Journal of Perinatology最新文献

{"title":"Implementation of a coarctation personalized longitudinal algorithm for newborns (Coarc-PLAN) in the care of patients with prenatal concern for coarctation of the aorta.","authors":"Meghan A Coghlan, Catherine Fitt, Kelli Hatter, Aimen Shaaban, Aaron Hamvas, Sheetal R Patel","doi":"10.1038/s41372-026-02678-x","DOIUrl":"https://doi.org/10.1038/s41372-026-02678-x","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the ability of a tiered, risk-stratified postnatal management pathway to safely provide monitoring and postnatal care recommendations based on the prenatal Coarctation of Aorta (CoA) risk category.</p><p><strong>Methods: </strong>Retrospective cohort study of fetuses with CoA concern on fetal echocardiogram. Postnatal recommendations were based on prenatal risk categories as follows: mild-concern (nursery, echo before discharge); moderate-concern (NICU, echo before 24 h); high-concern (PGE infusion, CICU, admission echo).</p><p><strong>Results: </strong>For mild (40/87), moderate (13/87), and high (34/87) concern categories, 3%, 38%, and 82% had CoA repair before initial discharge. Eighty percent of mild-concern initially remained with parents. For moderate-concern, 6/13 transferred to CICU and 5 required surgery pre-discharge. Umbilical catheters placed if CICU transfer.</p><p><strong>Conclusions: </strong>A standardized risk-stratified postnatal CoA pathway can be effectively implemented in a delivery hospital and minimize medicalization of low-to-moderate-concern newborns. With appropriate safety nets, select patients can concurrently receive CoA evaluation and newborn care.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-adjusted rapid shallow breathing index during spontaneous breathing trial in mechanically ventilated preterm infants.","authors":"Rongwei Ma, Li Wang, Xiangrong Zhang","doi":"10.1038/s41372-026-02708-8","DOIUrl":"https://doi.org/10.1038/s41372-026-02708-8","url":null,"abstract":"<p><strong>Objective: </strong>To characterize dynamic changes in the weight-adjusted rapid shallow breathing index (RSBI) during a 60-min spontaneous breathing trial (SBT) in mechanically ventilated preterm infants and evaluate its predictive value for weaning outcomes.</p><p><strong>Study design: </strong>This retrospective study included preterm infants undergoing SBT in a neonatal intensive care unit. Patients were classified as successful or failed weaning based on reintubation or escalation of respiratory support within 48 h. Weight-adjusted RSBI [f/(Vt/kg)] was calculated, and parameters at multiple SBT time points were compared. Receiver operating characteristic analysis assessed predictive performance.</p><p><strong>Result: </strong>Eighty-six infants were enrolled (58 successful, 28 failed). Baseline characteristics were comparable. RSBI increased significantly after 30 min in the failed group. At 60 min, RSBI was higher in failed infants (16.31 ± 3.82 vs. 9.79 ± 2.15; P < 0.001). Predictive ability was high (AUC 0.892; sensitivity 85.7%; specificity 82.8%).</p><p><strong>Conclusion: </strong>Rising weight-adjusted RSBI during late SBT predicts weaning failure reliably.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of nosocomial infections on neurodevelopmental outcome and rehospitalization rate in preterm infants with birth weight below 1500 g (NINO study).","authors":"Elisabeth Resch-Poteralski, Ute Maurer-Fellbaum, Julia Eichberger, Volker Strenger, Robert Krause, Elisabeth Pichler-Stachl, Alexander Avian, Bernhard Resch, Berndt Urlesberger","doi":"10.1038/s41372-026-02681-2","DOIUrl":"https://doi.org/10.1038/s41372-026-02681-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the influence of nosocomial bacterial and viral infections of preterm very low birth weight (VLBW) infants on neurodevelopmental outcome and on rehospitalization rates during the first two years of life.</p><p><strong>Study design: </strong>Retrospective single-center cohort study including preterm infant born between 2010 and 2018 and followed until two years of age corrected for prematurity (Bayley scales).</p><p><strong>Results: </strong>Of 620 study infants 418 without neurodevelopmental impairment (NDI). were compared to 202 infants with NDI. Single or multiple nosocomial infections were not risk factors for NDI in a multivariate logistic regression model checked for multicollinearity. Infants with NDI were of younger gestational age, had lower birth weights and higher rates of neonatal complications (ileus, periventricular leukomalacia, and bronchopulmonary dysplasia). Nosocomial infection were also not risk factors for rehospitalizations by infectious diseases.</p><p><strong>Conclusions: </strong>Nosocomial infections did not significantly influence NDI and rehospitalization rates in preterm VLBW infants.</p><p><strong>Trial registration number: </strong>The study was registered at \"Deutsches Register Klinischer Studien\" DRKS00019000.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding perspectives of safety-net NICU neonatologists disclosing genomic sequencing results: a mixed methods approach.","authors":"Sonia Hills, Meghan Werner, Jessica Douglas, Alissa M D'Gama, Monica H Wojcik, Vanessa Young, Timothy W Yu, Pankaj B Agrawal, Margaret G Parker","doi":"10.1038/s41372-026-02655-4","DOIUrl":"https://doi.org/10.1038/s41372-026-02655-4","url":null,"abstract":"<p><strong>Objective: </strong>Examine neonatologists' perspectives on disclosing rapid genomic sequencing (rGS) results, including the barriers and facilitators they perceive.</p><p><strong>Study design: </strong>Neonatologists from 10 NICUs participating in the Virtual Genome Center (VIGOR) study were surveyed after each rGS disclosure and interviewed regarding their experience after 2 or more disclosures. Quantitative results were compared by result type, and qualitative results were iteratively coded for themes.</p><p><strong>Results: </strong>93% of neonatologists felt comfortable disclosing rGS results regardless of result type. Neonatologists utilized multiple resources to prepare for disclosures, including the VIGOR Clinical Interpretive Report, medical literature, and local genetics experts. They preferred to have a geneticist present during disclosure when possible. Neonatologists were motivated to participate in disclosures to help families and leverage existing trust.</p><p><strong>Conclusion: </strong>Neonatologists are important to the rGS disclosure experience, but a joint effort with genetics experts may be the ideal model to successfully expand access.</p><p><strong>Trial registration number: </strong>NCT05205356/clinicaltrials.gov .</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timely administration of antibiotics for neonatal sepsis in the neonatal intensive care unit: A quality improvement initiative.","authors":"Harjinder P Singh, Sheri Landazuri, Susan Wilkinson","doi":"10.1038/s41372-026-02710-0","DOIUrl":"https://doi.org/10.1038/s41372-026-02710-0","url":null,"abstract":"<p><strong>Objective: </strong>To Improve timely administration of the first antibiotic dose in the neonatal intensive care unit (NICU) through a quality improvement (QI) initiative.</p><p><strong>Study design: </strong>Conducted in a 53- bed NICU over 3 years involving 1094 neonates who received antibiotics for suspected sepsis. Using the Institute for Healthcare Improvement (IHI) methods, three interventions were made: NICU staff education; developed order sets for stat antibiotic doses and implementation of a secure code medication delivery system. Outcomes included the infants receiving their first antibiotic dose within 60 min of ordering and average time from order to administration.</p><p><strong>Results: </strong>Infants receiving antibiotics within 60 min improved from baseline 32.7% to 84.4% over a 3 year period and has been sustained over 2 years. The average time to administration decreased from 93.3 min to 44.7 min.</p><p><strong>Conclusion: </strong>A systematic multidisciplinary approach decreased the time from antibiotic order to administration time in the NICU.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotyping persistent pulmonary hypertension of the newborn: recognition of its persistence across world symposium on pulmonary hypertension classifications.","authors":"Stephanie M Tsoi, Philip T Levy, Steven H Abman, Nidhy P Varghese","doi":"10.1038/s41372-026-02704-y","DOIUrl":"https://doi.org/10.1038/s41372-026-02704-y","url":null,"abstract":"<p><p>The earliest clinical sign of pulmonary vascular disease in neonates is persistent pulmonary hypertension of the newborn (PPHN), traditionally classified as World Symposium on Pulmonary Hypertension (WSPH) Group 1. Typical PPHN is defined by the delayed transition from intra- to extra- uterine life with failure of pulmonary artery pressures to fall after delivery. This results in sustained elevation of pulmonary vascular resistance and contributes to hypoxemic respiratory failure (HRF). However, early HRF can also arise from atypical PPHN phenotypes that may persist beyond the expected resolution of typical PPHN and are often classified within WSPH Groups 2, 3 and 5. In addition, a history of PPHN can be associated with the childhood and adulthood PH. In this perspective, we highlight the diverse etiologies contributing to the PPHN phenotype, with a focus on Group 3 disease, and propose a physiology-based framework to classify PPHN and delineate disease trajectories.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Impact of delayed cord clamping and immediate kangaroo mother care on oxygen saturation and heart rate in moderate and late preterm infants\".","authors":"Nerea Valles-Murcia, Marta Aguar, Alejandro Pinilla-González, Laura Torrejón-Rodriguez, Alba Cayuela-Hernández, Pilar Sáenz-González, Raquel Escrig-Fernández, Alba González-Timoneda, Laura Collados-Gómez, María Cernada, Máximo Vento, Álvaro Solaz-García","doi":"10.1038/s41372-026-02652-7","DOIUrl":"https://doi.org/10.1038/s41372-026-02652-7","url":null,"abstract":"<p><strong>Background: </strong>Immediate Kangaroo Mother Care (iKMC) after delivery and delayed cord clamping (DCC), both improve cardiorespiratory stability in newborns.</p><p><strong>Methods: </strong>This prospective observational study included 96 moderate to late preterm (MLPT) neonates. Preductal pulse oximetry (SpO₂) and heart rate (HR) were recorded during the first 10 min after birth. Neonates who received iKMC and DCC were compared to those who did not receive iKMC.</p><p><strong>Results: </strong>iKMC was performed in 64.6% of the infants. The iKMC group showed a non-significant trend toward higher SpO₂ levels. Mean SpO₂ was 76.06% in the iKMC group versus 70.98% in the non-iKMC group; at 420 s, it was 95.13% versus 93.77%. HR was significantly higher in the iKMC group at all time points, averaging 102.2 bpm at 120 s compared to 87.1 bpm in the non-iKMC group.</p><p><strong>Conclusions: </strong>Combining iKMC with DCC improves hemodynamic stability and oxygenation in MLPT infants, with higher HR and earlier stabilization of SpO₂ levels.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing breastfeeding outcomes in preterm infant: a collaborative approach with dedicated lactation specialists and family engagement.","authors":"Fu Zhenyan, Chen Yan, Jin Yao, Zhao Yan, Chen Juan, Yang Kaidi, Huang Chi, Quan Mingtao, Yu Na, Wang Yunfang, Xiao Yuxin, Huang Qijuan","doi":"10.1038/s41372-025-02482-z","DOIUrl":"https://doi.org/10.1038/s41372-025-02482-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the combined effects of dedicated lactation specialist roles and family-centered support to increase breastfeeding rate in very low birth weight infants.</p><p><strong>Methods: </strong>A non-concurrent controlled study was conducted. VLBWIs hospitalized at the Affiliated Hospital of Zunyi Medical University from November 2023 to November 2024 were selected as the intervention group. A dedicated team of breastfeeding nurses was established to implement the following interventions: early assessment and guidance for mothers within 12 h after neonatal NICU admission; regular communication with mothers and families to monitor maternal conditions; enhanced breast milk management via digital platforms; a nighttime breast milk reception green channel; material support; and the promotion of colostrum utilization. VLBWIs admitted between November 2022 and October 2023 were included as the conventional group for comparison.</p><p><strong>Results: </strong>The any breastfeeding rate in the intervention group (62.4%, 118/189) was significantly higher than that in the conventional group (42.5%, 74/174). The colostrum feeding rate in the intervention group (36.5%, 69/189) was higher than that in the conventional group (19%, 33/174), and the breastfeeding rate at discharge was significantly greater in the intervention group (37%, 70/189) than in the conventional group (26.4%, 46/174) (P < 0.05). The initiation time of pumped breast milk feeding in the intervention group was significantly earlier than that in the control group (P < 0.05).</p><p><strong>Conclusion: </strong>The dual-track empowerment model, which integrates dedicated breastfeeding lactation specialists and family support, effectively improved breastfeeding rates and practices for VLBWIs. This model provides a valuable reference for clinical healthcare providers to promote breastfeeding.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of uranium and other radioactive heavy metals in breast milk and their impact on early life health.","authors":"Aditya Hemendra Bhatt, Somashekhar Marutirao Nimbalkar, Dipen Vasudev Patel, Reshma Kushal Pujara","doi":"10.1038/s41372-026-02696-9","DOIUrl":"https://doi.org/10.1038/s41372-026-02696-9","url":null,"abstract":"<p><strong>Background: </strong>Radioactive heavy metals, including uranium, strontium-90, caesium-137, radium, thorium, and plutonium, pose potential health risks to nursing infants through breast milk transfer. Understanding the extent of contamination, transfer mechanisms, and health implications is critical for public health policy.</p><p><strong>Objective: </strong>This scoping review synthesises evidence on radioactive heavy metal contamination in breast milk, maternal-infant transfer mechanisms, and associated health impacts on early life development.</p><p><strong>Methods: </strong>A comprehensive scoping literature search was conducted in December 2024 across multiple electronic databases. After deduplication, 161 unique papers remained. An AI-assisted relevance scoring approach (SciSpace biomedical agent) was used to prioritize screening; final eligibility decisions and data extraction were performed by the authors. Thirty studies were included for synthesis.</p><p><strong>Results: </strong>Evidence demonstrates measurable concentrations of strontium-90, caesium-137, uranium, and radium in breast milk following environmental contamination events (Chernobyl, Techa River, nuclear weapons testing) and in regions with naturally elevated radioactivity. Transfer rates vary by radionuclide, with strontium-90 showing significant maternal-infant transfer. Biokinetic models indicate dose-dependent accumulation in infant tissues. Limited direct evidence exists for specific health outcomes, though theoretical risk assessments suggest potential impacts on hematopoietic development, bone metabolism, and long-term cancer risk.</p><p><strong>Conclusions: </strong>While breast milk contamination with radioactive heavy metals is documented in specific contexts, the health benefits of breastfeeding generally outweigh risks except in acute high-exposure scenarios. Gaps remain in understanding long-term neurodevelopmental and growth impacts. Enhanced biomonitoring and longitudinal studies are needed to inform evidence-based public health guidance.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal extracorporeal membrane oxygenation outcomes according to social determinants of health.","authors":"Swati Chandhoke, Isabella Zaniletti, Robert DiGeronimo, Shannon E G Hamrick, Karna Murthy, Michael A Padula, Natalie E Rintoul, Theresa R Grover, Philip T Levy, Katie M Moynihan","doi":"10.1038/s41372-026-02668-z","DOIUrl":"https://doi.org/10.1038/s41372-026-02668-z","url":null,"abstract":"<p><strong>Objective: </strong>To characterize relationships between social determinants of health (SDoH) and mortality among infants receiving extracorporeal membrane oxygenation (ECMO).</p><p><strong>Study design: </strong>Retrospectively, we identified infants born >34weeks gestation and >1.8 kilograms who received ECMO from 2010-2022. The primary predictor was the child opportunity index (COI). The outcome was in-NICU mortality. Due to interactions between SDoH and diagnoses, the main analyses were performed within the diagnostic cohort using multilevel socioecological factors.</p><p><strong>Results: </strong>Overall, 2254 neonates received ECMO [congenital diaphragmatic hernia (32%, CDH), meconium aspiration syndrome (27%, MAS), cardiac (13%) and other (28%, e.g., sepsis)]. Characteristics differed with MAS more common in lower COI and Black race, while CDH was more common in the White race. COI and maternal race/ethnicity were unrelated to in-NICU mortality.</p><p><strong>Conclusion: </strong>Despite epidemiological differences by SDoH, the primary outcome was consistent across groups, suggesting potential resilience to social risk factors and underscoring the importance of studying distinct cohorts separately.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}