Isabel Benavente-Fernández

University of Cádiz/ Hospital Universitario Puerta del Mar, Cádiz

Background Stability during early postnatal life in preterm infants is related to better outcomes. Although vital signs are monitored continuously in Neonatal Intensive Care Unites, this monitoring does not include all physiological parameters nor data such as movement patterns. Although there are scattered sources of data, there is no centralized...

Introduction Several studies demonstrate the relationship between preterm birth and a reduced thalamus volume at term-equivalent age. In contrast, this study aims to investigate the link between the thalamic growth trajectory during the early postnatal period and neurodevelopment at two years of age. Methods Thalamic volume was extracted from 84 e...

Preterm infants are prone to NeuroDevelopmental Impairment (NDI). Some previous works have identified clinical variables that can be potential predictors of NDI. However, machine learning (ML)-based models still present low predictive capabilities when addressing this problem. This work attempts to evaluate the application of ML techniques to predi...

This study examines the association between nurses’ perception of caring and attitudes toward caring for dying patients in end-of-life care units. We used a descriptive cross-sectional design with convenience sampling. Data were collected from May to June 2021 through self-reported questionnaires from 303 Spanish nurses (mean age = 48 years, 78.9%...

In this study, we introduce MGA-Net, a novel mask-guided attention neural network, which extends the U-net model for precision neonatal brain imaging. MGA-Net is designed to extract the brain from other structures and reconstruct high-quality brain images. The network employs a common encoder and two decoders: one for brain mask extraction and the...

An early prediction of outcomes of neonatal hypoxic-ischemic encephalopathy (NE) is of key importance in reducing neonatal mortality and morbidity. The objectives were (i) to analyze the characteristics of miRNA expression and metabolic patterns of neonates with NE and (ii) to assess their predictive performance for neurodevelopmental outcomes. Pla...

b> Introduction: The SafeBoosC-III trial investigated the effect of cerebral oximetry-guided treatment in the first 72 h after birth on mortality and severe brain injury diagnosed by cranial ultrasound in extremely preterm infants (EPIs). This ancillary study evaluated the effect of cerebral oximetry on global brain injury as assessed by magnetic r...

Magnetic Resonance Imaging (MRI) plays an important role in neurology, particularly in the precise segmentation of brain tissues. Accurate segmentation is crucial for diagnosing brain injuries and neurodegenerative conditions. We introduce an Enhanced Spatial Fuzzy C-means (esFCM) algorithm for 3D T1 MRI segmentation to three tissues, i.e. White Ma...

Advances in neonatology have significantly reduced mortality rates due to prematurity. However, complications of prematurity have barely changed in recent decades. Germinal matrix-intraventricular hemorrhage (GM-IVH) is one of the most severe complications of prematurity, and these children are prone to suffer short- and long-term sequelae, includi...

Background The corpus callosum (CC) is suggested as an indirect biomarker of white matter volume, which is often affected in preterm birth. However, diagnosing mild white matter injury is challenging. Methods We studied 124 children born preterm (mean age: 8.4 ± 1.1 years), using MRI to assess CC measurements and cognitive/motor outcomes based on...

The purpose of this study is to define the impact of early brain growth trajectory in very low birth weight infants (VLBWI) on neurological prognosis at 2 years, assessed using sequential ultrasound (US) scans. This is a prospective cohort study with consecutive inclusion of VLBWI ≤ 32 weeks gestational age and ≤ 1500 g at birth. Total brain volume...

Objective The goal was to analyze parental competences in Spanish families with very‐low‐birth‐weight infants (≤32 weeks and/or less 1500 g) over 18 months of corrected age. Background Parenting in families of very preterm infants is an interesting focus of research as we advance in the knowledge of how parental competences can have an important i...

Objective: To study the potential role of ventricular volume (VV) estimation in the management of post-hemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP) shunt insertion and 2-year neurodevelopmental outcome in infants born preterm. Study design: We included 59 patients from the "Early vs Late Ventricular Interv...

Children born preterm have increased rates of paediatric mortality and morbidity. Prematurity has been associated with impaired visual perception and visuo-motor integration. The alteration of the perception of verticality translates into alterations of the vestibular system at central and/or peripheral level, which may manifest itself in symptoms...

Background: Massive infarction in adults is a devastating entity characterized by signs of extreme swelling of the brain's parenchyma. We explored whether a similar entity exists in neonates, which we call massive neonatal arterial ischemic stroke (M-NAIS), and assess its potential clinical implications. Methods: Prospective multicenter cohort s...

In this work we introduce NeoCam , an open source hardware-software platform for video-based monitoring of preterms infants in Neonatal Intensive Care Units (NICUs). NeoCam includes an edge computing device that performs video acquisition and processing in real-time. Compared to other proposed solutions, it has the advantage of handling data mo...

Background: Preterm infants develop smaller brain volumes compared to term newborns. Our aim is to study early brain growth related to perinatal factors in very low birth weight infants (VLBWI). Methods: Manual segmentation of total brain volume (TBV) was performed in weekly 3D-ultrasonographies in our cohort of VLBWI. We studied the brain growt...

The incidence of premature births continues to rise each year and premature babies require specialized care in neonatal intensive care units (NICUs). The intermittent monitoring of these babies, however, poses challenges for clinicians in terms of visualizing and detecting meaningful diagnostic trends. In order to address this issue, the adoption o...

Purpose Children born preterm have increased rates of paediatric mortality and morbidity. Prematurity has been associated with impaired visual perception and visuo-motor integration. The aim of this study was to compare Subjective Visual Vertical Test (SVV) scores in children born preterm compared to children born at term at ages between 7 and 10....

Germinal matrix-intraventricular hemorrhage (GM-IVH) is the most frequent intracranial hemorrhage in the preterm infant (PT). Long-term GM-IVH-associated sequelae include cerebral palsy, sensory and motor impairment, learning disabilities, or neuropsychiatric disorders. The societal and health burden associated with GM-IVH is worsened by the fact t...

Missing values are common in many real-life datasets. However, most of the current machine learning methods can not handle missing values. This means that they should be imputed beforehand. Gaussian Processes (GPs) are non-parametric models with accurate uncertainty estimates that combined with sparse approximations and stochastic variational infer...

Premature birth exponentially increases the risk for impaired neurological outcomes later in life, andearly diagnosis is critical to optimise therapeutic options. There is evidence that oculomotor movementscan be used as biomarkers for cognitive impairment (CI) in adults and young children. The aim of thisstudy is to develop a prototype of a test b...

Preterm birth is one of the leading causes of neurodevelopmental disabilities. Many efforts have been made to improve the well-being and quality of life of preterm infants and their families, especially during the first months of life. Several authors investigated cognitive impairments in children, such as social disorders or attention deficit, usi...

Objective: To determine how preterm white matter injury (WMI) and long-term thalamic growth interact to predict eight-year neurodevelopmental outcomes. Methods: A prospective cohort of 114 children born at 24-32 weeks' gestational age (GA) underwent structural and diffusion tensor magnetic resonance imaging early in life (median 32 weeks), at te...

Objectives: The aim of this study is to explore if manually segmented total brain volume (TBV) from 3D ultrasonography (US) is comparable to TBV estimated by magnetic resonance imaging (MRI). We then wanted to test 2D based TBV estimation obtained through three linear axes which would enable monitoring brain growth in the preterm infant during admi...

Objective In contrast to motor impairments, the association between lesion location and cognitive or language deficits in patients with neonatal arterial ischaemic stroke remains largely unknown. We conducted a voxel-based lesion-symptom mapping cross-sectional study aiming to reveal neonatal arterial stroke location correlates of language, motor a...

Objective: To develop and test the Neonatal Encephalopathy - Rating Scale (NE-RS), a new rating scale to grade the severity of neonatal encephalopathy (NE) within the first six hours after birth. Study design: A three-phase process was conducted: 1) design of a comprehensive scale that would be specific, sensitive, brief, and unsophisticated; 2)...

Objective To determine the usefulness of video recordings for validating neonatal encephalopathy (NE) exams. Design Population-based prospective cohort study. NE was assessed and recorded at 1, 3 and 5 hours after birth by the attending physician. Recordings were reviewed blindly after the recruitment period by two specialists. Outcome was assesse...

The role of rhinoviruses (RVs) in children with clinical syndromes not classically associated with RV infections is not well understood. We analyzed a cohort of children ≤21 years old who were PCR+ for RV at a large Pediatric Hospital from 2011 to 2013. Using univariate and multivariable logistic regression, we analyzed the associations between dem...

To train, evaluate, and validate the application of a deep learning framework in three-dimensional ultrasound (3D US) for the automatic segmentation of ventricular volume in preterm infants with post haemorrhagic ventricular dilatation (PHVD). We trained a 2D convolutional neural network (CNN) for automatic segmentation ventricular volume from 3D U...

The germinal matrix-intraventricular hemorrhage (GM-IVH) is one of the most devastating complications of prematurity. The short- and long-term neurodevelopmental consequences after severe GM-IVH are a major concern for neonatologists. These kids are at high risk of psychomotor alterations and cerebral palsy; however, therapeutic approaches are limi...

Objective To compare the effect of intervention at low versus high threshold of ventriculomegaly in preterm infants with posthemorrhagic ventricular dilatation on death or severe neurodevelopmental disability. Study design Multicenter randomized controlled trial. Lumbar punctures were initiated after either a low threshold (LT, ventricular index >...

Introduction There is not much information about the care of infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) in Spain. This includes whether protocols are routinely used, the type of neuro-monitoring performed, and how information on the neurological prognosis is presented to families. The answers to th...

Background Post-haemorrhagic ventricular dilatation can be measured accurately by MRI. However, two-dimensional (2-D) cranial US can be used at the bedside on a daily basis. Objective To assess whether the ventricular volume can be determined accurately using US. Materials and methods We included 31 preterm infants with germinal matrix intraventr...

Background: Myocardial function in very-low-birth-weight infants (VLBWIs) develops during early postnatal life, but different patterns of temporal evolution that might be related to the development of bronchopulmonary dysplasia (BPD) are not completely understood. Methods: A prospective cohort study including VLBWIs admitted to our NICU from Januar...

Improved intensive care therapies have increased the survival of children born preterm. Yet, many preterm children experience long-term neurodevelopmental sequelae. Indeed, preterm birth remains a leading cause of lifelong neurodevelopmental disability globally, posing significant challenges to the child, family, and society. Neurodevelopmental dis...

In Respiratory Syncytial Virus infection, the early identification of infants at risk for severe disease in order to potentially decrease morbidity could be considered a major goal. Current guidelines recommend only clinical observation for this purpose in infants without known comorbidities. However, recent evidence shows that the presence of pulm...

In this work we evaluate and validate the lateral ventricular brain volume obtained using transfontanellar three-dimensional ultrasound (3D US). The goal is to improve diagnosis of excessive dilation of ventricles after germinal matrix- intraventricular hemorrhage in the preterm infant, a complication known as posthemorrhagic ventricular dilatation...

OBJECTIVE: To develop a simple imaging rule to predict neurodevelopmental outcomes at 4.5 years in a cohort of preterm neonates with white matter injury (WMI) based on lesion location and examine whether clinical variables enhance prediction. METHODS: Sixty-eight preterm neonates born 24-32 weeks' gestation (median 27.7 weeks) were diagnosed with W...

Objective: To develop a simple imaging rule to predict neurodevelopmental outcomes at 4.5 years in a cohort of preterm neonates with white matter injury (WMI) based on lesion location and examine whether clinical variables enhance prediction. Methods: Sixty-eight preterm neonates born 24-32 weeks' gestation (median 27.7 weeks) were diagnosed wit...

The objective is to examine the correlation between plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) echocardiographic parameters in the first 28 days of life in very-low-birth-weight infants (VLBWI). VLBWI admitted to the Neonatal Intensive Care Unit (NICU) at Hospital Puerta del Mar, Spain, fr...

Introduction: There is not much information about the care of infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) in Spain. This includes whether protocols are routinely used, the type of neuro-monitoring performed, and how information on the neurological prognosis is presented to families. The answers to...

Aim: To investigate whether the presence of left ventricular myocardial dysfunction (LVMD) assessed by Tei index (LVTX) impacts the outcomes of healthy infants with Respiratory Syncytial Virus Bronchiolitis (RSVB). To explore whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) increases the accuracy of traditional clinical markers in pre...

Aim: To explore NT-proBNP as biomarker for pulmonary hypertension (PH) in infants with respiratory syncytial virus infection (RSVI). Patients & methods: We prospectively enrolled 93 healthy infants with RSVI aged 1-12 months. NT-proBNP determination and echocardiography were performed at admission. Results: PH was found in 22% of patients and assoc...

Objective To describe normal C-reactive protein (CRP) levels of newborns diagnosed with hypoxic-ischemic encephalopathy (HIE) and assess the influence of therapeutic hypothermia (TH) and the severity of HIE. Study Design We prospectively recruited infants ≥35 weeks of gestational age diagnosed with HIE from 2000 to 2013 and compared CRP levels in t...

Importance Studies of socioeconomic status and neurodevelopmental outcome in very preterm neonates have not sensitively accounted for brain injury. Objective To determine the association of brain injury and maternal education with motor and cognitive outcomes at age 4.5 years in very preterm neonates. Design, Setting, and Participants Prospective...

Bronchopulmonary dysplasia (BPD) is a severe complication of prematurity that impacts survival and neurodevelopment. Currently, no early marker exists which could help clinicians identify which preterm infants will develop BPD. Given the evidence that NTproBNP is elevated in children with BPD, we hypothesized that it could be used as an early marke...

Background and objectives: Therapeutic interventions to improve the efficacy of whole-body cooling for hypoxic-ischemic encephalopathy (HIE) are desirable. Topiramate has been effective in reducing brain damage in experimental studies. However, in the clinical setting information is limited to a small number of feasibility trials. We launched a ra...

The care of the umbilical cord until its detachment still remains controversial. The latest updated recommendations by the World Health Organisation advocate dry cord care in those countries with adequate obstetric care and low neonatal mortality rate. In recent years, new studies and reviews attribute some benefit to applying chlorhexidine on the...

Resumen El cuidado del cordón umbilical hasta su desprendimiento continúa siendo motivo de controversia en la actualidad. La Organización Mundial de la Salud recomienda en su última revisión realizar la cura en seco en países con cuidados obstétricos adecuados y una tasa baja de mortalidad neonatal. Por otro lado, en los últimos años han surgido nu...

s Objectives This study aims to analyze the variability between two trained neonatologists when performing consecutive echocardiograms using tissue Doppler imaging (TDI) and conventional methods in very low birth weight infant (VLBWI). Methods Two serial echocardiograms were performed in 30 VLBWI infants. The echocardiographic parameters analyzed...

Background: Although Respiratory Syncytial Virus infection (RSVI) causes predominantly pulmonary problems, myocardial involvement has been observed in previously healthy infants with severe RSVI. However, there is no strong evidence of RSVI-related myocardial inflammation, left ventricular (LV) dysfunction or LV dilation. Also, reduced RV function...

Objective: To compare the effect of early and late intervention for posthemorrhagic ventricular dilatation on additional brain injury and ventricular volume using term-equivalent age-MRI. Study design: In the Early vs Late Ventricular Intervention Study (ELVIS) trial, 126 preterm infants ≤34 weeks of gestation with posthemorrhagic ventricular di...

Internal carotid arterial dissection is a rare and probably underestimated cause of neonatal stroke. We report a case of neonatal stroke underscoring the role of Doppler sonography of the intracranial arteries for the diagnosis and follow‐up tool.

Introduction Cerebral oximetry using near-infrared regional spectroscopy (NIRS) provides continuous, non-invasive assessment of the degree of hemoglobin saturation of the brain tissue. Previous studies suggest that high values of regional cerebral tissue oxygen saturation (rScO22) during the first days in neonates with significant hypoxic-ischaemic...

Introduction: There is not much information about the care of infants with hypoxic-ischaemic encephalopathy (HIE) treated with therapeutic hypothermia (TH) in Spain. This includes whether protocols are routinely used, the type of neuro-monitoring performed, and how information on the neurological prognosis is presented to families. The answers to t...

Introduction Current guidelines in Spain recommend performing transthoracic echocardiography (TTE) in all children under 2 years of age with a heart murmur. In 2014, the American Paediatric Association published the first appropriate use criteria (AUC) for outpatient paediatric transthoracic echocardiography (TTE) to promote its cost-efficient use....

Background Neonatal encephalopathy with seizures after general anesthesia not occurring in infants undergoing cardiac or major neurosurgery is very uncommon. An ischemic origin due to cerebral hypoperfusion from perioperative hypotension has been suggested, but there is a lack of a consensus definition for intraoperatory hypotension in neonates. Ca...

Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) remains a serious complication in the preterm newborn. The significant increase of survival rates in extremelye preterm newborns has also contributed to increase the absolute number of patients developing GMH-IVH. However, there are relatively few available animal models to understand...

Neonatal facial palsy is very uncommon and is generally diagnosed at birth. We present the first published case of neonatal facial palsy with identification of herpes simplex virus 1 in cerebrospinal fluid. A 35-day-old male was presented at the Emergency Department with mouth deviation to the left and impossibility of full closure of the right eye...