2025/05/09 更新

写真a

コバヤシ アキラ
小林 玲
KOBAYASHI Akira
所属
医歯学総合病院 総合周産期母子医療センター 講師
職名
講師
外部リンク

学位

  • 博士(医学) ( 2018年9月   新潟大学 )

研究分野

  • ライフサイエンス / 胎児医学、小児成育学

経歴(researchmap)

  • 新潟大学医歯学総合病院   総合周産期母子医療センター   講師

    2021年6月 - 現在

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  • 新潟大学医歯学総合病院   総合周産期母子医療センター

    2021年4月 - 2021年5月

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  • 長岡赤十字病院   新生児科

    2013年4月 - 2021年3月

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  • 新潟大学医歯学総合病院   総合周産期母子医療センター

    2010年4月 - 2013年3月

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  • 埼玉県立小児医療センター   未熟児新生児科

    2009年4月 - 2010年3月

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  • 新潟県立中央病院   小児科

    2008年4月 - 2009年3月

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  • 新潟大学医歯学総合病院   総合周産期母子医療センター

    2007年4月 - 2008年3月

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経歴

  • 新潟大学   医歯学総合病院 総合周産期母子医療センター   講師

    2021年6月 - 現在

学歴

  • 新潟大学   大学院医歯学総合研究科   生体機能調節医学専攻内部環境医学大講座小児科学

    - 2018年9月

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  • 新潟大学   医学部   医学科

    - 2001年3月

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委員歴

  • 日本周産期・新生児医学会   評議員  

    2022年 - 現在   

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    団体区分:学協会

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  • 日本新生児成育医学会   代議員  

    2020年 - 現在   

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    団体区分:学協会

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  • ハイリスク児フォローアップ研究会   幹事  

    2019年 - 現在   

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論文

  • High-Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure on Postnatal Growth and Feeding in Preterm Infants: A Secondary Analysis of the NIPPN Study. 査読 国際誌

    Yohei Minamitani, Shuntaro Oka, Naoyuki Miyahara, Mitsuhiro Haga, Atsushi Uchiyama, Masaki Wada, Kaoru Okazaki, Masatoshi Kondo, Nobuhiko Nagano, Akira Kobayashi, Yoshiki Soeno, Hidehiko Maruyama, Yushi Ito, Fumihiko Namba

    American journal of perinatology   2025年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE:  High-flow nasal cannula (HFNC) is generally considered to have fewer enteral feeding problems than nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation (NIPPV). However, the effects of HFNC on the feeding outcomes in preterm infants are still controversial. The aim of this study was to assess the effect of HFNC on postnatal growth and feeding. STUDY DESIGN:  We conducted a secondary analysis of a multicenter randomized controlled trial. Preterm infants born <34 weeks were randomly assigned to the HFNC or NCPAP/NIPPV groups after initial extubation between 2015 and 2018. Data on postnatal growth and oral feeds were analyzed. RESULTS:  Among 338 infants in the intention-to-treat analysis, the weight at 36 weeks in the HFNC group was significantly higher than that in the NCPAP/NIPPV group (1,926 vs. 1,804 g, p = 0.04). In the per-protocol analysis, HFNC showed increased daily weight gain from extubation to discharge after adjusting for confounding factors (24.2 vs. 22.4 g/day, adjusted difference 1.65 g/day, 95% confidence interval [CI]: 0.12-3.18). In the subgroup of infants born at 22 to 27 weeks, the weight at 36 weeks was significantly higher in the HFNC group (1,809 vs. 1,730 g, adjusted difference = 113.4 g, 95% CI: 5.0-221.8). There was no significant difference in time at initial and reached full oral feeding. CONCLUSION:  In preterm infants, especially extremely preterm infants, the use of HFNC may be associated with better weight gain. KEY POINTS: · HFNC showed better weight gain compared with NCPAP/NIPPV in preterm infants.. · HFNC was associated with higher weight at 36 weeks postmenstrual age in extremely preterm infants.. · This study suggests that HFNC may have benefits in postnatal growth among extremely preterm infants..

    DOI: 10.1055/a-2512-9531

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  • Preterm Infant with Generalized Arterial Calcification of Infancy Who Survived Due to Early Diagnosis and Appropriate Treatment with Bisphosphonates: A Case Report. 査読 国際誌

    Masato Tanaka, Akira Kobayashi, Haruhiro Kuwabara, Jun Nirei, Junichi Ozawa, Kentaro Sawano, Nao Shibata, Keisuke Nagasaki, Akihiko Saitoh

    Children (Basel, Switzerland)   11 ( 10 )   2024年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Generalized arterial calcification of infancy (GACI) is a rare disease characterized by arterial calcification. GACI is caused by a mutation in the ENPP1 or ABCC6 genes. GACI causes severe hypertension and heart failure, and approximately 50% of patients die within the first 6 months. In particular, preterm infants with GACI often die due to immature cardiac function. Bisphosphonates are effective in treating GACI; however, no standardized treatment regimen is available. We experienced a case of a preterm infant with GACI born at 30 weeks gestation. Ultrasonography showed high-intensity lesions in the arteries, and computed tomography revealed calcification of the arteries throughout the body, leading to the diagnosis of GACI. We administered intravenous pamidronate, and her cardiac contraction improved. The initial scheduled interval between drug administrations was 2 months. However, the cardiac contraction worsened 1 month after the pamidronate administration. Therefore, we decreased the dosing interval and administered a second course of pamidronate, which improved her cardiac function. We then switched to oral etidronate. To improve the morbidity and mortality rates of preterm infants with GACI, it is important to obtain an early diagnosis of GACI by investigating high-intensity lesions in the arteries and performing early administration of an appropriate type of bisphosphonate.

    DOI: 10.3390/children11101176

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  • Severe Bronchopulmonary Dysplasia Adversely Affects Brain Growth in Preterm Infants. 査読 国際誌

    Taiki Shimotsuma, Seiichi Tomotaki, Mitsuyo Akita, Ryosuke Araki, Hiroko Tomotaki, Kougoro Iwanaga, Akira Kobayashi, Akihiko Saitoh, Yasutaka Fushimi, Junko Takita, Masahiko Kawai

    Neonatology   1 - 9   2024年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Bronchopulmonary dysplasia (BPD) is associated with neurodevelopmental outcomes of preterm infants, but its effect on brain growth in preterm infants after the neonatal period is unknown. This study aimed to evaluate the effect of severe BPD on brain growth of preterm infants from term to 18 months of corrected age (CA). METHODS: Sixty-three preterm infants (42 with severe BPD and 21 without severe BPD) who underwent magnetic resonance imaging at term equivalent age (TEA) and 18 months of CA were studied by using the Infant Brain Extraction and Analysis Toolbox (iBEAT). We measured segmented brain volumes and compared brain volume and brain growth velocity between the severe BPD group and the non-severe BPD group. RESULTS: There was no significant difference in brain volumes at TEA between the groups. However, the brain volumes of the total brain and cerebral white matter in the severe BPD group were significantly smaller than those in the non-severe BPD group at 18 months of CA. The brain growth velocities from TEA to 18 months of CA in the total brain, cerebral cortex, and cerebral white matter in the severe BPD group were lower than those in the non-severe BPD group. CONCLUSION: Brain growth in preterm infants with severe BPD from TEA age to 18 months of CA is less than that in preterm infants without severe BPD.

    DOI: 10.1159/000538527

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  • Cord blood granulocyte Colony-Stimulating factor level as an optimal predictor of umbilical cord arteritis associated with brain injury at term equivalent age in preterm neonates. 査読 国際誌

    Jun Nirei, Akira Kobayashi, Rie Habuka, Hisanori Domon, Yutaka Terao, Akihiko Saitoh

    Cytokine   171   156369 - 156369   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The study aimed 1) to evaluate the association between the presence or absence of umbilical cord arteritis (UCA) and the cord blood cytokine levels, and 2) morbidity and mortality of preterm neonates; and 3) to identify predictive markers for UCA of preterm neonates. STUDY DESIGN: In this single-center retrospective observational cohort study, preterm neonates born at gestational age (GA) < 36 weeks were categorized pathologically according to the severity of intrauterine inflammation; those without UCA as Group 1, those with UCA as Group 2, and those without any intrauterine inflammation as Group 3 (control), and subgroup analyses classified by their GA were performed. We compared morbidity and mortality, and eight representative cytokine levels in cord blood samples between the groups. Subsequently, receiver operating characteristics (ROC) curves for UCA diagnosis for each cytokine were created, and values of areas under the curve (AUC) were calculated to determine the optimal predictive markers. RESULTS: In total, 105 patients (36, 58, and 11 in Groups 1, 2, and 3, respectively) were included. Multivariate logistic analysis revealed that patients with UCA had higher incidence of brain injury (Odds Ratio [OR] = 8.53, P = 0.0049, 95% Confidence Interval [CI]: 1.91 - 38.0), at term equivalent age in the subgroup analysis with GA < 32 weeks. Although the median value of cord blood granulocyte colony-stimulating factor (G-CSF) was significantly higher in Group 2 than in Group 1 or 3, only the G-CSF level was found to be high in the subgroup analysis with GA < 32 weeks. For UCA diagnosis, the AUC values of G-CSF were the highest among eight cytokines including interleukin 6 (IL-6). These findings were similar in the subgroup analysis with GA < 32 weeks. CONCLUSIONS: Preterm neonates, especially born at GA < 32 week, had higher morbidity from brain injury in the group with UCA. The cord blood G-CSF level was highly accurate for predicting UCA and could thus be used as an optimal biomarker.

    DOI: 10.1016/j.cyto.2023.156369

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  • School-Age Outcomes of Antenatal Magnesium Sulphate in Preterm Infants 査読

    Akira Kobayashi, Masato Ito, Erika Ota, Fumihiko Namba

    Children   10 ( 8 )   1324 - 1324   2023年7月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:MDPI AG  

    Background: Antenatal magnesium sulphate (MgSO4) therapy given to women at risk of preterm birth reduced the risk of cerebral palsy in early childhood. However, its effect on longer-term neurological outcomes remains uncertain. This study aimed to assess the effects of antenatal MgSO4 therapy on school-age outcomes of preterm infants. Methods: We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, CENTRAL, and CINAHL for randomized controlled trials (RCTs). Two reviewers independently evaluated the eligibility for inclusion and extracted data. Results: Ten RCTs were included. Only two of them were on school-age outcomes. Antenatal MgSO4 therapy had no impact on cerebral palsy, hearing impairment, neurosensory disability, and death at school-age. Meta-analysis on mental retardation and visual impairment was not able to be performed due to different methods of evaluation. In the analysis of short-term outcomes conducted as secondary outcomes, antenatal MgSO4 therapy increased the risk of maternal adverse events with any symptom (3 RCTs; risk ratio 2.79; 95% confidence interval 1.10 to 7.05, low certainty of evidence) but was not associated with any neonatal symptoms. Conclusions: The number of cases was insufficient to determine the impact of antenatal MgSO4 therapy on school-age outcomes. Further accumulation of long-term data is required.

    DOI: 10.3390/children10081324

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  • Randomized Controlled Trial of High-Flow Nasal Cannula in Preterm Infants After Extubation. 査読 国際誌

    Atsushi Uchiyama, Kaoru Okazaki, Masatoshi Kondo, Shuntaro Oka, Yukiko Motojima, Fumihiko Namba, Nobuhiko Nagano, Kayo Yoshikawa, Kazunori Kayama, Akira Kobayashi, Yoshiki Soeno, Osamu Numata, Hideyo Suenaga, Ken Imai, Hidehiko Maruyama, Hideshi Fujinaga, Hiroyuki Furuya, Yushi Ito

    Pediatrics   146 ( 6 )   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Our aim is to compare the efficacy and safety of high-flow nasal cannula (HFNC) against those of nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation (NIPPV) after extubation in preterm infants. METHODS: This prospective, randomized, noninferiority trial was conducted in 6 tertiary NICUs. Infants born at <34 weeks who needed noninvasive ventilation after extubation were enrolled. We randomly assigned infants to an HFNC group when HFNC was used or to an NCPAP/NIPPV group when NCPAP or NIPPV was used. The primary outcome was treatment failure within 7 days after extubation. We then examined clinical aspects of treatment failure with HFNC use. RESULTS: In total, 176 and 196 infants were assigned to the HFNC and NCPAP/NIPPV groups, respectively. The HFNC group showed a significantly higher rate of treatment failure than that of the NCPAP/NIPPV group, with treatment failure occurring in 54 infants (31%) compared with 31 infants (16%) in the NCPAP/NIPPV group (risk difference, 14.9 percentage points; 95% confidence interval, 6.2-23.2). Histologic chorioamnionitis (P = .02), treated patent ductus arteriosus (P = .001), and corrected gestational age at the start of treatment (P = .007) were factors independently related to treatment failure with HFNC use. CONCLUSIONS: We found HFNC revealed a significantly higher rate of treatment failure than NCPAP or NIPPV after extubation in preterm infants. The independent factors associated with treatment failure with HFNC use were histologic chorioamnionitis, treated patent ductus arteriosus, and a younger corrected gestational age at the start of treatment.

    DOI: 10.1542/peds.2020-1101

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  • Thyroid function in asphyxiated newborns who received hypothermia therapy. 査読 国際誌

    Akira Kobayashi, Touhei Usuda, Masaki Wada, Takayuki Kaneko, Kinuko Kojima, Akihiko Saitoh

    Pediatrics international : official journal of the Japan Pediatric Society   60 ( 5 )   433 - 437   2018年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Thyroid function in asphyxiated newborns who received hypothermia therapy and its relation to neurological outcome are not well described. METHODS: We performed a prospective study to measure thyroid function in 12 asphyxiated newborns who received hypothermia therapy. We measured serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) on admission, at 24, 72, and 96 h after birth, and at discharge (range, 17-54 days). The 12 newborns were divided into two groups based on the presence of brain injury on head magnetic resonance imaging (six in the abnormal imaging group and six in the normal imaging group), and thyroid function was compared between the two groups. RESULTS: Serum TSH was within the normal range in the 12 newborns. Serum FT3 and FT4 remained low at 24, 72, and 96 h after birth, and returned to normal range at discharge in the 12 newborns. There was no significant difference in serum TSH between the two groups, but serum FT3 at 96 h after birth, and serum FT4 at 72 and 96 h after birth, were significantly lower in the abnormal imaging group than in the normal imaging group (P = 0.02; P = 0.03; and P = 0.01, respectively). CONCLUSIONS: Asphyxiated newborns have transient low thyroid hormone levels at 24-96 h after birth. Serum FT3 and FT4 between 72 and 96 h after birth may predict brain injury in asphyxiated newborns.

    DOI: 10.1111/ped.13534

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  • Human parechovirus type 3 infection: Cause of apnea in infants born prematurely. 査読 国際誌

    Jun Nirei, Yuta Aizawa, Minoru Okazaki, Akira Kobayashi, Junya Onozuka, Osamu Numata, Tomohiro Oishi, Akihiko Saitoh

    Pediatrics international : official journal of the Japan Pediatric Society   58 ( 5 )   400 - 402   2016年5月

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    記述言語:英語  

    Four infants born prematurely presented with multiple apnea episodes caused by human parechovirus type 3 (HPeV3) infection. All patients required oxygen supplementation, and one patient required mechanical ventilation. HPeV3 infection might be included in the differential diagnosis of apnea in neonates and young infants, especially those born prematurely.

    DOI: 10.1111/ped.12869

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  • Interleukin-6 polymorphism and bronchopulmonary dysplasia risk in very low-birthweight infants. 査読 国際誌

    Touhei Usuda, Takehiro Kobayashi, Seiichi Sakakibara, Akira Kobayashi, Takayuki Kaneko, Masaki Wada, Junya Onozuka, Osamu Numata, Katsumi Torigoe, Hajime Yamazaki, Takashi Sato, Yoshihisa Nagayama, Makoto Uchiyama

    Pediatrics international : official journal of the Japan Pediatric Society   54 ( 4 )   471 - 5   2012年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The aim of the present study was to evaluate the role of interleukin (IL)-6-634 polymorphism in neonatal disorders such as bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL) in very low-birthweight (VLBW) infants. METHODS: This prospective cohort study included 202 infants (gestational age at birth, 23-34 weeks; birthweight, 500-1499 g). Genotypic analysis (polymerase chain reaction-restriction fragment length polymorphism) was performed with DNA extracted from whole-blood samples. RESULTS: Genotype distribution (66.8% CC, 28.2% CG, 5.0% GG) was similar to that in the adult Japanese population. BPD occurred in 85 infants (42.1%) among 202 VLBW infants. The duration of O(2) therapy in infants with CG/GG genotypes was significantly longer than that in infants with the CC genotype (CG/GG vs CC: 40.3 ± 52.2 days vs 28.4 ± 32.6 days, P < 0.05), but the prevalence of BPD was not associated with the CG/GG genotype (CG/GG, 40.0%; CC, 46.3%, P= 0.24). Infants with CG/GG genotypes were more likely to have received postnatal corticosteroid therapy for BPD than those with the CC genotype (CG/GG vs CC: 20.9% vs 11.1%, P = 0.05). PVL occurred in six infants (3.0%). There was no significant difference in the prevalence of PVL among IL-6-634 polymorphisms (CG/GG, 3.0%; CC, 3.0%, P = 0.65). CONCLUSIONS: IL-6-634 polymorphism is associated with duration of oxygen therapy in VLBW infants. This suggests that the IL-6-634 polymorphism G allele is an aggravating factor of BPD. IL-6-634 polymorphism is not associated with PVL.

    DOI: 10.1111/j.1442-200X.2012.03625.x

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担当経験のある授業科目

  • 病気と遺伝学

    2024年
    -
    現在
    機関名:新潟大学

  • 周産期病態論

    2023年
    -
    現在
    機関名:新潟大学

  • 助産学特論

    2023年
    -
    現在
    機関名:新潟大学