Journal of Perinatology最新文献

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Neonatal acute kidney injury and neurodevelopmental impairment: investigating associations in very low birthweight infants. 新生儿急性肾损伤和神经发育障碍:调查极低出生体重婴儿的关联。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-25 DOI: 10.1038/s41372-025-02370-6
Jeffrey E King, Jill C Newman, Olivia Kinsinger, Molly Mead, Megan D Rodgers, Amy L Ruddy-Humphries, Cassandra Coleman, David T Selewski, Heidi J Steflik
{"title":"Neonatal acute kidney injury and neurodevelopmental impairment: investigating associations in very low birthweight infants.","authors":"Jeffrey E King, Jill C Newman, Olivia Kinsinger, Molly Mead, Megan D Rodgers, Amy L Ruddy-Humphries, Cassandra Coleman, David T Selewski, Heidi J Steflik","doi":"10.1038/s41372-025-02370-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02370-6","url":null,"abstract":"<p><strong>Objective: </strong>Associations between neonatal acute kidney injury (AKI) and neurodevelopmental impairment (NDI) remains understudied. We hypothesized AKI is associated with NDI in very low birthweight (VLBW) infants.</p><p><strong>Study design: </strong>A single-center, retrospective cohort study of VLBW infants with and without AKI during hospitalization evaluated in developmental clinic at 18 to 35 months of age. Associations between AKI and NDI were examined using bivariate and multivariable generalized linear mixed modeling.</p><p><strong>Result: </strong>Of 203 infants included, 64 (32%) experienced neonatal AKI and 76 (37%) developed NDI. The relative risk of NDI was significantly higher in those with AKI (RR 1.67, 95% CI 1.18-2.36; p < 0.01). In multivariable analysis, AKI was not an independent predictor of NDI (aRR 1.07, 95% CI 0.68-1.68; p = 0.77).</p><p><strong>Conclusion: </strong>In bivariate analyses, AKI was a significant predictor of NDI. In a multivariable model, AKI was no longer an independent predictor of NDI. Further investigation is warranted.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707780","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}
引用次数: 0
Validation of a novel Bayesian predictive algorithm for detection of carbon dioxide retention using retrospective neonatal ICU data. 利用回顾性新生儿ICU数据验证一种新的贝叶斯预测算法用于检测二氧化碳潴留。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-23 DOI: 10.1038/s41372-025-02369-z
Luke T Viehl, Jeffrey L Segar, Zachary A Vesoulis
{"title":"Validation of a novel Bayesian predictive algorithm for detection of carbon dioxide retention using retrospective neonatal ICU data.","authors":"Luke T Viehl, Jeffrey L Segar, Zachary A Vesoulis","doi":"10.1038/s41372-025-02369-z","DOIUrl":"https://doi.org/10.1038/s41372-025-02369-z","url":null,"abstract":"<p><strong>Objective: </strong>To validate a novel Bayesian prediction algorithm (IVCO2 index) to calculate the probability of CO<sub>2</sub> retention in neonates using existing medical device outputs.</p><p><strong>Study design: </strong>A retrospective validation study from two level IV NICUs between September 2021 and May 2023. The algorithm calculated probabilities of PaCO<sub>2</sub> exceeding 50 mmHg (IVCO2_50) and 60 mmHg (IVCO2_60) using multimodal physiologic data. Performance was assessed through ROC analysis, range utilization, and resolution/limitation analysis.</p><p><strong>Results: </strong>Among 180 included neonates, 1092 arterial blood gas measurements were analyzed. IVCO2_50 and IVCO2_60 demonstrated excellent discriminatory performance (AUC 0.87, 95% CI 0.85-0.89 and AUC 0.90, 95% CI 0.68-0.93, respectively). The risk of elevated PaCO<sub>2</sub> scaled linearly with increasing index quartiles. Minimum scores (<1) showed >6-fold reduction in hypercapnia risk, while maximum scores (>99) demonstrated >3-fold reduction in normocapnia risk.</p><p><strong>Conclusion: </strong>The IVCO2 index accurately predicts CO<sub>2</sub> retention in neonates, offering potential for early detection of ventilation inadequacy without additional invasive monitoring.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698887","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}
引用次数: 0
Quicker team launch times for urgent priority neonatal retrievals: A Quality Improvement Initiative study. 更快的团队启动时间紧急优先新生儿检索:质量改进倡议研究。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-23 DOI: 10.1038/s41372-025-02354-6
Saumil Desai, Kevin George, Kylie McDonald, Alysha Timoney, Dahna Kelland, Stephanie Barr, Molly Carroll, David Lockhart, Olivia Peters, Matt Cooper, Jonathan Davis
{"title":"Quicker team launch times for urgent priority neonatal retrievals: A Quality Improvement Initiative study.","authors":"Saumil Desai, Kevin George, Kylie McDonald, Alysha Timoney, Dahna Kelland, Stephanie Barr, Molly Carroll, David Lockhart, Olivia Peters, Matt Cooper, Jonathan Davis","doi":"10.1038/s41372-025-02354-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02354-6","url":null,"abstract":"<p><strong>Background: </strong>Neonatal retrieval networks have adopted time-centric quality metrics as Key Performance Indicators (KPI) for setting and comparing benchmarking standards. Quicker launch time (departure from base), an essential KPI, enables neonatal retrieval teams to rapidly provide higher-level care to sick infants. The Newborn Emergency Transport Services of Western Australia (NETS WA) facilitates neonatal transfers across largest global retrieval area necessitating quicker team launch times for urgent retrievals. NETS WA conducted a quality improvement (QI) study to quicken team launch times for urgent retrievals.</p><p><strong>Aims: </strong>The smart aim was to quicken NETS WA team launch times on urgent retrievals to comply with the recent Australian New Zealand Neonatal Retrieval Network 2022 benchmark ( < 15 min). Secondary aims included impact of quicker launch times on \"first look time\" (time from decision to retrieve to presence at bed side) and \"total retrieval time\" (total time taken from the decision to transport until the handover of the patient at the receiving hospital).</p><p><strong>Settings: </strong>This study was completed over two years in NETS WA. Urgent priority retrievals are 10-15% of total transfers (120-180/year).</p><p><strong>Interventions: </strong>Plan-Do-Study-Action (PDSA) cycles: 1. Immediate access to transport cots 2. Additional personnel 3. Pre-defined priority matrix 4. Direct communication strategies. Launch time, first look time and total retrieval time were gathered from an electronic retrieval database (REDCap). Data collection were done at baseline (January-May 2022), during PDSA cycles (June 2022-April 2023) and after last PDSA cycle (May-December 2023).</p><p><strong>Results: </strong>Times are expressed as median (interquartile range IQR) in minutes. Comparisons were made for all transports and for road and air transports separately. Launch times decreased from 35.5 (21.5-90.0) at baseline to 17.0 (11.0-37.0) minutes (p 0.0006) after the last PDSA cycle for all urgent priority retrievals. Launch times for road only decreased to 15.0 (10.0-20.0) minutes (p 0.009). First look time decreased from 85.0 (54.8-269.3) to 52.5 (30.5-152.3) minutes (p 0.008). Total retrieval time changed from 243.5 (135.8-395.3) to 182.0 (117.0-390.0) minutes (p 0.33).</p><p><strong>Conclusion: </strong>Well-designed QI measures enabled NETS WA teams to quicken essential time-centric quality metrics for urgent priority neonatal retrievals.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698886","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}
引用次数: 0
Hypoalbuminemia, kernicterus, and the bilirubin/albumin ratio. 低白蛋白血症,核黄疸,和胆红素/白蛋白比率。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-23 DOI: 10.1038/s41372-025-02363-5
Robert L Stavis, Jeffrey S Gerdes
{"title":"Hypoalbuminemia, kernicterus, and the bilirubin/albumin ratio.","authors":"Robert L Stavis, Jeffrey S Gerdes","doi":"10.1038/s41372-025-02363-5","DOIUrl":"https://doi.org/10.1038/s41372-025-02363-5","url":null,"abstract":"","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698883","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}
引用次数: 0
Involving neonatal hematology and transfusion medicine in global efforts to eliminate severe retinopathy of prematurity. 涉及新生儿血液学和输血医学在全球努力消除严重的早产儿视网膜病变。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-23 DOI: 10.1038/s41372-025-02368-0
Robert D Christensen, Timothy M Bahr, Sarah J Ilstrup, M Elizabeth Hartnett, Robin K Ohls
{"title":"Involving neonatal hematology and transfusion medicine in global efforts to eliminate severe retinopathy of prematurity.","authors":"Robert D Christensen, Timothy M Bahr, Sarah J Ilstrup, M Elizabeth Hartnett, Robin K Ohls","doi":"10.1038/s41372-025-02368-0","DOIUrl":"https://doi.org/10.1038/s41372-025-02368-0","url":null,"abstract":"<p><p>Retinopathy of Prematurity (ROP) remains a worldwide problem. A more complete understanding of the pathogenesis might inform progress toward its elimination. ROP pathogenesis is undeniably complex, including preterm birth and oxygen exposure, but many other factors are implicated as well. In this Perspective, we focus on two pathogenic factors that are within the domain of neonatal hematology and transfusion medicine. Specifically, we address evidence that ROP pathogenesis can involve: 1) an elevated nucleated red blood cell (NRBC) count at preterm birth, as evidence of chronic hypoxia in utero, which should be recognized as a biomarker of elevated risk for developing ROP; and 2) transfusions of adult donor red blood cells (RBC) result in a dose-dependent elevation in adult hemoglobin (HbA), which can deliver and release excessive oxygen to the developing retina. Early studies indicate that eliminating adult donor RBC transfusions for vulnerable preterm infants might reduce or eliminate ROP.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698884","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}
引用次数: 0
Prenatal repair of myelomeningocele is associated with lower need for long-term feeding support. 脊髓脊膜膨出的产前修复与较低的长期喂养支持需求相关。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-23 DOI: 10.1038/s41372-025-02356-4
Jennifer Healy, Chunyan Liu, Shelley Ehrlich, Foong-Yen Lim, Jose L Peiro, Beth Haberman, Charles B Stevenson, Stefanie Riddle
{"title":"Prenatal repair of myelomeningocele is associated with lower need for long-term feeding support.","authors":"Jennifer Healy, Chunyan Liu, Shelley Ehrlich, Foong-Yen Lim, Jose L Peiro, Beth Haberman, Charles B Stevenson, Stefanie Riddle","doi":"10.1038/s41372-025-02356-4","DOIUrl":"https://doi.org/10.1038/s41372-025-02356-4","url":null,"abstract":"<p><strong>Objective: </strong>Infants with myelomeningocele (MMC) are at risk of brainstem dysfunction secondary to symptomatic Chiari II malformation with hindbrain herniation (HH), which can manifest as feeding difficulties including aspiration and dysphagia. This study aims to investigate whether prenatal repair of MMC is associated with improved feeding outcomes compared to postnatal repair.</p><p><strong>Study design: </strong>Retrospective observational study of 208 infants with MMC, 105 repaired prenatally and 103 repaired postnatally, from January 2011 to July 2022. Primary outcome was feeding tube at discharge and longitudinally through 12 months corrected gestational age (CGA).</p><p><strong>Results: </strong>9.5% of infants repaired prenatally and 13.6% repaired postnatally required feeding tube at discharge (p = 0.3585). By 53 weeks CGA, the prenatal repair group had decreased odds of requiring feeding tube (0.325 [95% CI 0.121, 0.872]).</p><p><strong>Conclusion: </strong>Prenatal MMC repair was associated with decreased need for long-term feeding support, suggesting a potential functional benefit of prenatal repair related to reversal of HH.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698885","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}
引用次数: 0
Evaluation of kidney oxygenation monitoring with near infrared spectroscopy in preterm neonates: kidney location, depth, and laterality differences. 近红外光谱对早产儿肾氧合监测的评价:肾脏位置、深度和侧位差异。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-19 DOI: 10.1038/s41372-025-02358-2
Matthew W Harer, Kate Walker, Lauren Gadek, Shayla Schwingle, Cassandra Nelson, Meg Baker, Elena Alfaro, Adam S Bauer, Paige Condit
{"title":"Evaluation of kidney oxygenation monitoring with near infrared spectroscopy in preterm neonates: kidney location, depth, and laterality differences.","authors":"Matthew W Harer, Kate Walker, Lauren Gadek, Shayla Schwingle, Cassandra Nelson, Meg Baker, Elena Alfaro, Adam S Bauer, Paige Condit","doi":"10.1038/s41372-025-02358-2","DOIUrl":"https://doi.org/10.1038/s41372-025-02358-2","url":null,"abstract":"<p><strong>Introduction: </strong>Near infrared spectroscopy (NIRS) monitoring of preterm kidney oxygenation is increasing. We sought to evaluate kidney positioning and oxygenation differences between the right and left kidneys.</p><p><strong>Methods: </strong>Preterm neonates <32 weeks' gestational age were enrolled in a prospective observational NIRS study. Two three-hour epochs of simultaneous bilateral kidney monitoring were performed (5-8 days, 9-14 days). Point of care kidney ultrasound was performed once between days 5 and 12.</p><p><strong>Results: </strong>There were no right-left differences in skin to superior kidney depth (0.39 and 0.38 cm; p = 0.62) or spine to kidney distance (1.06 and 1.02 cm; p = 0.31). There was a difference in right-left skin to inferior kidney depth (2.15 and 2.04 cm; p = 0.02). There was higher oxygenation in the left kidney compared to the right (65.6 vs. 62.7%, p < 0.01). Hourly individual differences of >10% were seen in 37% of neonates.</p><p><strong>Conclusions: </strong>Differences in kidney depth and right-left oxygenation exist in preterm neonates.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667850","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}
引用次数: 0
Clinical outcomes after implementation of a physiologic pre-operative management strategy in neonates with congenital diaphragmatic hernia. 新生儿先天性膈疝的术前生理性处理策略实施后的临床效果。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-18 DOI: 10.1038/s41372-025-02362-6
Carly Byrd, Julie Nogee, Maureen M Gilmore, Ahmet Baschat, Amaris Keiser, Jennifer Organ, Shaun Kunisaki, Suneetha Desiraju
{"title":"Clinical outcomes after implementation of a physiologic pre-operative management strategy in neonates with congenital diaphragmatic hernia.","authors":"Carly Byrd, Julie Nogee, Maureen M Gilmore, Ahmet Baschat, Amaris Keiser, Jennifer Organ, Shaun Kunisaki, Suneetha Desiraju","doi":"10.1038/s41372-025-02362-6","DOIUrl":"https://doi.org/10.1038/s41372-025-02362-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate neonatal outcomes in congenital diaphragmatic hernia (CDH) after implementation of new preoperative management guidelines based on physiologic fetal-to-neonatal transition.</p><p><strong>Study design: </strong>A retrospective single-center study of neonates with CDH was performed. Data were collected from 48 infants treated prior to new guideline implementation (Epoch 1) and 13 patients treated after implementation (Epoch 2). We hypothesized that rates of extracorporeal life support (ECLS) and inhaled nitric oxide (iNO) utilization would decrease after guideline implementation.</p><p><strong>Results: </strong>Neonates from Epoch 2 had a lower need for ECLS (p = 0.009) and iNO (p < 0.001) compared to Epoch 1. Compared to Epoch 1, neonates in Epoch 2 had decreased invasive mechanical ventilation duration (p = 0.001).</p><p><strong>Conclusion: </strong>Implementation of physiologically driven management guidelines led to reduced rates of ECLS cannulation, ventilator days, and iNO utilization. This study demonstrates the impact of pre-operative physiologic management in improving short-term outcomes of CDH patients.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659489","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}
引用次数: 0
Clinical risk factors and adverse perinatal outcomes among U.S. and African-born Black women in California. 加利福尼亚美国和非洲裔黑人妇女的临床危险因素和不良围产期结局。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-18 DOI: 10.1038/s41372-025-02361-7
Safyer McKenzie-Sampson, Rebecca J Baer, Jean Costello, Deborah Karasek, Jacqueline M Torres, Corinne A Riddell, Laura L Jelliffe-Pawlowski, Bridgette E Blebu
{"title":"Clinical risk factors and adverse perinatal outcomes among U.S. and African-born Black women in California.","authors":"Safyer McKenzie-Sampson, Rebecca J Baer, Jean Costello, Deborah Karasek, Jacqueline M Torres, Corinne A Riddell, Laura L Jelliffe-Pawlowski, Bridgette E Blebu","doi":"10.1038/s41372-025-02361-7","DOIUrl":"https://doi.org/10.1038/s41372-025-02361-7","url":null,"abstract":"<p><strong>Objective: </strong>Examine the association between clinical risk factors for preterm birth (PTB) and small for gestational age delivery (SGA) among United States (US)- and African-born Black women.</p><p><strong>Study design: </strong>Population-based study of singleton births to 171,051 US- and 19,269 African-born women in California (2011-2020). Associations between PTB and SGA with 14 clinical risk factors were examined. Adjusted Poisson regression models estimated the association between each clinical factor and the outcomes, while assessing interaction by nativity.</p><p><strong>Results: </strong>The prevalence of PTB, SGA, and clinical factors was greater among US-born Black women, with the exception of gestational diabetes. On average, the risk of PTB and SGA among women with each clinical risk factor was significantly higher for African- compared to US-born Black women.</p><p><strong>Conclusions: </strong>Clinical risk factors were higher among US-born women, however associations between each factor and adverse perinatal outcomes were stronger for African-born women.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667849","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}
引用次数: 0
Systemic hypotension and patterns of cerebral blood perfusion in newborns. 新生儿全身性低血压与脑血流灌注模式。
IF 2.4 3区 医学
Journal of Perinatology Pub Date : 2025-07-18 DOI: 10.1038/s41372-025-02357-3
Mohamed Al Kanjo, Patrick J McNamara, Theresa M Czech, Stephanie S Lee, Allison M Momany, Danielle R Rios
{"title":"Systemic hypotension and patterns of cerebral blood perfusion in newborns.","authors":"Mohamed Al Kanjo, Patrick J McNamara, Theresa M Czech, Stephanie S Lee, Allison M Momany, Danielle R Rios","doi":"10.1038/s41372-025-02357-3","DOIUrl":"https://doi.org/10.1038/s41372-025-02357-3","url":null,"abstract":"<p><strong>Background: </strong>The relationship between systemic hemodynamics and cerebral perfusion in neonates, particularly those with systemic hypotension, is complex and not clearly elucidated. Targeted neonatal echocardiography (TNE) provides valuable insights into cerebral hemodynamics by quantifying middle cerebral artery (MCA) flow in the context of systemic hemodynamics.</p><p><strong>Objectives: </strong>To investigate the correlation between blood pressure (BP), cardiac output (CO), and MCA Doppler indices in neonates, hypothesizing that BP alone is not a reliable measure of cerebral perfusion.</p><p><strong>Methods: </strong>A retrospective cohort study of neonates who underwent their first TNE in the Neonatal Intensive Care Unit. The analysis focused on the relationship between BP components and MCA Doppler measures (i.e., resistive index and pulsatility index).</p><p><strong>Results: </strong>The study included 194 neonates born at a mean gestational age and weight of 30.7 ± 6 weeks and 1744 ± 1246 g, respectively, classified into normotensive, hypotensive, and normotensive-treated groups. Weak correlations were observed between MCA Doppler measures and BP components across the entire cohort. Group comparisons found that neonates in the hypotensive group exhibited higher MCA-RI compared to both normotensive and normotensive-treated groups. Exploratory analyses revealed significant variation in MCA-RI that was explained by cardiac output after accounting for BP and gestational age.</p><p><strong>Conclusion: </strong>These findings suggest that BP alone is not a sufficient indicator of cerebral perfusion status. While the correlations were expected to be weak given the dynamic nature of cardiac output, the results highlight the need for comprehensive hemodynamic assessments in neonates with cardiovascular compromise to avoid reliance on oversimplified metrics such as BP versus Dopplers.</p>","PeriodicalId":16690,"journal":{"name":"Journal of Perinatology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667852","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}
引用次数: 0
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