Book Review:

Hematology, Immunology and Infectious Disease Neonatology Questions and Controversies

Robin K. Ohls and Mervin C.Yoyder

Saunders- Elsevier 2008: ISBN: 978-1-4160-3158-1

Series Editor: Richard Polin

Hard Cover. 294 pp, $78.

This is the latest in the ‘Neonatology Question and Controversies’ series. Its sixteen chapters have been written by experts from United States, Europe and Australia with first eleven addressing issues in neonatal immunology and hematology while the remaining chapters address various infection related subjects.

The earlier series had been very popular with neonatal clinicians thus I was looking forward to receiving my copy. However, going through it for this review I was a bit disappointed. I have no concern about the subjects chosen which have been written by ‘experts’ and edited succinctly. My concern is that the aims of 1) addressing controversial topics and advances in the field head on, 2) serve as a bridge between the latest cutting-edge research and its application to clinical practice have not been met.

The book starts with “ Stem Cell facts for Neonatologists”….I found this chapter fascinating and informative but it is not written in an user friendly manner thus, I suspect that the chapter would be of little use to a jobbing neonatologist. This is followed by an excellent, very useful and practical chapter on Thrombocytopenia. I found it a wonderful mix of information about recent advances and pragmatic advice on frequently faced clinical problems. There is then considerable duplication between the chapters ‘The Role of Leukocyte Colony Stimulating Factors in the Neonatal Intensive Care Unit’ and ‘Practical Approaches to the Neutropenic Neonate’ with a few differing messages.

After reading the chapter on ‘Why, When and how Should We Provide Red Cell Transfusion to Neonates?’ I was none the wiser except for reinforcing the view held by many neonatologists that deciding when to transfuse red cells to preterm infants remains problematic. The algorithm offers a pragmatic approach (with little evidence and there are many similar or perhaps better approaches available in literature) and the hematocrit values in the algorithm differ from those given in table 4-7. Whilst the chapter on ‘Controversies in Neonatal Thrombotic Disorders’ offered useful information but nothing that is not available in standard text and I was sad not to see any discussion on the controversies on the diagnosis and treatment of DIC.

The chapters on ‘What Evidence Supports Dietary Interventions to Prevent Infant Food Hypersensitivity and Allergy?’ and ‘Toll-like Receptor Responses in Neonatal Dendritic Cells’ provide deep insight into new and useful information which would improve neonatologists understanding of the subject. I found the ‘Maternally Mediated Neonatal Autoimmunity’ and ‘What Insights into Human Cord Blood Lymphocyte Function Can Be Gleaned from Studying Newborn Mice’ as highlights of the book. They are well written are highly informative and improved my understanding of the complex immune interactions between maternal and fetal immune systems and how lessons can be learnt from studying mice in our battle against infection. Chapters on ‘Influence of Passive Antibodies on the Immune Response of Young Infants’ and ‘Neonatal T-Cell Immunity and its regulation by Innate Immunity and Dendritic Cells’ were a good read but once again I did not find anything new that those interested in the subject do not already know…I suspect that will always be a problem in a book like this because of the rapid pace of change and advance in the field.

The two chapters I enjoyed most were ‘Breast Milk and Viral Infections’ and ‘Control of Antibiotic-Resistant Bacteria in the Neonatal Intensive Care Unit’. They are well written, balanced between what we know and what we should do. Sensible advice is given. My greatest disappointment was with the last two chapters ‘Neonatal Fungal Infections’ and ‘Effects of Chemoprophylaxis for Neonatal Group B Streptococcal Infections on the incidence of Gram-negative Infections and Antibiotic Resistance in Neonatal Pathogens’. They neither discuss the controversies which abound in these two area’s nor give any recent advances or any information that is not is already in the public domain.

In summary, I have mixed feelings about this book. I think it would be nice to have in a hospital’s library but I would not invest in it for my personal collection.

Khalid Haque

Professor of Neonatal Medicine

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