Journal of neonatal-perinatal medicine最新文献

{"title":"A rare yet preventable complication of lower extremity PICC malposition in an extreme preterm: Implications for enhanced procedural imaging standards.","authors":"Manal Mouhssine, Aimen Ben Ayad, Aiman Rahmani","doi":"10.1177/19345798251327379","DOIUrl":"https://doi.org/10.1177/19345798251327379","url":null,"abstract":"<p><p>Peripherally inserted central catheter (PICC) malposition is an underrecognized complication among neonatologists, especially when inserted in the lower extremity. In this report, we describe a rare abdominal wall complication of PICC placement through the saphenous vein in an extreme preterm, manifested clinically by hypoglycemia and a seemingly abdominal wall abscess. It was only after a lateral X-ray cross-table view of the abdomen that the abdominal wall collection was found to be a total parenteral nutrition (TPN) content extravasation, as the PICC tip was located inside the abdominal wall, which mandated its immediate removal. The patient's condition improved markedly afterward, leaving only a minor abdominal scar. Our case highlights the necessity of acquiring both anteroposterior and lateral X-ray images following PICC placement in the lower extremities to verify the correct catheter positioning and avoid potential complications.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"279-281"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976557","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":"Trends and racial differences in hypoxic ischemic encephalopathy-related mortality in newborns in the United States, 2007-2022.","authors":"Hannah Pulido, Fredrick Dapaah-Siakwan","doi":"10.1177/19345798251325496","DOIUrl":"https://doi.org/10.1177/19345798251325496","url":null,"abstract":"<p><p>BackgroundHypoxic ischemic encephalopathy (HIE) is a significant cause of morbidity and mortality. However, the changes in HIE-related mortality and its associated racial differences, if any, have not been extensively studied. We examined the population-based temporal trends and any racial differences in the HIE-related infant mortality rate (HIE-IMR) in the United States from 2007 through 2022.MethodsThis was a retrospective cross-sectional analysis of linked birth and infant death records data from the CDC WONDER from 2007-2022. We evaluated all infants born at ≥35 weeks gestational age (GA) who died within the first year of life with HIE (ICD-10 codes P91.6 and P21) as the underlying cause of death. The exposure was the year of death, and the outcomes were the changes in overall HIE-IMR and then stratified by race. HIE-IMR was calculated as per 100,000 live births. Linear regression was used for trend analysis.ResultsAmong 59,117,761 live births, 3998 infants with GA ≥ 35 weeks died from HIE (6.7 per 100,000). The overall HIE-IMR increased significantly from 5.2 to 9.6 per 100,000 (<i>p</i> < .001). The rate increased significantly in White (5.3 to 7.2; <i>p</i> < .001) and Black (5.2 to 8.1; <i>p</i> = .005) infants. The overall HIE-IMR was significantly higher in Black infants (7.3) than in White infants (7.2) [<i>p</i> = .02].ConclusionThe HIE-IMR rate increased significantly, and the rate was higher in Black than in White infants. The drivers behind these changes require further examination in future studies.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"270-273"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025518","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":"An investigation into the history of maternal risk factors in the incidence of perinatal mortality.","authors":"Maryam Zakerihamidi, Hassan Boskabadi","doi":"10.1177/19345798251324441","DOIUrl":"https://doi.org/10.1177/19345798251324441","url":null,"abstract":"<p><p>ObjectivesThe rate of perinatal mortality is an important indicator of maternal and neonatal health. Identification of risk factors for perinatal mortality may be effective in its prevention. Accordingly, this study aimed to identify maternal risk factors of perinatal mortality.MethodsA cross-sectional study was conducted on 547 stillbirths and 709 neonatal deaths at Ghaem Hospital of Mashhad, Iran, during 2008-2019. The data were collected using a researcher-made questionnaire in two parts of stillbirth (maternal diseases, main complication, and final diagnosis) and specifications of neonatal death (e.g., gender, length of hospitalization, age, first and fifth minute Apgar scores, gestational age, weight, resuscitation, mode of delivery, preterm rupture of membranes, main cause of death, and maternal diseases). Data analysis was performed by T-test and Chi-square tests using SPSS version 21 (V.21).ResultsOverall, 222 mothers (41%) had stillborn fetus and 325 (77%) with neonatal death had maternal risk factors. The 41% of neonatal deaths and 26% of stillbirths were along with maternal hypertension, 33% of neonatal deaths and 25% of stillbirths were along with maternal preeclampsia, and 9% of neonatal deaths and 12% of stillbirths were along with maternal diabetes. The cases of cesarean and neonatal resuscitation were higher in neonates with maternal risk factors (69% and 58%, respectively) than those with mothers who had no problem (43% and 32%, respectively).ConclusionHypertension, preeclampsia, and diabetes were three important diseases during pregnancy, associated with high stillbirths and neonatal deaths. Neonates of mothers with problem were pretermer or less birth weight and had more problems during delivery and died earlier.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"203-210"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969424","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":"Applications of lung ultrasound as an emerging tool in neonates.","authors":"Aimann Surak, Huma Shaireen, Yasser Elsayed","doi":"10.1177/19345798251325492","DOIUrl":"https://doi.org/10.1177/19345798251325492","url":null,"abstract":"<p><p>Lung ultrasound is increasingly used in neonatal intensive care units. We summarized the ultrasonographic patterns, features of most neonatal respiratory morbidities, and clinical application in neonates. Lung ultrasound is a non-invasive, radiation-free, and reproducible adjunct tool that can guide the clinical management of neonates presenting with respiratory distress.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"187-196"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970572","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":"Comparative study between nebulized and intravenous magnesium sulfate for treatment of persistent pulmonary hypertension in neonates.","authors":"Nashwa Farouk Mohamed, Osama Abu El Fetouh Zaki El Feky, Heba Morsy Saad El Din El Ganady, Walid Abd Elatif Abd El Halim","doi":"10.1177/19345798251325510","DOIUrl":"https://doi.org/10.1177/19345798251325510","url":null,"abstract":"<p><p>BackgroundPersistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition resulting from elevated pulmonary vascular resistance, causing severe hypoxemia. Magnesium sulfate (MgSO₄) is a potent vasodilator used in PPHN treatment, but its intravenous administration can cause systemic side effects. This study aims to compare the effects of nebulized and intravenous MgSO₄ on oxygenation and hemodynamic parameters in neonates with severe PPHN.MethodsThis non-randomized controlled study was conducted on 40 mechanically ventilated neonates with severe PPHN at Benha University Hospitals. Neonates were divided into two groups: one received nebulized MgSO₄ (NebMag, <i>n</i> = 20) and the other intravenous MgSO₄ (IVMag, <i>n</i> = 20). Primary outcome was the change in Oxygenation Index (OI) at 12 and 24 hours. Secondary outcomes included changes in mean arterial pressure (MABP), serum magnesium levels, and vasoactive inotropic score (VIS).ResultsBoth groups showed improvements in oxygenation and ventilatory parameters. However, after 24 hours, the NebMag group had significantly lower OI (19.75 ± 2.9 vs 22.1 ± 2.19, <i>p</i> = 0.032) and higher PaO₂ (69.45 ± 7.56 mmHg vs 60.75 ± 5.9 mmHg, <i>p</i> = 0.008). MABP was significantly higher and VIS was lower in the NebMag group at all time points. Serum magnesium levels were significantly lower in the NebMag group at 12 hours (3.6 ± 0.18 vs 1.2 ± 0.17 mmol/L, <i>p</i> < 0.001).ConclusionNebulized MgSO₄ may offer a safer alternative to intravenous administration, providing effective pulmonary vasodilation with fewer systemic side effects in neonates with PPHN.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"246-254"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997408","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":"Story-Telling Attention-Refocusing (STAR) intervention to alleviate acute stress in parents of infants in the NICU.","authors":"Anisia Wong, Sandra Fucile","doi":"10.1177/19345798251324449","DOIUrl":"10.1177/19345798251324449","url":null,"abstract":"<p><p>IntroductionAdmission of an infant to the neonatal intensive care unit (NICU) is a stressful event for parents. The physical separation and inability to hold their child due to minimal handling protocols or infection control such as in the recent COVID-19 pandemic is a major contributor to parental stress. Knowledge on a contact-free parent administered intervention to reduce the stress of parents whose infant necessitates neonatal intensive care is lacking.ObjectiveTo assess the effect of a contact-free, Story-Telling Attention-Refocusing (STAR) intervention on the acute stress of parents whose infant is in the NICU.MethodsA block-randomized controlled single-blind trial was conducted in a level II-III NICU. Parents in the experimental group provided the STAR intervention which consisted of designated prompts to share stories with their infants over a ten-minute period, three times per week, for 1 week. Parent acute stress was measured using the PSS:NICU questionnaire before and after the STAR intervention period, and differences in acute stress between mothers and fathers were assessed as well as parent satisfaction.ResultsTwenty-one parents completed the study. Results revealed that overall PSS:NICU stress scores lowered significantly within the intervention group (<i>p</i> = 0.04), and the intervention mediated acute stress of mothers and fathers differently (<i>p</i> = 0.01). Parents reported feeling overall satisfied with the STAR program and they felt less stressed in the hospital and more connected to their infants.ConclusionThe STAR program provides parents a unique opportunity to interact with their infant in a positive meaningful manner and may reduce acute stress in parents during their infants NICU stay.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"226-234"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018100","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":"Comparison of newborns' characteristics between neonates with proper and improper breastfeeding positions.","authors":"Maryam Zakerihamidi, Gholamali Maamouri, Abbas Boskabadi, Forough Rakhshanizadeh, Zahra Parvini, Asal Ramazani, Fatemeh Bagheri, Hassan Boskabadi","doi":"10.1177/19345798251327382","DOIUrl":"10.1177/19345798251327382","url":null,"abstract":"<p><p>IntroductionProper positioning for successful breastfeeding is important. The current study aimed to compare newborns' characteristics with proper and improper breastfeeding positions.MethodsThe current cross-sectional study was conducted on 591 neonates referred to the Neonatal Clinic, Ward, and Emergency Department of Ghaem Hospital in Mashhad, Iran, within 2019-2023. The subjects were selected through the availability sampling method. Neonates referred for the routine physical examination, jaundiced cases not requiring hospitalization, and newborns with hyperthermia and weight loss were included in the study. Neonates with less than 34 weeks of gestation, jaundiced cases requiring hospitalization, newborns with congenital anomalies, or those with confirmed infectious diseases were excluded from the study. Proper breastfeeding position was considered due to the status of attachment of the neonate to the mother's breast. The data collection tool was a researcher-made checklist, including laboratory data and maternal and neonatal characteristics. The data were analyzed using the t-test and chi-square test.ResultsAmong the 591 neonates, 466 (78.8%) and 125 (21.2%) subjects were nursed with proper and improper positioning, respectively. There were significant differences between the two groups in terms of admission weight (<i>p</i> = .000), daily weight loss (<i>p</i> = .000), daily weight loss percentage (<i>p</i> = .000), first breastfeeding time after delivery (<i>p</i> = .000), breastfeeding frequency (<i>p</i> = .000), breastfeeding duration (<i>p</i> = .002), urination frequency (<i>p</i> = .000), defecation frequency (<i>p</i> = .000), and serum levels of sodium (<i>p</i> = .000), urea (<i>p</i> = .000), creatinine (<i>p</i> = .000), hematocrit (<i>p</i> = .002), platelet count (<i>p</i> = .001), and blood glucose (<i>p</i> = .010). Moreover, lethargy, irritability, seizure, mucosal dryness, inverted fontanelle, hyperthermia, unsoftened breast after breastfeeding, nipple fissure, and pregnancy problems were higher in the group nursed with improper positioning than the other group.ConclusionIn our study, breast problems, feeding problems, hypernatremia, hyperuremia, and weight loss were more common in infants of mothers with improper positioning of breastfeeding. Therefore, it is recommended to provide mothers with appropriate training and strategies for proper breastfeeding position.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"218-225"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648789","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":"Malposition of a nasogastric tube into the middle ear of a premature one week old infant.","authors":"Abeer Alali, Sharon Cushing, Adrian James, Krista Marcotte, Noah Ditkofsky","doi":"10.1177/19345798251327369","DOIUrl":"https://doi.org/10.1177/19345798251327369","url":null,"abstract":"<p><p>A significant number of pediatric patients require a nasogastric tube (NGT) during their hospital stay for indications including nutrition support, medication delivery and decompression of the gastrointestinal tract. As such NGT placement is commonly performed; however, misplacement can occur into other anatomic sites within proximity.Primary DiagnosisWe report a first in the literature case of NGT misplacement into the middle ear via the eustachian tube in a one-week-old premature infant that required an NGT for feeding support.Clinical FindingsThere was no reported resistance or concerns during NGT insertion; however, blood was noted in the syringe during aspiration performed to confirm tube position. A plain film radiograph and thereafter high-resolution computed tomography (HRCT) imagining confirmed the malposition of the tube within the middle ear.Interventions and OutcomesAfter transfer to a tertiary center, the NGT was removed without event in the neonatal intensive care unit (NICU) under direct vision with a flexible nasal endoscopy and successful replacement occurred thereafter. No injury to the middle ear structures or hearing occurred.Practice RecommendationsWhile not a common site of misplacement, nasogastric tubes can be misdirected via the eustachian tube into the middle ear. Imaging modalities such as plain film radiographs and computed tomography can be helpful when misplacement is suspected based on bedside assessment. Protocols for routine replacement of functional nasogastric tubes after specific time periods in an effort to prevent nasal alar or nasal cavity complications from pressure should consider the risk of misplacement and consequences thereof.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"282-284"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016418","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":"Determinants of neonatal near miss among neonates admitted at Bahir Dar public hospitals, North West Ethiopia: A case-control study.","authors":"Daniel Mekete Alemu, Eleni Admasu, Mekonnen Melkie, Asnake Gashaw Belayneh","doi":"10.1177/19345798251324513","DOIUrl":"https://doi.org/10.1177/19345798251324513","url":null,"abstract":"<p><p>BackgroundNeonatal near miss is a significant public health issue in Ethiopia. Previous studies have often overlooked health system-related and behavioral factors of neonatal near miss. This study aimed to identify determinants of neonatal near misses in Bahir Dar public hospitals to fill those gaps in the aforementioned studies.MethodsAn unmatched case-control study was conducted in Bahir Dar public hospitals from October to December 2022, involving 443 neonates (147 cases, 296 controls). Cases were recruited consecutively, while controls were selected using systematic sampling. Data were collected using a pre-tested structured interviewer-administered questionnaire at discharge and from patients' cards using Epicollect5. Data were analyzed with SPSS version 26 for bivariable and multivariable binary logistic regression at a 95% confidence interval (CI). The Hosmer and Lemeshow test checked the model fit, with <i>p</i>-value <0.05 considered significant.ResultsDeterminants of neonatal near misses included not receiving exclusive breastfeeding within an hour of delivery [AOR = 3.13, 95% CI: 1.25, 7.83], a history of pregnancy-induced hypertension [AOR = 5.55, 95% CI: 2.34, 12.85], fewer than four antenatal care visits [AOR = 8.38, 95% CI: 3.62, 19.44], and travel time over an hour to reach health facilities [AOR = 6.55, 95% CI: 2.56, 16.78].Conclusion and recommendationDelayed initiation of exclusive breastfeeding, pregnancy-induced hypertension, travel time to health facilities, and the number of antenatal care visits were key determinants of neonatal near miss. Enhancing maternal health services, such as exclusive breastfeeding practices, increasing antenatal visits, improving ambulance accessibility, and prioritizing mothers with pregnancy-induced hypertension, is essential.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":"18 3","pages":"235-245"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998007","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":"Comparison of stress-induced hemolysis in neonatal intravenous catheters: Theoretical and experimental analysis of shear stress, exposure time, and index of hemolysis.","authors":"Gordon Y Chang, Cynthia A Cox, Ellen A Kane, Giovanna Palermo Tye, Paul Fawcett, Thomas H Shaffer","doi":"10.1177/19345798251326071","DOIUrl":"10.1177/19345798251326071","url":null,"abstract":"<p><p>BackgroundSeveral studies report hemolysis when packed red blood cells (PRBCs) are transfused through small-inner-diameter (ID) catheters using presence of biomarkers but do not address cause and amount of hemolysis. This study aims to determine the cause and index of hemolysis percent (IH%) when PRBCs are infused through small-ID catheters.MethodsThe IH% was calculated using Giersiepen's empirical power law, which describes a relationship between hemolysis and magnitude of shear stress and exposure time. Six- and 27-day-old PRBCs were infused through five catheters with IDs of 0.20 mm to 0.70 mm at infusion rates of 3 mL and 10 mL/hour. Shear stress and exposure time were calculated. Data were analyzed as a function of catheter ID, infusion rates, and blood age.ResultsThe study demonstrated that shear stress was supraphysiologic during laminar flow in catheters with IDs of 0.20 mm and 0.28 mm. These catheters' IH% were ∼117 times higher at 3 mL/hour and ∼75 times higher at 10 mL/hour than catheters with larger IDs of 0.48 mm, 0.51 mm, and 0.70 mm. For blood age, in catheters with IDs of 0.20 mm and 0.28 mm, IH% was ∼155 times higher at 6 days and ∼76 times higher at 27 days than in catheters with IDs of 0.48 mm, 0.51 mm, and 0.70 mm.ConclusionsThis study demonstrated that when RBCs are subjected to supraphysiologic shear stress in catheters with IDs of ≤0.28 mm, index of hemolysis is greater than in catheters with IDs ≥0.48 mm.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"255-269"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673938","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}