Delivery room management and outcome issues in the neonate

Issues relevant to term newborns include screening for functional neurologic deficits that may be improved by early detection and intervention. Papers are presented that consider ocular, acoustic, and cognitive evaluations in the term neonate. Delivery room management of the meconium-stained infant remains controversial and is discussed by several authors. Data are presented regarding intubation and its role in the prevention of meconium aspiration syndrome, causes of meconium passage in utero, and its significance for neonatal outcome. In addition, illicit drug use, especially cocaine, is a significant problem among pregnant women with multiple sequelae for the fetus and newborn. Papers reviewed include a comparison of neonatal drug screening techniques, fetal effects of subacute maternal cocaine use, and follow-up data in a large cocaine-exposed cohort. The impact of the cocaine problem is growing nationally, overwhelming existing programs for medical care and rehabilitation, and mandating change at all levels of intervention. Finally, the search for a definitive indicator or predictor of birth asphyxia continues to generate literature in both the pediatric and obstetric journals.