Journal of neonatal-perinatal medicine最新文献

{"title":"A prospective observational study comparing the developmental changes in work of breathing indices and oxygen saturation of term and preterm infants at birth. Do premature infants compensate?","authors":"Kanishk Jha, Thomas H Shaffer, Amy Mackley, Shannon Traczykiewicz, Tariq Rahman, Keshab Subedi, Kelley Kovatis","doi":"10.1177/19345798251384932","DOIUrl":"https://doi.org/10.1177/19345798251384932","url":null,"abstract":"<p><p>BackgroundIntrauterine lung development is a complex process. Little is known regarding developmental breathing patterns of infants from delivery to discharge. In this study, we analyze developmental changes in work of breathing indices and oxygen saturation between healthy preterm and term infants at discharge.MethodsA prospective, observational study of healthy term infants at a single center nursery. Respiratory Inductive Plethysmography and pulse oximetry were studied in the supine position, between 12 and 48 h of birth. Comparative analysis was performed with data from our study of premature infants without BPD.ResultsThe study included 63 infants (32 premature and 31 full term). Work of breathing was increased in term infants compared to preterm infants at discharge (Mean phase-angle, Φ ± SEM; Term: 73 ± 5° vs Preterm: 49 ± 7°; <i>p</i> = 0.017). Term infants had lower mean oxygen saturation (Term: 95 ± 0.42% vs Preterm: 97 ± 0.32%; <i>p</i> < 0.001), respiratory rate (Term: 56 ± 2.99 br/min vs Preterm: 67 ± 2.55 br/min; <i>p</i> < 0.008), and heart rate (Term: 130 ± 2.4 bpm vs Preterm: 158 ± 1.8 bpm; <i>p</i> < 0.0001) compared to preterm infants at discharge.ConclusionPreterm infants at discharge demonstrated more efficient thoracoabdominal synchrony and higher oxygen saturation than term infants. These findings suggest that preterm infants develop adaptive respiratory strategies in response to early and prolonged extrauterine respiratory demands, which confer physiological advantages despite structural immaturity. The data could influence post-discharge monitoring of preterm infants.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251384932"},"PeriodicalIF":0.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology to support bonding when separated at birth: A narrative review.","authors":"S Schwartz, B Lorenz, K Agbemenu, M Sperlich","doi":"10.1177/19345798251384292","DOIUrl":"https://doi.org/10.1177/19345798251384292","url":null,"abstract":"<p><p>BackgroundAcross the United States, newborns are being transferred from their birth hospital to a tertiary hospital for more care. This action separates the mother from her newborn, breaking a bond, or emotional tie, between the two. This narrative review explores the available literature on technology being used in the neonatal intensive care unit (NICU) to help support bonding when the mother is separated from her newborn.MethodsUtilizing the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) approach for this review, four databases (CINAHL, MEDLINE, Web of Science, and PUBMED) were searched. Terms searched were bonding, technology, neonatal intensive care OR NICU, and web camera. The search included the years 2016-2023 and the English language.ResultsEleven studies were included in this review, which resulted in the identification of three positive and two negative emotions that described how parents felt about using technology to see their newborn. The positive emotions include a decrease in stress and anxiety, and improved family relationships. The negative emotions included guilt and experiencing psychological distress. Additionally, the review showed that staff in the NICU need to be consulted before implementing this type of technology to ensure success.ConclusionUnderstanding the different types of technology in the NICU, how it affects parents, and nurse workflow is necessary to identify ways to promote bonding when separated at birth.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251384292"},"PeriodicalIF":0.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning demonstrates normal fetal Doppler velocimetry associated with reduced risk of necrotizing enterocolitis among preterm infants with growth restriction.","authors":"F Kim, K E Joung, H Field, M Garland, A Lyford, J J Sheen, T Hays","doi":"10.1177/19345798251382946","DOIUrl":"https://doi.org/10.1177/19345798251382946","url":null,"abstract":"<p><p>BackgroundNecrotizing enterocolitis (NEC) is an intestinal ischemic disease that affects preterm infants with fetal growth restriction (FGR). The role of fetal Dopplers in stratifying risk for developing NEC is unclear but the innovative use of machine learning technology may aid in identifying their contribution.MethodsThis is a single center retrospective cohort of 164 infants born before 33 weeks' gestation with FGR from 2016 to 2019. We used machine learning to classify NEC and to evaluate the predictive values of gestational age (GA), birth weight (BW), and the presence of abnormal umbilical artery (UA) Dopplers before delivery.ResultsEarly GA and lower BW strongly predicted NEC. The presence of normal fetal UA Dopplers was heavily weighted in classifying infants unlikely to develop NEC. Fetal UA Dopplers had a 95% specificity (15% sensitivity) for NEC.ConclusionsIf validated, normal fetal UA Doppler studies may identify infants with FGR at low risk for NEC who may avoid conservative NEC-prevention strategies.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251382946"},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized bullous drug reaction to cefotaxime leading to wet gangrene in a neonate: A case report.","authors":"K Krishna Kumar, Choudri Muzafar Paswal, Swasthi Kabi Satpathy, Gudipudi Sai Vamsi Manoj, Neeraj Gupta","doi":"10.1177/19345798251384933","DOIUrl":"https://doi.org/10.1177/19345798251384933","url":null,"abstract":"<p><p>BackgroundBullous drug eruptions are rare but serious adverse reactions in neonates. Cefotaxime, a commonly used third-generation cephalosporin in neonatal intensive care, can rarely cause severe cutaneous adverse reactions.ResultsWe report a case of a term, large-for-gestational-age male neonate who developed bullous drug eruption following intravenous cefotaxime administration on Day 3 of life. The patient was initially admitted for decreased urine output and received prophylactic cefotaxime for suspected sepsis. Immediately after the fifth dose of intravenous cefotaxime, blister formation occurred over all five left toes distal to the IV cannula site. This progressed to gangrenous changes involving all five toes with erythematous discoloration extending to the metacarpophalangeal joints. Conservative management, including antibiotics and local wound care, resulted in gradual improvement, characterized by the formation of demarcation lines and the resolution of inflammation.ConclusionThis case highlights a rare but serious complication of cefotaxime use in neonates. Healthcare providers should be aware of this potential severe cutaneous adverse reaction, particularly when cefotaxime is administered via peripheral intravenous access. Early recognition and immediate discontinuation of the offending drug, along with conservative management, can lead to favorable outcomes.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251384933"},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Kangaroo Mother Care on oxygen saturation histogram profiles among preterm infants: A prospective comparative study.","authors":"V P Sathyamoorthy, Nishad Plakkal, Usha Devi","doi":"10.1177/19345798251384953","DOIUrl":"https://doi.org/10.1177/19345798251384953","url":null,"abstract":"<p><p>BackgroundPreterm infants often experience oxygen saturation (SpO₂) instability due to immature respiratory control. While Kangaroo Mother Care (KMC) is known to improve cardiorespiratory stability, its impact on detailed SpO₂ dynamics using histogram analysis has not been well studied.MethodsIn this prospective observational study, 120 paired sessions of KMC and off-KMC were analyzed in preterm infants (26 + 0 to 32 + 6 weeks gestation) admitted to a tertiary neonatal unit. Each session involved continuous SpO₂ monitoring using Masimo Radical-7 oximeters. The primary outcome was the percentage of time with SpO₂ ≤90%. Secondary outcomes included subgroup analyses by postmenstrual age (PMA) and respiratory support status.ResultsInfants spent less time with SpO₂ ≤90% during KMC (median 10%, IQR: 7-17) compared to off-KMC (12%, IQR: 8-18), although not statistically significant (<i>p</i> = 0.06). A significant reduction was noted in infants on room air (median 9% vs 11%; <i>p</i> = 0.01). No significant difference was observed in those on CPAP, HFNC, or NIPPV. Infants with PMA >34 weeks showed an improvement in histogram trend during KMC, which was not statistically significant (<i>p</i> = 0.06).ConclusionsOverall, KMC showed a trend towards improved oxygen saturation patterns, although this was not statistically significant. Among stable preterm infants on room air without respiratory support, KMC was associated with a significant improvement.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251384953"},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of non-adhesive suspension method for fixing umbilical lines on CLABSI in preterm neonates - A propensity score matched study.","authors":"Tsv Vahnita, Umamaheswari Balakrishnan, Prakash Amboiram, Saishree Pradhan","doi":"10.1177/19345798251380176","DOIUrl":"https://doi.org/10.1177/19345798251380176","url":null,"abstract":"<p><p>BackgroundFixing umbilical lines using medical adhesives raises concern of skin injury, creating a potential source of infection increasing the likelihood of central associated blood stream infection (CLABSI). Considering this, we adapted an alternate method of non-adhesive vertical suspension technique for fixation of umbilical lines. This study compared CLABSI rate between suspension method and conventional method.MethodsThis before-after design (observational study) included preterm neonates <32 weeks of gestational age (GA) who required umbilical line insertion. Suspension technique for fixation of umbilical lines was adopted from October, 2024. Based on the technique, neonates were grouped as ADHESIVE group (AG) admitted between October 2023 and September 2024, and SUSPENSION group (SG) admitted between October 2024 and March 2025. Propensity matching for GA formed a matched cohort of 60 neonates. Outcome of the study included comparison of CLABSI rate among two groups, and skin injury and displacement of umbilical lines in SG.ResultsOut of 60 matched neonates, 30 were included in the SG. CLABSI rate in the SG and AG was 6.2 and 30.1, respectively (RR- 0.20, 95% CI 0.004-1.83). According to McNemar's test SG had a significant lower CLABSI rate (<i>p</i> < 0.001).ConclusionThis study highlights the feasibility of the non-adhesive suspension technique as a method to fix umbilical catheter with no associated skin injury and displacement. Though there was no difference in CLABSI rate overall, with propensity matching for GA, this technique had lower CLABSI rate. Future larger studies are needed to evaluate efficacy of this technique.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251380176"},"PeriodicalIF":0.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resident intubation attempts in the neonatal intensive care unit: Assessing trends in pediatric resident training.","authors":"Laura G Wolfe, Richard S Song, Crystal N Le, Hailey M Catrambone, Jim Goodmar, Charles W Sauer","doi":"10.1177/19345798251377440","DOIUrl":"https://doi.org/10.1177/19345798251377440","url":null,"abstract":"<p><p>ObjectivePediatric residents are currently having fewer opportunities for procedures than in years past. The objective of this study was to assess changes in the number of neonatal intubation attempts performed by University of California, San Diego (UCSD) pediatric residents from 2007 to 2022.Study DesignRetrospective review of medical records and database review of neonatal endotracheal intubations over a 15-year period for the number of intubation attempts performed by pediatric residents at the UCSD NICUs in La Jolla and Hillcrest.ResultsIn the past 15 years, the number of intubation attempts by residents decreased from 48.8% to 0% at this university training program. The decrease in resident intubation attempts was analyzed using linear regression and found to be statistically significant (R 0.983, 95% CI -4.503, -3.594, p < 0.001).ConclusionNeonatal endotracheal intubation opportunities have significantly declined over a 15-year period for pediatric residents at University of California, San Diego. This highlights the need for targeted interventions to ensure procedural competency during residency, particularly for residents pursuing critical care specialties.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251377440"},"PeriodicalIF":0.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of apnea of prematurity following early discontinuation of caffeine: A prospective analytical study.","authors":"Nikhil Kumar, Aswathy Rahul, Anand Nandakumar, Radhika Sujatha, Sobhakumar Saraswathy Amma","doi":"10.1177/19345798251380137","DOIUrl":"https://doi.org/10.1177/19345798251380137","url":null,"abstract":"<p><p>BackgroundThere are variations in practices regarding the initiation and stopping of caffeine for apnea of prematurity among neonates above 28 weeks.ObjectiveTo estimate the proportion of recurrence of apnea of prematurity among neonates between 28 and 32 weeks on stopping caffeine after an apnea-free period of 7 days.MethodologyThis was a prospective, observational study conducted in a tertiary care government medical college from April 2023 to May 2024. Study population were neonates between 28 and 32 weeks gestation. Injection Caffeine citrate was started for all within 2 hours of birth and it was stopped after an apnea-free period of 7 days.ResultsOut of the total 300 neonates enrolled, 285 were available for primary outcome analysis. Out of the 38.2% (<i>n</i> = 109) who developed recurrence of apnea, only 11.9% (CI: 8.4%-16.3%, <i>n</i> = 34) was due to apnea of prematurity. Late-onset sepsis was the major cause in the rest. The median day of recurrence was 7 days (IQR 3) after stopping caffeine. On multivariable logistic regression birth weight less than 1250 g was the only significant predictor for the recurrence.ConclusionThe incidence of recurrence of apnea of prematurity was only 11.9 % (CI 8.4%-16.3%) among 28-32 weeks babies on early stopping of caffeine. For judicious use of caffeine, considering its cost and side effects, it may be reasonable to stop it after an apnea-free period of 7 days. Close monitoring is required for 7-10 days in babies less than 1250 g.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251380137"},"PeriodicalIF":0.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion tensor imaging and MR spectroscopy in the evaluation of neonatal encephalopathies.","authors":"Adya Mehra, Priya Pattath Sankaran, Sheila S Mathai, Rajagopal Kadavigere, Prakashini Koteshwara","doi":"10.1177/19345798251380181","DOIUrl":"https://doi.org/10.1177/19345798251380181","url":null,"abstract":"<p><p>BackgroundNeonatal encephalopathy is a broad term encompassing many underlying pathologies, most commonly hypoxic-ischemic encephalopathy. Though this diagnosis has long been derived from relevant history, examination and lab parameters, this study aims to illustrate the diagnostic power of advanced radiological techniques such as MR Spectroscopy and Diffusion Tensor Imaging to objectively classify subjects based on disease severity and predict adverse outcomes.Methods41 cases of neonatal encephalopathy with MRI Brain were included in the study. NAA/Cr, NAA/Cho, Cho/Cr and Lac/Cr ratios in basal ganglia and white matter, and DTI parameters of FA, ADC and MD in five major tracts were recorded. Developmental milestones were assessed on follow up of the child at 6 months. Correlation of the MRS and DTI values with disease severity and status at follow up was done.ResultsThe ratios of NAA/Cr and Lac/Cr in basal ganglia and white matter showed strong positive correlation with the disease severity at onset. Lac/Cr also positively correlated with the abnormal outcome group. FA values in the posterior limbs of internal capsule, thalami and corpus callosum were seen to most consistently correlate with the abnormal outcome group, substantiating these objective and reproducible metrics that can be employed for neuro-prognostication across all etiologies of neonatal encephalopathy.ConclusionNeonatal encephalopathy is an umbrella term for conditions that can cause devastating neurological sequelae, which necessitates radiological pattern recognition for identification of etiology, and use of supplementary quantitative techniques such as MRS and DTI is endorsed for objective evaluation of clinical outcomes.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251380181"},"PeriodicalIF":0.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental hyperthermia, a hidden risk factor of neonatal morbidity and mortality in Tesseney Community Hospital, Eritrea: A cross-sectional study.","authors":"Okbu Frezgi, Berhe Tesfai, Ghide Gebreweld, Abdul-Aziz Mohamedsied, Hailemichael Gebremariam, Asmerom Tesfagiorgis, Teweldemedhin Gebrejesus","doi":"10.1177/19345798251380108","DOIUrl":"https://doi.org/10.1177/19345798251380108","url":null,"abstract":"<p><p>BackgroundHyperthermia related to heat stress appears to be a silent, high-risk condition in hot tropical climates. Less attention being paid even in hottest areas of the world. Threatening global warming will have profound impact in neonates in near future, and the aim of this study was to assess if there was a correlation between high environmental temperature and neonatal outcome.MethodsThe study was a retrospective, cross-sectional study on neonates admitted in Tesseney Hospital from 1^st January 2020 to 31^st December 2020. Data was extracted from the admission cards using a pretested questionnaire, and chi-square was used to identify characteristics associated with neonatal mortality.Results82 neonates were admitted to the hospital during the study period. A majority of the neonates had low birth weight (51%) and delivered at term (71%). Mode of delivery was via cesarean section in 15% of the neonates and 13% were home deliveries. During admission, 60% of the neonates had fever, 59 % were not able to breast feed, and 5% had convulsion. The majority of the neonatal admission and mortality were from May to August, the hottest months of the year. At univariate analysis, preterm delivery (COR: 3.62; 95% CI: 1.28-10.20, <i>p</i>-value 0.015) and home delivery (COR: 4.13; 95% CI: 1.11-15.30, <i>p</i>-value 0.034) had a significant association with neonatal mortality, while neonatal admission from May to August (COR: 1.95; 95% CI: 0.57-6.67 <i>p</i>-value 0.287) had increased risk of adverse neonatal outcome. At multivariate analysis, birth weight above 2.5 kg (AOR: 0.01; 95% CI: 0.00-0.66 <i>p</i>-value 0.031) and hospital stay above 72 h (AOR: 0.05; 95% CI: 0.00-0.59 <i>p</i>-value 0.012) had a significant association with neonatal survival.ConclusionPreterm delivery, home delivery, and low-birth weight had a significant association with neonatal mortality. The hottest months of the year were associated with increased admission rate and neonatal mortality. Maintaining safe room temperature during heat stress of a year is crucial for neonatal well-being, and further large prospective study addressing limitation of the study was crucial.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798251380108"},"PeriodicalIF":0.9,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}