Journal of neonatal-perinatal medicine最新文献

{"title":"Prenatal double bubble with distal fluid: Not a marker for malrotation with volvulus.","authors":"Caitlin J Cain-Trivette, Christopher Nemeh, Yeu Sanz Wu, Brooks Melnyk, Jooyoung P Park, Lynn L Simpson, Russell Miller, Vincent Duron","doi":"10.1177/19345798261475329","DOIUrl":"https://doi.org/10.1177/19345798261475329","url":null,"abstract":"<p><p>BackgroundThe prenatal \"double bubble\" (DB) sign is a marker of duodenal obstruction. When accompanied by distal bowel fluid on prenatal imaging, concern may arise for malrotation with volvulus. This study evaluated whether distal bowel fluid in fetuses with a prenatal DB sign is associated with malrotation or volvulus.MethodsWe performed an 11-year retrospective review (Jan 2015-Dec 2025) of fetuses with a prenatal DB sign evaluated at a single tertiary care center. Prenatal ultrasound and fetal MRI findings, operative diagnoses, and neonatal outcomes were reviewed, with specific attention to distal bowel fluid on fetal MRI.ResultsTwenty-nine fetuses were identified. Median gestational age at birth was 37.5 weeks (IQR 34.5-38.0), and polyhydramnios was present in 62.1%. Fetal MRI was performed in 10 cases, demonstrating distal bowel fluid in 5. No prenatal imaging suggested volvulus. Among 27 neonates undergoing surgery, duodenal obstruction was confirmed in 25 (93.8%). Asymptomatic malrotation was identified in 5 infants, and no cases of prenatal or postnatal midgut volvulus occurred. One-year survival was 100%.ConclusionsPrenatal DB is a highly sensitive marker of duodenal obstruction. Distal bowel fluid on fetal MRI was not associated with malrotation with volvulus, supporting reassurance during prenatal counseling.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475329"},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630676","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":"Developing a predictive model for early identification of hypoxic-ischemic encephalopathy in high-risk neonates using clinical data.","authors":"Jack Rausch, Joshua C Euteneuer, Nick Townley, Amanda O Johnson, Ann Anderson Berry, Eric S Peeples","doi":"10.1177/19345798261459425","DOIUrl":"https://doi.org/10.1177/19345798261459425","url":null,"abstract":"<p><p>BackgroundNeonatal encephalopathy is a leading cause of death and disability in neonates. Most cases are due to hypoxic-ischemic encephalopathy (HIE) which is treated with therapeutic hypothermia (TH). Treatment is only effective if initiated within 6 h of birth, leaving a narrow window for diagnosis. Early recognition is challenging because clinicians must rely on nonspecific clinical signs and basic laboratory indicators. Although multiple biomarkers, including metabolites and electroencephalography, show potential, none have demonstrated adequate diagnostic accuracy or practicality for universal bedside use. As a result, many infants at risk remain unidentified in time for treatment. Therefore, we developed a predictive model using early clinical data to identify neonates at risk for HIE requiring TH.MethodsA secondary analysis was conducted on 362 neonates from the Midwest Neonatal Encephalopathy Registry. Eligible neonates had HIE receiving TH or controls requiring positive pressure ventilation in the delivery room but no HIE/TH. Logistic regression was used to predict HIE.ResultsHIE was associated with higher ALT, AST, creatinine, lactate, nucleated red blood cells, and lower pH compared to those receiving resuscitation in the delivery room but without a diagnosis of HIE receiving TH. The regression model incorporating base excess, signs of possible fetal hypoxia, and 5-min Apgar scores provided the best discrimination with an AUC of 0.831 in 259 infants.ConclusionThis simple model demonstrates robust accuracy as a screening tool for HIE using data available within the first hours of life but requires validation in larger cohorts.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261459425"},"PeriodicalIF":1.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630661","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 labor before delivery on necrotizing enterocolitis in very low birth weight infants.","authors":"Neha Dhawan, Sara Yasrebi, Joseph Hagan, Maya I Brasher, Monika S Patil","doi":"10.1177/19345798261475330","DOIUrl":"https://doi.org/10.1177/19345798261475330","url":null,"abstract":"<p><p>BackgroundNecrotizing Enterocolitis (NEC) is multifactorial, and the gut microbiome may contribute. Neonatal gut colonization differs by delivery mode; while delivery mode has not been linked to NEC in prior studies, the impact of labor prior to delivery is unknown. Our objective was to investigate the impact of labor prior to delivery on NEC incidence in very low birth weight (VLBW, <1500 g) infants.MethodsWe performed a single-center retrospective cohort study of VLBW infants 23 0/7-34 6/7 weeks gestation born at our center between 03/25/2012 and 12/31/2023. Infants with congenital anomalies or who died prior to admission were excluded. Labor was defined as uterine contractions with cervical dilation or effacement. When cervical exam was undocumented, labor was determined by presence of regular contractions >1 h before delivery. Multivariable logistic regression evaluated the association between labor before delivery and NEC after adjusting for baseline differences.ResultsAmong 1,951 infants, 1,175 (60.2%) were exposed to labor before delivery. Groups differed by gestational age, birth weight, chorioamnionitis, maternal diabetes, multiple gestation, and small for gestational age. Exposure to labor had lower odds of NEC (odds ratio [OR] = 0.606, 95% confidence interval [CI]: 0.407-0.902, <i>p</i> = 0.01), compared to those unexposed. This association remained significant after adjustment (adjusted OR = 0.614, 95% CI: 0.384-0.983, <i>p</i> = 0.04). There was no difference in surgical NEC.ConclusionsLabor prior to delivery was associated with lower odds of NEC in this VLBW cohort, highlighting the potential importance of perinatal microbial exposures and suggesting new avenues for NEC risk stratification and prevention.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261475330"},"PeriodicalIF":1.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620384","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 introduction of bubble CPAP on neonatal mortality in Tajikistan.","authors":"Manzura Mirsaidova, Zulfiya Abdusamatzoda, Shamshod Muzaffarov, Firuza Zakirova, Farida Olimova, Isoeva Mavjuda, Matluba Kosimova, Aziza Mamatova, Manizha Makhmudova, Nasiba Solieva, Daniel Woodhead, Steve Smith, Marcia Bennett, Mark A Underwood","doi":"10.1177/19345798261471904","DOIUrl":"https://doi.org/10.1177/19345798261471904","url":null,"abstract":"<p><p>BackgroundPreterm infants with respiratory distress are at high risk of mortality in low-resource settings due to limited access to advanced respiratory support. Bubble Continuous Positive Airway Pressure (bCPAP) improves outcomes in preterm infants with respiratory distress but generally requires significant infrastructure (electricity and blended oxygen). We hypothesized that introduction of a novel bCPAP device (Vayu) that does not require electricity or a pressurized air source would improve survival of moderately preterm infants.MethodsIn this pilot observational cohort study, demographic and mortality data were collected for 2 months prior to and 14 months following introduction of Vayu bCPAP in 2024 at three hospitals in Tajikistan. Similar data were collected following introduction of bCPAP in four additional hospitals and compared to historical mortality data for those same hospitals from 2023. Finally, mortality was compared for all seven hospitals following introduction of bCPAP to historical data from 2023.ResultsFollowing introduction of bCPAP, survival improved in the three initial hospitals for infants with birth weight of 1000-1499 g and 1500-2499 g. In the second group of four hospitals, improved survival was seen in infants with birth weight of 500-999 g compared to historical data. Combined data from all seven hospitals showed improvement in mortality for infants with birth weight of 500-999 g and 1000-1499 g.ConclusionsbCPAP that does not require electricity or a pressurized air source was associated with improved survival in very preterm infants. Our data suggest feasibility and benefit in a central Asian country. Further studies of bCPAP in low-middle income countries are warranted.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261471904"},"PeriodicalIF":1.0,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603856","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":"Acute kidney injury in early preterm neonates with severe birth asphyxia: Incidence, predictors and role of caffeine initiation timing.","authors":"Hari Prasath C, P Anil Kumar, Pentala Sripooja","doi":"10.1177/19345798261469523","DOIUrl":"https://doi.org/10.1177/19345798261469523","url":null,"abstract":"<p><p>BackgroundAcute kidney injury (AKI) is a serious complication in early preterm neonates with severe birth asphyxia, yet its incidence and predictors in this specific population remain incompletely characterised. The effect of caffeine initiation timing on AKI outcomes has not been prospectively examined.MethodsThis prospective observational cohort study enrolled 112 neonates of 28-32 weeks gestational age with severe birth asphyxia admitted to a level III neonatal intensive care unit (NICU) in South India (February-August 2025). AKI was defined by neonatal KDIGO (nKDIGO) criteria. Neonates were categorised according to early (≤6 h) or delayed (>6 h) caffeine initiation; delayed initiation was primarily associated with outborn status and haemodynamic instability at admission. Independent predictors of AKI were identified by multivariate logistic regression with bootstrap confidence intervals.ResultsAKI was diagnosed in 48 of 112 neonates (42.9%; 95% CI 34.1-52.1%). Stage 1 disease predominated (47.9% of AKI cases), with onset in the first 48 h in the majority. On multivariate analysis, early caffeine initiation was independently associated with reduced odds of AKI (aOR 0.22; 95% CI 0.11-0.43; <i>p</i> < 0.001), and cumulative fluid balance at 48 h was associated with increased odds (aOR 6.30 per SD [21.8 ml/kg]; 95% CI 4.27-13.05; <i>p</i> < 0.001). AKI incidence was 24.1% in the early caffeine group versus 60.3% in the delayed group (<i>p</i> < 0.001), with an observed difference in AKI incidence of 36.2%. In-hospital mortality was higher in the AKI group (10.4% vs 0%; <i>p</i> = 0.013).ConclusionsAKI occurred in 42.9% of early preterm neonates with severe birth asphyxia. Early caffeine initiation (≤6 h) was associated with reduced AKI incidence. Positive fluid balance at 48 h was an independent predictor. These findings suggest early caffeine initiation as a potentially modifiable factor associated with reduced AKI risk and identify fluid balance as a clinically relevant early marker in this high-risk population.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261469523"},"PeriodicalIF":1.0,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471156","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 early initiation of breastfeeding in Somalia: A population based study using the 2020 demographic and health survey data.","authors":"Nur Rashid Ahmed, Ahmed Mohamed Dirie, Shafie Abdirahman Dirie, Ahmed Saed Hussein, Yahye Sheikh Abdulle Hassan, Kassim Abdi Jimale, Osman Abubakar Fiidow, Abdirahman Mohamud Mohamed","doi":"10.1177/19345798261459393","DOIUrl":"https://doi.org/10.1177/19345798261459393","url":null,"abstract":"<p><p>BackgroundEarly initiation of breastfeeding (EIBF) within one hour of birth is essential for neonatal survival, yet evidence from Somalia is limited. This study examined determinants of EIBF using nationally representative data.MethodsA secondary analysis of the 2020 Somali Demographic and Health Survey (SDHS) was conducted among 2,020 women with children aged 0-23 months. Sampling weights were applied. EIBF was analyzed as a binary outcome using bivariate and multivariate logistic regression. Statistical significance was set at <i>p</i> ≤ 0.05. Analyses were performed using SPSS version 27.ResultsOverall, 75% of newborns were breastfed within the first hour after birth. In the multivariate analysis, mothers aged 30-39 years were more likely to initiate breastfeeding early compared with those aged 15-19 years (AOR = 1.65; 95% CI: 1.01-2.70). Urban residence was positively associated with EIBF (AOR = 1.31; 95% CI: 1.02-1.68), while nomadic residence was negatively associated (AOR = 0.52; 95% CI: 0.40-0.68). Mothers without radio exposure (AOR = 0.68; 95% CI: 0.47-1.00), unemployed mothers (AOR = 0.17; 95% CI: 0.04-0.85), and those whose husbands were unemployed (AOR = 0.75; 95% CI: 0.63-0.91) had lower odds of EIBF. Facility delivery significantly increased the likelihood of EIBF (AOR = 1.44; 95% CI: 1.03-2.00).ConclusionEIBF in Somalia is influenced by maternal, socioeconomic, and health service related factors. Strengthening facility-based deliveries and expanding health education through mass media may improve EIBF practices.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261459393"},"PeriodicalIF":1.0,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497702","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":"Heatwaves and neonatal outcomes beyond preterm birth and low birth weight: A scoping review.","authors":"Aditya Hemendra Bhatt, Somashekhar Marutirao Nimbalkar, Archana Marutirao Nimbalkar, Lalan K Bharti","doi":"10.1177/19345798261450476","DOIUrl":"https://doi.org/10.1177/19345798261450476","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundClimate change is increasing the frequency and intensity of heatwaves globally, with potential implications for maternal and neonatal health. While associations between heat exposure and preterm birth (PTB) and low birth weight (LBW) have been documented, the broader spectrum of neonatal morbidities remains incompletely characterized. This scoping review systematically maps the evidence on heatwaves and neonatal outcomes beyond PTB and LBW.ObjectivesTo identify and synthesize evidence on (1) which neonatal morbidities beyond PTB and LBW are studied in relation to heat exposure; (2) exposure windows examined (preconception, trimester-specific, peripartum); and (3) heat metrics employed in the literature.MethodsFollowing PRISMA-ScR guidelines and the JBI Population-Concept-Context (PCC) framework, we searched PubMed, Embase, Web of Science, and Scopus for peer-reviewed studies examining maternal heat exposure during pregnancy and neonatal outcomes in the first 28 days of life other than PTB and LBW. Because this was a scoping review of a heterogeneous literature, we retained variation in study design, exposure metrics, and outcome definitions rather than attempting quantitative pooling. Two reviewers independently screened titles, abstracts, and full texts. Data were extracted on study characteristics, neonatal outcomes, exposure windows, and heat metrics. Risk of bias was assessed using design-appropriate tools.ResultsFrom 165 initial records, 15 records informed the review. The evidence base was heterogeneous in design, exposure assessment, and outcome definition, and represented 62,986,500 participants across nine countries (primary study publication period: 2012-2020). Eight neonatal outcome categories were identified: mortality (n = 7 evidence sources), NICU admissions (n = 5), thermoregulation disorders (n = 4), metabolic complications (n = 4), respiratory morbidity (n = 3), clinical assessment/Apgar scores (n = 3), congenital anomalies (n = 3), and infectious complications (n = 2). Third-trimester exposure was most frequently studied (n = 9), followed by peripartum (n = 3), second trimester (n = 2), and first trimester (n = 2). Heat metrics included maximum temperature (n = 5), heat index (n = 4), heatwave definitions (n = 4), mean temperature (n = 4), apparent temperature (n = 2), humidex (n = 1), and WBGT (n = 1). Seven studies (47%) were rated as low risk of bias. Across outcome groups, the literature generally suggested adverse associations with heat exposure, but the magnitude, statistical significance, and certainty varied across designs and metrics.ConclusionsThis scoping review reveals a growing, yet heterogeneous, body of evidence linking heat exposure to diverse neonatal morbidities beyond PTB and LBW. Third-trimester and peripartum exposures appear especially relevant, but conclusions should remain cautious because the included evidence varies in design, exposure metrics, outcome definitions, and confounder control","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261450476"},"PeriodicalIF":1.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471187","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":"Delivery-room transcutaneous pacing and ECMO support in the NICU for a preterm neonate with congenital complete heart block.","authors":"Susana Elena Zeballos Sarrato, Teresa Álvarez Martín, Dorotea Blanco Bravo, Manuel Sánchez Luna","doi":"10.1177/19345798261459419","DOIUrl":"https://doi.org/10.1177/19345798261459419","url":null,"abstract":"<p><p>Congenital complete heart block (CCHB) is a rare condition that may lead to severe bradycardia and hemodynamic instability at birth, particularly in preterm infants with limited myocardial reserve. The use of transcutaneous pacing (TCP) in the delivery room has rarely been reported in neonates with CCHB, and extracorporeal membrane oxygenation (ECMO) during neonatal intensive care has sporadically been described. We report a preterm infant with antenatally diagnosed isolated CCHB who developed severe bradycardia and hemodynamic compromise immediately after birth despite adequate ventilation. Emergency TCP achieved prompt electrical capture and rapid hemodynamic stabilization in the delivery room. During attempted early permanent pacemaker implantation in the Neonatal Intensive Care Unit (NICU), the patient developed intraoperative cardiorespiratory arrest requiring venoarterial ECMO support and placement of a temporary epicardial pacing system. After myocardial recovery, a permanent pacemaker was successfully implanted, and the infant was discharged with normal ventricular function. TCP may provide rapid hemodynamic stabilization in the delivery room for neonates with life-threatening bradycardia due to CCHB, and it may serve as a bridge to more definitive pacing modalities. This case suggests that a stepwise stabilization approach may be considered in critically unstable neonates with CCHB, incorporating delivery-room transcutaneous pacing followed by extracorporeal support in the NICU to allow deferred definitive pacing. In selected critically unstable patients, ECMO may provide life-saving support during surgical intervention.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261459419"},"PeriodicalIF":1.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430621","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":"Neonatal parenteral nutrition: An expert narrative review of international guidelines and contemporary evidence.","authors":"Aditya H Bhatt","doi":"10.1177/19345798261468683","DOIUrl":"https://doi.org/10.1177/19345798261468683","url":null,"abstract":"<p><p>Neonatal parenteral nutrition (PN) remains a cornerstone of care for preterm infants and for selected term infants when enteral feeding is not possible or is clearly insufficient. In day-to-day neonatal practice, decisions about when to initiate PN, how quickly to advance macronutrient delivery, which lipid emulsion to use, and how closely to monitor biochemical tolerance are guided by several major documents rather than by a single universally adopted standard. This expert narrative review compares the principal recommendations from ASPEN, NICE, and the ESPGHAN/ESPEN/ESPR/CSPEN pediatric PN guideline series, and interprets them alongside contemporary trials, systematic reviews, meta-analyses, and clinically relevant safety guidance. Across these sources, there is broad agreement on the essentials: start PN early when clearly indicated, introduce amino acids and lipids without unnecessary delay, individualize glucose delivery according to tolerance, provide vitamins and trace elements early, and monitor closely for electrolyte disturbances and catheter- or liver-related complications. The remaining areas of disagreement are narrower but important at the bedside, particularly the upper limits of amino acid provision, timing of PN in critically ill term infants, routine use of standardized versus individualized formulations, interpretation of triglyceride concentrations, and the clinical role of mixed-oil or fish-oil-containing lipid emulsions. A practical reading of the literature suggests that the most workable neonatal PN pathway borrows the operational detail of NICE, the physiologic and subgroup-specific framework of the European guidance, and the evidentiary caution emphasized by ASPEN.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261468683"},"PeriodicalIF":1.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421213","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":"Red cell distribution width as a diagnostic and prognostic biomarker in neonatal sepsis: A scoping review.","authors":"Nur Afifah Mohamad Asri, Hani Ajrina Zulkeflee, Alina Md Fauzi, Tengku Amatullah Madeehah Tengku Mohd, Lidiya Mohd Yusof, Nur Wahidah Batrisya Zahidi, Fadzlin Syazani Binti Azizi, Aliyyah Mohammad Khuzaini","doi":"10.1177/19345798261464931","DOIUrl":"https://doi.org/10.1177/19345798261464931","url":null,"abstract":"<p><p>BackgroundNeonatal sepsis remains a leading cause of infant mortality worldwide, with the greatest burden in low- and middle-income settings. Diagnosis is largely clinical and supported by blood culture, despite being limited by delayed results and suboptimal sensitivity. Red cell distribution width (RDW), a routine parameter in the full blood count, has been explored as a simple and cost-neutral marker of systemic inflammation and sepsis.MethodsWe conducted a scoping review of published research in MEDLINE, EMBASE, Scopus, and the Cochrane Library from inception to December 2025, supplemented by manual screening of reference lists. Studies evaluating RDW as a diagnostic and/or prognostic marker in neonates (≤28 days) with suspected or confirmed sepsis were included.ResultsFourteen studies involving 2907 participants were included in this review. RDW levels were significantly higher in septic neonates compared to healthy controls, with diagnostic accuracy with Area Under Curve (AUC) ranging from 0.70 to 0.97. Elevated RDW served as a strong independent predictor of mortality, with prognostic AUCs between 0.75 and 0.80; thresholds above 19-20% correlated with an increased risk of mortality. In comparison to CRP and ESR, RDW often matched or exceeded their diagnostic performance. However, significant methodological heterogeneity exists regarding laboratory standards, timing of sampling, and sepsis definitions.ConclusionsRDW is a promising and accessible marker for early risk stratification, particularly in resource-limited settings. However, current evidence is insufficient to support its use as a standalone tool; therefore, further studies are needed to validate its role in the future clinical settings.</p>","PeriodicalId":16537,"journal":{"name":"Journal of neonatal-perinatal medicine","volume":" ","pages":"19345798261464931"},"PeriodicalIF":1.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421711","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}