Katharine P Callahan, Anup C Katheria, Thuy Mai Luu, Rebecca Pearce, Annie Janvier
{"title":"Integrating parent voices into research at the extremes of prematurity: what are we doing and where should we go?","authors":"Katharine P Callahan, Anup C Katheria, Thuy Mai Luu, Rebecca Pearce, Annie Janvier","doi":"10.1038/s41372-024-02165-1","DOIUrl":"https://doi.org/10.1038/s41372-024-02165-1","url":null,"abstract":"<p><p>When a baby is born premature, a landscape of potential problems replaces an imagined future. Outcomes become the measures of success. Researchers are recognizing that we need the direct input of parents to select meaningful outcomes. In this article, we describe how researchers and clinicians in neonatology have historically defined outcomes and the limitations of these methods. We chart the integration of stakeholders-patients and parents-into outcomes selection. 'Parent-important outcomes' are those deemed most important by parents, as the voices of their children. We outline a path toward determining parent-important outcomes in neonatology through mixed methods research. We conclude by suggesting how parent-important outcomes can be integrated into neonatal follow up research and clinical trial design. Ultimately, all researchers of prematurity aim in some way to improve outcomes that parents and patients care about. We hope this article will remind us of this beacon.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639223","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}
Kayla L Karvonen, Olga Smith, Brittany Chambers-Butcher, Patience Afulani, Tameyah Mathis-Perry, Khuzaima Rangwalla, Monica McLemore, Elizabeth E Rogers
{"title":"Audio-diary reflections after community focus groups to address local racial inequities in the neonatal intensive care unit.","authors":"Kayla L Karvonen, Olga Smith, Brittany Chambers-Butcher, Patience Afulani, Tameyah Mathis-Perry, Khuzaima Rangwalla, Monica McLemore, Elizabeth E Rogers","doi":"10.1038/s41372-024-02176-y","DOIUrl":"https://doi.org/10.1038/s41372-024-02176-y","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622593","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}
Lucia Ferrer, Christina Chambers, Anup Katheria, Annie Nguyen, Gretchen Bandoli
{"title":"Prenatal homelessness, food insecurity, and unemployment and adverse infant outcomes in a California cohort, 2007-2020.","authors":"Lucia Ferrer, Christina Chambers, Anup Katheria, Annie Nguyen, Gretchen Bandoli","doi":"10.1038/s41372-024-02161-5","DOIUrl":"https://doi.org/10.1038/s41372-024-02161-5","url":null,"abstract":"<p><strong>Objectives: </strong>Characterize the relationship between infant outcomes and prenatal homelessness, food insecurity and unemployment.</p><p><strong>Study design: </strong>California live births between 22- and 44-weeks' gestation comprised 6,089,327 pregnancies (2007-2020). Data were collected from linked Vital Statistics and hospital discharge records. Prenatal homelessness, food insecurity, and unemployment were classified as health-related social needs (HRSN) using International Classification of Disease codes in delivery records. Risk ratios for preterm birth, low birthweight, small for gestational age, neonatal intensive care unit admission, emergency department admission, rehospitalization, and death were estimated using log-linear Poisson regression adjusted for birthing person race, payer, and education.</p><p><strong>Results: </strong>65.7 per 100,000 births had HRSN. These infants had a higher risk of preterm birth (aRR 2.7), low birthweight (aRR 2.7), SGA (aRR 1.5), NICU admission (aRR 3.5), and death (aRR 3.0).</p><p><strong>Conclusions: </strong>HRSN increase the risk of infant morbidity and mortality but remain underreported in administrative records, making definitive conclusions difficult.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639228","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}
Timothy M Bahr, Kenneth J Moise, Kathy Lowry, Martha A Monson, Ibrahim A Hammad, Sasidhar Goteti, Sarah J Ilstrup, Paul Vanasco, Robin K Ohls, Robert D Christensen
{"title":"Duration of hemolysis among infants with hemolytic disease of the fetus and newborn.","authors":"Timothy M Bahr, Kenneth J Moise, Kathy Lowry, Martha A Monson, Ibrahim A Hammad, Sasidhar Goteti, Sarah J Ilstrup, Paul Vanasco, Robin K Ohls, Robert D Christensen","doi":"10.1038/s41372-024-02163-3","DOIUrl":"https://doi.org/10.1038/s41372-024-02163-3","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622605","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}
Heidi Morris, Kathleen Nilan, Meghan Burkhardt, Audrey Wood, Molly Passarella, Kathleen Gibbs, Sara B DeMauro
{"title":"Early progressive mobility to improve neurodevelopment of infants with severe bronchopulmonary dysplasia at a level IV neonatal intensive care unit: a prospective cohort study.","authors":"Heidi Morris, Kathleen Nilan, Meghan Burkhardt, Audrey Wood, Molly Passarella, Kathleen Gibbs, Sara B DeMauro","doi":"10.1038/s41372-024-02168-y","DOIUrl":"https://doi.org/10.1038/s41372-024-02168-y","url":null,"abstract":"<p><strong>Objective: </strong>To measure the feasibility of early progressive mobility (EPM) in intubated infants with severe bronchopulmonary dysplasia (BPD) and compare neurodevelopmental skill acquisition of these infants before and after implementation of a clinical EPM program.</p><p><strong>Study design: </strong>Single-center pre-post intervention prospective cohort study in a level IV Neonatal Intensive Care Unit (NICU) from 2019-2022. Bivariate tests compared EPM interventions and results of serial Test of Infant Motor Performance (TIMP) assessments in 32 intubated infants with severe BPD cared for during two epochs, before and after NICU-wide EPM implementation.</p><p><strong>Results: </strong>Infants in epoch 2 experienced significantly more EPM interventions than infants in epoch 1. Infants in epoch 2 also had more advanced motor skills on the TIMP than infants in epoch 1. There were no unplanned extubations.</p><p><strong>Conclusions: </strong>We demonstrated successful implementation of EPM in this high-risk population with evidence of beneficial impacts on early motor development.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622610","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}
Abrar Majeedi, Patrick J Peebles, Yin Li, Ryan M McAdams
{"title":"Glottic opening detection using deep learning for neonatal intubation with video laryngoscopy.","authors":"Abrar Majeedi, Patrick J Peebles, Yin Li, Ryan M McAdams","doi":"10.1038/s41372-024-02171-3","DOIUrl":"https://doi.org/10.1038/s41372-024-02171-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop an artificial intelligence (AI) method to augment video laryngoscopy (VL) by automating the detection of the glottic opening in neonates, as a step toward future studies on improving intubation outcomes.</p><p><strong>Study design: </strong>A deep learning model, YOLOv8, was trained on 1623 video frames from 84 neonatal intubations to detect the glottic opening and evaluated using 14-fold cross-validation on metrics like precision and recall. Additionally, it was compared with 25 medical providers of varied intubation experience to assess its relative performance.</p><p><strong>Results: </strong>The model demonstrated a precision of 80.8% and a recall of 75.3% in identifying the glottic opening, detecting it 0.31 s faster than the average medical provider. It performed comparably or better than novice and intermediate providers, and slightly slower than experts.</p><p><strong>Conclusion: </strong>AI-powered tools can aid VL by providing real-time guidance, potentially enhancing neonatal intubation safety and efficiency for less experienced users.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622624","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}
Emma Rose Miller-Bedell, Lillian Sie, Suzan L Carmichael, Nana Matoba, Ya'el Weiner, Joseph J Kim, Arash Anoshiravani, Dominika Seidman, Deirdre J Lyell, Henry C Lee
{"title":"Birth outcomes of individuals who have experienced incarceration during pregnancy.","authors":"Emma Rose Miller-Bedell, Lillian Sie, Suzan L Carmichael, Nana Matoba, Ya'el Weiner, Joseph J Kim, Arash Anoshiravani, Dominika Seidman, Deirdre J Lyell, Henry C Lee","doi":"10.1038/s41372-024-02170-4","DOIUrl":"https://doi.org/10.1038/s41372-024-02170-4","url":null,"abstract":"<p><strong>Objectives: </strong>Describe the prevalence, health, and birth outcomes of incarcerated pregnant individuals in California between 2011 and 2015.</p><p><strong>Study design: </strong>A population-based cohort study was performed using linked birth certificate and hospital discharge data. Associations between incarceration and birth outcomes were examined, including multivariable logistic regression to estimate odds ratios and 95% confidence intervals.</p><p><strong>Results: </strong>Amongst 1401 incarcerated and 551,029 nonincarcerated pregnant people across 112 delivery hospitals, 33% of incarcerated individuals had late initiation of prenatal care; 2.4% experienced severe maternal morbidity, compared to 18.9% and 1.6% of controls, respectively (p < 0.05). Births to incarcerated individuals had higher adjusted likelihoods of prematurity (OR 1.42, 95% CI 1.21, 1.67), small for gestational age (OR 1.31, 95% CI 1.11, 1.56), and NICU admission (OR 1.64, 95% CI, 1.40, 1.93) relative to controls.</p><p><strong>Conclusion: </strong>Incarcerated individuals have greater likelihood of negative birth outcomes. Identification of approaches to reduce these harms is warranted.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622602","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":"ABCs of base therapy in neonatology: role of acetate, bicarbonate, citrate and lactate.","authors":"Gagandeep Dhugga, Deepika Sankaran, Satyan Lakshminrusimha","doi":"10.1038/s41372-024-02169-x","DOIUrl":"https://doi.org/10.1038/s41372-024-02169-x","url":null,"abstract":"<p><p>Metabolic acidosis is common in preterm and term newborn infants and may be attributed to a variety of etiologies, potentially requiring base therapy such as acetate or bicarbonate. However, concerns exist regarding potential harm of sodium bicarbonate due to intracellular acidosis, fluctuations in cerebral blood flow, and osmolar load with rapid infusions, with no improvement in survival when used during resuscitation. Alternative approaches to correct metabolic acidosis include the addition of acetate in parenteral nutrition, intravenous lactated Ringer's (LR) solution, and use of oral citrate. Current guidelines focus on addressing the underlying cause of acidosis, reserving the use of sodium bicarbonate (NaHCO<sub>3</sub>) for severe cases requiring acute correction, LR instead of saline for volume boluses and using acetate or citrate for slow correction to stabilize acid-base status. Further research is necessary to better understand the efficacy and safety of acetate, NaHCO<sub>3</sub>, and other base sources in treating metabolic acidosis in neonates.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622591","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":"Implementation of an EOS calculator-based protocol decreased infant antibiotic exposure in chorioamnionitis without correlation with placental histopathology.","authors":"Tonya Robinson, Kimberly Knott, Zhanxu Liu, Maiying Kong, Sucheta Telang","doi":"10.1038/s41372-024-02167-z","DOIUrl":"https://doi.org/10.1038/s41372-024-02167-z","url":null,"abstract":"<p><strong>Objective: </strong>To determine the impact of the Early Onset Sepsis (EOS) calculator on antibiotic exposure in infants born to mothers with clinical chorioamnionitis and correlate EOS calculator-guided recommendations with placental histopathology.</p><p><strong>Study design: </strong>Retrospective observational study comparing infants ≥ 36 weeks gestation exposed to maternal clinical chorioamnionitis admitted to the neonatal intensive care unit (NICU) before (Group 1, n = 69) and after (Group 2, n = 139) implementation of an EOS calculator protocol for chorioamnionitis. Infant antibiotic exposure and placental pathology were reviewed. Comparisons were made using Mann-Whitney and chi-square tests.</p><p><strong>Results: </strong>There was a statistically significant decrease in antibiotic exposure from Group 1 to Group 2 (p < 0.001) with no EOS cases missed. No correlation was found between EOS calculator-based treatment and participant placental histopathology (p = 0.966).</p><p><strong>Conclusion: </strong>Implementation of an EOS calculator protocol specific to our study population reduced antibiotic exposure. No correlations were found between EOS calculator-based antibiotic treatment and histological chorioamnionitis.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622559","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}
Eric A Raynal, Isabella K Pallotto, Jennifer M Brady, DonnaMaria E Cortezzo, Ellen A Lipstein
{"title":"Balancing survival and suffering: factors influencing parental decision making after periviable consultation.","authors":"Eric A Raynal, Isabella K Pallotto, Jennifer M Brady, DonnaMaria E Cortezzo, Ellen A Lipstein","doi":"10.1038/s41372-024-02166-0","DOIUrl":"https://doi.org/10.1038/s41372-024-02166-0","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to identify factors birthing parents consider related to potential resuscitation of a periviable infant.</p><p><strong>Study design: </strong>Birthing parents who received a prenatal consult from a newborn intensive care unit provider between 22.0 and 24.6 weeks gestational age were eligible to participate in a semi-structured interview focused on their periviable decision making. Interview transcripts were coded and analyzed using thematic content analysis.</p><p><strong>Result: </strong>Qualitative analysis shows that birthing parents attribute their decision to a balance between vitality and suffering, with the balance point influenced by various elements. While parents described the choice they made, none reported that the information they received during the prenatal consult had a significant impact.</p><p><strong>Conclusion: </strong>This study highlights the minimal impact that information given during a periviable consult has on parental decision making. Information from this study can be used to develop an improved model of perinatal consultation.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622596","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}