Journal of neonatal-perinatal medicine最新文献

{"title":"Feasibility and limitations of the prenatal sonographic assessment of choanal flow and neonatal implications.","authors":"Assaad Kesrouani, Nadine Cheaib, Wael Abdalla, Alain Daher, Fadi Sleilaty","doi":"10.1177/19345798251336732","DOIUrl":"10.1177/19345798251336732","url":null,"abstract":"<p><p>ObjectiveTo evaluate the factors associated with the prenatal detection of choanal flow (CF) in a normal population.MethodsFifty pregnant women underwent CF evaluation using B-Mode and color Doppler. Screening for CF began at 22 weeks, standardized according to two section planes: sagittal and transverse. CF was considered positive when flow was seen, and negative if no flow was detected after 1 minute. The screening was repeated monthly until flow was observed. We assessed maternal BMI, fetal gender, gestational age at the first detection of flow, placental site, visibility noted by the sonographer, nasal asymmetry, and possible nostril dilatation.ResultsChoanal flow was established in all patients except two cases where the fetal face was consistently downwards (48/50). The gestational age at first detection of choanal flow was 28 weeks ± 3.5 weeks. Flow was unilateral in 56.3% of cases and bilateral in 43.8% of cases. Visibility assessed by the operator was rated as good in 72% of cases, average in 20%, and poor in 8%. The only factor significantly associated with the gestational age at first detection of choanal flow was visibility (<i>p</i> = 0.006).ConclusionThe average gestational age for the detection of choanal flow is 28 weeks. Relying solely on second-trimester morphological ultrasound may result in missed detections.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"419-422"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005318","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":"Myocardial calcifications in a neonate with surgically corrected truncus arteriosus: Case report.","authors":"Celia Permuy, María Sánchez-Holgado, Paloma López-Ortego, Monserrat Bret, Carlos Labrandero, Mercedes Sampedro, Juvenal Rey, Esther Mazarío, Adelina Pellicer","doi":"10.1177/19345798251337296","DOIUrl":"10.1177/19345798251337296","url":null,"abstract":"<p><p>BackgroundMyocardial calcifications in neonates with truncus arteriosus are rare and poorly understood. These calcifications, resulting from dystrophic processes in injured tissue, may have significant clinical implications. This case highlights a neonate with truncus arteriosus and interrupted aortic arch who developed extensive myocardial calcifications following surgical correction and extracorporeal membrane oxygenation (ECMO).MethodsA neonate with truncus arteriosus underwent surgical repair at 11 days of life, requiring ECMO support. Clinical data, imaging findings, and therapeutic interventions were analyzed to explore the pathophysiology and clinical implications of myocardial calcifications.ResultsThe patient developed recurrent ischemic episodes, significant left ventricular dysfunction, and severe vascular abnormalities. Echocardiography and computed tomography revealed extensive myocardial and extracardiac calcifications. Despite maintaining normal calcium levels, myocardial calcifications were accompanied by progressive heart failure. Surgical attempts to address associated coronary and valvular complications failed to improve outcomes, leading to intractable heart failure and death at 4.5 months of age.ConclusionsThis case underscores the potential role of ischemia-reperfusion injuries, ECMO, and neonatal surgical interventions in the pathogenesis of myocardial calcifications in complex congenital heart disease. These findings highlight the need for further research into preventative and therapeutic strategies for this severe and rare complication.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"496-500"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023481","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":"Reliability of comprehensive echocardiography evaluation of patent ductus arteriosus among extremely preterm neonates across a national network: A prospective observational study.","authors":"Dany E Weisz, Laura Thomas, Xiang Y Ye, Luc Mertens, Anie Lapointe, Andréanne Villeneuve, Gabriel Altit, Renjini Lalitha, Nadya Ben Fadel, George Jacob, Deepak Louis, Soume Bhattacharya, Amuchou Soraisham, Audrey Hébert, Souvik Mitra, Abbas Hyderi, Joseph Y Ting, Michael Castaldo, Aimann Surak, Poorva Deshpande, Yasser Elsayed, Bonny Jasani, Sagee Nissimov, Faith Zhu, Prakesh Shah, Amish Jain","doi":"10.1177/19345798251349744","DOIUrl":"10.1177/19345798251349744","url":null,"abstract":"<p><p>BackgroundPrior studies on the reliability of targeted neonatal echocardiography (TNE) among extremely low gestational age neonates (ELGANs) with a patent ductus arteriosus (PDA) have been limited to evaluation of pre-defined images by a small set of study observers. The objective of this study was to investigate the interobserver reliability of comprehensive echocardiography measures of PDA size/shunt volume and ventricular performance among TNE-neonatologists in a large national network.MethodsWe conducted a prospective observational study. TNEs performed for the evaluation of PDA among ELGANs were analyzed by TNE-neonatologists from the Canadian TNE Consortium. Analyses were conducted via an interactive videoconferencing platform offering full remote control to the review software. Reliability for continuous measures was evaluated using the intraclass correlation coefficient (ICC) and coefficient of variation. The kappa statistic was used to evaluate the interobserver reliability of categorical parameters.ResultsReliability was excellent among indices of PDA size and gradient (ICC≥0.91) and good-to-excellent among most indices of left ventricular (LV) size and output (ICC≥0.79, except for LV end-systolic volume and left atrium to aortic root ratio). There was substantial to near-complete agreement on PDA shunt direction and diastolic flow abnormalities in the abdominal aorta and systemic arteries (kappa ≥0.78). However, reliability for measures of LV systolic and diastolic performance was variable with ICC range 0.21-0.95, though with low coefficient of variation (<15%).ConclusionsInterobserver reliability for most TNE measures of PDA size, gradient, shunt volume, and LV dimensions and function is good-to-excellent, supporting the validity of incorporating these indices in prospective multicenter research.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"456-466"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing the practice of early skin-to-skin contact among infants ≥34 weeks gestation born by caesarean section: A quality improvement study.","authors":"Md Habibullah Sk, Saugata Chaudhuri, Bijan Saha","doi":"10.1177/19345798251349219","DOIUrl":"10.1177/19345798251349219","url":null,"abstract":"<p><p>BackgroundSeparating mothers and newborns after caesarean delivery prevents early skin-to-skin contact (SSC), despite WHO recommendations to initiate SSC immediately at birth. Early SSC promotes breastfeeding success, enhances thermoregulation, reduces maternal postpartum complications, and fosters bonding. In our hospital, SSC was not practiced after caesarean deliveries, prompting this quality improvement (QI) initiative.MethodsConducted in the operating theatre of a tertiary care hospital over 4 months (January-April 2024), with a 3-month sustenance phase. Inborn infants ≥34 weeks gestation and ≥1.8 kg delivered via caesarean section, with good tone and breathing at birth, were eligible. Sequential Plan-Do-Study-Act (PDSA) cycles were implemented to introduce SSC within 5 minutes of birth, aiming for ≥90% compliance. Interventions included staff training, SSC protocol development, operating room reorganization, and maternal support during recovery.ResultsSSC compliance increased from 0% at baseline to 100% by cycle 4. Breastfeeding initiation improved from 48% to 95%, and exclusive breastfeeding at discharge increased from 77% to 97%. Deferred weighing and vitamin K administration rates increased from 10% to 100%.ConclusionThrough systematic interventions, we achieved and sustained 100% SSC compliance for caesarean births. This study demonstrates that with a structured, multidisciplinary approach, SSC can be successfully integrated into caesarean delivery routines, potentially enhancing maternal-infant bonding and early breastfeeding initiation.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"484-490"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310050","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":"Understanding and addressing bias in urine drug screening protocols on high-volume labor and delivery units.","authors":"Megan Kalata, G Sotolongo, L Ahlers, L Byrne, O Doll, O Foley, G Folino, K Hermann, M Maglasang, N Perme, A Van Cleave","doi":"10.1177/19345798251349418","DOIUrl":"10.1177/19345798251349418","url":null,"abstract":"<p><p>BackgroundThe purpose of this study was to understand the current demographics and characteristics of patients undergoing urine drug screening on labor and delivery units with the intention of using this data to create a more evidence-based, equitable policy to reduce bias in the screening process.MethodsA retrospective chart review was performed of 509 instances of drug screening occurring for pregnant and recently delivered patients across three hospitals in Omaha, Nebraska. Demographics of patients, including age, race, ethnicity, and insurance status, as well as reasons for drug screening, patient consent, screening results, and disclosure of results, were analyzed to assess patterns in screening.Results509 screening instances were evaluated with 324 unique patients. While Black patients made up 11.6% of the overall patient population, they accounted for 26.2% of the patients undergoing urine drug screenings. 2.88% of all patients self-identified as Hispanic; however, they comprised 13.4% of all patients screened. Consent was documented in 11.3% of cases and a reason for obtaining UDS was documented in 61.5% of cases. The most common reasons cited were history of substance use or current use, medical indications, and suspected use without documented history of use.ConclusionsEstablishment of more specific, evidence-based policies for urine drug screening may reduce the impact of implicit biases on current screening practices and serve as one avenue to rebuild trust with patients who have historically been marginalized by the medical community.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"478-483"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302262","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":"Can B-type natriuretic peptide be used diagnostically for patent ductus arteriosus in extremely preterm infants?","authors":"Juan Longhi, Maxwell Corrigan","doi":"10.1177/19345798251349746","DOIUrl":"10.1177/19345798251349746","url":null,"abstract":"<p><p>BackgroundB-type natriuretic peptide (BNP) can help define the hemodynamic significance of patent ductus arteriosus (PDA). The aim of this study was to examine if BNP can be used independently to discriminate between large and small PDAs even in extremely premature humans of less than 25 weeks of gestational age.MethodsThis was a retrospective observational study of 102 infants with a gestational age (GA) <30 weeks and more specifically of 42 infants with GA <25 weeks. BNP measurement and echocardiograms performed within 72 hours of each other were reviewed. Receiver operating characteristic curves were generated to assess diagnostic significance and optimal use thresholds.ResultsInfants with moderate to large PDAs (<i>n</i> = 79) had significantly higher BNP levels compared to infants with small or closed PDAs (<i>n</i> = 25) (median [IQ range]): 550 (277-1106) pg/mL versus 62 (33-164) pg/mL, <i>p</i> < 0.001). The optimal threshold for the recognition of moderate and large PDAs was 201 pg/mL (sensitivity 86%, specificity 87%, AUC: 0.89, <i>p</i> < 0.001) for infants <30 weeks GA and 188 pg/mL (sensitivity 88%, specificity 87%, AUC: 0.93, <i>p</i> < 0.001) for infants <25 weeks GA.ConclusionsBNP is an accurate PDA diagnostic tool for extremely preterm infants of less than 25 weeks in GA. Clinicians may consider BNP in preliminary determination of the significance of PDA and in settings with limited echocardiogram capabilities.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"441-448"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302250","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":"Tight junction proteins and intestinal health in preterm infants.","authors":"Parvesh Mohan Garg, McKenzie X Denton, Srikanth Ravisankar, Maja Herco, Jeffrey S Shenberger, Yan-Hua Chen","doi":"10.1177/19345798251349394","DOIUrl":"10.1177/19345798251349394","url":null,"abstract":"<p><p>The intestinal epithelial barrier consists of a single layer of cells that separate the gut lumen from the rest of the body. It regulates and protects the intestinal tract immunologically and mechanically. Necrotizing enterocolitis (NEC) is one of the most common conditions requiring emergency surgery in the neonatal intensive care unit and is associated with a septic shock-like state contributing to multi-organ dysfunction. NEC affects 6-10% of very low birthweight infants and remains a leading cause of death. This review presents current evidence of the role of tight junction (TJ) proteins in clinical neonatology and intestinal health using information from our own clinical and laboratory research in conjunction with information collected from an extensive search in the databases PubMed, EMBASE, and Scopus. The ability to measure the permeability of the intestinal barrier in real-time is essential to understanding the disease process of NEC and the subsequent morbidities. Detection of TJ proteins in blood and stool of preterm infants represents a potential biomarker for the early NEC diagnosis. Therapeutics targeting TJ proteins may also mitigate NEC severity and improve clinical outcomes.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"409-418"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination therapy for patent ductus arteriosus in preterm infants: Narrative review.","authors":"Eyad Bitar, Aimann Surak, Kumar Kumaran, Abbas Hyderi","doi":"10.1177/19345798251337433","DOIUrl":"10.1177/19345798251337433","url":null,"abstract":"<p><p>Management of patent ductus arteriosus (PDA) in preterm infants remains controversial and is a matter of continuous debate with a lack of consensus among practitioners on the optimal therapeutic strategy. The success rate of the most commonly used agents for PDA closure is variable, despite different medications, dosage regimens, routes of administration, and timing or duration of treatment. Combination therapy works by inhibiting prostaglandin production at different levels on the synthesis pathway; so combining acetaminophen and nonsteroidal anti-inflammatory drugs might potentially enhance PDA closure. Few studies explored the effectiveness and safety profile of combination therapy. This review summarizes the best available evidence on the efficacy and safety profile of combination pharmacological therapy for PDA treatment in preterm infants.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"401-408"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Little Bookworms: Examining participation in a NICU reading program and parental attachment and anxiety.","authors":"A D Henry, C A Stanton, E J Plosa, J C Boles","doi":"10.1177/19345798251349416","DOIUrl":"10.1177/19345798251349416","url":null,"abstract":"<p><p>BackgroundIn recent years, bedside reading programs have multiplied as an accessible means of enhancing parent/caregiver engagement in the neonatal intensive care unit (NICU). However, little is yet known about the relationship between program participation and parent/caregiver well-being. Therefore, the aim of this study was to investigate potential relationships between a parent-led, bedside NICU reading program and parent/caregiver attachment, anxiety, and satisfaction.MethodsA sample of 60 NICU parents/caregivers participated in a parent-led, bedside reading program in 2024. They completed pre- and post-intervention self-reported measures of anxiety and attachment; upon discharge, participants also completed a Program Perceptions and Experiences survey.ResultsParent-reported anxiety was observed to decrease significantly between the pre- and post-intervention time points. Overall, postnatal attachment scores, and more specifically, Quality of Attachment sub-scale scores, were seen to significantly increase in mothers between the pre- and post-intervention periods. Conversely, no significant differences in attachment were found in fathers across time points. Program Perceptions and Experiences survey responses indicated participants enjoyed the reading program and perceived that it enhanced their feelings of attachment towards their infants.ConclusionsParticipants reported significant decreases in anxiety and significant increases in postnatal attachment over time, with more pronounced change observed in mothers compared to fathers. Though these results may also align with improving medical status and movement towards discharge, participants' positive reflections on the program, combined with the minimal time and resources required to implement it, suggest that parental bedside reading interventions for NICU parents/caregivers may be a useful avenue of family-centered intervention.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"467-477"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low birth weight among neonates: Investigating incidence, risk factors, and AI-enabled predictive modeling for risk estimation.","authors":"Archana Maju, Sarita Shokandha, Sugandha Arya","doi":"10.1177/19345798251349745","DOIUrl":"10.1177/19345798251349745","url":null,"abstract":"<p><p>BackgroundLow birth weight serves as a vital measure of maternal health and the efficacy of prenatal care globally. The study was aimed to assess the incidence and risk factors of low birth weight among neonates. Further to develop a predictive model that identifies the risk factors contributing to low birth weight using artificial intelligence.MethodsThe study employed a dual research design, incorporating both descriptive and case-control methodologies. The data was analyzed using descriptive and inferential statistics. Further a predictive model was developed using logistic regression through artificial intelligence.ResultsThe incidence rate of low-birth-weight babies was approximately 304.7 (30.47%) per 1000 live births. Logistic regression analysis identified significant risk factors for low birth weight (LBW), with notably high adjusted odds ratios (AOR). Key factors included inadequate weight gain during pregnancy <9 kg (AOR = 11.89, 95% CI: 6.03-23.44), gestational age <37 weeks (AOR = 12.81, 95% CI: 6.55-25.02), fetal complications reported during pregnancy (AOR = 13.25, 95% CI: 6.81-25.77), and multiple gestation (AOR = 26.88, 95% CI: 3.31-217.99). The developed AI-enabled predictive model demonstrates a high overall accuracy of 90%.ConclusionMost identified risk factors are modifiable, and early prenatal care can greatly reduce LBW incidence and improve neonatal outcomes. The predictive model demonstrated strong accuracy in classifying newborns by birth weight. Integrating the model into healthcare systems can aid early risk detection, reducing low birth weight and improving neonatal outcomes.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"431-440"},"PeriodicalIF":0.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302260","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}