15% of children experience recurrent respiratory tract infections (RRTI). Unfortunately, there is no universal consensus on the definition of recurrent respiratory tract infections in children. In additio...

Mother's milk immunoglobulins (Igs) delivered to infants during breastfeeding are crucial in shaping and modulating immature infants' immune system and provide efficient protection against pathogens. The aim of the study was to evaluate the immunoglobulin concentrations in milk of 116 lactating mothers over prolonged lactation from the 1st to the 4...

Genetic disorders are the leading cause of infant morbidity and mortality. Due to the large number of genetic diseases, molecular and phenotype heterogeneity and often severe course, these diseases remain undiagnosed. In infants with a suspected acute monogenic disease, rapid whole-exome sequencing (R-WES) can be successfully performed. R-WES (sing...

Popular beliefs regarding a mother’s diet during lactation have a significant impact on breastfeeding practices among mothers, as well on breastfeeding counseling among healthcare providers worldwide. The objective of this study was to assess mothers’ and medical professionals’ knowledge and opinions on the “lactating mother’s diet”. An electronic...

It is known that nutritional composition of breast milk is, to a certain extent, related to maternal diet. The question of nutritional adequacy of mothers’ milk is often raised whenever a vegetarian or vegan diet during the lactation process is concerned. For this reason, in some countries, the recruitment of vegan lactating women as milk donors is...

Objectives: The objective of this study is to understand knowledge, attitudes and practices of non-nutritional breast milk use among lactating women in respect of skin diseases and other frequent ailments. Material and methods: The study, in the form of a questionnaire, spread on social media, was targeted at breastfeeding women. The questionnai...

Abstract This letter has been written by the components of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification in response to a recent paper published by Mathes et al. (BMC Pediatr. 2018 May 8;18(1):154) with the aim of drawing attention to the importance of the use of a metabolic marker to adapt protein intake in pr...

In light of the immunoprotective function of human milk and the incontestable impact of IgG glycosylation on its immune functions, characterization of the sialylation profile of human milk IgG is needed. Lectins as a molecular probe were applied in lectin-IgG-ELISA to analyze the sialylation and galactosylation pattern of skim milk IgG of mothers w...

Objectives: The aim of the study was to present the variability of patients who received donor human milk (DHM) duringNeonatal Intensive Care Unit (NICU) hospitalization, including time of its usage and volume of portions. Material and methods: A retrospective analysis of data was conducted for all infants admitted to the NICU at the UniversityH...

Among the immunologically important bioactive factors present in human milk, lactoferrin (Lf) has emerged as a key player with wide-ranging features that directly and indirectly protect the neonate against infection caused by a variety of pathogens. The concentration of Lf in human milk is lactation-stage related; colostrum contains more than 5 g/L...

Objective: Twin pregnancies are associated with higher neonatal mortality and morbidity. Growth discordance and monochorionicity are among the factors that worsen the course of pregnancy. The study aimed to assess neonatal conditions and mortality in relation to growth type and chorionicity. Materials and methods: Data from 820 pregnant women wi...

The use of home remedies for the treatment of moderately severe ailments is a common practice in the Polish population. Currently, the topic of the potential non-nutritional properties of human milk is attracting the attention of breastfeeding mothers. This study was aimed at understanding lactating women’s knowledge, attitudes, and practices of no...

Pregnancy is a period of intense fetal development, as well as maternal physiological adaptation. During this period a varied diet is particularly important, as intake of macronutrients and micronutrients directly affects pregnancy outcome and the quality of breast milk. The dietary recommendations for pregnant women are indeed very similar to thos...

Objective: Aim: To evaluate how useful it is to make measurements of gentamicin concentrations in newborns' blood in order to optimize antibiotic therapy. Patients and methods: Material and methods: 73 newborns empirically treated with gentamicin, in doses consistent with the Neofax® guidelines. There were 152 measurements of maximum and minimum...

Objective: The aim: To study the effect of therapeutic intervention on the improvement of the rhythmicity of non-nutritive and nutritive sucking in premature newborns and on the suck central pattern generator. Patients and methods: Material and methods: Stimulation of the breast zone was performed in two premature newborns by means of the Vojta...

Objective: Lethal defects lead to the intrauterine death of the fetus or the passing away of the child immediately after birth or in early infancy, regardless of the treatment used. In the case of lethal defects, it is not possible to effectively help the child, despite using the most modern equipment or medicines in the treatment or the progress...

Human milk (HM) is the first dietary exposure in infancy and the best nutritional option for growth and healthy development of the newborn and infant. The concentrations of macronutrients, namely proteins, carbohydrates and lipids, change during lactation stages. HM has been studied extensively in the first 6 months of lactation, but there are limi...

Conjoined twins (CT) in triplet pregnancies are especially rare, approximately less than one in a million deliveries. Purpose: For better understanding of such malformations the authors performed a review of the literature published in the era of sonographic imaging, concerning CT in triplet gestations, as well as in the multiple pregnancies concei...

Advances in medicine and the evolution of health-related behaviors through time and across cultures have contributed to changes in attitudes toward natural alimentation. In the past, women who breastfed their babies were educated by word of mouth and family traditions passed on by their female relatives and communities, and the act of breastfeeding...

The Neurofascins (NFASCs) are a family of proteins encoded by alternative transcripts of NFASC that cooperate in the assembly of the node of Ranvier in myelinated nerves. Differential expression of NFASC in neurons and glia presents a remarkable example of cell-type specific expression of protein isoforms with a common overall function. In mice the...

Stem cells represent 10-15% of all cells that appear in breast milk. They participate in the mechanisms that control the homeostasis and processes self-healing of tissues in neonates. The first reports on the presence of stem cells in breast milk appeared in 2007. Stem cells exceed the barrier in the intestine, migrate to, and integrate with all bo...

Background: Refeeding Syndrome (RFS) is a well-known group of symptoms which occur after the introduction of enteral or parenteral nutrition in undernourished patients. Intrauterine growth restriction (IUGR) is the equivalent of postnatal RFS following the beginning of feeding. The aggressive parenteral nutrition of neonates with very low birth we...

Streszczenie Spośród czynników infekcyjnych wirus cytomegalii uważany jest za najczęstszą przyczynę postępującej utraty słuchu oraz zaburzeń neurologicznych u dzieci. Rosnąca liczba zakażeń wrodzonych spowodowanych tym wirusem wymusza podjęcie działań zmierzających do szybkiego ustalenia rozpoznania oraz wdrożenia leczenia. Wczesna diagnostyka oraz...

Latest forecasts predict that half of the European population will be allergic within the coming 15 years, with food allergies contributing substantially to the total burden; preventive measures are urgently needed. Unfortunately, all attempted alimentary strategies for primary prevention of allergic diseases through allergen avoidance so far have...

Background Fucosylated glycotopes of milk immunoglobulin G (IgG) are ligands in reactions of biological recognition protecting newborns against infection and ensuring proper development. Materials and methods Relative amounts of IgG fucosyl-glycovariants in milk of mothers giving birth to term and premature newborns (term and preterm milk groups)...

Objective Exclusive breastfeeding is safe and beneficial for healthy infants; it is the optimal feeding method during the first 6 months of life. Infants should be complementary fed in conjunction with breastfeeding until 12 months of age or longer. The aim of the present study was to analyse the duration of breastfeeding through 12 months of age....

Objective. To compare respiratory disorders (respiratory distress syndrome, requirement for respiratory support, development of chronic lung disease), duration of hospitalization and other neonatal outcomes between newborns born from triplet pregnancies over a ten year period. Methods. A retrospective analysis of 34 triplet pregnancies delivered be...

Over the past few decades, the advancements in the perinatal and neonatal intensive care have led to a significant survival of premature infants. However neurodevelopmental outcome still remains the topical issues of concern. Developmental care is an approach that is aimed to reduce the mismatches between extra- and intra-uterine environments, decr...

Arachnoid cysts are one of the endocranial pathologies occurring between dura mater of cerebrum and cerebellum and pia mater. The symptoms of arachnoid cysts depend on their size and localization. Small cysts are usually asymptomatic or present mild symptoms. Vast cysts cause mass effect, create pressure, displace surrounding tissues, and increase...

The decision to terminate causative treatment greatly affects the course of treatment and the patient's future. There is a serious conflict when there is a significant difference in opinion about further treatment between the physician and the patient or his family. In the present paper, there is a case report of a child born with Down syndrome and...

Presenter: M. Lachowska (e-mail: monika.lachowska@umed.wroc.pl) Introduction: Due to advances in reproductive medicine and the wide use of artificial reproductive technologies (ART) a significant increase in multiple pregnancies has been observed in the past years. The aim of the work was to compare respiratory disorders (respiratory distress syndr...

Introduction Percutaneously inserted central venous catheters (epicutaneo-cava-catheter - ECC) are widely used in neonatal intensive care, facilitating the parenteral nutrition and the treatment of critically ill newborns. This invasive procedure is regarded as safe and associated with low complication rate. Possible life-threatening complications...

Netherton Syndrome (NS) is a very rare genetic skin disease resulting from defects in the SPINK5 gene (encoding the protease inhibitor lympho-epithelial Kazal type inhibitor 1, LEKTI1). In this report, we provide a detailed clinical description of a Polish patient with two SPINK5 mutations, the novel c.1816_1820+21delinsCT and possibly recurrent c....

Noonan syndrome (NS) is a clinically heterogeneous and autosomal dominant disorder which occurs with a frequency of 1:1000–2500 live births regardless of gender. The most characteristic clinical features are: short stature, congenital heart defects, numerous and various dysmorphic features (eg.: hypertelorism, palpebral fissures slant down, low-set...

Renal vein thrombosis (RVT) in neonates is a rare condition of low mortality but significant morbidity due to renal impairment. We report the case of a male term newborn with left RVT and elevated serum factor VIII (FVIII). The main symptoms of the patient and the important clinical findings: prompt diagnosis of RVT was possible because the classic...

coauthor with M.Nehring-Gugulaska, P.Nehring

Aplasia cutis congenita (ACC) is usually located on the hairy scalp, on the vertex of the head, but can also occur in other locations, such as limbs, trunk. Congenital skin aplasia on the lower limb is very rare disorder. The exact etiopathogenesis is not known, but intrauterine conditions play a role in its development. ACC visually resembles an u...

Congenital defects are some of the most common reasons of neonatal morbidity and in some cases those may have lethal prognosis. Progress in the diagnostics of congenital defects enables most cases to be diagnosed prenatally. Because of that reason, the number of newborn with lethal defect diagnosed prenatally increases. Diagnosis of lethal defect i...

In the past decades, we have observed a large increase in the number of multifetal pregnancies, which is mainly associated with the introduction of assisted reproductive techniques. Even though neonatal intensive care of very premature infants has improved significantly, the risk of mortality and long-term morbidity is still much higher among these...

Objective: The objective of the study was to investigate whether concentrations of chemokines in the umbilical cord blood of neonates are affected by delivery via cesarean section. Study design: Umbilical cord blood was obtained from 116 singleton late-preterm and full-term neonates without infections, born to healthy pregnant women. Concentrations...

Introduction: Natural killer (NK) cells are an important element connecting innate and acquired resistance in humans. They can be detected in fetal liver since the 6th week of pregnancy and in the second half of pregnancy the number increases to values observed in adults. The main aim of the study was the assessment of the NK cells and defining a r...

AimThe aim of the study was quantitative evaluation and determination to what degree the time of delivery causes a change in percentage and number of CD19+ lymphocytes and their subpopulations CD5+, CD23+.

To define to what degree time and the way of delivery cause changes in CD3+ lymphocytes and their subpopulations CD4+, CD8+, CD25+ and CD19+ lymphocytes and their subpopulations CD5+, CD23+. 49 healthy neonates born in the years 1998-2003 in the Clinical Ward of Perinatology and Gynecology of Silesian Medical University in Zabrze were examined. Tak...

To define a relationship between emergency and elective indications for cesarean section and quantitative changes of percentage and quantity of T and B lymphocytes and their subpopulations in healthy full-term neonates. The study included 43 healthy neonates born in the years 1998 - 2003 in the Department of Perinatology and Gynecology of Silesian...

Liver fibrosis plays a pivotal role in liver function impairment. Hepatic fibrosis is a complex process that involves changes in the amounts of extracellular matrix components, activation of cells capable of producing matrix materials, cytokin release, and tissue remodelling. Chronic disturbed lymph flow from the liver induced fibrosis in this orga...

Aim and material. The assessment of etiology, perinatal risk factors, clinical signs and results of the treatment of meningitis in 38 (28 boys, 10 girls) full-term neonates, among them 19 with early-onset and 19 with late-onset. Results. In all neonates with early-onset meningitis and in 89% of late-onset perinatal risk factors were stated. Etiolog...