Neonatology pp 471-480 | Cite as

Primary Investigations in the Term and Preterm Newborn

  • Diego GazzoloEmail author
  • Francesco Risso
  • Andrea Sannia
Reference work entry


Admission to nursery or to neonatal intensive care unit represents one of the topic moments in newborn’s early post-natal life. Moving from adequate obstetrical history documentation according to maternal-fetal risk factors and to gestational age at birth, the neonatal team have to decide which clinical, laboratory and diagnostic procedure need to be performed. Some primary investigations such as metabolic screening are generally regulated by national governments, independently from clinical conditions, whilst others depend from perinatal risk factors and by clinical evaluation at birth. This refers to the occurrence in term and preterm newborns of the main post-natal complications such as infections, glucose and bilirubinemia metabolism disturbances. Although respiratory, cardiovascular and cerebral complications account in the majority of preterm infants, these clinical aspects have to be taken into the due consideration also in term newborns. In the present chapter on overview on new insight on neonatal laboratory technique and in non-invasive monitoring devices currently used in nursery and in intensive care is provided.


  1. American Academy of Pediatrics, American College of Obstetricians and Gynecologist (2002) Guidelines for perinatal care, 5th edn. American Academy of Pediatrics, Elk Grove VillageGoogle Scholar
  2. Benitz WE, Han MY, Madan A, Ramachandra P (1998) Serial serum C-reactive protein levels in the diagnosis of neonatal infection. Pediatrics 102:E41CrossRefGoogle Scholar
  3. Bibby E, Stewart A (2004) The epidemiology of preterm birth. Neuro Endocrinol Lett 25(Suppl 1):43–47PubMedGoogle Scholar
  4. Binder N, Atherton H, Thorkelsson T, Hoath SB (1994) Measurement of transcutaneous carbon dioxide in low birthweight infants during the first two weeks of life. Am J Perinatol 11:237–241CrossRefGoogle Scholar
  5. Brat R, Yousef N, Klifa R, Reynaud S, Shankar Aguilera S, De Luca D (2015) Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr 169(8):e151797. Epub 2015 Aug 3CrossRefPubMedGoogle Scholar
  6. Brouillette RT, Waxman DH (1997) Evaluation of the newborn’s blood gas status. Clin Chem 43:215–221PubMedGoogle Scholar
  7. Campi R, Bonati M (2007) Italian child health statistic review: births and deaths. Ital J Pediatr 33:67–73Google Scholar
  8. Challis JR, Lye SJ, Gibb W (2001) Understanding preterm labor. Ann N Y Acad Sci 943:225–234CrossRefGoogle Scholar
  9. Cornblath M, Schwartz R (1993) Hypoglycemia in the neonate. J Pediatr Endocrinol 6:113–129PubMedGoogle Scholar
  10. Crider KS, Whitehead N, Buus RM (2005) Genetic variation associated with preterm birth: a HuGE review. Genet Med 7:593–604CrossRefGoogle Scholar
  11. de Vries LS, Benders MJ, Groenendaal F (2015) Progress in neonatal neurology with a focus on neuroimaging in the preterm infant. Neuropediatrics 46(4):234–241. Epub 2015 Jun 29CrossRefPubMedGoogle Scholar
  12. Delanghe JR, Speeckaert MM (2015) Translational research and biomarkers in neonatal sepsis. Clin Chim Acta 451(Pt A):46–64. Epub 2015 Feb 4. ReviewCrossRefPubMedGoogle Scholar
  13. DuClos T (2000) Function of C-reactive protein. Ann Med 32:274–278CrossRefGoogle Scholar
  14. Escobar GJ, Dekun L, Armstrong MA et al (2000) Neonatal sepsis workups in infants 2000 grams at birth: a population-based study. Pediatrics 106:256–263CrossRefGoogle Scholar
  15. Gabay C, Kushner I (1999) Mechanisms of disease: acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340:448–454CrossRefGoogle Scholar
  16. Genc MR, Onderdonk AB, Vardhana S et al (2004) Polymorphism in intron 2 of the interleukin-1 receptor antagonist gene, local midtrimester cytokine response to vaginal flora, and subsequent preterm birth. Am J Obstet Gynecol 191:1324–1330CrossRefGoogle Scholar
  17. Geven WB, Nagler E, deBoo T, Lemmens W (1987) Combined transcutaneous oxygen, carbon dioxide tensions and end-expired CO2 levels in severely ill newborns. Adv Exp Med Biol 220:115–120PubMedGoogle Scholar
  18. Goldstein MR, Martin GI, Sindel BD et al (1997) Novel pulse oximetry technology resistant to noise artifact and low perfusion: “the neonatal model”. Am J Respir Crit Care Med 155:A717Google Scholar
  19. Green NS, Damus K, Simpson JL et al (2005) Research agenda for preterm birth: Recommendations from the March of Dimes. Am J Obstet Gynecol 193:626–635CrossRefGoogle Scholar
  20. Holditch-Davis D, Scher M, Schwartz T (2004) Respiratory development in preterm infants. J Perinatol 24:631–639CrossRefGoogle Scholar
  21. Holmes JM, Zhang S, Leske DA, Lanier WL (1998) Carbon dioxide-induced retinopathy in the neonatal rat. Curr Eye Res 17:608–616CrossRefGoogle Scholar
  22. Institute of Medicine, Committee on Understanding Premature Birth and Assuring Healthy Outcomes (2007) Preterm birth: causes, consequences, and prevention. National Academies Press, Washington, DCGoogle Scholar
  23. Jeffrey S, Gerdes MD (2004) Diagnosis and management of bacterial infections in the neonate. Pediatr Clin North Am 51:939–959CrossRefGoogle Scholar
  24. Johnson WG, Scholl TO, Spychala JR et al (2005) Common di- hydrofolate reductase 19-base pair deletion allele: a novel risk factor for preterm delivery. Am J Clin Nutr 81:664–668CrossRefGoogle Scholar
  25. Kite P, Millar MR, Gorham P et al (1988) Comparison of 5 tests in diagnosis of neonatal bacteraemia. Arch Dis Child 63:639–643CrossRefGoogle Scholar
  26. Kogan MD (1995) Social causes of low birth weight. J R Soc Med 88:611–615PubMedPubMedCentralGoogle Scholar
  27. Levy HL (1998) Newborn screening by tandem mass spectrometry: a new era. Clin Chem 44:2401–2402PubMedGoogle Scholar
  28. Macones GA, Parry S, Elkousy M et al (2004) A polymorphism in the promoter region of TNF and bacterial vaginosis: preliminary evidence of geneenvironment interaction in the etiology of spontaneous preterm birth. Am J Obstet Gynecol 190:1504–1508CrossRefGoogle Scholar
  29. Marsden D, Larson C, Levy HL (2006) Newborn screening for metabolic disorders. J Pediatr 148:577–584CrossRefGoogle Scholar
  30. Maternal and Child Health Bureau (2006) Newborn Screening: Toward a Uniform Screening Panel and System.
  31. Mathews TJ, Menacker F, MacDorman MF (2004) Infant mortality statistics from the 2002 period: linked birth/infant death data set. Natl Vital Stat Rep 53:1–29PubMedGoogle Scholar
  32. Meem M, Modak JK, Mortuza R, Morshed M, Islam MS, Saha SK (2011) Biomarkers for diagnosis of neonatal infections: a systematic analysis of their potential as a point-of-care diagnostics. J Glob Health 1(2):201–209PubMedPubMedCentralGoogle Scholar
  33. Moore S, Ide M, Randhawa M et al (2004) An investigation into the association among preterm birth, cytokine gene polymorphisms and periodontal disease. BJOG 111:125–132CrossRefGoogle Scholar
  34. Morrison JJ, Rennie JM (1997) Clinical, scientific and ethical aspects of fetal and neonatal care at extremely preterm periods of gestation. Br J Obstet Gynaecol 104:1341CrossRefGoogle Scholar
  35. Nuntnarumit P, Yang W, Bada-Ellzey HS (1999) Blood pressure measurements in the newborn. Clin Perinatol 26:981–996CrossRefGoogle Scholar
  36. O’Flynn ME (1992) Newborn screening for phenylketonuria: thirty years of progress. Curr Probl Pediatr 22:159–165CrossRefGoogle Scholar
  37. Ombrone D, Giocaliere E, Forni G, Malvagia S, la Marca G (2016) Expanded newborn screening by mass spectrometry: new tests, future perspectives. Mass Spectrom Rev 35(1):71–84. Epub 2015 May 7CrossRefGoogle Scholar
  38. Rodwell RL, Taylor KM, Tudehope DI, Gray PH (1993) Hematologic scoring system in early diagnosis of sepsis in neutropenic newborns. Pediatr Infect Dis J 12:372–376CrossRefGoogle Scholar
  39. Sahni R, Gupta A, Ohira-Kist K et al (2003) Motion resistant pulse oximetry in neonates. Arch Dis Child Fetal Neonat Ed 88:F505–F508CrossRefGoogle Scholar
  40. Schelonka RL, Bradley YA, desJardins SE et al (1994) Peripheral leukocyte count and leukocyte indexes in healthy newborn term infants. J Pediatr 125:603–606CrossRefGoogle Scholar
  41. Suberviola B, Márquez-López A, Castellanos-Ortega A, Fernández-Mazarrasa C, Santibáñez M, Martínez LM (2016) Microbiological diagnosis of sepsis: polymerase chain reaction system versus blood cultures. Am J Crit Care 25(1):68–75. Scholar
  42. Taeusch HW, Ballard RA, Gleason CA (2005) Avery’s disease of the newborn, 8th edn. Elsevier Saunders, PhiladelphiaGoogle Scholar
  43. Wang X, Zuckerman B, Pearson C et al (2002) Maternal cigarette smoking, metabolic gene polymorphism, and infant birth weight. JAMA 287:195–202CrossRefGoogle Scholar
  44. Wilcox MA, Smith SJ, Johnson IR (1995) The effect of social deprivation on birthweight, excluding physiological and pathological effects. Br J Obstet Gynaecol 102:918–924CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neonatal Intensive Care Unit, Department of MaternalFetal and Neonatal Medicine, S. Arrigo Children’s HospitalAlessandriaItaly
  2. 2.Neonatal Intensive Care Unit, Department of Emergency MedicineG. Gaslini Children’s HospitalGenoaItaly

Personalised recommendations