povidone-iodine and Infant--Newborn--Diseases

Neonatal herpes infection is secondary to pre/perinatal viral contamination from mother by HSV2 (70 p. 100) or HSV1 (30 p. 100). Incidence in French population is closed to 3/100,000 live births corresponding to 20 cases per year. Risk for maternal viral transmission to the neonate is 30 p. 100 with genital herpetic primo infection and 3 p. 100 in recurrence. However, in 70 p. 100 of cases, maternal history is not contributive. Three main clinical presentations are described However atypical symptoms - as isolated fever - can be a telltale sign. Mean clinical delay from birth to first clinical symptoms is 6 to 12 days and neonate is usually symptom - free at birth. Viral cultures from pharynx, stools, cutaneous lesions and specific PCR in blood and cerebrospinal fluid confirm the diagnosis. Curative treatment is acyclovir at high dosage - 60 mg/kg/d - during 14 days for localized forms and 21 days for neurological and disseminated diseases. Compared to conventional dosages, this treatment leads to a reduction in mortality which however remains high in disseminated forms, 31 p. 100 and 6 to 11 p. 100 in CNS infection. Morbidity is also high in survived patients, 17 p. 100 and 31 p. 100 respectively. Efficacy of prophylactic viral decontamination by anti-herpetic eye drops and cutaneous polyvidone iodine bath, which is largely used at birth in France, has never been evaluated.

Topics: Acyclovir; Anti-Infective Agents, Local; Antiviral Agents; Drug Therapy, Combination; Female; France; Herpes Simplex; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Infant, Newborn; Infant, Newborn, Diseases; Povidone-Iodine; Pregnancy; Pregnancy Complications, Infectious

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Iodides; Povidone; Povidone-Iodine; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Thyroid Diseases; Thyroid Hormones; Thyrotropin; Thyroxine; Triiodothyronine

Topics: Disinfection; Female; Humans; Hypothyroidism; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Male; Povidone; Povidone-Iodine; Preoperative Care; Prospective Studies; Sterilization; Thyrotropin; Thyroxine

Topics: Administration, Topical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Povidone; Povidone-Iodine; Thyroid Diseases; Thyroid Function Tests; Thyrotropin

Topics: Female; Hernia, Umbilical; Humans; Hypothyroidism; Infant, Newborn; Infant, Newborn, Diseases; Povidone; Povidone-Iodine; Thyroid Gland

While screening 30 000 children for congenital hypothyroidism by radioimmunological determination of thyroid stimulating hormone (TSH) in blood spotted on filter paper on the 5th day of life, 12 neonates were found with this condition. In addition 99 infants were found who showed temporarily elevated TSH levels (20-80 microU/ml). Seven of the transitory cases could be traced to a vaginal application of povidone-iodine in the mother. Alimentary iodine deficiency, which is known to exist in parts of Lower Saxony, may be another explanation for some of the others.

Topics: Congenital Hypothyroidism; Female; Humans; Hypothyroidism; Infant, Newborn; Infant, Newborn, Diseases; Iodine; Maternal-Fetal Exchange; Povidone-Iodine; Pregnancy; Surveys and Questionnaires; Thyrotropin

Severe iodine-induced hypothyroidism was recently diagnosed in several neonates raising the responsibility of the iodine antiseptic agents routinely used in these patients. Postnatal iodine overload due to cutaneous application of these agents (povidone iodine and fluorescinated alcoholic-iodine solution) was studied in 5 patients. Thyroid function studies were performed in iodine-overload neonates and in control neonates with comparable gestional age. Results indicated strong evidence of cutaneous absorption of iodine from the antiseptic agents used, leading to hypothyroidism in 12 of them. The frequency and the severity of thyroid dysfunction was closely related to the degree of prematurity. Full recovery was observed in all cases after withdrawal of the iodine-containing agents. It is therefore recommended to avoid any postnatal use of iodine preparations in neonates, mainly in preterm infants, and to use iodine antiseptic agents with great caution, when necessary during the neonatal period.

Topics: Anti-Infective Agents, Local; Benzalkonium Compounds; Female; Gestational Age; Humans; Hypothyroidism; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Iodine; Male; Povidone-Iodine; Retrospective Studies; Thyroid Function Tests

Topics: False Positive Reactions; Hematuria; Humans; Infant, Newborn; Infant, Newborn, Diseases; Povidone-Iodine